A novel approach to managing facility airborne diseases: suppressing air pathogens with smoke aerosols generated from fungicide phase transition.

BACKGROUND: Environmental microorganisms are major contributors to the development and spread of disease. Chemical disinfection can inhibit pathogens and play a preventive role against diseases. In agriculture, prolonging the floating time of chemical pesticides in the air has a positive effect on the control of airborne diseases. However, the interaction of chemical pesticides with airborne pathogens is not yet known. RESULTS: Here, triazole fungicide was transformed into stable smoke aerosols in order to assess the feasibility of employing phase transition release pesticides for air disinfection. The phase transition had a minimal impact on hexaconazole (Hexa) and myclobutanil (Mycl), with their smoke formation rates remaining consistently >90%. In microscopic morphology, triadimenol (Tria) and epoxiconazole (Epox) are solid, and tebuconazole (Tebu), Hexa, Mycl and difenoconazole (Dife) are liquid. Liquid smoke has advantages over solid smoke in the inhibition of environmental pathogens. The floatability and spatial distribution of fungicide aerosol were optimized by the combination of smoke particles with different properties, so that the fungicide aerosol could meet the conditions of practical application. In practical applications, smoke exhibits a gentler deposition process at the target interface compared to spray, along with a more homogeneous distribution of fungicides. Moreover, fungicide smoke demonstrates superior control efficacy and leaves behind lower residual amounts on fruit. CONCLUSION: In conclusion, the implementation of fungicide phase transition as a smoke aerosol offers a viable approach to effectively suppress pathogen aerosols and enhance the control of airborne diseases. © 2024 Society of Chemical Industry.

Experimental evaluation of a full-scale in-duct UV germicidal irradiation system for bioaerosols inactivation.

Bioaerosols control techniques, especially ultraviolet germicidal irradiation (UVGI) are gaining attention due to increasing needs for controlling of health risk caused by airborne biocontaminants. The effectiveness of a full-scale in-duct UVGI air disinfection system was investigated. One bacterium, a wild type Escherichia coli, and three fungal spores, Penicillium aragonense, Rhodotorula glutinis, and Cladosporium sp., were selected as test organisms and their inactivation under different conditions representative of a real application in HVAC systems were investigated. The results demonstrated that inactivation of airborne E. coli by the UVGI system was extremely effective, with >99.5 % of the input E. coli inactivated at a residence time lower than 0.36 s in the disinfection section. Airborne fungal spores were less susceptible to UV irradiation than E. coli. Under same conditions, viable counts reduction of P. aragonense, R. glutinis, and Cladosporium sp. spores were 53 %, 63 % and 73 %, respectively. The effect of UV light intensity, air flowrate and relative humidity were analyzed separately. A simplified model based on redefinition of the parameters in the classical inactivation kinetic equation was used to simulate the inactivation of airborne contaminants in the in-duct system under different conditions. The results showed that the simplified model was adequate to estimate disinfection efficacy of different bioaerosols by the UVGI system which could be useful for system design. Overall, this study shows that such in-duct UVGI systems can provide significant control of bioaerosols.

Air disinfection by nanosecond pulsed DBD plasma.

Atmospheric pressure dielectric barrier discharge (DBD) plasma is an emerging and promising technique for air disinfection in public environments. Power supply is a crucial factor but it remains unclear about its impacts on the air disinfection performance of plasmas. In this work, a nanosecond (ns) pulsed power supply was applied to drive an in-duct grating-like DBD array to achieve fast single-pass air disinfection. The influence of pulse parameters and environmental factors on both the discharge characteristics and the single-pass bacterial inactivation efficiency were uncovered. At a close relative humidity (RH) level, the efficiency was dominated by the discharge power, namely, specific input energy could serve as the disinfection dose. A higher frequency, shorter pulse rising time, and suitable pulse width are preferred to obtain a higher Z value. The pulsed source was not notably superior to an alternating current source, or even worse at a low voltage frequency at the same discharge power. Airflow humidity was a predominant factor to improve the efficiency and a single-pass efficiency of ∼ 99% and a Z value of 2.2 L/J were achieved under an optimal RH of 50%-60%. This work provides fundamental knowledge of ns-pulsed DBD on discharge characteristics and air disinfection behaviors.

