There are a number of advantages of EAW,above all its rapid and pronounced bactericidal action (especially electrolyzed strong acid water).After manual cleaning,freshly generated EAW was found to be highly effective against mycobacteria(M.tuberculosis,M.avium-intracellulare,M.chelonae),Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, Bacillus subtilis var.niger spores,methicillin-resistant Staphylococcus aureus,Candida albicans,poliovirus type 2 and HIV type1,producing a 5 log 10(99.99%) reduction in organism count within 2minustes or less. The chlorine content is 10 ±2ppm ,and should be monitored using test paper.

EAW is classified as non-imitant,and has minimal toxicity.It is considered safe for patients,staff and the environment,and does not harm human tissue.Afurther advantage of EAW is its low production costs since only salt,tap water and electricity are required.

One of the disadvantages of EAW is that the bactericidal effect is drastically decreased in the presence of organic matter or biofilm.To ensure maximal bactericidal action,it is essential that items are met-for example with respect to generating current,redox potential and pH.If EAW is not continuously supplied with H+,HCLO and Cl2 by electrolysis,the solution rapidly loses its oxidative and acidic properties.

There are many commercial products available and the user should be aware of variations in their properties that may result in either damage to the endoscope or inadequate disinfection.Only one EAW product has so far been approved by the FDA.However,its high 650-675 ppm free chlorine level may not be compatible with manufacturers’requirements since damage to the material covering the insertion tube has been reported. Other non-FDA approved products with 30-50 ppm chlorine are available, but they may fail to achieve a high lefel of disinfection.