**Specifications of the Quality of Granulated Activated Charcoal Used in Water Systems Treatment in Hemodialysis Centers in Brazil**

Eden Cavalcanti Albuquerque Júnior1, Marcos Antonio de Souza Barros1, Manoel O. Mendez2, Aparecido R. Coutinho2 and Telma T. Franco3 *1Professional Masters in Environmental Technology, Technology Institute of Pernambuco 2Energy and Environment Laboratory, Methodist University of Piracicaba 3School of Chemical Engineering, State University of Campinas Brazil* 

#### **1. Introduction**

146 Technical Problems in Patients on Hemodialysis

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Freedman BI, Chan YH, Crumrine D, Elias PM.Skin barrier structure and function and their relationship to pruritus in end-stage renal disease.Nephrol Dial According to the Brazilian Nephrology Society, in 2009, Brazil had approximately 600 Hemodialysis clinical centers. Currently, more than 77,000 Brazilians, who resort to specialized Hemodialysis services, are exposed to a volume of water of 18,000 to 36,000 L/year (Silva et al., 1996). Therefore, if the water used in these centers during the service is not duly treated, many chemical, toxic and bacteriological contaminants may be transferred to the patients, eliciting adverse effects, sometimes lethal (Buchanan et al., 1982; Arvanitidou et al., 2000).

The water used in these Hemodialysis centers come mainly from the public supply, and it is known that in many water reservoirs that are aimed for the population supply and consume, as the ones located in the Brazilian states like São Paulo, Paraná and Pernambuco, there is a propensity towards cyanobacteria toxic growing (Mendonça et al., 1999). The first report of human death from hepatotoxins of cyanobacteria, more specifically the microcystins -LR, -YR and -AR, happened in intravenous exposition in a Hemodialysis clinic in the city of Caruaru, Pernambuco, in 1996 (Carmichael et al., 2001).

In 2001, another incident involving Hemodialysis water contamination by microcystins was reported. Toxic growths of cyanobacteria with preponderance of the *Microcystis sp*. and *Anabaena sp.* were identified in the Funil reservoir and in the Guandu River, both used as water resources for the public supply in the city of Rio de Janeiro, RJ, Brazil. Thus, from that episode, microcystins concentration of the order of 4 g/L and 0.32 g/L, respectively were detected in the water and in the activated charcoal filter, used by the water treatment station of the Hemodialysis Center of the Clementino Fraga Filho Hospital of the Federal University of Rio de Janeiro, which is supplied by the water reservoir of Funil and the Guandu river.

As a consequence of this incident, a total of 44 uremic patients who had received care in this Hemodialysis Center, were believed to be exposed to the microcystins found in the water used in the preparation of the dialysate, being until the present time, monitored as to evaluate a possible chronic exposition to those toxins (Soares et al., 2006).

Considering thus the need to define the minimal criteria for the functioning and assessment of the public and private services which perform dialysis in outpatients, bearers of chronic

Specifications of the Quality of Granulated Activated Charcoal

thoroughly described by Albuquerque Junior et al. (2005)\*.

AC-A-D Criciúma, Brazil Coal

Table 1. Assessed Activated Charcoals

**2.1 Characterization of activated charcoals** 

Reference Origin Precursor

AC-B-F Bahia Carbon®, Brazil Coconut shell AC-R-G Author\* Coconut shell AC-R-H Author\* Sugar Cane Bagasse

AC-A-A Unknown Coconut Tree wood AC-A-B Calgon®, EUA Coconut Shell AC-A-C Calgon®, EUA Coconut Shell

AC-B-E Carboleste, Brazil Babaçu coconut endocarp

desiccators with silica gel until reached room temperature for its posterior use.

For the characterization in liquid phase by means of use of methylene blue solution and in gaseous phase by N2, the charcoals were marked in mortar and pestle, grinded in a sieve with nominal opening mesh of 0.075mm. Whereas the ones used in the experiments in fixed bed column were grinded in sieves with nominal opening mesh of 0.50mm and 0.35mm, being the obtained material in this last sieve collected for the referred experiment. The charcoals were then dried in greenhouse at 150 ºC by 3 hours minimally, and then cooled in

**2.1.1 Adsorption in gaseous phase: Specific surface area and distribution of pores size**  As the analysis procedures, all the ACs were degasified in vacuum at 150 ºC for 24 h. A software in interface with a gas analyzer (model NOVA-1200, Quantachrome Corp.) was used in the measures of specific surface area and distribution of pores size. Equilibrium data obtained from the isothermal of adsorption /desorption of gaseous nitrogen at 196 ºC were used to determine the specific surface area by means of application of the method developed by Brunauer, Emmet and Teller (BET). The micropores area was obtained by the "t-plot" method. The total volume of the pores was determined converting in liquid volume the

**2. Sampling of activated charcoals** 

adsorbents.