Evaluating the Performance of UV Disinfection across the 222-365 nm Spectrum against Aerosolized Bacteria and Viruses.

Bioaerosols play a significant role in the transmission of many infectious diseases, especially in enclosed indoor environments. Ultraviolet (UV) disinfection has demonstrated a high efficacy in inactivating microorganisms suspended in the air. To develop more effective and efficient UV disinfection protocols, it is necessary to evaluate and optimize the effectiveness of UV disinfection against aerosolized bacteria and viruses across the entire UV spectrum. In this study, we evaluated the performance of UV disinfection across the UV spectrum, ranging from 222 to 365 nm, against aerosolized bacteria and viruses, including Escherichia coli, Staphylococcus epidermidis, Salmonella enterica, MS2, P22, and Phi6. Six commonly available UV sources, including gas discharge tubes and light-emitting diodes with different emission spectra, were utilized, and their performance in terms of inactivation efficacy, action spectrum, and energy efficiency was determined. Among these UV sources, the krypton chloride excilamp emitting at a peak wavelength of 222 nm was the most efficient in inactivating viral bioaerosols. A low-pressure mercury lamp emitting at 254 nm performed well on both inactivation efficacy and energy efficiency. A UV light-emitting diode emitting at 268 nm demonstrated the highest bacterial inactivation efficacy, but required approximately 10 times more energy to achieve an equivalent inactivation level compared with that of the krypton chloride excilamp and low-pressure mercury lamp. This study provides insights into UV inactivation on bioaerosols, which can guide the development of effective wavelength-targeted UV air disinfection technologies and may significantly help reduce bioaerosol transmission in public areas.

Bactericidal efficacy of mobile ultraviolet-C disinfection devices in reducing contamination in biosafety laboratories.

INTRODUCTION: Biosafety research requires a wide range of microorganisms and thorough disinfection to prevent laboratory infection is often required. Ultraviolet-C (UV-C) exposure reduces bacterial and viral concentrations. Therefore, in this study, we aimed to evaluate the efficacy of a mobile UV-C device as a non-contact disinfection strategy. METHODOLOGY: The bactericidal efficacy of the UV-C device was determined based on log10 decreases in the relative abundances of bacterial indicators, including Escherichia coli, Staphylococcus aureus, Staphylococcus albus, and Pseudomonas aeruginosa at 0.5 and 1.0 m after irradiation for 30, 60, and 90 min. Next, the reduction of natural bacteria in air and on surface as a result of the UV-C device exposure in the laboratory were determined. RESULTS: Exposure to the UV-C disinfection device resulted in mean log10 decreases in microbial contamination of 3.55 and 5.85 following irradiation for 30 and 90 min, respectively, at a distance of 0.5 m. Further, P. aeruginosa and E. coli were the most and least sensitive to UV-C exposure, respectively. The bacterial load in air decreased by 65.53% after 60 min of irradiation, while those on surfaces decreased by 44.19% and 78.23% after 30 and 60 min of irradiation, respectively. CONCLUSIONS: The UV-C device effectively reduced bacterial load after irradiation for over 60 min. Further studies are encouraged to determine the effectiveness of the UV-C disinfection device in frequently occupied institutions, such as primary medical, health, and nursery, and its efficiency in infection control.

Quantitative Microbial Risk Assessment for Quantification of the Effects of Ultraviolet Germicidal Irradiation on COVID-19 Transmission.

Quantitative microbial risk assessment (QMRA) is presented as a tool for evaluation of the effectiveness of ultraviolet germicidal irradiation (UVGI) systems for the disinfection of indoor air. The QMRA is developed in the context of UVGI system implementation for control of SARS-CoV-2 infection and comprises submodels to address problem formulation, exposure assessment, and health effects assessment, all of which provide input to a risk characterization submodel. The model simulations indicate that UVGI systems can effectively control the risk of infection associated with SARS-CoV-2 for low to moderate virus emission rates. The risk of disease transmission is strongly influenced by the rate of pathogen emission by an infected individual, the output power of UVGI fixtures and their configuration, the source of UV-C radiation implemented in the UVGI fixtures, and the characteristics of the heating, ventilation, and air conditioning (HVAC) system. The QMRA framework provides a quantitative link between UVGI/HVAC system characteristics and changes in the risk of disease transmission. The framework can be adapted to other airborne pathogens and provides a rational basis for the design, testing, and validation of UVGI systems.

