Residual Viral and Bacterial Contamination of Surfaces after Cleaning and Disinfection

Environmental surfaces contaminated with pathogens can be sources of indirect transmission, and cleaning and disinfection are common interventions focused on reducing contamination levels. We determined the efficacy of cleaning and disinfection procedures for reducing contamination by noroviruses, rotavirus, poliovirus, parechovirus, adenovirus, influenza virus, Staphylococcus aureus, and Salmonella enterica from artificially contaminated stainless steel surfaces. After a single wipe with water, liquid soap, or 250-ppm free chlorine solution, the numbers of infective viruses and bacteria were reduced by 1 log₁₀ for poliovirus and close to 4 log₁₀ for influenza virus. There was no significant difference in residual contamination levels after wiping with water, liquid soap, or 250-ppm chlorine solution. When a single wipe with liquid soap was followed by a second wipe using 250- or 1,000-ppm chlorine, an extra 1- to 3-log₁₀ reduction was achieved, and except for rotavirus and norovirus genogroup I, no significant additional effect of 1,000 ppm compared to 250 ppm was found. A reduced correlation between reduction in PCR units (PCRU) and reduction in infectious particles suggests that at least part of the reduction achieved in the second step is due to inactivation instead of removal alone. We used data on infectious doses and transfer efficiencies to estimate a target level to which the residual contamination should be reduced and found that a single wipe with liquid soap followed by a wipe with 250-ppm free chlorine solution was sufficient to reduce the residual contamination to below the target level for most of the pathogens tested.     

An observational study investigating the association of ultrasonographically assessed machine milking-induced changes in teat condition and teat-end shape in dairy cows

Mechanical forces during machine milking induce changes in teat condition which can be differentiated into short-term and long-term changes. Machine milking-induced short-term changes in teat condition (STC) are defined as tissue responses to a single milking and have been associated with the risk of new intramammary infection. Albeit, their association with teat characteristics, such as teat-end shape, has not been investigated by rigorous methods. The primary objective was to determine the association of STC, as measured by ultrasonography, with teat-end shape. The second objective was to describe possible differences in the recovery time of teat tissue after machine milking among teats with different teat-end shapes. Holstein cows (n=128) were enrolled in an observational study, housed in free-stall pens with sand bedding and milked three times a day. Ultrasonography of the left front and right hind teat was performed after teat preparation before milking (t−1), immediately after milking (t₀) and 1, 3, 5 and 7 h after milking (t₁, t₃, t₅, t₇). The teat tissue parameters measured from ultrasound scans were teat canal length, teat-end diameter, teat-end diameter at the midpoint between the distal and proximal end of the teat canal, teat wall thickness, and teat cistern width. Teat-end shape was assessed visually and classified into three categories: pointed, flat and round. Multivariable linear regression analyses showed differences in the relative change of teat tissue parameters (compared with t−1) at t₀ among teats with different teat-end shapes, with most parameters showing the largest change for round teats. The premilking values were reached (recovery time) after 7 h in teats with a pointed teat-end shape, whereas recovery time was greater than 7 h in teats with flat and round teat-end shapes. Under the same liner and milking machine conditions, teats with a round teat-end shape had the most severe short-term changes. The results of this observational study indicated that teat-end shape may be one of the factors that contribute to the severity of STC.     

Evaluation of alcohol wipes used during aseptic manufacturing

Aim: During aseptic manufacturing and specifically during the transfer of items into an isolator, disinfection of surfaces is essential for reducing the risk of final product contamination. Surface disinfection can be carried out by a variety of methods, however the most accepted current practice is a combination of spraying with 70% alcohol and wiping. The aim of this study was to evaluate the effectiveness of two wipe systems by determining their ability to remove, kill and transfer bacterial contaminants from standardized surfaces. Methods and Results: The protocol used to achieve these objectives was based on a newly published method specifically designed to test wipes. Alcohol impregnated wipes performed better at reducing microbial bioburden than the alcohol spray/dry wipe applications. Impregnated wipes drastically reduced (1–2 log₁₀ reduction) a small bioburden (approx. 2 log₁₀) of spores of Bacillus subtilis and methicillin‐resistant Staphylococcus aureus from the surface, but failed to remove (<0·2 log₁₀ reduction) Staphylococcus epidermidis. The alcohol spray/dry wipes did not manage to remove (<0·2 log₁₀ reduction) spore or bacterial bioburden from surfaces and was able to transfer some viable micro‐organisms to other surfaces. Both wipe types showed poor antimicrobial efficacy (<1 log₁₀ reduction) against the test bacteria and spores. Conclusions: As far as the authors are aware this is the first time that such a practical study has been reported and our results suggest that the best wipes for surface disinfection in aseptic units are the alcohol (IPA) impregnated wipes when compared with the dry wipes sprayed with alcohol. Significance and Impact of the Study: The impregnated wipes performed better than the dry wipes sprayed with alcohol and should be used for surface disinfection in aseptic units.     

