An overview on the use of ultraviolet radiation to disinfect air and surfaces

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Roberto Albertini
Maria Eugenia Colucci
Alessia Coluccia
Mostafa Mohieldin Mahgoub Ibrahim
Roberta Zoni
Licia Veronesi
Paola Affanni
Cesira Pasquarella

Keywords

UV radiation, air and surfaces, operating theatres, disinfection

Abstract

Background and aim


Ultraviolet radiation (UV) is the portion of the electromagnetic spectrum of wavelengths between 200 and 400 nm divided into three bands called UVA, UVB and UVC. Due its well-described antimicrobial activity, UVC can represent a useful tool for disinfect surfaces, water, and air. The aim of this study was to illustrate the studies over time ultraviolet germicidal irradiation (UVGI) to disinfect air and surfaces.


Methods


Articles on Scopus published until April 14, 2023, were considered. Many issues involving UV were deepened crosschecking with e.g., “air”, “surfaces”, “disinfection”, “bacteria”, “fungi”, “operating theatres”. According to the case, the following variables were considered: years and related number of articles, sources of publications, subject areas, type of document published, type of journal, nationalities of the authors.


Results


Since 30’s, 287 448 articles on UV have been published. Among UVGI, 22 159 articles covered bacteria issue, followed by fungi and viruses with about 12000 both. UVGI was addressed by 1941 and 931 articles for surfaces and air respectively. Of these, 122 were performed in operating theatres. Since 1987 works have been published on spacecraft and since 2000, on the use of UVGI robots for disinfect air and surfaces.


Conclusions


Our study shows the studies on UVGI and related issues. It also shows most recently perspectives about the applications e.g. during prolonged human-crewed missions on spacecrafts, to inactivate microorganisms in environments where the exchange of air is impossible.

