27th IOA World Congress, Aug. 25–28, 2025, Atlanta, GA, USA
34th Annual Conference on Ozone Science and Technology in Japan Institute of Science Tokyo, Ookayama Campus, June 26–27, 2025
Ozone in Medicine. Ozone as Redox Bioregulator VI. Medical Ozone in Early Rheumatoid Arthritis
Volume 53 / No. 2 • March 2025
Editor-in-Chief: Dr. Saad Jasim
Ozone News (ISSN 1065-5905) is a bimonthly publication of the International Ozone Association (IOA). Annual subscription rate: $150.00. For editorial and advertising information, please contact:
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As a member of the IOA, you’ll receive bimonthly issues of Ozone News, bimonthly issues of the technical journal Ozone: Science & Engineering (OS&E), and IOA’s Publication Catalog, which includes worldwide conference proceedings, monographs, and special reprints. In addition, members receive discounts on IOA worldwide publications and meetings.
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For membership and publication information, please contact the IOA office nearest you:
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6 Cristian Carboni, New President of IOA-EA3G
7 How Ozone Treatment Tackles Pharmaceutical Residues in Wastewater
9 World Water Day: March 22
10 PFAS Removal in Webinar
Pioneering Innovation in Environmental Decontamination with Non-Thermal Plasma
11 WateReuse Texas Research Committee Meets Nutrient Runoff Capture, Recycling, Repurposing and Harmful Algae Bloom Remediation Webinar Series
12 Contaminants of Emerging Concern in the New European Water Regulations and the Importance of Ozone in Their Management
13 Ozone-Based Drinking Water Treatment for Arsenic and Manganese Removal: A Case Study of a Municipality in British Columbia, Canada
14 Ozone-Based Drinking Water Treatment for Arsenic and Manganese Removal: A Case Study of a Municipality In British Columbia, Canada
18 New Members
19 Ozone in Medicine. Ozone as Redox Bioregulator: VI. Medical Ozone in Early Rheumatoid Arthritis
22 2025 IOA World Congress, August 25–28, 2025, Omni Atlanta Hotel, Centennial Park, Atlanta, Georgia, USA
Page 2 Air Physics Co., Ltd.
Page 4 ANSEROS Klaus Nonnenmacher GmbH
Page 5 Statiflo
Page 6 Plasma Technics, Inc.
Page 7 Teledyne API
Page 9 Mazzei
Page 10 BMT
Page 11 BMT
Page 13 Tersano
Page 24 AirSep
Copyright ©2025 International Ozone Association. All rights reserved. No part of this publication may be reproduced, stored, transmitted, or disseminated in any form or by any means without prior written permission from the International Ozone Association. The publisher assumes no responsibility for any statements of fact or opinion expressed in the published papers.
Earth’s average surface temperature in 2024 was the warmest on record, according to an analysis led by NASA scientists. Global temperatures in 2024 were 1.28°C above the agency’s 20thcentury baseline (1951-1980), which tops the record set in 2023. The new record comes after 15 consecutive months (June 2023 through August 2024) of monthly temperature records — an unprecedented heat streak.
The latest forecast from the World Meteorological Organization (WMO) indicates that there is an 80% likelihood that the world will see the annual average global temperature temporarily exceed 1.5°C above preindustrial levels for at least one of the next five years.
“WMO is sounding the alarm that we will be exceeding the 1.5°C level on a temporary basis with increasing frequency. We have already temporarily surpassed this
level for individual months and indeed as averaged over the most recent 12-month period,”
What does that mean to challenges facing the water industry? We had previous articles linked the temperature impacts on water supplies. The Harmful Algal Blooms, and Cyanotoxins will continue to be a significant concern to water systems.
Dr. Saad Y. Jasim, P.Eng., IOA Ozone News Editor-in-Chief
April 8–10, 2025 — Advanced Oxidation Processes 7th International Conference, Frankfurt am Main, Germany
May 5–7, 2025 — Ontario’s Water Conference & Trade Show 2025, Blue Mountain Resort Village Conference Centre, Ontario, Canada
Statiflo supply a range of custom designed Ozone contacting systems which continually meet and exceed our guaranteed 95% mass transfer efficiency.
The Statiflo Gas Dispersion System (GDS) is often used by our customers to replace other high-maintenance and low-efficiency technologies, reducing overall costs and reducing your environmental impact.
June 8–11, 2025 — AWWA’s 2025 Annual Conference & Expo Denver, Colorado, USA
June 26–27, 2025 — Japan Ozone Association 34th Annual Research Conference, 2025, Tokyo, Japan
Aug. 25–28, 2025 — 27th IOA World Congress, Atlanta, Georgia, USA
Key benefits include:
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Business Development Manager of De Nora Water Technologies S.r.l.