Effect of forceful suction and air disinfection machines on aerosol removal.

BACKGROUNDS: Dental procedures involving drilling and grinding can produce a significant amount of suspended aerosol particles (PM) and bioaerosols. This study aims to analyze the size and concentration of aerosol particles generated during drilling and to investigate the effectiveness of two air exchange systems, namely forceful suction (FS) and air disinfection machines (DM), in removing PM. METHODS: For this study, 100 extracted permanent teeth were collected and divided into three groups: without suction (n = 50), suction with forceful suction (n = 25), and suction with air disinfection machines (n = 25). The removal rate of suspended aerosol particles was analyzed using particle counters and air data multimeter. RESULTS: When drilling and grinding were performed without vacuum, 0.75% of the aerosol particles generated were PM2.5-10, 78.25% of total suspended aerosol particles (TSP) were PM2.5, and 98.68% of TSP were PM1. The nanoanalyzer measurements revealed that the aerodynamic diameter of most aerosol particles was below 60 nm, with an average particle diameter of 52.61 nm and an average concentration of 2.6*1011 ultrafine aerosol particles. The air change per hour (ACH) was significantly lower in the air disinfection machines group compared to the forceful suction group. Additionally, the number of aerosol particles and mass concentration was significantly lower in the air disinfection machines group compared to the forceful suction group in terms of PM2.5 levels. However, the forceful suction group also reduced the mass concentration in PM10 level than the air disinfection machines group. CONCLUSION: In conclusion, the air exchange system can reduce the aerosol particles generated during drilling and grinding. Comparing the two air exchange systems, it was found that the air disinfection machines group reduces the number of aerosol particles and mass concentration in PM2.5 levels, while the forceful suction group reduces the mass concentration in PM10 level.

A simple and effective aerosol pathogen disinfection test for a flowing air disinfector.

Aerosol transmission is an important disease transmission route and has been especially pertinent to hospital and biosafety laboratories during the SARS-CoV-2 pandemic. The thermal resistance of airborne SARS-CoV-2 is lower than that of Bacillus subtilis spores, which are often used to test the effectiveness of SARS-CoV-2 and other pathogen disinfection methods. Herein, we propose a new method to test the disinfection ability of a flowing air disinfector (a digital electromagnetic induction air heater) using B. subtilis spores. The study provides an alternative air disinfection test method. The new test system combined an aerosol generator and a respiratory filter designed in-house and could effectively recover spores on the filter membrane at the air outlet after passing through the flowing air disinfector. The total number of bacterial spores used in the test was within the range of 5 × 105-5 × 106 colony-forming units (CFUs) specified in the technical standard for disinfection. The calculation was based on the calculation method in Air Disinfection Effect Appraisal Test in Technical Standard for Disinfection (2002 Edition). At an air speed of 3.5 m/s, we used a digital electromagnetic induction air heater to disinfect flowing air containing 4.100 × 106 CFUs of B. subtilis spores and determined that the minimum disinfection temperature was 350 °C for a killing rate of 99.99%. At 400 °C, additional experiments using higher spore concentrations (4.700 × 106 ± 1.871 × 105 CFU) and a higher airspeed (4 m/s) showed that the killing rate remained>99.99%. B. subtilis spores, as a biological indicator for testing the efficiency of dry-heat sterilization, were killed by the high temperatures used in this system. The proposed method used to test the flowing air disinfector is simple, stable, and effective. This study provides a reference for the development of test systems that can assess the disinfection ability of flowing air disinfectors.

Grating-like DBD plasma for air disinfection: Dose and dose-response characteristics.