Sanitation in self-service automatic washers.

The potential for microbial transfer in self-service laundry washing machines was investigated by obtaining swab samples from the interior surfaces of commercial machines and wash water samples before and after disinfectant treatment. Three disinfectants (chlorine, a quaternary ammonium product, and a phenolic disinfectant) were used. Four self-service laundry facilities were sampled, with 10 replications of the procedure for each treatment at each location. Although washers were set on a warmwater setting, the wash water temperatures ranged from 24 to 51 degrees C. The quaternary ammonium product seemed most effective, averaging a 97% microbial kill; chlorine was the second most effective, with a 58% kill, and the phenolic disinfectant was least effective, with only a 25% kill. The efficacies of the chlorine and phenolic disinfectants were reduced at low water temperatures commonly experienced in self-service laundries. Interfamily cross-contamination in self-service facilities is a potential public health problem, which is aggravated by environmental conditions, such as water temperature and the practices of the previous users of the equipment. Procedural changes in laundering are recommended, including the use of a disinfectant to maintain adequate levels of sanitation.     

Sanitation in self-service automatic washers.

The potential for microbial transfer in self-service laundry washing machines was investigated by obtaining swab samples from the interior surfaces of commercial machines and wash water samples before and after disinfectant treatment. Three disinfectants (chlorine, a quaternary ammonium product, and a phenolic disinfectant) were used. Four self-service laundry facilities were sampled, with 10 replications of the procedure for each treatment at each location. Although washers were set on a warmwater setting, the wash water temperatures ranged from 24 to 51 degrees C. The quaternary ammonium product seemed most effective, averaging a 97% microbial kill; chlorine was the second most effective, with a 58% kill, and the phenolic disinfectant was least effective, with only a 25% kill. The efficacies of the chlorine and phenolic disinfectants were reduced at low water temperatures commonly experienced in self-service laundries. Interfamily cross-contamination in self-service facilities is a potential public health problem, which is aggravated by environmental conditions, such as water temperature and the practices of the previous users of the equipment. Procedural changes in laundering are recommended, including the use of a disinfectant to maintain adequate levels of sanitation.     

The Effect of Post Milking Teat Dip and Suckling on Teat Skin Condition,Bacterial Colonisation,and Udder Health

The teat skin of cows was scored (1: smooth as silk; 2: smooth; 3: slightly rough; 4: rough; 5: cracked; and 6: sores) by trained technicians who moved their fingers down the barrel of the teat with a light touch. Technicians ranked the same population of teats in the same rank order, but their mean values differed by half a score which probably could be related to the skin condition of their own fingers. Half udder experiments were carried out for 6 months at 4 farms with 35 to 52 cows each. A postmilking teat spray with 10% glycerol improved teat skin condition (p<0.10) compared with no teat spray. A postmilking teat spray with 120 ppm chlorine dioxide did not influence teat skin condition compared with no teat spray. No differences in udder health could be proven between treatments. Control studies revealed that 10% glycerol as an emollient of a postmilking teat spray improved teat skin condition within 3 weeks from being slightly rough to being smooth for lactating cows (p<0.05) but not for dry cows having smooth teat skin. Neither glycerol nor chlorine dioxide influenced absolute number of bacteria on teat skin after a challenge with Streptococcus uberis and Staphylococcus aureus but half life of S. aureus on unsprayed teats was longest (p = 0.05). Suckling made teat skin more rough than machine milking. Nevertheless, suckling lowered the number of esculin positive bacteria on the teat skin. We concluded that the condition of healthy teat skin (scores 1–4) has no influence on bacterial colonisation in the absence of cracks and sores (scores 5–6).     