Used in Water Systems Treatment in Hemodialysis Centers in Brazil 149

adsorption capacity of the GAC commonly used by water treatment stations in the Brazilian Hemodialysis Centers, providing indicators which may be used as to purchase these

Activated charcoals used in two Brazilian Hemodialysis Centers, located in the city of Recife/Pernambuco, Brazil - Hemodialysis Center of the Clinical Hospital of the Federal University of Pernambuco, coordinates 08º03'15.40''S 34º52'52.52''W (termed A) - and in the city of Campinas/São Paulo, Brazil - Hemodialysis Center of the Clinical Hospital of the State University of Campinas, coordinates 22º54'25.58''S 47º03'47.66''W (termed B) - were used in this study. Besides that, sugarcane bagasse (CA-R-H) and dry coconut shell (CA-R-G) based-activated charcoal were specially produced for this work and used as reference charcoals (termed R) (Table 1). These charcoals were activated with water steam at temperature close to 900 ºC. The raw material preparation conditions, the carbonization and activation, besides those charcoals full characteristics, in liquid and gaseous phase, are

renal insufficiency, as well as the mechanisms of their monitoring , moreover the need of risk reduction to which the dialysis patients are submitted , the ANVISA (The National Agency of Sanitary Surveillance) has established as resolution (RESOLUÇÃO-RDC nº 154, of June 15th, 2004, republished in May 31, 2006) which foresees the technical regulation for the functioning of these services in Brazil.

It was established from that resolution's publication, that the water used in the preparation of dialysate, must have its quality guaranteed in all phases of the treatment, storage and distribution through the monitoring of the microbiological and physic-chemical parameters, as well as the procedures for the treatment themselves. Therefore, the water provision of the dialysis services from the public supply, from wells and any other sources must have its drinking standard as provisioned in the Act MS Nr. 518 of March 25th, 2004, (Brazilian Health Ministry) or of any legal instrument which may replace that one. Regarding the cyanotoxins, according to the art. 14 of this regulation, it was established that the upper limit allowed of microcystins in water for public supply be of 1 g/L, it was also recommended that the analysis for the cyanotoxins included the determination of cylindrospermopsin and saxitoxins (STX), taking into consideration, respectively, the value limits of 15.0 µg/L e 3.0 µg/L of STX/L equivalents.

A good example of cyanotoxins monitoring is being made in the systems of water collection which supply the city of São Paulo, Brazil (systems Rio Grande, Alto Tiête and Guarapiranga) by the Basic Sanitation Company and water treatment of São Paulo,- SABESP. It has been noticed that despite the mycrocystin levels are below the standard established by the MS 518/2004, many Hemodialysis clinics, in where this water is used, are at alert, as the water used by them for the Hemodialysis treatment needs to be with microcystins concentration equal to zero.

In Brazil, according to the Brazilian Society of Nephrology, in order to guarantee the water quality used for renal patients, more than 80% of the Hemodialysis centers have water treatment systems which use reverse osmoses, deionization, integrated system of reverse osmoses + deionization, besides activated charcoal.

The granulated activated charcoal (GAC) is an adsorbent used in processes of water treatment (activated charcoal filters) to remove micropollutants present in water, as pesticides, industrial chemical agents, cyanobacterial secondary metabolites such as geosmim and 2-methyl isoborneol (MIB) which give taste and odor to water, and toxins like hepatotoxins (microcystins) and neurotoxins (Newcombe, 1999).

The adsorption capacity of activated charcoals (AC) by compounds in the water is mainly influenced by the physical structure and chemical characteristics of the surface of these adsorbents, their previous material, and their preparation condition (Newcombe, 1999; Karanfil et al., 1999). Different research groups have shown that the ACs with pore volume developed in the regions of mesopores and secondary micropores can be very effective in the removal of microcystins (Falconer et al., 1989; Donati et al., 1994; Pendleton et al. 2001; Campinas & Rosas, 2010a, 2010b). Therefore, it is indispensable to estimate the distribution of pores in these regions, whether by means of adsorbing in liquid phase by using the methylene blue solution or in gaseous phase using N2.

The Hemodialysis Centers are concerned with the correct quality parameters which would indicate from those parameters which is the best charcoal to be used in their water treatment, as the activated charcoal, associated with other technologies, is commonly used by water treatment stations in Hemodialysis Centers. Thus, in this Chapter, are discussed the adsorption techniques in liquid and gaseous phase which were used aiming to assess the adsorption capacity of the GAC commonly used by water treatment stations in the Brazilian Hemodialysis Centers, providing indicators which may be used as to purchase these adsorbents.
