The history of ultraviolet germicidal irradiation for air disinfection

Physiological and Molecular Response Modifications by Ultraviolet-C Radiation in Plutella xylostella and Its Compatibility with Cordyceps fumosorosea

Ultraviolet-C (UV-C) radiation significantly impacts living organisms. UV-C radiation can also be used as a pest management tool. Therefore, this study was designed to investigate the effect of UV-C radiation on the physiology and gene expression level of Plutella xylostella, a destructive vegetable pest. Results showed that, after exposure to UV-C radiation for 3, 6, 12, and 24 h, the activity of SOD (superoxide dismutase) and CAT (catalase) of P. xylostella increased, while the activity of PPO (polyphenol oxidase), POD (peroxidase), AChE (acetylcholinesterase), CarE (carboxylesterase), and ACP (acid phosphatase) decreased with increased exposure time. Correlation coefficient analyses indicated that the activity of CAT correlated positively, while PPO and CarE correlated negatively, with exposure time. Gene regulation analysis via qRT-PCR confirmed a significant increase in regulation in CAT, CarE, and PPO-related genes. We also investigated the effect of UV-C exposure on the virulence of Cordyceps fumosorosea against P. xylostella. Here, results indicated that when the fungal treatment was applied to larvae before UV-C radiation, the virulence of C. fumosorosea was significantly reduced. However, this decline in virulence of C. fumosorosea due to UV-C exposure remained only for one generation, and no effect was observed on secondary infection. On the other hand, when larvae were exposed to UV-C radiation before fungal application, the mortality rate significantly increased as the exposure time to UV-C radiation increased. From the current study, it could be concluded that UV-C exposure suppressed the immunity to P. xylostella, which later enhanced the virulence of entomopathogenic fungi. Moreover, the study also suggested that UV irradiation is an effective pest management tool that could be incorporated into pest management strategies, which could help reduce pesticide application, be economically beneficial for the farmer, and be environmentally safe.

A review of facilities management interventions to mitigate respiratory infections in existing buildings

The Covid-19 pandemic reveals that the hazard of the respiratory virus was a secondary consideration in the design, development, construction, and management of public and commercial buildings. Retrofitting such buildings poses a significant challenge for building owners and facilities managers. This article reviews current research and practices in building operations interventions for indoor respiratory infection control from the perspective of facilities managers to assess the effectiveness of available solutions. This review systematically selects and synthesises eighty-six articles identified through the PRISMA process plus supplementary articles identified as part of the review process, that deal with facilities' operations and maintenance (O&M) interventions. The paper reviewed the context, interventions, mechanisms, and outcomes discussed in these articles, concluding that interventions for respiratory virus transmission in existing buildings fall into three categories under the Facilities Management (FM) discipline: Hard services (HVAC and drainage system controls) to prevent aerosol transmissions, Soft Services (cleaning and disinfection) to prevent fomite transmissions, and space management (space planning and occupancy controls) to eliminate droplet transmissions. Additionally, the research emphasised the need for FM intervention studies that examine occupant behaviours with integrated intervention results and guide FM intervention decision-making. This review expands the knowledge of FM for infection control and highlights future research opportunities.

Design of a COVID-19 treatment facility in a sustainable health-care environment

Due to the recent pandemic situation that has erupted all around us, healthcare facility design is a must. Healthcare providers and administrators must concentrate on the changes that must be made in existing healthcare facilities. The isolated healthcare facilities are essential because the corona virus is spread mainly through close contact (within six feet), such as handshaking (if someone's hands are infected) or touching contaminated surfaces. Healthcare facilities are most susceptible to the spread of the corona virus due to the high number of symptomatic patients admitted. Coronavirus is the leading cause of infectious disease morbidity and mortality worldwide. Thus, if the pandemic situation worsens, new plans and designs for existing healthcare facilities will be required, as well as temporary versions. Societal gains from increased research in this area. In the coming years, healthcare workers will be better trained, and healthcare facilities will be upgraded. This paper proposes new plans and designs to address the issues raised.