Cleaning and decontamination efficacy of wiping cloths and silver dihydrogen citrate on food contact surfaces

Aims: To test the efficacy of four wipe cloth types (cotton bar towel, nonwoven, microfibre and blended cellulose/cotton) with either quaternary ammonia cleaning solution or silver dihydrogen citrate (SDC) in cleaning food contact surfaces. Methods: Swab samples collected from untreated, cloth‐treated and cloth disinfectant‐treated surfaces were subjected to hygiene monitoring using adenosine triphosphate (ATP) bioluminescence and aerobic total plate counting (TPC) assays. Results: Adenosine triphosphate measurements taken after wiping the surfaces showed poor cleaning by nonwoven cloths (2·89 RLU 100 cm^?2) than the microfibre (2·30 RLU 100 cm^?2), cotton terry bar (2·26 RLU 100 cm^?2) and blended cellulose/cotton cloth types (2·20 RLU 100 cm^?2). The cellulose/cotton cloth showed highest log reduction in ATP‐B RLU values (95%) and CFU values (98·03%) when used in combination with SDC disinfectant. Conclusions: Cleaning effect of wiping cloths on food contact surfaces can be enhanced by dipping them in SDC disinfectant. ATP‐B measurements can be used for real‐time hygiene monitoring in public sector, and testing microbial contamination provides more reliable measure of cleanliness. Significance and Impact of the Study: Contaminated food contact surfaces need regular hygiene monitoring. This study could help to estimate and establish contamination thresholds for surfaces at public sector facilities and to base the effectiveness of cleaning methods.     

Effects of amount of milk, milk flow and access to a rubber teat on cross-sucking and non-nutritive sucking in dairy calves

The aim of this study was to test the effects of different amounts of milk, flow rate of milk, and access to a teat after milk intake on non-nutritive sucking on an empty teat and on cross-sucking on other calves in Bos taurus dairy calves. An additional aim was to test if calves prefer to perform non-nutritive sucking on a teat with the taste of milk or on a clean teat. First experiment involved 11 groups of three calves during gradual decrease from 5 to 2.5 and 1 to 0l of whole milk per meal twice daily. Milk flow was either 0.5 or 1l/min, and the teat buckets were either left or removed after milk intake. When the calves were fed with 5l of milk, non-nutritive sucking and cross-sucking decreased (P<0.001), compared to 1 and 2.5l. Removing the empty teat after milk intake increased cross-sucking (P<0.001). Slow milk flow reduced non-nutritive sucking after milk intake (P<0.05), but did not influence cross-sucking. Duration of recorded milk intake was similar with fast flow and 5l of milk, compared to slow flow and 2.5l of milk. The latter combination increased non-nutritive sucking and cross-sucking, suggesting that amount of milk is more important than duration of milk intake.Second experiment was carried out on 12 individually kept calves. The calves received 2.5l of milk either in an open bucket, in a rubber teat bucket, or half/half in both buckets. When not used for feeding, the open bucket and the teat bucket were filled and emptied again to make them 'tasty' with some drops of milk. The tasty teat bucket was either removed or present after milk intake. The calves had always access to a second clean teat bucket. Source of milk had no influence on recorded behaviour after milk intake. The tasty teat was sucked for twice as long as the clean one when both teats were present (P<0.001). When the tasty teat was removed, the calves increased sucking on the clean teat (P<0.001), but decreased total time spent sucking (P<0.001). We conclude that a high amount of milk and the presence of the teat bucket after milk intake reduces cross-sucking, and that a clean teat is less effective in encouraging calves to suck than a teat with taste of milk.     

Genotyping by sequencing reveals a new locus for pig teat number

Teat number is an extremely valuable trait for sow reproduction performance and piglet survival. Here, we used genotyping‐by‐sequencing and a general liner model to carry out genome‐wide analysis of sow total teat number in an Erhualian population. The results indicated that eight SNPs on chromosomes 4, 5, 9 and 10 were significant genome wide (Bonferroni method, P < 2.85E‐7) for sow total teat number. Validation analyses were performed in 298 Erhualian and 904 Large White sows using these significant SNPs and the general liner model procedure in sas . Finally, only the SNP on chromosome 5 was found to be significantly associated with sow teat number in both populations. The GG genotype individuals had 2.23 and 0.82 more teat numbers respectively than did the AA genotype individuals in these two populations (P < 0.05). According to the expression and annotation analyses, we inferred the presence of a gene or lincRNA that could affect teat number by regulating other genes and ultimately affecting the mammogenesis of pigs. Further studies using methods such as Cas9 editing and gene silencing analysis are necessary for additional function analysis.     