Cristian has 30 years of experience in project management, research, technological innovation, and water and wastewater treatment. He is the author of numerous scientific publications and a reviewer of scientific journals. In Italy, he collaborates with various national institutions (Regions, Ministries, Associations, Civil Protection, etc.).
President of the IOA EA3G (International Ozone Association European African Asian Australian Group), member of the Board of Directors of the International Ozone Association and member of the board of directors of the Lombardy Energy Cleantech
Cluster (LE2C); Leader of the Expert Group Zero Pollution & Health of Water Europe and member of the Scientific Committee of the Polo Agrifood (Italy)
Since 2017, he has collaborated with the Executive Agency for Small and Medium-Sized Enterprises (EASME-European Commission). He is an external expert of the European Innovation Council and the Executive Agency for SMEs (EISMEA—European Commission).
Pinnacle Ozone Solutions
Introduction
Pharmaceutical residues in wastewater have become a growing environmental concern. Traces of medications, antibiotics, and other pharmaceutical products are often found in water sources after being discharged from industrial facilities, hospitals, and households. These residues can pose serious risks to aquatic ecosystems and human health. Traditional wastewater treatment methods are often ineffective at fully eliminating these contaminants, but ozone
treatment offers a powerful, eco-friendly solution. In this blog, we explore how ozone technology helps reduce pharmaceutical residues in wastewater, ensuring safer water for both the environment and communities.
The challenge of pharmaceutical residues in wastewater
Pharmaceuticals enter wastewater through a variety of channels, including industrial waste, hospital discharges, and human excretion. Conventional
Teledyne
wastewater treatment processes, such as filtration and biological treatments, are not designed to effectively break down complex pharmaceutical compounds.
As a result, pharmaceutical residues can persist in treated water and eventually enter natural water bodies, impacting aquatic life and even contaminating drinking water supplies.
Common pharmaceutical residues found in wastewater
• Antibiotics and painkillers
• Hormonal medications
• Anti-depressants and anti-anxiety drugs
• Anti-inflammatory drugs (NSAIDs)
These residues can affect the behavior and physiology of aquatic organisms, disrupt ecosystems, and contribute to the development of antibiotic-resistant bacteria.
How ozone technology addresses pharmaceutical contaminants
Ozone treatment is a highly effective method for reducing pharmaceutical residues in wastewater. Ozone is a strong oxidizing agent that breaks down complex organic molecules, including pharmaceutical compounds, into simpler, harmless substances. Unlike traditional chemical treatments, ozone doesn’t introduce new contaminants into the water, making it an environmentally friendly solution.
Key benefits of ozone in reducing pharmaceutical residues
Efficient Oxidation: Ozone breaks down pharmaceutical molecules into smaller, non-toxic compounds.
No Harmful By-products: Ozone decomposes naturally into oxygen after the treatment process, leaving no harmful residues in the water.
Broad-Spectrum Removal: Ozone can target a wide range of pharmaceutical compounds, ensuring comprehensive water treatment.
Pharmaceutical residues in wastewater represent a unique challenge for conventional treatment methods, but ozone’s powerful oxidative properties make it an ideal solution. Here’s why ozone stands out as the best choice for removing pharmaceuticals from wastewater:
Powerful Oxidation: Ozone’s strong oxidative capabilities allow it to break down a wide variety of pharmaceutical compounds, including those that are resistant to traditional treatments.
Environmental Safety: Unlike chemical treatments, ozone does not leave harmful by-products, making it safer for aquatic life and the environment.
Compliance with Regulations: Ozone helps wastewater facilities meet increasingly stringent environmental regulations regarding pharmaceutical contamination, ensuring safer discharge into natural water systems.
As environmental regulations tighten and awareness of pharmaceutical contamination grows, ozone treatment will play a crucial role in the future of wastewater treatment. Its ability to target and break down complex contaminants, while maintaining an eco-friendly approach, makes ozone an essential tool for both industrial and municipal wastewater facilities.
Sustainable and Effective: Ozone technology not only reduces pharmaceutical residues but also supports broader environmental sustainability goals by minimizing the need for chemical disinfectants and improving water quality.
Pharmaceutical contamination in wastewater is a significant challenge that requires advanced treatment methods. Ozone technology provides a powerful, chemical-free solution for reducing pharmaceutical residues, protecting aquatic ecosystems, and ensuring safer water for communities. Pinnacle Ozone Solutions offers advanced ozone systems designed to meet the specific needs of wastewater treatment facilities, helping them achieve cleaner, safer water.
Published by: WATER ONLINE
World Water Day, held on 22 March every year since 1993, is an annual United Nations Observance focusing on the importance of freshwater. World Water Day celebrates water and raises awareness of the 2.2 billion people living without access to safe water. It is about taking action to tackle the global water crisis. A core focus of World Water Day is to support the achievement of Sustainable Development Goal 6: water and sanitation for all by 2030.
