Use of Bleach for Disinfection of Drug Injection
Equipment
On April 19, 1993, the National Institute on Drug
Abuse of the National Institutes of Health, the Center
for Substance Abuse Treatment of the Substance Abuse and
Mental Health Services Administration, and CDC issued a
joint bulletin updating recommendations to prevent
transmission of human immunodeficiency virus (HIV)
through the use of bleach for disinfection of drug
injection equipment. The bulletin particularly addresses
persons who cannot or will not stop injecting drugs. This
bulletin states that 1) bleach disinfection of needles
and syringes continues to have an important role in
reducing the risk for HIV transmission for injecting-drug
users who reuse or share a needle or syringe; and 2)
sterile, never-used needles and syringes are safer than
bleach-disinfected, previously used needles and syringes.
The bulletin contains provisional recommendations for the
use of bleach to disinfect needles and syringes
(including the recommendation for the use of
full-strength household bleach to disinfect needles and
syringes).
CDC recommendations for disinfecting environmental
surfaces contaminated with blood are unchanged. The CDC
recommendation for disinfecting environmental surfaces
continues to include use of a 1:100 dilution of household
bleach (or 1/4 cup bleach to 1 gallon tap water) or other
appropriate disinfectants (1).
The difference in the recommended concentrations of
bleach reflects the difficulty of cleaning the interior
of needles and syringes and the use of needles and
syringes for parenteral injection. Thorough cleaning is
an important step in the disinfection process. Disposable
syringes and needles are not intended for reuse and,
because of their configuration, are extremely difficult
to clean thoroughly. In addition, the needles and
syringes will be used for parenteral injection. For these
reasons, full-strength bleach is recommended for the
disinfection of needles and syringes.
Copies of the bulletin are available from the CDC
National AIDS Clearinghouse, telephone (800) 458-5231 or
the National Clearinghouse for Alcohol and Drug Abuse
Information, telephone (800) 729-6686.
Reported by: National Institute on Drug Abuse, National
Institutes of Health. Center for Substance Abuse
Treatment, Substance Abuse and Mental Health Svcs
Administration. Office of the Associate Director
HIV/AIDS, Office of the Director; Div of Sexually
Transmitted Diseases and HIV Prevention, National Center
for Prevention Svcs; Hospital Infections Program, and Div
of HIV/AIDS, National Center for Infectious Diseases;
National Institute for Occupational Safety and Health,
CDC.
Reference
CDC. Recommendations for the prevention of HIV
transmission in health-care settings. MMWR 1987;36(suppl
2S):9S-11S.
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