Ceiling impact on air disinfection performance of Upper-Room Germicidal Ultraviolet (UR-GUV).

This study used Computational Fluid Dynamics (CFD) to investigate air disinfection for SARS-CoV-2 by the Upper-Room Germicidal Ultraviolet (UR-GUV), with focus on ceiling impact. The study includes three indoor settings, i.e., low (airport bus), medium (classroom) and high (rehearsal room) ceilings, which were ventilated with 100% clean air (CA case), 80% air-recirculation with a low filtration (LF case), and 80% air-recirculation with a high filtration (HF case). According to the results, using UR-GUV can offset the increased infection risk caused by air recirculation, with viral concentrations in near field (NF) and far field (FF) in the LF case similar to those in the CA case. In the CA case, fraction remaining (FR) was 0.48-0.73 with 25% occupancy rate (OR) and 0.49-0.91 with 45% OR in the bus, 0.41 in NF and 0.11 in FF in the classroom, and 0.18 in NF and 0.09 in FF in the rehearsal room. Obviously, UR-GUV performance in NF can be improved in a room with a high ceiling where FR has a power relationship with UV zone height. As using UR-GUV can only extend the exposure time to get infection risk of 1% (T 1% ) to 8 min in NF in the classroom, and 47 min in NF in the rehearsal room, it is necessary to abide by social distancing in the two rooms. In addition, T 1% in FF was calculated to be 18.3 min with 25% OR and 21.4% with 45% OR in the airport bus, showing the necessity to further wear a mask.

Toward a Test Protocol for Surface Decontamination Using a Mobile Whole-room UVGI Device†.

Mobile whole-room UVGI devices are used in healthcare settings to control surface-borne pathogens. Unfortunately, no standard method comparing the efficacy of these devices is available. We accessed the effect of shadows on UVC 254 nm inactivation. The evaluation of a mobile whole-room UVGI device used spores of Bacillus atrophaeus as a surrogate for Clostridium difficile and Staphylococcus aureus as a surrogate for MSRA. Inactivation after 10 min of exposure varied significantly depending on whether the spores received direct UV exposure (4.3 log reduction), both direct and reflected UV exposure (3.0-4.0 log reduction) or reflected UV exposure alone (<1.0 log reduction). The susceptibility (z-value) for inactivation of B. atrophaeus spores on a glass surface was estimated to be 0.00312 m2  J-1 . Staphylococcus aureus microbial log reductions were approximately 5.5 for direct UV exposure, 3.6-5.2 for both direct and reflected UV exposure and approximately 2.75 for only reflected UV exposure. Our measurement of reflected dose ranged from 0.46% to 1.47%. Based on our findings, B. atrophaeus spores should be considered as a model organism for testing the impact of shadows on mobile whole-room UVGI device inactivation. Optimizing the reflected component of whole-room UVGI is important, especially for UVC-resistant organisms.

Surgical reconstruction of the ossicular chain with custom 3D printed ossicular prosthesis.

BACKGROUND: Conductive hearing loss due to ossicular abnormalities occurs from many causes, including trauma, infection, cholesteatoma, surgery and congenital anomalies. Surgical reconstruction of the ossicular chain is a well-established procedure for repair of ossicular defects, but is still plagued by high failure rates. Underlying disease and proper sizing of prostheses are two challenges that lead to component failure. Three-dimensional (3D) printing has been used successfully to solve a number of medical prosthesis problems. Custom 3D printing an individualized ossicular prosthesis would be a potential solution for the wide range of anatomic variation encountered in the pathological middle ear, and could decrease the rate of post-operative prosthesis displacement by increasing the likelihood of a proper fit, in addition to decreasing surgical time.In this study, the incus was removed from three formalin-fixed cadaveric human temporal bones with no macro- or microscopic evidence of pathology. Imaging of the cadaveric bone was obtained using a standard temporal bone CT protocol. A custom prosthesis for each cadaveric human temporal bone was designed using the Mimics Innovation Suite software (Materialise, Belgium) and fabricated on a Form2 3D printer (FormLabs, Somerville, Massachusetts). Four surgeons then performed insertion of each prosthesis into each middle ear, blinded to the bone from and for which each was designed. The surgeons were asked to match each prosthesis to its correct parent bone. RESULTS: Each prosthesis had unique measurements. Each of the four surgeons was able to correctly match the prosthesis model to its intended temporal bone. The chances of this occurring randomly are 1:1296. CONCLUSIONS: A custom 3D printed ossicular prosthesis is a viable solution for conductive hearing loss due to ossicular chain defects. Commercially available CT scanners can detect significant anatomic differences in normal human middle ear ossicles. These differences can be accurately represented with current 3D printing technology and, more significantly, surgeons can detect these differences.