Every year, UN-Water — the UN’s coordination mechanism on water and sanitation — sets the theme for World Water Day. In 2023, the focus was on Accelerating Change. In 2024, on Leveraging Water for Peace. In 2025, the theme will be Glacier Preservation.
Key messages for World Water Day 2025
• Glaciers are melting faster than ever. As the planet gets hotter due to climate change, our frozen world is shrinking, making the water cycle more unpredictable and extreme.
• Glacial retreat threatens devastation. For billions of people, meltwater flows are changing, causing floods, droughts, landslides and sea level rise, and damaging ecosystems.
• Glacier preservation is a survival strategy. We must work together to reduce greenhouse gas emissions and manage meltwater more sustainably for people and the planet.
• uniformly distributes ozone
• minimizes size & cost of ozone contacting system
Cristian Carboni and Tom Muilenberg
Cristian Carboni, President of IOA EA3G, recently joined his colleague Tom Muilenberg in the webinar “Why Forever Can’t Last—Removing PFAS from Water with the Lowest Total Cost of Ownership.” The session provided valuable insights into the challenges of per- and poly-fluoroalkyl substances (PFAS) contamination and the most effective strategies for their removal.
A key takeaway from the discussion was the role of ozone in PFAS treatment. While ozone alone cannot fully eliminate PFAS, it enhances the efficiency of activated carbon filtration, extending the lifespan of the carbon and reducing replacement costs. This highlights the potential of combined treatment methods for environmental and economic benefits.
The webinar underscored the critical need for innovative, cost-effective solutions in tackling PFAS contamination and guided optimizing treatment strategies for long-term sustainability.
Professor Chedly Tizaoui, Swansea University, Editor-in-Chief OS&E
Professor Chedly Tizaoui, Swansea University, Editor-in-Chief Ozone Science and Engineering (OS&E), delivered an insightful seminar on non-thermal plasma (NTP) for the Environment Platform Wales. While NTP is traditionally associated with ozone production, its applications extend far beyond this. NTP is recognized as the fourth state of matter, emerging when a gas is energized to the point of ionization. This process creates a dynamic mix of reactive species through the exposure of a gas to high voltage, including both relatively stable compounds like ozone, hydrogen peroxide, and nitrous oxides, as well as highly reactive, short-lived species such as hydroxyl radicals, singlet oxygen, UV radiation,
Continued on page 18
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Dr. Keisuke Ikehata, Chair, Publication Committee-IOA
The WateReuse Texas Research Committee held its first meeting of 2025, coming together to advance Texas reuse research and identify ways to engage students in water reuse research. It was also our first meeting in 2025 with our new Chair at the helm — Keisuke Ikehata, PhD, of Texas State University. Keisuke spent eight years at a water resources engineering firm before making the move to academia. In 2019, he joined Texas State as one of four founding faculty members of their new civil engineering program. As the previous Research Committee Vice-Chair and the inaugural recipient of the WRTX Reuse Impact Award, recognized for his contributions to advancing reuse and mentoring the next generation, Keisuke will no doubt use both his expertise and relationships in his new role.
Dr. Saad Y. Jasim, P.Eng., Editor-in-Chief Ozone News IOA
On Feb. 7, at the Nutrient Runoff Capture, Recycling, Repurposing and Harmful Algae Bloom Remediation Webinar series, organized by the National Algae Association, Dr. Saad Jasim, P.Eng., delivered a presentation on the oxidation of Cyanotoxins using Ozone & Advanced Oxidation Processes. The webinar addressed steps to reduce harmful algae blooms and advanced technologies to reduce impacts on lakes, coastlines and in drinking water.
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BMT MESSTECHNIK GMBH - Hamburger Str. 19 - D-14532 Stahnsdorf, Germany - Phone +49-3329-69677-0 - www.bmtberlin.de OSTI Inc. (Ozone Systems & Technology Int'l) - P.O. Box 63928 - Colorado Springs, CO 80962 - Phone +1-831-649 1141www.osti-inc.com
Cristian Carboni, President, IOA-EA3G, Business Development Manager of De Nora Water Technologies S.r.l., De Nora, Italy, E-mail: cristian.carboni@denora.com
Vítor Jorge Pais Vilar, Principal Researcher, Faculty of Engineering, University of Porto, Porto, Portugal, E-mail: vilar@fe.up.pt
Keywords: micropollutants, ozone, adsorption
The Winter School on Contaminants of Emerging Concern (CECs) and Disinfection By-Products (DBPs) took place in Porto on 25 and 26 November, and from 27 to 29 November, the International Conference of the International Ozone Association European, Africa Asia Australasia Group (IOA EA3G) took place at the same venue.