Atmospheric pressure dielectric barrier discharge (DBD) plasma is an emerging technique for effective bioaerosol decontamination and is promising to be used in indoor environments to reduce infections. However, fundamental knowledge of the dose and dose-response characteristics of plasma-based disinfection technology is very limited. By examining the single-pass removal efficiency of S. lentus aerosol by in-duct grating-like DBD plasma reactors with varied discharge setups (gap distance, electrode size, number of discharge layers, frequency, dielectric material), it was found that the specific input energy (SIE) could be served as the dose for disinfection, and the efficiency was exponentially dependent on SIE in most cases. The corresponding susceptibility constants (Z values) were obtained hereinafter. Humidity was a prominent factor boosting the efficiency with a Z value of 0.36 L/J at relative humidity (RH) of 20% and 1.68 L/J at RH of 60%. MS2 phage showed a much higher efficiency of 2.66-3.08 log10 of reduction than those of S. lentus (38-85%) and E. coli (42%-95%) under the same condition. Using SIE as the dose, the performance of plasma reactors in the literature was compared and evaluated. This work provides a theoretical and engineering basis for air disinfection by plasma-based technology.

Quantifying the effectiveness of ultraviolet-C light at inactivating airborne Mycobacterium abscessus.

BACKGROUND: Mycobacterium abscessus (MABS) group are environmental organisms that can cause infection in people with cystic fibrosis (CF) and other suppurative lung diseases. There is potential for person-to-person airborne transmission of MABS among people with CF attending the same care centre. Ultraviolet light (band C, UV-C) is used for Mycobacterium tuberculosis control indoors; however, no studies have assessed UV-C for airborne MABS. AIM: To determine whether a range of UV-C doses increased the inactivation of airborne MABS, compared with no-UVC conditions. METHODS: MABS was generated by a vibrating mesh nebulizer located within a 400 L rotating drum sampler, and then exposed to an array of 265 nm UV-C light-emitting diodes (LED). A six-stage Andersen Cascade Impactor was used to collect aerosols. Standard microbiological protocols were used for enumerating MABS, and these quantified the effectiveness of UV-C doses (in triplicate). UV-C effectiveness was estimated using the difference between inactivation with and without UV-C. FINDINGS: Sixteen tests were performed, with UV-C doses ranging from 276 to 1104 µW s/cm2. Mean (±SD) UV-C effectiveness ranged from 47.1% (±13.4) to 83.6% (±3.3). UV-C led to significantly greater inactivation of MABS (all P-values ≤0.045) than natural decay at all doses assessed. Using an indoor model of the hospital environment, it was estimated that UV-C doses in the range studied here could be safely delivered in clinical settings where patients and staff are present. CONCLUSION: This study provides empirical in-vitro evidence that nebulized MABS are susceptible to UV-C inactivation.

TiO2-based photocatalyst Generated Reactive Oxygen Species cause cell membrane disruption of Staphylococcus aureus and Escherichia coli O157:H7.

Photocatalysts, including titanium dioxide (TiO2), have attracted much attention in food safety for controlling foodborne pathogens. However, the study of the photocatalytic activity on various food-surrounding media and the factors that affect the efficacy of photocatalytic inactivation is incomplete. In this study, to inactivate foodborne pathogens in food-surrounding environments, TiO2-based photocatalysts with ultraviolet A (UVA, 365 nm) and visible light (VIS, 405 nm) were employed. Three TiO2-based photocatalysts, namely, Degussa P25 TiO2, carbon-modified KRONOClean 7000® (C-TiO2), and Pt-doped Ishihara-Sangyo MPT-623 (Pt-TiO2) inactivated Staphylococcus aureus and Escherichia coli O157:H7 exposed to UVA and VIS light in both water and air samples. Among them, Degussa P25 under UVA showed the highest bactericidal effects in both water and air treatments, which induced 5.19 log reductions in S. aureus when treated for 11.68 J/cm2, and E. coli O157:H7 was reduced by more than 6.21 log for 1.32 J/cm2 in the water sample. For air treatment, the combination of Degussa P25 and UVA achieved 3.45 and 3.28 log reductions for Staphylococcus aureus and E. coli O157:H7, respectively, in a developed laboratory-scale chamber for 1 h and 20.02 J/cm2. Scavenger assays showed that regardless of the photocatalyst and wavelength used, reactive oxygen species (ROS) generation causes cell membrane disruption of foodborne pathogens. However, the types of ROS that are generated vary among the photocatalysts and are related to different bactericidal efficacies. These results indicated that TiO2-based photocatalytic activity can be used to control microbiological hazards in various environments in the food industry.

The Effectiveness of Ultraviolet-C (UV-C) Irradiation on the Viability of Airborne Pseudomonas aeruginosa.