Numerical Modeling of Indoor Environment with a Ceiling Fan and an Upper-Room Ultraviolet Germicidal Irradiation System.

This study proposes a numerical modeling method for the indoor environment with ceiling fans and upper-room ultraviolet germicidal irradiation (UR-UVGI) fixtures. The numerical modeling deployed steady-state Computational Fluid Dynamics (CFD) with a rotating reference frame to simulate the rotation of fan blades. CFD was validated with experimental data of velocity field and fraction of microorganism remaining at the exhaust diffuser. The fraction of microorganism remaining represented the ratio of the concentration of airborne microorganisms measured with UVGI turned on to the one measured with UVGI turned off. According to the validation results, the CFD model correctly reproduced the air movement induced by the rotation of ceiling fan. When the ambient ventilation rate was 2 ACH (air changes per hour) or 6 ACH, the CFD model accurately predicted the average vertical speeds in the section 2.44 m above the floor with the errors less than 10%, regardless of the ceiling fan's rotational direction or speed. In addition, the simulation results showed that the fraction of microorganism remaining increased with the ambient air exchange rate when the fan blew air downward with a rotational speed as high as 235 rpm, which corresponded with the experimental results. Furthermore, the simulation results accurately predicted the fraction of microorganism remaining when the ambient air exchange rate was 2 ACH. We conclude that this novel numerical model can reproduce the effects of ceiling fans and UR-UVGI fixtures on indoor environment, and should aid in the investigation of the impact of ceiling fans on UR-UVGI disinfection efficacy.

Numerical investigation of upper-room UVGI disinfection efficacy in an environmental chamber with a ceiling fan.

This study investigated the disinfection efficacy of the upper-room ultraviolet germicidal irradiation (UR-UVGI) system with ceiling fans. The investigation used the steady-state computational fluid dynamics (CFD) simulations to solve the rotation of ceiling fan with a rotating reference frame. Two ambient air exchange rates, 2 and 6 air changes per hour (ACH), and four downward fan rotational speeds, 0, 80, 150 and 235 rpm were considered. In addition, the passive scalar concentration simulations incorporated ultraviolet (UV) dose by two methods: one based on the total exposure time and average UV fluence rate, and another based on SVE3* (New Scale for Ventilation Efficiency 3), originally defined to evaluate the mean age of the air from an air supply opening. Overall, the CFD results enabled the evaluation of UR-UVGI disinfection efficacy using different indices, including the fraction of remaining microorganisms, equivalent air exchange rate, UR-UVGI effectiveness and tuberculosis infection probability by the Wells-Riley equation. The results indicated that air exchange rate was the decisive factor for determining UR-UVGI performance in disinfecting indoor air. Using a ceiling fan could also improve the performance in general. Furthermore, the results clarified the mechanism for the ceiling fan to influence UR-UVGI disinfection efficacy.

Ultraviolet germicidal irradiation safety concerns: a lesson from the Tuberculosis Ultraviolet Shelter Study: Murphy's Law affirmed.