The two events were a precious opportunity to delve into the problems related to emerging pollutants, new regulations, and technologies for treating them, mainly through ozonation.
considers clinical, veterinary, and environmental aspects from a One-Health perspective.
The publication of Directive (EU) 2020/2184 was a first step in this direction. The Drinking Water Directive includes updated safety standards, introduces a methodology to identify and manage quality risks in the whole water supply chain, establishes a watch list of emerging substances such as microplastics, endocrine disruptors, as well as new types of chemicals to be monitored and introduces conformity provisions for products to be used in contact with drinking water.
However, the changes Directive (EU) 2020/2184 introduced are insufficient.
It is necessary to provide integrated management of water resources because if pollutants are not treated close to the source, even with decentralized systems, they will continue to pollute waterways, soils and aquifers and make wastewater reuse difficult to treat.
CECs are substances that, based on their (eco) toxicity, their potential effects on human health, and their presence and persistence in the environment, have recently been included in regulations at the European level or are candidates to be so in the future. This is a dynamic list to which new substances are continually added, such as drugs for human and veterinary use (e.g. antibiotics and hormones), endocrine modifiers and disruptors, perfluorinated compounds, psychoactive substances used by humans (e.g. drugs, nicotine), toxins produced by cyanobacteria (e.g. microcystins) and others.
To address the problem of micropollutants, the current approach, mainly focused on treating contaminants in drinking water treatment plants, must be modified to move to a global, holistic, ecosystem approach that provides for integrated management of water resources. The new approach must be based on a risk analysis that
On 5 November 2024. the “Council of the European Union” gave the final green light for a revised EU directive on urban wastewater treatment. The revised directive extends the scope to smaller agglomerations, covers more pollutants, including micropollutants, and contributes to energy neutrality.
By 2039, removing nitrogen and phosphorus (tertiary treatment) will be mandatory for urban wastewater treatment plants treating urban wastewater with a load of 150,000 population equivalents (p.e.) and above. For those urban wastewater treatment plants (and over 10,000 p.e. based on a risk assessment), by 2045 member states will have to apply an additional treatment to remove micropollutants, known as quaternary treatment. Producers of pharmaceuticals and cosmetics — the primary source of micropollutants in urban wastewater — will need to contribute a minimum of 80% of the additional costs for the quaternary treatment through an extended producer responsibility (EPR) scheme and following the ‘polluter pays’ principle.
In recent years, Integrated Water Services Companies have been developing their monitoring and treatment capabilities to meet new national and European regulatory requirements in collaboration with the world of research and technology-producing companies. The different technological solutions have advantages and disadvantages. For this reason, they must be evaluated according to the various application contexts, according to
the chemical-physical characteristics of the contaminants and of the water to be treated, the diversity of the pollutants and their concentration, the potential uses of the treated water or its release into the environment; for these reasons, the risk analysis must be accompanied by an economic and environmental analysis to validate its sustainability.
The processes most studied for the removal of micropollutants are:
• nanofiltration and reverse osmosis,
• adsorption on activated carbon (granular or powder)
• adsorption on exchange resins
• ozone oxidation or Advanced Oxidation Processes (AOP)
• oxidation by solar AOPs and photochemical processes
Membrane systems involve the treatment or disposal of concentrates, require additional pretreatment systems to reduce the development of biofilm and fouling, and are often unable to filter all micropollutants. Operational costs for large water flows are high due to the energy consumption associated with pumping and the need to maintain and replace membranes.
Activated carbons can reduce their adsorption capacity towards micropollutants in the presence of other organic compounds, and their use involves the need for regeneration or replacement with related costs.
Ozonation and AOP can lead to the creation of nonmeasurable by-products. For this reason, in addition to monitoring toxicity, their combination with adsorption systems (such as activated carbon) is often recommended. For these reasons, the best solutions frequently arise when different technologies are combined. One of the effective combinations is that between ozone and activated carbon or ozone and a biological active filter, resulting in simultaneous adsorption and/or biodegradation of organic compounds. Ozonation contributes to the oxidation of non-biodegradable micropollutants and other organic substances present in water by reducing the load of pollutants that reaches the activated
carbons or filters, reducing the competition of organic matter with the substances that must be adsorbed, favouring biodegradation from part of the microorganisms, prolonging the useful life of the activated carbon. In these systems, ozone is generated on the site of use by generators that use electricity and oxygen.
Since 2014, Switzerland has implemented a strategy to reduce the contamination of micropollutants by intervening in the central wastewater treatment plants; the technological choices focused above all on ozonation and activated carbon. The installations in Switzerland were followed by installations in other countries, demonstrating that ozonation and adsorption on activated carbon, in addition to secondary treatment, are effective and economically sustainable.
