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Can germ pass from the humidifier to me ?
#1
[parts of this thread were copied from our old forum]

Can germ pass from the humidifier to me ?
No, using a heated humidifier in line with your CPAP device will not cause you to become sick or give you germs. Fisher & Paykel Healthcare's heated humidifiers are pass-over humidifiers that do not produce aerosols (the fine water droplets that are visible to the eye such as steam from a kettle). Pass-over humidifiers add moisture in the form of water vapor. Water vapor particles are smaller than bacteria or viruses so it is impossible for them to be transported up to the mask (and then to you). Even if pathogens (germs) were able to exist in the chamber, they would not be able to be transported to you.
The important thing to remember is that all equipment (especially your mask) needs to be cleaned thoroughly on a regular basis, so that it does not become a desirable environment for bacteria to live and grow. Follow the cleaning instructions for all equipment to ensure proper hygiene and cleaning.
http://www.fphcare.com/osa/clinical-and-...qs.html#ns

zimlich wrote:
Very interesting, zonk. Thanks.

weeble wrote:
I was actually just wondering the same thing myself - so that's good to know!!

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#2
From Alpine Home Medical

Do I really need to replace my supplies?
We’d like to refer you to a study presented in 2009 at the 23rd Annual Meeting of the Associated Professional Sleep Societies, LLC.

Methods: 30 patients on CPAP for more than one month were studied. Clinical global improvement on CPAP was measured as was frequency of cleaning, and type and age of interface. Bacterial and fungal cultures were taken from the interfaces and humidifiers. Cultures were classified, photographed, and colonies counted. Culture growth was so significant on the first 20 patients, that a secondary trial of mask washing and repeat culture was added.

Results: CGI scores noted 63% of the patients much improved or improved. Although the cultures grew mostly normal flora, the colony counts were high; 21% of the patients had 100-500 colonies and 48% grew >2000 colonies per plate. There was no significant correlation of severity or cleaning frequency with colony counts. Mask age was important; with fungal growth from 100% >1 year old, and only 25% aged 1-3 months. Gram negative bacteria increased almost linearly with mask age. In the secondary trial, interfaces were rewashed, resulting in 90% lower colony counts, unless they were >1 year old when washing was ineffective.

Conclusion: This pilot study suggests there are high counts of bacterial and fungal flora on CPAP interfaces, despite routine washing, with the older interfaces, more contaminated and resistant to cleaning.*

What does this mean in layman terms? CPAP masks and humidifiers grow germs. Not just a few but a significant amount. Washing supplies helps reduces these germs but as a mask gets older washing become less and less effective.

Germs cannot be seen by the human eye but that does not mean they aren’t there. You are breathing through this equipment night after night. Anything growing in your mask can be introduced directly to your lungs.

*0634 SLEEP AND BREATHING: CARE OF CPAP EQUIPMENT A FACTOR IN COMPLIANCE AND HYGIENE

Horowitz S1,2, Horowitz A3, Chun C4

1Sleep Medicine, Harvard Medical School, Framingham, MA, USA,2Neurology, University of Massachusetts, Worcester, MA, USA, 3Science, UCLA, Los Angeles, CA, USA, 4Medicine, Metrowest Medical Center Natick Campus, Natick, MA, USA

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#3
So... The second post would contradict the first one? I'm so confused. If I have germs, can I give them to my cpap machine? If I do, will it have to go to the cpap doctor? That would actually be a good thing because I could go too and ask for some new stuff.
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#4
US National Library of Medicine National Institutes of Health

Sci Prog. 1989;73(292 Pt 4):469-99.
Airborne bacteria and viruses.
Cox CS.
Abstract

Coughing, sneezing, talking, bed-making, turning pages of books, etc. all generate microbial aerosols which are carried and dispersed by air movements. Inhalation of these particles may cause allergic responses but whether or not infectious disease ensues depends in part on the viability and infectivity of the inhaled microbes and their landing sites. Desiccation is experienced by all airborne microbes; gram-negative bacteria and lipid-containing viruses demonstrate phase changes in their outer phospholipid bilayer membranes owing to concomitant changes in water content and/or temperature. These changes most likely lead to cross-linking reactions of associated protein moieties principally at mid to high relative humidity (RH). For lipid-free viruses these reactions of their surface protein moieties occur most rapidly at low RH. Radiation, oxygen, ozone and its reaction products and various pollutants also decrease viability and infectivity through chemical, physical and biological modification to phospholipid, protein and nucleic acid moieties. The extent of damage and the degree of repair together with the efficacy of host defence mechanisms largely controls whether the causative microbes take hold and spread disease via the airborne route. At least indoors, where desiccation is the predominant stress, the general reversibility of membrane-phase changes by vapour-phase rehydration when coupled with efficacious microbial enzymatic repair mechanisms under genetic control, virtually ensures the spread of disease by the aerobiological pathway.