Pseudomonas aeruginosa (Pa) is the predominant bacterial pathogen in people with cystic fibrosis (CF) and can be transmitted by airborne droplet nuclei. Little is known about the ability of ultraviolet band C (UV-C) irradiation to inactivate Pa at doses and conditions relevant to implementation in indoor clinical settings. We assessed the effectiveness of UV-C (265 nm) at up to seven doses on the decay of nebulized Pa aerosols (clonal Pa strain) under a range of experimental conditions. Experiments were done in a 400 L rotating sampling drum. A six-stage Andersen cascade impactor was used to collect aerosols inside the drum and the particle size distribution was characterized by an optical particle counter. UV-C effectiveness was characterized relative to control tests (no UV-C) of the natural decay of Pa. We performed 112 tests in total across all experimental conditions. The addition of UV-C significantly increased the inactivation of Pa compared with natural decay alone at all but one of the UV-C doses assessed. UV-C doses from 246-1968 µW s/cm2 had an estimated effectiveness of approximately 50-90% for airborne Pa. The effectiveness of doses ≥984 µW s/cm2 were not significantly different from each other (p-values: 0.365 to ~1), consistent with a flattening of effectiveness at higher doses. Modelling showed that delivering the highest dose associated with significant improvement in effectiveness (984 µW s/cm2) to the upper air of three clinical rooms would lead to lower room doses from 37-49% of the 8 h occupational limit. Our results suggest that UV-C can expedite the inactivation of nebulized airborne Pa under controlled conditions, at levels that can be delivered safely in occupied settings. These findings need corroboration, but UV-C may have potential applications in locations where people with CF congregate, coupled with other indoor and administrative infection control measures.

Double-Grafted PET Fiber Material to Remove Airborne Bacteria with High Efficiency.

Air pollution caused by bacteria and viruses has posed a serious threat to public health. Commercial air purifiers based on dense fibrous filters can remove particulate matter, including airborne pathogens, but do not kill them efficiently. Here, we developed a double-grafted antibacterial fiber material for the high-efficiency capture and inactivation of airborne microorganisms. Tetracarboxyl phthalocyanine zinc, a photosensitizer, was first grafted onto the polyester (PET) fiber, followed by coating with chitosan on the surface of PET fiber to make a double-grafted fiber material. Under the irradiation of light with a specific wavelength (680 nm), double-grafted fiber materials killed up to 99.99% of Gram-positive bacteria and Gram-negative bacteria and had a significant antibacterial effect on drug-resistant bacteria. The double-grafted PET fiber showed broad-spectrum antibacterial activities and was capable to inactivate drug-resistant bacteria. Notably, in filtration experiments for airborne bacteria, this double-grafted PET fiber demonstrated a high bacteria capture efficiency (95.68%) better than the untreated PET fiber (64.87%). Besides, the double-grafted PET fiber was capable of efficiently killing airborne bacteria. This work provides a new idea for the development of air filtration materials that can efficiently kill airborne pathogen and has good biosafety.

In-duct grating-like dielectric barrier discharge system for air disinfection.

In the context of spreading Coronavirus disease 2019 (COVID-19), the combination of heating, ventilation, and air-conditioning (HVAC) system with air disinfection device is an effective way to reduce transmissible infections. Atmospheric-pressure non-equilibrium plasma is an emerging technique for fast pathogen aerosol abatement. In this work, in-duct disinfectors based on grating-like dielectric barrier discharge (DBD) plasmas with varied electrode arrangements were established and evaluated. The highest airborne bacterial inactivation efficiency was achieved by 'vertical' structure, namely when aerosol was in direct contact with the discharge region, at a given discharge power. For all reactors, the efficiency was linearly correlated to the discharge power (R2 =0.929-0.994). The effects of environmental factors were examined. Decreased airflow rates boosted the efficiency, which reached 99.8% at the velocity of 0.5 m/s with an aerosol residence time of ~3.6 ms. Increasing humidity (relative humidity (RH)=20-60%) contributed to inactivation efficacy, while high humidity (RH=70%-90%) led to a saturated efficiency, possibly due to the disruption of discharge uniformity. As suggested by the plasma effluent treatment and scavenger experiments, gaseous short-lived chemical species or charged particles were concluded as the major agents accounting for bacterial inactivation. This research provides new hints for air disinfection by DBD plasmas.