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References

1. ASHRAE Handbook—HVAC Applications. Ultraviolet air and surface treatment. Chapter 62, 2019. Available from: https://www.ashrae.org/file%20library/technical%20resources
/covid-19/i-p_a19_ch62_uvairandsurfacetreatment.pdf.
2. World Health Organization, World Meteorological Organization, United Nations Environment Programme & International Commission on Non-Ionizing Radiation Protection. (2002). Global solar UV index: a practical guide. World Health Organization. https://apps.who.int/iris
/handle/10665/42459.
3. Reed NG. The History of Ultraviolet Germicidal Irradiation for Air Disinfection. Public Health Reports 2010;125(1):15-27. doi: 10.1177/003335491012500105.
4. Schmarda LK. Der Einfluss des Lichtes auf die Infusionsthierchen.Med Jahrbücher des k. k. Österreichischen Staates 1845;54:257-70.
5. Downes A, Blunt TP. The influence of light upon the development of bacteria. Nature 1877;16:218. doi: 10.1038/016218a0.
6. Downes A, Blunt TP. Researches on the effect of light upon bacteria and other organisms. Proc R Soc Lond 1877;26:488-500. doi: 10.1098/rspl.1877.0068.
7. Downes A, Blunt TP. On the influence of light upon protoplasm. Proc R Soc Lond 1878;28:199-212. doi: 10.1098
/rspl.1878.0109.
8. Tyndall J. Note on the influence exercised by light on organic infusions. Proc R Soc Lond 1878;28:212-3. doi: 10.1098/rspl.1878.0110.
9. Tyndall J. On the arrestation of infusorial life. Science 1881;2(68):478. doi: 10.1126/science.os-2.68.478.
10. Hockberger PE. A history of ultraviolet photobiology for humans, animals, and microorganisms. Photochem Photobiol 2002; 76(6):561-79. doi: 10.1562/0031-8655
(2002)0760561AHOUPF2.0.CO2.
11. Henri MmeV, Henri V. Variation du pouvoir abiotique des rayons ultraviolets avec leur longueur d’onde. C R Seances Soc Biol Fil 1914;73:321-2.
12. Gates FL. A study of the bactericidal action of ultraviolet light: I. The reaction to monochromatic radiations. J Gen Physiol 1929;13(2):231-48. doi: 10.1085/jgp.13.2.231.
13. Gates FL. A study of the bactericidal action of ultraviolet light: II. The effect of various environmental factors and conditions. J Gen Physiol 1929;13(2):249-60. doi: 10.1085
/jgp.13.2.249.
14. Gates FL. A study of the bactericidal action of ultraviolet light: III. The absorption of ultraviolet light by bacteria. J Gen Physiol 1930;14(1):31-42. doi: 10.1085
/jgp.14.1.31.
15. Harris FI, Hoyt HS. The possible origin of the toxicity of ultra-violet light. Science 1917; 46(1187):318-20. doi: 10.1126/science.46.1187.318.
16. Beukers R, Berends W. Isolation and identification of the irradiation product of thymine. Biochim Biophys Acta 1960;41:550-1. doi: 10.1016/0006-3002(60)90063-9.
17. Flügge C. Ueber Luftinfektion. Z Hyg Infectionskr 1897;25:179-224.
18. Wells WF. On air-borne infection: study II. Droplets and droplet nuclei. Am J Hyg 1934;20:611-8.
19. Wells WF, Fair MG. Viability of B. coli exposed to ultra-violet radiation in air. Science 1935; 82(2125):280-1. doi: 10.1126/science.82.2125.280-a.
20. Sharp DG. A quantitative method of determining the lethal effect of ultraviolet light on bacteria suspended in air. J Bacteriol 1938;35:589-99. doi: 10.1128/jb.35.6.589-599.1938.
21. Sharp DG. The effects of ultraviolet light on bacteria suspended in air. J Bacteriol 1940;39:535-47. doi: 10.1128
/jb.39.5.535-547.1940.
22. Hart D. Sterilization of the air in the operating room by special bactericidal radiant energy: results of its use in extra-pleural thoracoplasties. J Thorac Surg 1936;6:45-81. doi: 10.1016/S0096-5588(20)32445-4.
23. Hart D. Bactericidal ultraviolet radiation in the operating room: twenty-nine-year study for control of infections. JAMA 1960;172:1019-28. doi: 10.1001/jama
.1960.03020100027006.