Haroon R. Mian1, Guangji Hu2, Madjid Mohseni3, Saad Jasim4, Kasun Hewage1, Rehan Sadiq1
1: School of Engineering, University of British Columbia (Okanagan), Kelowna, Canada
2: School of Environment and Geography, Qingdao University, Qingdao, Shandong 266071, China
3: Chemical and Biological Engineering, University of British Columbia, Vancouver, Canada
4: SJ Environmental Consultants (Windsor) Inc.
1. Introduction
Elevated arsenic and heavy metal levels in source water could deteriorate drinking water quality and pose a health risk to the public due to their toxicity, persistence, and bioaccumulative nature. Arsenic compounds are odorless, tasteless, and readily water-soluble, making chronic arsenic poisoning much more insidious than acute poisoning. Manganese is also widely present in the water environment from natural sources (rock and soil weathering) and human activities such as mining and landfill leaching. Guidelines for manganese and arsenic have been set in several countries based on the consideration of human health protection.
In the past, the City of White Rock, British Columbia, faced challenges of elevated concentrations of
naturally occurring arsenic and manganese in its water supply. Despite elevated arsenic and manganese concentrations in the source water, the City’s drinking water distribution system met the Guidelines for Canadian Drinking Water Quality. Nevertheless, to further improve drinking water quality and safeguard the health of residents in this city, the local water utility initiated a pilot project to evaluate the efficacy of different water treatment methods in reducing arsenic and manganese levels. The City of White Rock was also interested in assessing the potential human health risks due to arsenic and manganese exposure.
The City’s water utility, the Department of Chemical and Biological Engineering, and the Life Cycle Management Laboratory of the University of British Columbia investigated the arsenic and manganese removal performance of the oxidation/filtration-adsorption process in the pilot-scale water treatment. They assessed the human health risk mitigation effect. Different oxidants and filtration media, such as ozone and manganese dioxide-coated sands, were used in the oxidation/filtration process (i.e., BRIM® and Greensand Plus®), and arsenic adsorption was accomplished using a granular iron-based adsorbent (Bayox-
ide®). The health risks from arsenic and manganese exposure were assessed to evaluate drinking water quality before and after the treatment. The findings can also serve as a useful reference to water utilities to solve similar water quality issues worldwide.
Two treatment trains were investigated in the pilot project, as shown in Figure 1.
Water samples were collected at five different points (i.e., S1 to S5) of the two treatment trains, as given in Figure 1. The sampling points are described in Table 1.
Water samples were collected using 250-mL acid-washed Nalgene bottles and kept at 4 °C in coolers packed with ice until analysis. The arsenic and manganese concentrations were measured using an inductively coupled plasma system mass spectrometry, according to the standard method. Each sample was analyzed five times, and the average value was reported. The design parameters for selected processes were set as provided in Table 2.
Human health risk assessments were carried out to estimate the health risks associated with water
consumption from different sources/treatments. They were performed following the Guidance on Human Health Detailed Quantitative Risk Assessment for Chemicals (DQRACHEM) implemented by Health Canada. In DQRACHEM, a four-step framework comprising problem formulation, exposure assessment, toxicity assessment, and risk characterization is recommended for a health risk assessment. Arsenic and manganese in drinking water were assessed for health risk quantification. Human receptors include all city residents, and they were categorized into five age groups with different mean body weight, daily water intake, and fraction of lifetime patterns. Details can be found in Hu et al. (2020).
Both point and probabilistic estimations were carried out. In point estimation, the mean body weights and daily water intakes, representing the central tendency of the variability of the two parameters, were used in risk characterization. The probabilistic estimation yields a probability distribution for risk by assigning probability distributions to represent variability or uncertainty in input parameters, such as body weight, daily water intake, and contaminant concentration. Based on the identified distribution functions of input parameters, Monte Carlo simulations with 10,000 permutations were performed using @Risk 7.6 (Palisade Corp., USA). The Monte Carlo simulation generated all possible health risk assessment outcomes in hazard quotient (HQs) and incremental lifetime cancer risk (ILCRs).
Figure 2 presents the arsenic and manganese concentrations in source water drawn from different wells between 2015 and 2018. The high arsenic concentration was primarily due to the arsenic-related mineral deposits on the aquifer floors.
Figure 2a shows that some sampled arsenic concentrations in wells #6 and #7 were higher than the MAC of 10.0 μg/L. Whereas, arsenic concentrations in wells #1 to 3 were relatively low, ranging from 5.0 to 7.0 μg/L. However, this concentration range is slightly higher than the commonly reported arsenic concentration range (i.e., 1.0–5.0 μg/L) in uncontaminated Canadian surface and groundwater water.