Cow teat skin, a potential source of diverse microbial populations for cheese production

The diversity of the microbial community on cow teat skin was evaluated using a culture-dependent method based on the use of different dairy-specific media, followed by the identification of isolates by 16S rRNA gene sequencing. This was combined with a direct molecular approach by cloning and 16S rRNA gene sequencing. This study highlighted the large diversity of the bacterial community that may be found on teat skin, where 79.8% of clones corresponded to various unidentified species as well as 66 identified species, mainly belonging to those commonly found in raw milk (Enterococcus, Pediococcus, Enterobacter, Pantoea, Aerococcus, and Staphylococcus). Several of them, such as nonstarter lactic acid bacteria (NSLAB), Staphylococcus, and Actinobacteria, may contribute to the development of the sensory characteristics of cheese during ripening. Therefore, teat skin could be an interesting source or vector of biodiversity for milk. Variations of microbial counts and diversity between the farms studied have been observed. Moreover, Staphylococcus auricularis, Staphylococcus devriesei, Staphylococcus arlettae, Streptococcus bovis, Streptococcus equinus, Clavibacter michiganensis, Coprococcus catus, or Arthrobacter gandavensis commensal bacteria of teat skin and teat canal, as well as human skin, are not common in milk, suggesting that there is a breakdown of microbial flow from animal to milk. It would then be interesting to thoroughly study this microbial flow from teat to milk.     

Reduction of Escherichia coli O157:H7 on radish seeds by sequential application of aqueous chlorine dioxide and dry‐heat treatment

Aims: To assess the effectiveness of sequential treatments of radish seeds with aqueous chlorine dioxide (ClO₂) and dry heat in reducing the number of Escherichia coli O157:H7. Methods and Results: Radish seeds containing E. coli O157:H7 at 5·5 log CFU g^?1 were treated with 500 μg ml^?1 ClO₂ for 5 min and subsequently heated at 60°C and 23% relative humidity for up to 48 h. Escherichia coli O157:H7 decreased by more than 4·8 log CFU g^?1 after 12 h dry‐heat treatment. The pathogen was inactivated after 48 h dry‐heat treatment, but the germination rate of treated seeds was substantially reduced from 91·2 ± 5·0% to 68·7 ± 12·3%. Conclusions: Escherichia coli O157:H7 on radish seeds can be effectively reduced by sequential treatments with ClO₂ and dry heat. To eliminate E. coli O157:H7 on radish seeds without decreasing the germination rate, partial drying of seeds at ambient temperature before dry‐heat treatment should be investigated, and conditions for drying and dry‐heat treatment should be optimized. Significance and Impact of the study: This study showed that sequential treatment with ClO₂ and dry‐heat was effective in inactivating large numbers of E. coli O157:H7 on radish seeds. These findings will be useful when developing sanitizing strategies for seeds without compromising germination rates.     

The effects of cleaning and disinfection in reducing Salmonella contamination in a laboratory model kitchen

AIMS: To establish a laboratory model to compare the effectiveness of detergent-based disinfection procedures for reducing cross-contamination risks during handling of contaminated chicken. METHODS AND RESULTS: During handling of chickens, artificially contaminated with Salmonella enteritidis PT4, the organism was widely spread to hands, cloths, and hand- and food-contact surfaces. Hygiene procedures were assessed on the basis of their ability to reduce the number of recoverable salmonellas to <1 CFU. Although detergent-based cleaning using a typical bowl-wash routine without rinsing produced some risk reduction (from 100 to 61.4% of contaminated surfaces), it was insufficient to consistently restore surfaces to a hygienic state. By combining detergent-based cleaning with a rinsing step or with hypochlorite at 500 ppm (of available chlorine) some further reduction in microbial risk was achieved, but was not considered satisfactory for food hygiene purposes. By contrast the risk reduction produced by hypochlorite at 5000 ppm was highly significant and was sufficient to reduce the number of contaminated surfaces to 2.9%. CONCLUSIONS: A key step in achieving a hygienic state through detergent-based cleaning is rinsing but even this will not produce a 'hygienic' result for difficult surfaces such as the chopping board or the dishcloth. Disinfectant compounds should be considered in order to reduce the potential for foodborne cross infection within the home environment. SIGNIFICANCE AND IMPACT OF THE STUDY: Although tests are available to determine the performance of disinfectants, there are no quantitative procedures available to compare the risk reduction achieved by disinfection with that produced by detergent-based procedures. This study describes a reproducible laboratory method which can be used to differentiate the effectiveness of different hygiene procedures for reducing cross-contamination risks during food handling.     