24. Overholt RH, Betts RH. A comparative report on infection of thoracoplasty wounds: experiences with ultraviolet irradiation of operating room air. J Thorac Surg 1940;9:520-9. doi: 10.1016/S0096-5588(20)32260-1.
25. Kraissl CJ, Cimiotti JG, Meleney FL. Considerations in the use of ultraviolet radiation in operating rooms. Ann Surg 1940;111:161-85. doi: 10.1097/00000658-194002000
-00001.
26. Woodhall B, Neill RG, Dratz HM. Ultraviolet radiation as an adjunct in the control of postoperative neurosurgical infection. II clinical experience 1938–1948. Ann Surg 1949;129:820-4.
27. Goldner JL, Moggio M, Beissinger SF, McCollum DE. Ultraviolet light for the control of airborne bacteria in the operating room. Ann N Y Acad Sci 1980;353:271-84. doi: 10.1111/j.1749-6632.1980.tb18930.x.
28. Lowell JD, Kundsin RB, Schwartz CM, Pozin D. Ultraviolet radiation and reduction of deep wound infection following hip and knee arthroplasty. Ann N Y Acad Sci 1980;353:
285-93. doi: 10.1111/j.1749-6632.1980.tb18931.x.
29. Luckiesh M. Applications of germicidal, erythemal, and infrared energy. New York: D. Van Nostrand Company; 1946. doi: 10.1093/ptj/27.3.204b.
30. Harstad JB, Decker HM, Wedum AG. Use of ultraviolet irradiation in a room air conditioner for removal of bacteria. Appl Microbiol 1954;2:148-51. doi: 10.1128/am.2.3
.148-151.1954.
31. Miller OT, Schmitt RF, Phillips GB. Applications of germicidal ultraviolet in infectious disease laboratories: I. Sterilization of small volumes of air by ultraviolet irradiation. Am J Public Health Nations Health 1955;45:1420-3. doi: 10.2105/ajph.45.11.1420.
32. Wells WF. Airborne Contagion and Air Hygiene: An Ecological Study of Droplet Infections. Ed Harvard University; 1955:1-423. doi: 10.1093/ajcp/25.11.1301.
33. Nardell EA. Transmission and safety issues. In: Friedman LN, editor. Tuberculosis: current concepts and treatment. Boca Raton (FL): CRC Press; 1994:53-70.
34. Riley RL, O’Grady F. Airborne infection: transmission and control. New York: The Macmillan Company; 1961.
35. Riley RL, Wells WF, Mills CC, Nyka W, McLean RL. Air hygiene in tuberculosis: quantitative studies of infectivity and control in a pilot ward. Am Rev Tuberc 1957;75:
420-31. doi: 10.1164/artpd.1957.75.3.420.
36. McLean RL. The mechanism of spread of Asian influenza: general discussion. Am Rev Respir Dis 1961(2 Pt 2);83:36-8.
37. Riley RL, Permutt S. Room air disinfection by ultraviolet irradiation of upper air: air mixing and germicidal effectiveness. Arch Environ Health 1971;22:208-19. doi: 10.1080/00039896.1971.10665834.
38. Riley RL, Permutt S, Kaufman JE. Convection, air mixing, and ultraviolet air disinfection in rooms. Arch Environ Health 1971;22:200-7. doi: 10.1080/00039896.1971.10665833.
39. Riley RL, Permutt S, Kaufman JE. Room air disinfection by ultraviolet irradiation of upper air: further analysis of convective air exchange. Arch Environ Health 1971;23:35-9. doi: 10.1080/00039896.1971.10665951.
40. Riley RL, Nardell EA. Clearing the air: the theory and application of ultraviolet air disinfection. Am Rev Repir Dis 1989;139:1286-94. doi: 10.1164/ajrccm/139.5.1286.
41. Wells MW. Ventilation in the spread of chickenpox and measles within school rooms. JAMA 1945;129:197-200. doi:10.1001/jama.1945.02860370019006.
42. Perkins JE, Bahlke AM, Silverman HF. Effect of ultra-violet irradiation of classrooms on spread of measles in large rural central schools: preliminary report. Am J Public Health Nations Health 1947;37:529-37.
43. Brooks GL, Wilson U, Blackfan KD. Studies of cross--infection in the infants’ hospital in Boston. In: Moulton FR, editor. Aerobiology (Publication of the American Association for the Advancement of Science, No. 17). Washington: AAAS; 1942:228-32.