Efficacy of single pass UVC air treatment for the inactivation of coronavirus, MS2 coliphage and Staphylococcus aureus bioaerosols

There is strong evidence that SARS-CoV-2 is spread predominantly by airborne transmission, with high viral loads released into the air as respiratory droplets and aerosols from the infected subject. The spread and persistence of SARS-CoV-2 in diverse indoor environments reinforces the urgent need to supplement distancing and PPE based approaches with effective engineering measures for microbial decontamination - thereby addressing the significant risk posed by aerosols. We hypothesized that a portable, single-pass UVC air treatment device (air flow 1254 L/min) could effectively inactivate bioaerosols containing bacterial and viral indicator organisms, and coronavirus without reliance on filtration technology, at reasonable scale. Robust experiments demonstrated UVC dose dependent inactivation of Staphylococcus aureus (UV rate constant (k) = 0.098 m²/J) and bacteriophage MS2, with up to 6-log MS2 reduction achieved in a single pass through the system (k = 0.119 m²/J). The inclusion of a PTFE diffuse reflector increased the effective UVC dose by up to 34% in comparison to a standard Al foil reflector (with identical lamp output), resulting in significant additional pathogen inactivation (1-log S. aureus and MS2, p < 0.001). Complete inactivation of bovine coronavirus bioaerosols was demonstrated through tissue culture infectivity (2.4-log reduction) and RT-qPCR analysis - confirming single pass UVC treatment to effectively deactivate coronavirus to the limit of detection of the culture-based method. Scenario-based modelling was used to investigate the reduction in risk of airborne person-to-person transmission based upon a single infected subject within the small room. Use of the system providing 5 air changes per hour was shown to significantly reduce airborne viral load and maintain low numbers of RNA copies when the infected subject remained in the room, reducing the risk of airborne pathogen transmission to other room users. We conclude that the application of single-pass UVC systems (without reliance on HEPA filtration) could play a critical role in reducing the risk of airborne pathogen transfer, including SARS-CoV2, in locations where adequate fresh air ventilation cannot be implemented.

Photocatalytic oxidation conveyor "PCOC" system for large scale surface disinfection

In this paper, we present a surface decontamination system that substitutes traditional chemicals and scrubbing agents, which will be useful for the general public during a pandemic. The technique is based on a hybrid process in which UV-C light and its photons interact with metal oxide nano-catalysts to generate hydroxyl radicals, which can enhance the deactivation process, and the system can work even in the shadow regions via a dry process. The optimum number of UV light sources in combination with TiO₂ nanoparticles catalysts on aluminum plates have been used synergistically in the system. The UV dose in the disinfection chamber has been optimized, which is between 60 and 500 mJ/cm² throughout the disinfection chamber. The concentration of hydroxyl radicals is reported more than 25 000 ions/cm³ within the disinfection chamber. These ions are circulated throughout the disinfection volume. The disinfection efficiency has been tested on bacteria and spores, and the obtained results are correlated. Around 8 log reductions in the counts of the test bacteria of Escherichia coli and Klebsiella pneumoniae have been achieved in just 2 min of exposure in the continuous operation of the system. Tests have also been performed on Geobacillus stearothermophilus spores, and the method described here is the result of multiple tests, a review of the scientific literature, and the incorporation of current laboratory practice. The deactivation tested in the system is larger than that of known bacteria and viruses in terms of UV-doses, signifying its utility during the pandemic.

Improving the air quality with Functionalized Carbon Nanotubes: Sensing and remediation applications in the real world

With the world developing exponentially every day, the collateral damage to air is incessant. There are many methods to purify the air but using carbon nanotubes (CNTs) as adsorbents remains one of the most efficient and reliable methods, due to their high maximum adsorption capacity which renders them extremely useful for removing pollutants from the air. The different types of CNTs, their synthesis, functionalization, purification, functioning, and advantages over conventional filters are deliberated along with diverse types of CNTs like single-walled (SWCNTs), multiwalled (MWCNTs), and others, which can be functionalized and deployed for the removal of harmful gases like oxides of nitrogen and sulphur, and ozone, and volatile organic compounds (VOCs), among others. A comprehensive description of CNTs is provided in this overview with illustrative examples from the past five years. The fabrication methods and target gases of many CNTs-based gas sensors are highlighted, in addition to the comparison of their properties, mainly sensitivity. The effect of functionalization on sensors has been discussed in detail for various composites targeting specific gases, including the future outlook of functionalized CNTs in assorted practical applications.