Effects of chronic chlorine exposure on litter processing in outdoor experimental streams

SUMMARY 1. The effects of chlorine on litter ( Potamogeton crispus L.) processing were examined using six outdoor experimental streams. Downstream portions of two streams were dosed at c . 10 μg l⁻¹ Total Residual Chlorine (TRC), one stream at 64 μgl¹, and one stream at 230μg l⁻¹. Two control streams were not dosed; upstream riffles of each stream served as instream controls.
2. Two 35 day litter breakdown (per cent AFDW remaining) experiments indicated significantly lower decay rates in the high dose riffle. No other concentration of chlorine significantly affected decay rate.
3. A third experiment, conducted in medium and high dose streams, indicated that high dose chlorine exposure reduced litter decomposition rates significantly, and reduced microbial colonization, microbial electron transport system activity, and microbial litter decomposition after 4 days but not after 11 days of exposure. The number of amphipod shredders colonizing litter bags was also reduced significantly with high chlorine dose.
4. A fourth experiment, after dosing was terminated, provided direct evidence that amphipod shredders were important in facilitating litter decomposition: litter bags stocked with amphipods had significantly higher decomposition rates than bags which excluded shredders.
5. Overall results indicate that the high dose (c. 230 μgl⁻¹ TRC) of chlorine reduced litter processing rates partly by reducing initial microbial conditioning, but primarily by reducing the colonization of amphipod shredders.     

Evaluation of a Disinfectant Wipe Intervention on Fomite-to-Finger Microbial Transfer

Inanimate surfaces, or fomites, can serve as routes of transmission of enteric and respiratory pathogens. No previous studies have evaluated the impact of surface disinfection on the level of pathogen transfer from fomites to fingers. Thus, the present study investigated the change in microbial transfer from contaminated fomites to fingers following disinfecting wipe use. Escherichia coli (10⁸ to 10⁹ CFU/ml), Staphylococcus aureus (10⁹ CFU/ml), Bacillus thuringiensis spores (10⁷ to 10⁸ CFU/ml), and poliovirus 1 (10⁸ PFU/ml) were seeded on ceramic tile, laminate, and granite in 10-μl drops and allowed to dry for 30 min at a relative humidity of 15 to 32%. The seeded fomites were treated with a disinfectant wipe and allowed to dry for an additional 10 min. Fomite-to-finger transfer trials were conducted to measure concentrations of transferred microorganisms on the fingers after the disinfectant wipe intervention. The mean log₁₀ reduction of the test microorganisms on fomites by the disinfectant wipe treatment varied from 1.9 to 5.0, depending on the microorganism and the fomite. Microbial transfer from disinfectant-wipe-treated fomites was lower (up to <0.1% on average) than from nontreated surfaces (up to 36.3% on average, reported in our previous study) for all types of microorganisms and fomites. This is the first study quantifying microbial transfer from contaminated fomites to fingers after the use of disinfectant wipe intervention. The data generated in the present study can be used in quantitative microbial risk assessment models to predict the effect of disinfectant wipes in reducing microbial exposure.     

Semi-log model for interpreting the results of swabbing surfaces naturally contaminated

Two mathematical models for depicting microbial depletions during six consecutive swabbings of refrigerated tank wall and teat skin were tested. Although a second degree polynomial equation gave a better adjustment of the data, a first degree equation was preferred to calculate the total numbers of micro-organisms possibly retrieved from surfaces by swabbing. This model was used for estimating the level of milk contamination by teat skin.     

Semi-log model for interpreting the results of swabbing surfaces naturally contaminated

Two mathematical models for depicting microbial depletions during six consecutive swabbings of refrigerated tank wall and teat skin were tested. Although a second degree polynomial equation gave a better adjustment of the data, a first degree equation was preferred to calculate the total numbers of micro-organisms possibly retrieved from surfaces by swabbing. This model was used for estimating the level of milk contamination by teat skin.     