44. Schneiter R, Hollaender A, Caminita BH, et al. Effectiveness of ultraviolet irradiation of upper air for the control of bacterial air contamination in sleeping quarters. Preliminary report. Am J Hyg 1944;40:136-53. doi: 10.1093/oxfordjournals.aje.a118981.
45. duBuy HG, Dunn JE, Brackett FS, Dreessen WC, Neal PA, Posner I. An evaluation of ultraviolet radiation of sleeping quarters as supplement of accepted methods of disease control. Am J Hyg 1948;48:207-26. doi: 10.1093
/oxfordjournals.aje.a119236.
46. Kingston D, Lidwell OM, Williams RE. The epidemiology of the common cold: III. The effect of ventilation, air disinfection and room size. J Hyg (Lond) 1962;60:341-52. doi: 10.1017/s0022172400020453.
47. Lidwell OM. Ultraviolet radiation and the control of airborne contamination in the operating room. J Hosp Infect 1994;28:245-8. doi: 10.1016/0195-6701(94)90088-4.
48. Commission Internationale de l’Eclairage. Technical report: ultraviolet air disinfection (CIE 155/2003). Vienna:
CIE; 2003.
49. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep 2005;54(RR17):1-141.
50. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities, 1994. MMWR Recomm Rep 1994;43(RR-13):1-132.
51. Centers for Disease Control and Prevention (US). Environmental control for tuberculosis: basic upper-room ultraviolet germicidal irradiation guidelines for healthcare settings. Atlanta: CDC, National Institute for Occupational Safety and Health (US); 2009. DHHS (NIOSH) Publication No. 2009-105.
52. Escombe AR, Moore DAJ, Gilman RH, et al. Upper-room ultraviolet light and negative air ionization to prevent tuberculosis transmission. PLoS Med 2009;6:e43. doi: 10.1371/journal
.pmed.1000043.
53. Yıldırım G, Kılıç H, Karakaş HM. The antimicrobial efficacy of shielded ultraviolet germicidal irradiation in CT rooms with intense human circulation. Diagn Interv Radiol 2021 ;27(2):293-301. doi: 10.5152/dir.2021.20688.
54. Ijaz MK, Zargar B, Wright KE, Rubino JR, Sattar SA. Generic aspects of the airborne spread of human pathogens indoors and emerging air decontamination technologies. Am J Infect Control 2016;44(Suppl 9):S109-20. doi: 10.1016/j
.ajic.2016.06.008.
55. Li Y, Leung GM, Tang JW, et al. Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review. Indoor Air 2007;17:2-18. doi: 10.1111/j.1600-0668.2006.00445.x.
56. Martinez JA, Ruthazer R, Hansjosten K, Barefoot L, Snydman DR. Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci in patients treated in a medical intensive care unit. Arch Intern Med 2003;163:1905-12. doi: 10.1001
/archinte.163.16.1905.
57. Mitchell BG, Dancer SJ, Anderson M, Dehn E. Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis. J Hosp Infect 2015;91:211-7. doi: 10.1016/j.jhin.2015.08.005.
58. Suleyman G, Alangaden G, Bardossy AC. The role of environmental contamination in the transmission of nosocomial pathogens and healthcare-associated infections. Curr Infect Dis Rep 2018;20:12. doi: 10.1007/s11908-018-0620-2.
59. Sehulster L, Chinn RY. CDC, HICPAC. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 2003;52:1-42.
60. McCullers JA, Williams BF, Wu S, et al. Healthcare-associated infections at a children’s cancer hospital, 1983-2008. J Pediatric Infect Dis Soc 2012;1:26-34. doi: 10.1093/jpids/pis034.
61. Sung MK, Kato S. Estimating the germicidal effect of upper-room UVGI system on exhaled air of patients based on ventilation efficiency. Build Environ 2011;46:2326-32. doi: 10.1016/j.buildenv.2011.05.015.
62. Ethington T, Newsome S, Waugh J, Lee LD. Cleaning the air with ultraviolet germicidal irradiation lessened contact infections in a long-term acute care hospital. Am J Infect Control 2018;46:482-6. doi: 10.1016/j.ajic.2017.11.008.
63. Guimera D, Trzil J, Joyner J, Hysmith ND. Effectiveness of a shielded ultraviolet C air disinfection system in an inpatient pharmacy of a tertiary care children’s hospital. Am J Infect Control 2018;46:223-5. doi: 10.1016/j.ajic.2017.07.026.