Figure 2b shows that wells #1, 3, 4, 6, and 7 were associated with high manganese concentrations. All
manganese concentrations in the source water from these five wells were higher than the AO value (i.e., 20.0 μg/L). The mean values of reported manganese concentrations in source water from wells #3, 4, and 6 were higher than the MAC value.
The results of arsenic and manganese removal using two treatment trains are shown in Figure 3. OSF treatment showed limited arsenic removal as there was no significant statistical difference (p > 0.05) between arsenic concentrations in water samples collected at sampling locations S1 and S2. Furthermore, no significant statistical difference was observed between water samples collected at S1 and S4, indicating that manganese-coated sands (manganese greensand and BIRM) also had limited arsenic removal effects in the pilot treatment. It has been reported that manganese oxide-coated sands alone are ineffective in arsenic removal because they are specifically developed for oxidizing and removing iron and manganese from water. Nevertheless, arsenic can be reduced from 50 μg/L to < 4.5 μg/L using manganese greensands in acidic water. The OSF process showed promising manganese removal as the manganese concentration was reduced to < 5 μg/L throughout the pilot study period. BIRM also showed satisfactory manganese removal in the first two weeks, but the removal efficiency decreased because of the increased treatment volume of influent.
4.1.1
Figure 4 provides the human health risk assessment results before and after selected drinking water treatment trains. Since water is not consumed directly from the wells, health risks posed by arsenic and manganese in source water and S1 were not assessed. Arsenic is assessed for both cancer and non-cancer risk, and manganese was assessed for non-cancer risk only.
Based on the water samples collected at S3 and S5, all HQs calculated for all age groups were lower than the critical value, indicating that OSFIA
and BIA treatments are effective in reducing the non-cancer risk of arsenic. On average, the two treatment processes can reduce 50% of the non-cancer risk. In addition, the HQs calculated for infants were relatively higher, making them more susceptible to the adverse health effects of arsenic.
The ILCRs calculated based on arsenic concentrations fell within the range of the excessive lifetime cancer risks suggested by Health Canada. Furthermore, the estimated lifetime risk of cancers associated with arsenic in drinking water at the set MAC benchmark was between 3E-5 (the lower bound) to 3.9E-4 (the upper bound). The lower bound of the risk range exceeded the risk guideline of 1E-5. Risk-based benchmarks are typically conservative and consider exposure, immune response, and other simultaneous contributing conditions. The non-cancer health risks associated with manganese in different water sources are negligible. The HQs for different age groups were identified to be much lower than the critical value. The highest HQ due to manganese exposure was calculated to be 0.06 for infants (the most susceptible age group). Both
OSF and OSFIA treatments can reduce the manganese concentration in water to a nondetectable level. Hence, the effects of non-cancer diseases can be almost eliminated.
The cumulative distributions of probabilistic non-cancer risk assessment outcomes are shown in Figure 5. The probabilities of HQs > 1 were estimated to be higher than zero for all age groups due to ingesting water from different sources. The Monte Carlo simulation considered all possible arsenic exposure scenarios, including the extreme ones. Under extreme exposure scenarios, such as an infant (e.g., 4.00 kg) daily ingesting a large volume of water (e.g., 1.00 L) with a relatively high arsenic concentration (e.g., 9.50 μg/L), the
associated HQ will be calculated higher than one. Nevertheless, the historical sampling results indicated that arsenic concentration is not high. Moreover, considering that infants and toddlers only account for 4.11% of the total population of White Rock, it could be highly unlikely for extreme exposure scenarios to occur in the real world. Considering all extreme exposure scenarios, the probability of HQ > 1 for infants was estimated to be 0.30 as a result of ingestion of water, and OSFIA treatment can reduce this probability to 0.13 (Fig. 5a). The probabilities of HQs exceeding the critical value were estimated to be 0.10 for children (Fig. 5c) and 0.05 for adults (Fig. 5d) as a result of ingestion of the DWDS water, and those can be reduced to 0.05 and 0.03.
The pilot study demonstrated the effectiveness of combined ozonation and manganese-coated sand filtration (i.e., BRIM® and Greensand Plus®) along with iron-based granular media adsorption (Bayoxide®), in reducing both arsenic and manganese concentrations. Manganese removal was highly efficient, whereas
arsenic removal required the incorporation of specific adsorption media to achieve meaningful reductions. The health risk assessment results also indicate that the treatments effectively minimized the non-cancer risks associated with manganese as well as both cancer and non-cancer risks linked to arsenic exposure. The probabilistic analyses reaffirm the robustness of the selected treatment methods in protecting sensitive populations, such as infants, from potential health impacts. Overall, the results underscore the importance of a multi-stage water treatment approach to address specific contaminant challenges and safeguard public health. These insights serve as valuable references for other global water utilities facing similar issues.
