Dialysis Water Standards Changed : State Hopes to Eliminate Chloramine Danger for Patients

Kidney dialysis facilities throughout the state were sent new standards Wednesday for removing potentially toxic chloramines from water under proposals issued by the California Department of Health.

The standards are to go into effect by April 1 in anticipation of the reintroduction of chloramines, a disinfecting mixture of chlorine and ammonia, into water provided by the Metropolitan Water District.

Charlene Stewart, head of the department’s licensing and certification division, notified about 200 facilities--half of them in Los Angeles County--that the new standards are aimed at eliminating danger to kidney patients from the chloramines. Meetings among health officials and kidney dialysis providers will be conducted next week to review the new standards.

Chloramines were introduced into the six-county water district service area water supply in November, but their use was suspended on Dec. 20 after kidney patients in San Diego and Lynwood reacted negatively to the additive. The chemical replaced chlorine as an additive after studies showed that chlorine is a potential carcinogen.

Potentially Fatal Chloramines are considered harmless to most people, but they are potentially fatal to kidney patients unless removed from the water used in the dialysis machines.

In early December, incidents occurred in kidney dialysis centers in San Diego and Lynwood in which several patients had to be hospitalized briefly. The water district then suspended its use of chloramines until the utility could investigate whether the facilities were properly removing the chemical, a district spokeswoman said.

The spokeswoman said a dozen facilities were surveyed by a team of experts that discovered that seven of the kidney dialysis centers had potential problems. As a result of the study, state and county health officials formulated the new standards that were sent out Wednesday.

Although the facilities have until April 1 to meet the new standards, it was uncertain when the water district might resume the use of chloramines in the water supply. The district spokeswoman said health officials and the water district want to be assured that safeguards are in use at kidney dialysis facilities before the chemical is reintroduced.