A Systematic Literature Review of Indoor Air Disinfection Techniques for Airborne Bacterial Respiratory Pathogens.

Interrupting the transmission of airborne (<≈5 µm) respiratory pathogens indoors is not a new challenge, but it has attracted unprecedented interest due to the COVID-19 pandemic during 2020-2021. However, bacterial respiratory pathogens with known or potential airborne transmission account for an appreciable proportion of the communicable disease burden globally. We aimed to systematically review quantitative, laboratory-based studies of air disinfection techniques for airborne respiratory bacteria. Three databases (PubMed, Web of Science, Scopus) were searched, following PRISMA guidelines. A total of 9596 articles were identified, of which 517 were assessed in detail and of which 26 met the inclusion and quality assessment criteria. Seven air disinfection techniques, including UV-C light, filtration, and face masks, among others, were applied to 13 different bacterial pathogens. More than 80% of studies suggested that air disinfection techniques were more effective at inactivating or killing bacteria than the comparator or baseline condition. However, it was not possible to compare these techniques because of methodological heterogeneity and the relatively small number of the studies. Laboratory studies are useful for demonstrating proof-of-concept and performance under controlled conditions. However, the generalisability of their findings to person-to-person transmission in real-world settings is unclear for most of the pathogens and techniques we assessed.

Unani medicinal herbs as potential air disinfectants: an evidence-based review.

OBJECTIVES: Indoor air quality has a significant impact on our health and quality of life, as people spends 80-90% of their time indoors. Fumigation of several medicinal herbs has been recommended by Unani scholars to improve air quality, but their efficacy in air purification is still unknown. Hence, this article aims to discuss the applicability of proposed medicinal herbs in the light of current researches. METHODS: A manual literature survey of classical Unani texts was conducted to collect information about the herbs recommended for air purification. In addition, research databases such as PubMed, Google Scholar, and ScienceDirect were extensively searched for evidence on the efficacy and mechanism of action of the suggested herbs in air purification. RESULTS: In classical Unani texts, authors have found descriptions of 26 herbs that have been recommended for improving air quality. In-vitro studies have confirmed the antimicrobial activity of 19 of these herbs. Moreover, the efficacy of Styrax benzoin, Commiphora myrrha and Acorus calamus fumigation on aerial microbes have also been validated by studies. CONCLUSIONS: The findings of the literature review clearly demonstrated that the herbs recommended by Unani scholars for air purification have broad-spectrum antimicrobial activity, indicating that these herbs could be a potential candidate for air disinfectant. Therefore, authors recommend the further researches on proposed herbs to validate their efficiency against airborne pathogens in the vapour phase.

Wind of change: Better air for microbial environmental control.

Background: The COVID19 epidemic highlighted the importance of air in the transmission of pathogens. Air disinfection is one of the key points to reduce the risk of transmission both in the health sector and in public, civil and industrial environments. All bacteria and viruses tested to date can be inactivated by UV-C rays. Laboratory tested UV-C systems are increasingly popular and proposed as effective technologies for air purification; few studies have evaluated their performance in populated indoor environments. The aim of this investigation was to evaluate the effectiveness of a UV-C disinfection system for air in a real working context. Methods: This experimental study was conducted between December 2020 and February 2021 in an office of the Department of Molecular and Developmental Medicine of the University of Siena, Italy. A pre-final version air purifier (Cleaning Air T12), capable of treating 210 m3/h of air, was first tested for its ability to filter particulates and reduce microbial air contamination in the absence of people. Subsequently, the experiments were conducted in the presence of 3-5 subjects who worked for several hours in an office. During the tests, microbiological samples of air were collected in real time, switching the system on and off periodically. Air samples were collected and incubated on Petri dishes at 36 °C and 22 °C. Statistical analysis was performed with Stata 16 software assuming a significance level of 95%. An interpolating model was identified to describe the dynamics of contamination reduction when the device operates. Results: Preliminary tests showed a significant 62.5% reduction in Colony-Forming Units (CFUs) with 36 °C incubation. Reductions in the particulate component were also observed. In the main test, comparison of CFU data, between the device-on phase (90 min) and the subsequent device-off phase (60 min), showed statistically significant increase (p = 0.001) of environmental contamination passing from a mean of 86.6 (65.8-107.4) to 171.1 (143.9-198.3) CFU/m3, that is a rise of about 100%. The interpolating model exhibited a good fit of CFU reduction trend with the device on. Conclusions: The system, which mainly uses UV-C lamps for disinfection, was able to significantly reduce environmental and human contamination in real time. Experimental tests have shown that as soon as the device is switched off, after at least half an hour of operation, the healthiness of the air decreases drastically within 10 minutes, bringing the airborne microbial contamination (induced by the presence of operators in the environment) to levels even higher than 150% of the last value with the device on. Re-engineering strategies for system improvement were also discussed.