Efficacy of common disinfection processes against infective spores (arthroconidia) and mycelia of Microsporum gallinae causing avian dermatophytosis

Background and Aim:

Microsporum gallinae is the major dermatophyte species that causes avian dermatophytosis. Disinfection plays an important role in controlling and preventing dermatophytosis; however, information about the effect of common disinfection processes on M. gallinae is limited. This study aimed to investigate the disinfection efficacy of ultraviolet (UV) irradiation, heat treatment, detergents, and germicides against infective spores (arthroconidia) and vegetative mycelia of M. gallinae.

Materials and Methods:

The minimum inhibitory and minimum fungicidal concentrations of benzalkonium chloride, chlorhexidine, ethanol, formaldehyde, glutaraldehyde, hydrogen peroxide, phenol, povidone-iodine, and sodium hypochlorite germicides against arthroconidia and mycelia of M. gallinae American type culture collection (ATCC) 90749 were determined by broth microdilution. Time-kill assays were used to determine the fungicidal efficacy of moist heat treatment, UV irradiation, commercially available detergents, and germicides.

Results:

There were no significant differences between the arthroconidia and mycelia growth stages of M. gallinae ATCC 90749 in the magnitude of the log₁₀ cell reductions in the number of viable fungal cells induced by the disinfection treatments (all p > 0.05). Moist heat treatment at 40°C did not reduce the number of viable fungal cells at any time (1–60 min); however, treatment at 50°C for 25 min and either 60°C or 80°C for 5 min eliminated > 99.999% of viable fungal cells. Irradiation of fungal cultures with UVC and UVB at doses higher than or equal to 0.4 and 0.8 J/cm², respectively, resulted in a 5-log₁₀ reduction in the number of viable fungal cells, whereas UVA only reduced the number of viable fungal cells by < 2-log₁₀ up to a dose of 1.6 J/cm². All the tested detergents demonstrated minimal fungicidal effects with < 1-log₁₀ reductions in the number of viable fungal cells at concentrations up to 8% w/v. All of the tested germicides eradicated the fungus after treatment for 1 min at 1–1000× minimum inhibitory concentration (MIC), except for hydrogen peroxide, which was not fungicidal after treatment for 20 min at 100× MIC.

Conclusion:

Moist heat treatment at temperatures greater than or equal to 50°C, UVC and UVB irradiation at doses higher than or equal to 0.4 and 0.8 J/cm², respectively, and treatment with all tested germicides except hydrogen peroxide can be considered effective processes for disinfecting the fungus M. gallinae from the equipment employed in poultry farming. In contrast, commercially available detergents are not suitable for use as M. gallinae disinfectants.

Characterization of a robot-assisted UV-C disinfection for the inactivation of surface-associated microorganisms and viruses

Microorganisms pose a serious threat for us humans, which is exemplified by the recent emergence of pathogens such as SARS-CoV-2 or the increasing number of multi-resistant pathogens such as MRSA. To control surface microorganisms and viruses, we investigated the disinfection properties of an AI-controlled robot, HERO21, equipped with eight 130-W low pressure UV-C mercury vapor discharge lamps emitting at a wavelength of 254 nm, which is strongly absorbed by DNA and RNA, thus inactivating illuminated microorganisms. Emissivity and spatial irradiance distribution of a single UV-C lamp unit was determined using a calibrated spectrometer and numerical simulation, respectively. The disinfection efficiency of single lamps is determined by microbiological tests using B. subtilis spores, which are known to be UV-C resistant. The required time for D₉₉ disinfection and the corresponding UV-C irradiance dose amount to 60 s and 37.3 mJ•cm⁻² at a distance of 1 m to the Hg-lamp, respectively. Spatially resolved irradiance produced by a disinfection unit consisting of eight lamps is calculated using results of one UV-C lamp characterization. This calculation shows that the UV-C robot HERO21 equipped with the mentioned UV-C unit causes an irradiance at λ=254 nm of 2.67 mJ•cm⁻²•s⁻¹ at 1 m and 0.29 mJ•cm⁻²•s⁻¹ at 3 m distances. These values result in D₉₉ disinfection times of 14 s and 129 s for B. subtilis spores, respectively. Similarly, human coronavirus 229E, structurally very similar to SARS-CoV-2, could be efficiently inactivated by 3–5 orders of magnitude within 10 - 30 s exposure time or doses of 2 - 6 mJ•cm⁻², respectively. In conclusion, with the development of the HERO21 disinfection robot, we were able to determine the inactivation efficiency of bacteria and viruses on surfaces under laboratory conditions.