Disclaimer This document contains information from previously published articles by the same authors.
Hu, G., Mian, H. R., Dyck, R., Mohseni, M., Jasim, S., Hewage, K., & Sadiq, R. (2020). Drinking Water treatments for arsenic and manganese removal and health risk assessment in White Rock, Canada. Exposure and Health, 12(4), 793-807.
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Environmental Decontamination with Non-Thermal Plasma CONTINUED FROM PAGE 10
ultrasound, and shock waves. These reactive species are potent oxidants, capable of breaking down a wide range of organic and inorganic contaminants across water, air, and solid media. In his seminar, Professor Tizaoui explored the underlying principles of NTP and highlighted its promising applications in addressing emerging environmental challenges, such as the degradation of emerging contaminants, PFAS in water, and nitrous oxide in the air.
Mr. Jonathan ANDRY Xylem Water Solutions
Australia/New Zealand Ltd. 14 Emporium Avenue
KEMPS CREEK NSW 2178
Mr. Christian KIECHLE Hydro Elektrik GmbH Angelestrasse 48/50 88214 RAVENSBURG
Pr. Rui MARTINS University of Coimbra Urbanização Nova Conímbriga, Lote 16 3150-230 COINDEIXA
Mr. Jumeng ZHENG PWNT R&D B.V. Dijkweg 1 1619 HA ANDIJK
Renate Viebahn-Haensler & Olga Sonia León Fernández
Keywords: medical ozone, prevention, early rheumatoid arthritis
Abstract: Medical ozone is a pleiotropic substance with different therapeutic targets (regulation of the redox state and the antioxidant/pro-oxidant balance; activity of the mitochondrial aldehyde dehydrogenase enzyme isoform 2 and adenosine A1 receptors among others. All these pharmacological targets have different properties and effects, depending on the disease. The therapeutic actions of ozone, regulating these molecules, have been demonstrated in animal studies. Likewise, the clinical response of patients has corresponded with the preclinical studies carried out. Rheumatoid arthritis (RA) is a chronic, autoimmune and multisystem disease whose main target is the synovial membrane. It is an event that is present from the beginning of the disease and in its later stages. Chronic degradation leads the entire process, and is the fundamental cause of a poor quality of life for the patients with this pathological condition. The purpose of this study is show, from an updated review and the results obtained in different animal studies and clinics trials, the potential of medical ozone in preventing the onset of the disease and its treatment, with the remission of the signs and symptoms of RA and a notable improvement in the quality of life, based on the mechanisms involved in chronic inflammation.
Introduction
RA is a chronic, autoimmune, multisystem disease whose main target is the synovial membrane. The synovium is the principal target as it is associated with the degree
of RA activity. This compartment is severely infiltrated by immune system cells leading to neovascularization (Wang et al., 2022). The joints of patients affected by RA show inflammation, edematous synovial tissue with hyperemia and other alterations (Buckley, et al., 2021). Early detection and immediate treatment of the disease is crucial, since the evolution of the patient with an active disease or an asymptomatic disease depends on this. In other words, the patient continues to be sick but without any of the characteristic symptoms of RA responsible for cartilage destruction and bone erosion. The main consequences of late-diagnosed RA are shown in Figure 1.
preventive, effective and safe therapy
Activation of innate immunity In the synovium occurs early In RA and serves as a key pathogenic mechanism that leads to inflammation. Cells of the innate immune system such as monocytes, macrophages and dendritic cells (DCs) have a critical place in innate immunity initiating and perpetuating the disease (Maria I. Edilova et al., 2020). The pathogenic role of monocytes and macrophages in RA is due to the generation of cytokines, growth factors and reactive oxygen species (ERO) which together with other molecules trigger inflammation and destruction of synovial structures, resulting in inflammation as a critical event that is detected from early stages.
English researchers (Emeri and Salmon, 1955) reported that RA is the most common cause of disability, with treatment potential, in the Western world, if the RA is diagnosed early. Although it has been demonstrated and recognized that the early detection of RA and its immediate treatment has achieved the remission of the disease, there is still no generalized awareness of which is the most suitable “window of possibilities”.
In general, it is considered that detection must be understood, from the beginning of symptoms, between 3 and 12 months (Hua et al., 2017). A duration greater than a year characterizes what has been called an established RA (Bordy et al., 2018). It should be mentioned that there are authors who consider 2 years, and up to 3 years as the period of detection of early rheumatoid arthritis (Dismorle et al., 2012). Different stages have been considered from the beginning to the development of an established RA. In an early stage the joint and bone can
be target of the APCC (anti-cyclic citrullinate peptides), with a lower infiltration of immune cells. During this stage, patients are initially asymptomatic but in a short time they develop arthralgia and early bone loss (Van Steenbergen et al., 2017).