I think that makes it pretty clear that not only is it possible to get germs from your PAP but its humidifier is also guilty. Along with that is the very air entering the device.

The article also make it very clear that whomsoever (my biggest word) wrote it had a very good command of the language and terms involved. Anybody that can justifiably use terms like concomitant and moieties is my hero. I believe every word he says even though I don't know what they mean.

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#5
I think what it said was you should wash your hands after you desiccate.

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#6
(08-06-2014, 12:50 PM)surferdude2 Wrote: I think that makes it pretty clear that not only is it possible to get germs from your PAP but its humidifier is also guilty. Along with that is the very air entering the device.

The theory is that whatever might be living in the humidifier water gets left behind when the water evaporates.

The humidifier is intended not to aerosolize (make droplets of) water, only to let water evaporate as a gas. Germs don't evaporate. There's some doubt whether the humidifiers actually aerosolize the water.

Also realize that viruses can't multiply outside the body, and very often don't live outside the body for very long.

You also need to realize that the germs you breathe out into the mask are not dangerous to you at the time you exhale them. If you've got bacteria Y living in your nose and throat, you have billions of copies of Y already inside you. Even without CPAP, every time you inhale, you inhale millions of the germ from you nose back deeper into your body. Re-inhaling what you just breathed out isn't going to make much difference.

Your own germs will only matter long after you've gotten over your infection and your immune system has forgotten how to fight it, or if they multiply outside the body in such numbers that they can overwhelm you.

It would be different if you were using CPAP equipment that had been used by someone else.

As for airborne germs getting in the CPAP equipment, remember you're breathing those germs 16 hours a day anyway. Unless they find some fertile ground inside the CPAP to grow, it's no worse than a person who doesn't use CPAP. People worry because the CPAP equipment may be damp, but germs need more than just water and air to grow. They need some form of food for energy and raw material to build protein and other materials.

Dump the humidifier water and clean occasionally to keep it from becoming a growth medium for germs. The contaminants in the water concentrate as water evaporates. Distilled water helps by having less germ food available to start with, but you should still dump it and clean it fairly regularly.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#7
(08-06-2014, 12:50 PM)surferdude2 Wrote: US National Library of Medicine National Institutes of Health

Sci Prog. 1989;73(292 Pt 4):469-99.
Airborne bacteria and viruses.
Cox CS.
Abstract

Coughing, sneezing, talking, bed-making, turning pages of books, etc. all generate microbial aerosols which are carried and dispersed by air movements. Inhalation of these particles may cause allergic responses but whether or not infectious disease ensues depends in part on the viability and infectivity of the inhaled microbes and their landing sites. Desiccation is experienced by all airborne microbes; gram-negative bacteria and lipid-containing viruses demonstrate phase changes in their outer phospholipid bilayer membranes owing to concomitant changes in water content and/or temperature. These changes most likely lead to cross-linking reactions of associated protein moieties principally at mid to high relative humidity (RH). For lipid-free viruses these reactions of their surface protein moieties occur most rapidly at low RH. Radiation, oxygen, ozone and its reaction products and various pollutants also decrease viability and infectivity through chemical, physical and biological modification to phospholipid, protein and nucleic acid moieties. The extent of damage and the degree of repair together with the efficacy of host defence mechanisms largely controls whether the causative microbes take hold and spread disease via the airborne route. At least indoors, where desiccation is the predominant stress, the general reversibility of membrane-phase changes by vapour-phase rehydration when coupled with efficacious microbial enzymatic repair mechanisms under genetic control, virtually ensures the spread of disease by the aerobiological pathway.

I think that makes it pretty clear that not only is it possible to get germs from your PAP but its humidifier is also guilty. Along with that is the very air entering the device.

The article also make it very clear that whomsoever (my biggest word) wrote it had a very good command of the language and terms involved. Anybody that can justifiably use terms like concomitant and moieties is my hero. I believe every word he says even though I don't know what they mean.

I think that article is not really applicable to PAP.
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#8
Theoretically, yes. As a practical matter, you shouldn't have a problem if you clean things occasionally. The biggest potential problem is probably mold from an uncleaned humidifier. I'm assuming you aren't dealing with a compromised immune system.
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