The impact of heating, ventilation, and air conditioning design features on the transmission of viruses, including the 2019 novel coronavirus: A systematic review of ultraviolet radiation

Respiratory viruses are capable of transmitting via an aerosol route. Emerging evidence suggests that SARS-CoV-2 which causes COVID-19 can be spread through airborne transmission, particularly in indoor environments with poor ventilation. Heating, ventilation, and air conditioning (HVAC) systems can play a role in mitigating airborne virus transmission. Ultraviolet germicidal irradiation (UVGI), a feature that can be incorporated into HVAC systems, can be used to impede the ability of viruses to replicate and infect a host. We conducted a systematic review of the scientific literature examining the effectiveness of HVAC design features in reducing virus transmission—here we report results for ultraviolet (UV) radiation. We followed international standards for conducting systematic reviews and developed an a priori protocol. We conducted a comprehensive search to January 2021 of published and grey literature using Ovid MEDLINE, Compendex, and Web of Science Core. Two reviewers were involved in study selection, data extraction, and risk of bias assessments. We presented study characteristics and results in evidence tables, and synthesized results across studies narratively. We identified 32 relevant studies published between 1936 and 2020. Research demonstrates that: viruses and bacteriophages are inactivated by UV radiation; increasing UV dose is associated with decreasing survival fraction of viruses and bacteriophages; increasing relative humidity is associated with decreasing susceptibility to UV radiation; UV dose and corresponding survival fraction are affected by airflow pattern, air changes per hour, and UV device location; and UV radiation is associated with decreased transmission in both animal and human studies. While UV radiation has been shown to be effective in inactivating viruses and reducing disease transmission, practical implementation of UVGI in HVAC systems needs to consider airflow patterns, air changes per hour, and UV device location. The majority of the scientific literature is comprised of experimental, laboratory-based studies. Further, a variety of viruses have been examined; however, there are few studies of coronaviruses and none to date of SARS-CoV-2. Future field studies of UVGI systems could address an existing research gap and provide important information on system performance in real-world situations, particularly in the context of the current COVID-19 pandemic. This comprehensive synthesis of the scientific evidence examining the impact of UV radiation on virus transmission can be used to guide implementation of systems to mitigate airborne spread and identify priorities for future research.

Trial registration PROSPERO 2020 CRD42020193968.

Does light-based tertiary treatment prevent the spread of antibiotic resistance genes? Performance, regrowth and future direction

The common occurrence of antibiotic-resistance genes (ARGs) originating from pathogenic and facultative pathogenic bacteria pose a high risk to aquatic environments. Low removal of ARGs in conventional wastewater treatment processes and horizontal dissemination of resistance genes between environmental bacteria and human pathogens have made antibiotic resistance evolution a complex global health issue. The phenomenon of regrowth of bacteria after disinfection raised some concerns regarding the long-lasting safety of treated waters. Despite the inactivation of living antibiotic-resistant bacteria (ARB), the possibility of transferring intact and liberated DNA containing ARGs remains. A step in this direction would be to apply new types of disinfection methods addressing this issue in detail, such as light-based advanced oxidation, that potentially enhance the effect of direct light interaction with DNA. This study is devoted to comprehensively and critically review the current state-of-art for light-driven disinfection. The main focus of the article is to provide an insight into the different photochemical disinfection methods currently being studied worldwide with respect to ARGs removal as an alternative to conventional methods. The systematic comparison of UV/chlorination, UV/H₂O₂, sulfate radical based-AOPs, photocatalytic processes and photoFenton considering their mode of action on molecular level, operational parameters of the processes, and overall efficiency of removal of ARGs is presented. An in-depth discussion of different light-dependent inactivation pathways, influence of DBP and DOM on ARG removal and the potential bacterial regrowth after treatment is presented. Based on presented revision the risk of ARG transfer from reactivated bacteria has been evaluated, leading to a future direction for research addressing the challenges of light-based disinfection technologies.