Evaluation of multiple fixed in-room air cleaners with ultraviolet germicidal irradiation, in high-occupancy areas of selected commercial indoor environments.

The use of ultraviolet germicidal irradiation (UVGI) to combat disease transmission has come into the international spotlight again because of the recent SARS-CoV-2 pandemic and ongoing outbreaks of multidrug resistant organisms in hospitals. Although the implementation of ultraviolet disinfection technology is widely employed in healthcare facilities and its effectiveness has been repeatedly demonstrated, the use of such technology in the commercial sector has been limited. Considering that most disease transmission occurs in commercial, public, and residential indoor environments as opposed to healthcare facilities, there is a need to understand whether ultraviolet (UV) disinfection technology can be effective for mitigating disease transmission in these environments. The results presented here demonstrate that the installation of fixed in-room UVGI air cleaners in commercial buildings, including restaurants and offices, can produce significant reductions in both airborne and surface-borne bacterial contamination. Total airborne reductions after UV implementation at six separate commercial sites averaged 73% (p < 0.0001) with a range of 71-88%. Total non-high touch surface reductions after implementation averaged 55% (p < 0.0001) with a range of 28-88%. All reductions at the mitigated sites were statistically significant. The mean value of indoor airborne bacteria was 320 CFU/m3 before intervention and 76 CFU/m3 after. The mean value of indoor non-high touch surface borne bacteria was 131 CFU/plate before intervention and 47 CFU/plate after. All test locations and controls had their required pandemic cleaning procedures in place for pre- and post-sampling events. Outdoor levels of airborne bacteria were monitored and there was no significant correlation between the levels of airborne bacteria in the outside air as opposed to the indoor air. Rooms with fixed in-room UVGI air cleaners installed had significant CFU reductions on local surface contamination, which is a novel and important finding. Installation of fixed in-room UVGI air cleaners in commercial buildings will decontaminate the indoor environment and reduce hazardous exposure to human pathogens.

Effectiveness Between Daily and After-Each-Case Room Disinfection of the Endoscopy Unit.

Background: To evaluate the effectiveness between daily and after-each-case room disinfection in the endoscopy unit. Methods: This study was conducted in an endoscopy unit of the First Affiliation of Zhejiang Chinese Medical University. We cultured samples from the surface of endoscopy unit items, including operation unit air, isolation gown of an endoscopist, control panel buttons, workstation mouse, and the bed head of the patient. All the samples were divided into daily and after-each-case room disinfection groups. In addition, each group was subdivided into sedation and nonsedation gastroscopy with and without ventilation room groups. Results: The qualified rate of bed head samples of the patient were lower in the daily room disinfection group (76.67%) compared with the after-each-case group (100%). The isolation gown, mouse at the workstation, and the bed head of the patient demonstrated the lowest bacterial and fungal load in the after-each-case room disinfection group compared with the daily room disinfection group (p < 0.05). In the subgroup analysis, a higher microbial load was observed for the isolation gown of the endoscopist used during nonsedation gastroscopy in an unventilated room under the after-each-case room disinfection pattern (p < 0.05); a higher microbial load was observed for the control panel buttons used during nonsedation gastroscopy under the after-each-case room disinfection pattern (p < 0.05). Conclusions: For risk-free or low-risk patients, daily room disinfection provides the basic health requirements of the endoscopy procedure. However, it is better to adopt the after-each-case room disinfection for the isolation gown of the endoscopist and bed head of the patient. For the patients with high risk, the after-each-case room disinfection is more suitable for every endoscopy unit (www.ClinicalTrials.gov, NCT04399005).