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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.


  1. CDC. Recommendations for the prevention of HIV transmission in health-care settings. MMWR 1987;36(suppl 2S):9S-11S.

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