UV inactivation of Semliki Forest virus and bacteria by alternative light sources

The quick spreading of the SARS-CoV-2 virus, initiating the global pandemic with a significant impact on economics and health, highlighted an urgent need for effective and sustainable restriction mechanisms of pathogenic microorganisms. UV-C radiation, causing inactivation of many viruses and bacteria, is one of the tools for disinfection of different surfaces, liquids, and air; however, mainly mercury 254 nm line is commonly used for it. In this paper, we report our results of the experiments with newly elaborated special type polychromatic non-mercury UV light sources, having spectral lines in the spectral region from 190 nm to 280 nm. Inactivation tests were performed with both Escherichia coli (E.coli) bacteria and Semliki Forest virus (SFV) as a representative of human enveloped RNA viruses. In addition, the effect of prepared lamps on virus samples in liquid and dry form (dried virus-containing solution) was tested. Reduction of 4 log10 of E.coli was obtained after 10 min of irradiation with both thallium-antimony and arsenic high-frequency electrodeless lamps. High reduction results for the arsenic light source demonstrated sensitivity of E. coli to wavelengths below 230 nm, including spectral lines around 200 nm. For the Semliki Forest virus, the thallium-antimony light source showed virus inactivation efficiency with a high virus reduction rate in the range of 3.10 to > 4.99 log10 within 5 min of exposure. Thus, the new thallium-antimony light source showed the most promising disinfection effect in bacteria and viruses, and arsenic light sources for bacteria inactivation, opening doors for many applications in disinfection systems, including for pathogenic human RNA viruses.

UVC-PURGE: A Novel Cost-Effective Disinfection Robot for Combating COVID-19 Pandemic

During the COVID-19 pandemic, surface disinfection using prevailing chemical disinfection methods had several limitations. Due to cost-inefficiency and the inability to disinfect shaded places, static UVC lamps cannot address these limitations properly. Moreover, the average market price of the prevailing UVC robots is huge, approximately 55,165 USD. In this research firstly, a requirement elicitation study was conducted using a semi-structured interview approach to reveal the requirements to develop a cost-effective UVC robot. Secondly, a semi-autonomous robot named UVC-PURGE was developed based on the revealed requirements. Thirdly, a two-phased evaluation study was undertaken to validate the effectiveness of UVC-PURGE to inactivate the SARS-CoV-2 virus and the capability of semi-autonomous navigation in the first phase and to evaluate the usability of the system through a hybrid approach of SUPR-Q forms and subjective evaluation of the user feedback in the second phase. Pre-treatment swab testing revealed the presence of both Gram-positive and Gram-Negative bacteria at 17 out of 20 test surfaces in the conducted tests. After the UVC irradiation of the robot, the microbial load was detected in only 2 (1D and 1H) out of 17 test surfaces with significant reductions (95.33% in 1D and 90.9% in 1H) of microbial load. Moreover, the usability evaluation yields an above-average SUPR-Q score of 81.91% with significant scores in all the criteria (usability, trust, loyalty, and appearance) and the number of positive themes from the subjective evaluation using thematic analysis is twice the number of negative themes. Additionally, compared with the prevailing UVC disinfection robots in the market, UVC-PURGE is cost-effective with a price of less than 800 USD. Moreover, small form factor along with the real time camera feedback in the developed system helps the user to navigate in congested places easily. The developed robot can be used in any indoor environment in this prevailing pandemic situation and it can also provide cost-effective disinfection in medical facilities against the long-term residual effect of COVID-19 in the post-pandemic era.

Effect of Ultraviolet Light C (UV-C) Radiation Generated by Semiconductor Light Sources on Human Beta-Coronaviruses' Inactivation

