WATER QUALITY TESTING CHART

ACTION IF LIMITS
TEST LIMITS FREQUENCY SITE METHOD
EXCEEDED

Chemical Contaminants & Maximum Allowed (mg/l) CHLORINE and CHLORAMINES CHLORAMINE test sample Chlorine and chloramines must Employ appropriate water
must be tested each shift (FDA should be drawn between be tested on site to insure treatment system
Aluminum 0.01 Lead 0.005 Safety Alert, Feb ’88) carbon tanks #1 and #2 accuracy. Test kits are (deionization, reverse osmosis,
Antimony 0.006 Magnesium 4.0 (0.3 mEq/L) commercially available for this water softener, charcoal filter
Arsenic 0.005 Mercury 0.0002 purpose or necessary combinations)
Barium 0.10 Nitrates 2.0 Monthly after installing H2O Obtain samples from
Beryllium 0.0004 Potassium 8.0 (0.2 mEq/L) treatment system (or after common source where Performed by a laboratory using OR
Cadmium 0.001 Selenium 0.09 system change) until pattern water enters the dialysate accepted analytical methods with
Calcium 20 (0.1 mEq/L) Silver 0.005 established supply system equipment capable of obtaining Evaluate current system and
Chloramines 0.1 Sodium 70.0 (3.0mEq/L) accurate results at levels supplement as necessary
Chromium 0.014 Sulfate 100.0 Quarterly if no H2O treatment (RD5, 4.2.2) appropriate for dialysis use as
Copper 0.1 Thallium 0.002 system in place opposed to potable water
Fluoride 0.2 Zinc 0.1 (RD5, 4.2.2)
Free Chlorine 0.5
(RD62:2001) Annually if RO or DI used
(RD5, B5)

Bacteria Maximum Allowed Obtain water samples at Obtain total viable counts using
site where H2O enters spread plate or membrane filter Action level is 50 CFU/ml
Water used for dialysate < 200 CFU/ml Weekly until result consistently dialysis machine (RD5, techniques. Use TSA agar. Do not And 1 EU/ml
(RD5, 3.2.1.1) Endotoxin level < 2 EU/ml satisfactory… then 4.2.1.1) use blood agar. Calibrated loop
shall not be used. Assay sample If action levels are observed in
Dialysate < 200 CFU/ml (NEWRD52) Not less than monthly… and Obtain dialysate samples at within 30 min. of collection, or, the product water, corrective
(RD5, 3.2.1.2) Endotoxin level < 2 EU/ml -after pyrogenic raction outflow side of dialyzer refrigerate immediately at 5oC measures, such as disinfection
-after system change (RD5, 4.2.1.2) and assay within 24 hrs. Count and retesting, should be
Bicarbonate concentrate < 200 CFU/ml (RD5,B5) colonies after 48 hrs of promptly taken to reduce the
(RD5, 3.3.1.4) (RD47, 13.2.1) Sites selected randomly, or, incubation at 35o – 37oC. levels into the acceptable
(RD47, as clinical circumstances (RD5, 4.21 & RD5, 4.3.1.4) range
Water used for dialyzer < 200 CFU/ml &/or 2 EU/ml 11.4.1.4) warrant
Reprocessing (RD5, 11.2.2) &/or 1ngLPS/ml Dip sticks are commercially
(RD47, 11.4.1.4) H2O for reuse should be available which allow readings
tested @ site where more specific than powers of 10
dialyzer rinsed germicide
diluted
(RD47, 7.1.2)
Quality Control Device Audible & Visual Alarms
(temperature compensated) Annual test of device accuracy

Deionizer resistivity Resistivity < 1 megohm Daily Resistivity light or meter Record reading on light or meter
(RD, 3.2.3.4) Initiate appropriate action

Reverse Osmosis Determines rejection rates &/or resistivity Daily Quality control light Record ON and OFF
Calculated limit based on feedwater analysis &
initial rejection characteristics & shall
correspond to highest rejection coefficient @
which contaminants reach unsafe limits
(RD5, 3.2.3.5)

• 230mg/L (10mEq/L) where Na concentration of the concentrate has been reduced to compensate for excess Na in water, if conductivity monitored continuously
Reference to corresponding AAMI standards appears in parentheses. RD5 = AAMI Standard for “Hemodialysis Systems” RD47 = AAMI Standard for “Reuse of Hemodialyzers"
RD52 = AMMI Standard for “Dialysis” CFU = colony forming units
EU = endotoxin units LPS = lipopolysaccharide
RD62:2001 = AANSI/AAMI Standard for “Maximum allowable chemical contaminant levels in water to prepare dialysate”