Concerns about the safety of Ultraviolet Germicidal Irradiation (UVGI) applications on human beings have been an issue at least since the introduction of this technology for practical use in the 1930s. The resurgence of tuberculosis (TB) in the United States in the mid-1980s led to a revival of interest in UV technology, a focus that had almost disappeared because alternate means of controlling TB had inaccurately been deemed successful. These failures in TB control led to a revival of UVGI use. And with that revival grew necessary and appropriate concerns about attempts to eliminate human overexposure. For all those working in the field of UVGI, safety issues must be a concern because when UVGI fixtures are placed improperly, or precautions ignored, room occupants are placed at risk of photokeratoconjunctivitis and photodermatitis. If safety is so prominent a concern, why do incidents of UV side effects continue to occur? See Murphy's Law.

Latent tuberculosis and active tuberculosis disease rates among the homeless, New York, New York, USA, 1992-2006.

We conducted a retrospective study to examine trends in latent tuberculosis infection (LTBI) and TB disease rates among homeless persons in shelters in New York, NY, 1992-2006. Although TB case rates fell from 1,502/100,000 population to 0, a 31% LTBI rate in 2006 shows the value of identifying and treating TB in the homeless.

Safety of upper-room ultraviolet germicidal air disinfection for room occupants: results from the Tuberculosis Ultraviolet Shelter Study.

OBJECTIVES: We evaluated the safety of room occupants in the Tuberculosis Ultraviolet Shelter Study (TUSS), a double-blind, placebo-controlled field trial of upper-room ultraviolet germicidal irradiation (UVGI) at 14 homeless shelters in six U.S. cities from 1997 to 2004. METHODS: Data collection involved administering questionnaires regarding eye and skin irritation to a total of 3,611 staff and homeless study subjects. RESULTS: Among these subjects, there were 223 reports of eye or skin symptoms. During the active UV period, 95 questionnaires (6%) noted such symptoms, and during the placebo period, 92 questionnaires (6%) did so. In the 36 remaining cases, either the UV period when symptoms took place was unknown or the symptoms spanned both periods. There was no statistically significant difference in the number of reports of symptoms between the active and placebo periods. One definite instance of UV-related keratoconjunctivitis occurred, resulting from a placement of a bunk bed in a dormitory where a single bed had been used when the UV fixtures were first installed. CONCLUSIONS: These findings demonstrate that careful application of upper-room UVGI can be achieved without an apparent increase in the incidence of the most common side effects of accidental UV overexposure.

Fundamental factors affecting upper-room ultraviolet germicidal irradiation - part I. Experimental.

The objective of this research was to study the factors that relate to the effectiveness of upper-room ultraviolet germicidal irradiation for inactivating airborne microorganisms. The work was conducted in a room-sized chamber designed and furnished for investigations of this nature. Nebulized Serratia marcescens, Bacillus subtilis spores, and vaccinia virus were used as test aerosols. Most data were collected from steady-state experiments comparing the number of viable organisms in the chamber air remaining with UV lamps turned on to the number with UV lamps turned off, but some decay experiments were conducted to compare the two methods. UV power level had a strong influence but was fully effective only in the presence of air mixing that produced vigorous vertical air currents. A conclusion of the study is that an upper-room ultraviolet installation is a complex system that requires careful integration of UV luminaires, UV power, and room ventilation arrangements.

The application of ultraviolet germicidal irradiation to control transmission of airborne disease: bioterrorism countermeasure.

Bioterrorism is an area of increasing public health concern. The intent of this article is to review the air cleansing technologies available to protect building occupants from the intentional release of bioterror agents into congregate spaces (such as offices, schools, auditoriums, and transportation centers), as well as through outside air intakes and by way of recirculation air ducts. Current available technologies include increased ventilation, filtration, and ultraviolet germicidal irradiation (UVGI) UVGI is a common tool in laboratories and health care facilities, but is not familiar to the public, or to some heating, ventilation, and air conditioning engineers. Interest in UVGI is increasing as concern about a possible malicious release of bioterror agents mounts. Recent applications of UVGI have focused on control of tuberculosis transmission, but a wide range of airborne respiratory pathogens are susceptible to deactivation by UVGI. In this article, the authors provide an overview of air disinfection technologies, and an in-depth analysis of UVGI-its history, applications, and effectiveness.