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has completely disrupted people’s lives. All over the world, many restrictions and precautions have been introduced to reduce the spread of coronavirus disease 2019 (COVID-19). Ultraviolet C (UV-C) radiation is widely used to disinfect rooms, surfaces, and medical tools; however, this paper presents novel results obtained for modern UV-C light-emitting diodes (LEDs), examining their effect on inhibiting the multiplication of viruses. The main goal of the work was to investigate how to most effectively use UV-C LEDs to inactivate viruses. We showed that UV-C radiation operating at a 275 nm wavelength is optimal for germicidal effectiveness in a time exposure (25−48 s) study: >3 log-reduction with the Kärber method and >6 log-reduction with UV spectrophotometry were noted. We used real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) to reliably estimate virus infectivity reduction after 275 nm UV-C disinfection. The relative quantification (RQ) of infectious particles detected after 40−48 s distinctly decreased. The irradiated viral RNAs were underexpressed compared to the untreated control virial amplicon (estimated as RQ = 1). In conclusion, this work provides the first experimental data on 275 nm UV-C in the inactivation of human coronavirus OC43 (HoV-OC43), showing the most potent germicidal effect without hazardous effect.

An Experimental Analysis of Five Household Equipment-Based Methods for Decontamination and Reuse of Surgical Masks

The current coronavirus pandemic has increased worldwide consumption of individual protective devices. Single-use surgical masks are one of the most used devices to prevent the transmission of the COVID-19 virus. Nevertheless, the improper management of such protective equipment threatens our environment with a new form of plastic pollution. With the intention of contributing to a responsible policy of recycling, in the present work, five decontamination methods for used surgical masks that can be easily replicated with common household equipment are described. The decontamination procedures were hot water at 40 °C and 80 °C; autoclave; microwave at 750 W; and ultraviolet germicidal irradiation. After each decontamination procedure, the bacterial load reduction of Staphylococcus aureus ATCC 6538 was recorded to verify the effectiveness of these methods and, moreover, bacterial filtration efficiency and breathability tests were performed to evaluate mask performances. The best results were obtained with the immersion in 80 °C water and the microwave-assisted sterilization. Both methods achieved a high degree of mask decontamination without altering the filtration efficiency and breathability, in accordance with the quality standard. The proposed decontamination methods represent a useful approach to reduce the environmental impact of this new waste material. Moreover, these procedures can be easily reproduced with common household equipment to increase the recycling efforts.

Evaluation of UV-C Radiation Efficiency in the Decontamination of Inanimate Surfaces and Personal Protective Equipment Contaminated with Phage ϕ6

To help halt the global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appropriate disinfection techniques are required. Over the last years, the interest in Ultraviolet-C (UV-C) radiation as a method to disinfect inanimate surfaces and personal protective equipment (PPE) has increased, mainly to efficiently disinfect and prevent SARS-CoV-2 from spreading and allow for the safe reuse of said equipment. The bacteriophage ϕ6 (or simply phage ϕ6) is an RNA virus with a phospholipid envelope and is commonly used in environmental studies as a surrogate for human RNA-enveloped viruses, including SARS-CoV-2. The present study investigated the use of two new UV irradiation systems ((2)2.4W and (8)5.5W)) constituted by conventional mercury UV-C lamps with a strong emission peak at ~254 nm to potentially inactivate phage ϕ6 on different surfaces (glass, plastic, stainless steel, and wood) and personal protective equipment, PPE, (surgical and filtering facepiece 2, FFP2, masks, a clear acetate visor, and disposable protective clothing). The results showed that both UV-C systems were effective in inactivating phage ϕ6, but the UV-C sterilizing chamber (8)5.5W had the best disinfection performance on the tested surfaces. The inactivation effectiveness is material-dependent on all surfaces, reaching the detection limit of the method at different times (between 60 and 240 s of irradiation). The glass surface needed less time to reduce the virus (30 s) when compared with plastic, stainless, and wood surfaces (60 s). The virus inactivation was more effective in the disposable surgical and FFP2 masks (60 and 120 s, respectively) than in the disposable vest and clear acetate visor (240 s). Overall, this study suggests that UV-C lamps with peak emission at ~254 nm could provide rapid, efficient, and sustainable sanitization procedures to different materials and surfaces. However, dosage and irradiation time are important parameters to be considered during their implementation as a tool in the fight against human coronaviruses, namely against SARS-CoV-2.