Effectiveness of cleaning techniques used in the food industry in terms of the removal of bacterial biofilms

The effectiveness of cleaning was investigated through food factory trials and laboratory experiments using a naturally occurring biofilm from a food factory environment and generated biofilms. The efficacy of factory cleaning and disinfection programmes was assessed by swabbing and total viable count (TVC) analysis of surfaces before cleaning, after cleaning and after disinfection. Cleaning produced a 0.91 log reduction in the attached population. Investigation of the effectiveness of a variety of cleaning methods in the removal of a naturally occurring food factory biofilm showed that the high pressure spray and the mechanical floor scrubber, which use a high degree of mechanical action, were most effective. Cleaning trials with biofilms of Pseudomonas aeruginosa or Staphylococcus aureus showed that spraying with water at pressures of 34.5, 51.7 and 68.9 bar did not significantly increase the removal, as assessed by direct epifluorescent microscopy (DEM) and swabbing and TVC analysis, beyond the three log reduction observed at 17.2 bar. The effect of spray time at 17.2 bar showed that increasing spray time from 1 to 10 s did not significantly increase removal of Ps. aeruginosa biofilm. Investigation of the optimum distance of the spray lance from the surface at 17.2 bar was found to be between 125 and 250 mm. The use of an alkaline, acidic or neutral detergent prior to spraying with water at 17.2 bar did not significantly increase the removal of Ps. aeruginosa or Staph. aureus. However, the acidic and alkaline products significantly (P = 0.05) affected the viability of Staph. aureus and Ps. aeruginosa, respectively, thereby minimizing the potential for the spread of contamination.     

Do European Standard Disinfectant tests truly simulate in‐use microbial and organic soiling conditions on food preparation surfaces?

Aims: The results from European standard disinfectant tests are used as one basis to approve the use of disinfectants in Europe. The design of these laboratory‐based tests should thus simulate as closely as possible the practical conditions and challenges that the disinfectants would encounter in use. No evidence is available that the organic and microbial loading in these tests simulates actual levels in the food service sector. Methods and Results: Total organic carbon (TOC) and total viable count (TVC) were determined on 17 visibly clean and 45 visibly dirty surfaces in two restaurants and the food preparation surfaces of a large retail store. These values were compared to reference values recovered from surfaces soiled with the organic and microbial loading, following the standard conditions of the European Surface Test for bactericidal efficacy, EN 13697. Conclusions: The TOC reference values for clean and dirty conditions were higher than the data from practice, but cannot be regarded as statistical outliers. This was considered as a conservative assessment; however, as additional nine TOC samples from visibly dirty surfaces were discarded from the analysis, as their loading made them impossible to process. Similarly, the recovery of test organisms from surfaces contaminated according to EN 13697 was higher than the TVC from visibly dirty surfaces in practice; though they could not be regarded as statistical outliers of the whole data field. No correlation was found between TVC and TOC in the sampled data, which re‐emphasizes the potential presence of micro‐organisms on visibly clean surfaces and thus the need for the same degree of disinfection as visibly dirty surfaces. Significance and Impact of the Study: The organic soil and the microbial burden used in EN disinfectant standards represent a realistic worst‐case scenario for disinfectants used in the food service and food‐processing areas.     

Evaluation of cleaning strategies for removal of biofilms from reverse-osmosis membranes

An evaluation was made of the efficiency of five classes of chemical cleaning agents for removing biofilm from spirally wound cellulose acetate reverse-osmosis membranes receiving influent with high or low levels of combined chlorine. Each cleaning regimen utilized one or more of the following types of chemical: (i) surfactants and detergents, (ii) chaotropic agents, (iii) bactericidal agents, (iv) enzymes, and (v) antiprecipitants. Cleaning efficiency was tested in the laboratory on membrane material removed from operations at various intervals (2 to 74 days). Cleaning effectiveness was evaluated against nontreated control membranes and was scored by scanning electron microscopy and enumeration of surviving bacteria after treatment of the membranes. The combinations of classes which were most effective in biofilm removal were the anionic and chaotropic agent combination and combinations involving enzyme-containing preparations. Membranes receiving influent with high levels of combined chlorine were easier to clean but more susceptible to structural damage from prolonged exposure to combined chlorine. No treatment or combination of treatments was completely effective or effective at all stages of biofilm development.