It has been well recognized that RA as a chronic inflammation has a close connection with oxidative stress which is defined as a redox imbalance, where the generation of ROS exceeds antioxidant defenses. The inflammation causes hypertrophy of the synovium resulting in an abnormal tissue called pannus that invades and destroys local joint structures. Cells in the pannus express proinflammatory cytokines, chemokines and matrix metalloproteinases that contribute to progressive cartilage and bone destruction (McInnes et al, 2016). There is a close relationship between innate immunity, inflammation and early RA. Innate immunity is an early immune response to the recognition of signs of tissue damage that can be generated by the start of an early RA. Innate immunity cells are responsible for inducing the initial inflammatory response that in early RA has a subclinical expression. The inflammatory response is protective but when it becomes excessive — without resolving the damage that originated it — it becomes chronic with responses causing damage from different tissues and cellular structures. Avoiding a development of the inflammatory process is one of the main goals in the treatment of AR. It is in this context that inflammation is of particular importance (Figure 2). In effect, inflammation is a biological repair process tightly controlled by intracellular complexes, known as inflammasomes, which act as sensors and mediators of the inflammatory process (Montaño et al. 2017). This cytosolic structure is present in most inflammatory processes. Excessive or abnormal inflammasome activity is associated with different diseases, including autoimmune diseases such as rheumatoid arthritis,
multiple sclerosis, type I diabetes mellitus and systemic lupus erythematosus (Qi et al., 2023). There are different types of inflammasomes but the most studied, and associated with different diseases is NLRP3.
Figure 2 shows how damage signals (TNFRs), which can be derived from RA with early inflammation, activate the nuclear transcription factor NF-kB, whose gene transcription products, NLRP3 protein and pro-IL-1β and IL18 (not shown in the figure) assemble with the ASC protein allowing the coupling of NLRP3 with Caspase-1, an enzyme that converts pro-IL1β into mature and active IL-1β: this escapes into the extracellular medium via pores in the cell membrane; these, in turn, originate from the activation of another protein (Gasdermin D) that lead to the release of other cytokines. IL-1β (very important in RA), thus triggering off the different pathological events (here illustrated). Additionally, the formation of pores as described favors pyroptosis, a type of programmed lytic cell death, which is also highly inflammatory.
The proliferation of FLS (fibroblast-like synoviocytes) occurs during the early stages of RA to procude proinflammatory cytokines, matrix-degrading enzymes, and proangiogenic factors, which in turn leads to the release of inflammatory mediators, bone destruction, and angiogenesis (Mousavi et al., 2021). The importance of redox balance when mediated by medical ozone is evidenced in the mechanisms regulating the NLRP3 inflammasome. Production of ROS derived from the mitochondria and other sources is one of the mechanisms of inflammasome activation, which involves 2 steps: firstly, endogenous cytokines bind to cell membrane receptors to activate NF- κ B, thus increasing the expression of NLRP3 protein and pro-IL-1 β ; secondly, endogenous signals from RA trigger the activation of signals that recruit ASC and caspase 1 to form the inflammasome complex (Figure 2) (Jo et al., 2016).
The different targets regulated by medical ozone are represented in blue circles in Figure 2, including the actions of ozone on innate immunity (Oru et al., 2019). In this context, the cellular redox balance plays a central role as a regulator of inflammasome activity. ROS constitute one of the activation mechanisms of NLRP3: these are regulated by medical ozone (León et al, 2016). The activation of NF-κB is decisive in synthesis
Figure 2. Abbreviated representation of RA medical ozone targets with potentialities in the prevention of cartilage degradation and bone erosion through regulation of innate immunity, NF-κB and the inflammosome NLRP3. RA, rheumatoid arthritis; TNFRs, TNF receptor; DAMPs, damage-associated molecular patterns; ROS, reactive oxygen species; NLRP3, NLRP3 (sensor protein); ASC, adaptor protein; caspase 1, effector enzyme; NF-κB, nuclear transcription factor.
of the NLRP3 protein, a damage sensor that activates the inflammasome. It is here that ozone regulates the p65 subunit of NF-κB, and this critical protein for the activation of the inflammasome will be deficient. Il-1β, a damage amplifier, is also regulated by medical ozone (J Dranguet, 2013) — together with TNF-α — which initiates the activation of the inflammasome.
Medical ozone regulates the activity of the inflammasome, which, moreover, should not be inhibited: this is because it plays a protective role when it is not overactivated. The regulatory effects of ozone on critical events of the inflammatory process in RA support confirm its use in the form of a combined therapy with methotrexate once RA is detected early; this should allow patient to remain asymptomatic and significantly improve his or her quality of life.
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August 25-29, 2025 | Atlanta, GA
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