64. Kane DW, Finley C, Brown D. UV-C light and infection rate in a long-term care ventilator unit. Can J Infect Control 2018;33:44-8.
65. Lee LD. Surface and air: what impact does UV-C at the room level have on airborne and surface bacteria? Can J Infect Control 2017;32:108-11.
66. Xu P, Kujundzic E, Peccia J, Schafer MP, et al. Impact of environmental factors on efficacy of upper-room air ultraviolet germicidal irradiation for inactivating airborne mycobacteria. Environ Sci Technol 2005;39:9656-64. doi: 10.1021/es0504892.
67. Wolfe RL. Ultraviolet disinfection of potable water - current technology and research needs. Environ Sci Technol 1990;24:768-72.
68. Anderson DJ, Chen LF, Weber DJ, et al. Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study. Lancet 2017;389:805-14. doi: 10.1016/S0140-6736(16)31588-4.
69. Anderson DJ, Moehring RW, Weber DJ, et al. Effectiveness of targeted enhanced terminal room disinfection on hospital wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover design (BETR Disinfection). Lancet Infect Dis 2018;18:845-53. doi: 10.1016/S1473-3099(18)30278-0.
70. El Haddad L, Ghantoji SS, Stibich M, et al. Evaluation of a pulsed xenon ultraviolet disinfection system to decrease bacterial contamination in operating rooms. BMC Infect Dis 2017;17:672. doi: 10.1186/s12879-017-2792-z.
71. Zeber JE, Pfeiffer C, Baddley JW, et al. Effect of pulsed xenon ultraviolet room disinfection devices on microbial counts for methicillin-resistant Staphylococcus aureus and aerobic bacterial colonies. Am J Infect Control 2018;46:668-73. doi: 10.1016/j.ajic.2018.02.001.
72. Lombini M, Schreiber L, Albertini R. et al. Solar Ultraviolet Light Collector for Germicidal Irradiation on the Moon. Submitted to Scientific Reports 2023.
73. Albertini R, Veronesi L, Colucci ME, Pasquarella C. The scenario of the studies on ragweed (Ambrosia Sp.) and related issues from its beginning to today: a useful tool for future goals in a one health approach. Acta Biomed 2022;93(5):e2022324. doi: 10.23750/abm.v93i5.13771.
74. Albertini R, Coluccia A, Colucci ME, et al. An overview of the studies on microbial air contamination in operating theatres and related issues over time: a useful tool for a multidisciplinary approach. Acta Biomed. 2023;94(S3):e2023149. doi: 10.23750/abm.v94iS3.14507.
75. Falagas ME, Pitsouni EI, Malietzis GA, Pappas G. Comparison of PubMed, Scopus, Web of Science, and Google Scholar: strengths and weaknesses. FASEB J 2008;22(2):338-42. doi: 10.1096/fj.07-9492LSF.
76. Scott R, Joshi LT, McGinn C. Hospital surface disinfection using ultraviolet germicidal irradiation technology: A review. Health Technol Lett 2022;9(3):25-33. doi: 10.1049
/htl2.12032.
77. Diab-El Schahawi M, Zingg W, Vos M, et al. Ultraviolet disinfection robots to improve hospital cleaning: Real promise or just a gimmick? Antimicrob Resist Infect Control 2021;12:10(1):33. doi: 10.1186/s13756-020-00878-4.
78. Kampf G, Scheithauer S, Lemmen S, Saliou P, Suchomel M. COVID-19-associated shortage of alcohol-based hand rubs, face masks, medical gloves, and gowns—proposal for a risk-adapted approach to ensure patient and healthcare worker safety. J Hosp Infect 2020;105(3):424–7. doi: 10.1016/j.jhin.2020.04.041.
79. Carling PC. Evaluating the thoroughness of environmental cleaning in hospitals. J Hosp Infect 2008;68(3):273–4. doi: 10.1016/j.jhin.2007.10.023.
80. Mehta I, Hsueh HY, Taghipour S, Li W, Saeedi S. UV Disinfection Robots: A Review. Rob Auton Syst 2023;161:104332. doi: 10.1016/j.robot.2022.104332.
81. Weber DJ, Anderson D, Rutala WA. The role of the surface environment in healthcare-associated infections. Curr Opin Infect Dis 2013;26(4):338–44. doi: 10.1097
/QCO.0b013e3283630f04.