Personal protective equipment and adverse dermatological reactions among healthcare workers: Survey observations from the COVID-19 pandemic

The pandemic of the 2019 novel coronavirus disease (COVID-19) has caused an unprecedented mobilization of the United States' healthcare workforce. In addition to working extended hours under increased duress, healthcare professionals (HCP) of all stations have been making use of various types of personal protective equipment (PPE) with greatly increased frequency and duration. Current data regarding adverse skin reactions as a possible consequence of PPE use are, particularly in the United States, largely insufficient for policy-makers to make informed decisions regarding daily PPE use among HCP.The research vehicle employed by this study is a cross-sectional 25-item survey distributed via email to workers currently employed by a five-hospital system in southcentral Kentucky. This survey was used to collect information from hospital workers of all professional roles about their experiences during the COVID-19 pandemic, focusing on reports of adverse dermatological reactions and associated risk factors.Out of 879 respondents, 54.4% reported some type of skin irritation reaction. Skin irritation was significantly more prevalent among medical and medical support staff than non-medical hospital workers, with the highest prevalence among Certified Nurse Assistant (CNAs). Among clinical workers, those in dedicated COVID-19 units reported the highest prevalence of adverse skin reaction. The most common complaint was dryness/scaling of the skin (306 out of 439, 69.7%), and the most common location was the facial cheeks (305 out of 516, 59.1%). Among those who reported skin irritation, the average self-reported severity of skin reaction (on a scale of 1-5) was 2.00 ± 0.05, and the mean total days of skin reaction per month was 11.70 ± 0.39 days. Total days of irritation per month was found to be significantly related to "total days of PPE use per month," "hours of PPE use per day," "frequency of hand washing," and "use of disinfecting UV irradiation." Severity of skin reaction was found to be significantly related to "hours per day of PPE use," "consecutive days of PPE use," and "female sex."Clinical workers that put in the most face-to-face time with patients, and those in dedicated COVID-19 units, had the highest risk of adverse skin reaction. Overall, skin reactions were found to be mild, even in those hospital workers with the heaviest PPE use. Because the widespread and consistent use of facial masks in public settings has become a key tool in our protracted struggle with SARS-CoV-2, these findings may help to ameliorate concerns that everyday facial mask and/or other PPE usage contributes to significant dermatologic morbidity among both medical professionals and public citizens.

COVID-19 outbreak: Should dental and medical practices consider uv-c technology to enhance disinfection on surfaces? - A systematic review

AIMS

During the COVID-19 pandemic the search for complementary methods to enhance manual disinfection in dental and medical practices raised relevance. We sought evidence for the addition of ultraviolet-C (UV-C) disinfection to manual cleaning protocols -and whether it improves the logarithmic (log) reduction of surface pathogen colonies.

METHODS

This review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD420200193961. Six electronic sources were consulted looking for clinical trials performed in healthcare environments in which pathogens were quantified by colony-forming unit (CFU)-enumeration before and after interventions, all databases were last consulted on May 2021. We assessed the risk of bias using an adapted Revised Cochrane Risk of Bias Tool (RoB 2). The certainty of the evidence was qualified according to the Classification of Recommendations, Evaluation, Development, and Evaluation (GRADE) approach.

RESULTS

We identified 1012 records and 12 studies fulfilled the inclusion criteria. All included studies reported enhanced disinfection in the UV-C arm; most of them reported 1-log to 2-log reduction in approximately 10 to 25 min. Only three studies reached a 5-log and 6-log reduction. When manual cleaning was performed alone, only two studies reported a 1-log reduction using a chlorine-based disinfectant. We detected a high risk of bias in 1 study. Certainty of evidence was classified as moderate and low.

CONCLUSIONS

The evidence points out the effectiveness of UV-C technology in reducing manual cleaning failures, enhancing the logarithmic reduction of surface pathogen colonies. However, the safety and success of these devices will depend on several physical and biological factors. A judicious project must precede their use in clinical and medical offices under the supervision of a physicist or other trained professional.

Review of component designs for post-COVID-19 HVAC systems: Possibilities and challenges

The globally occurring recurrent waves of the COVID-19 pandemic, primarily caused by the transmission of aerosolized droplets from an infected person to a healthy person in the indoor environment, has led to the urgency of designing new modes of indoor ventilation. To prevent cross-contaminations due to airborne viruses, bacteria, and other pollutants in indoor environments, heating ventilation and air-conditioning (HVAC) systems need to be redesigned with anti-pandemic components. The three vital anti-pandemic components for the post-COVID-19 HVAC systems, as identified by the authors, are: a biological contaminant inactivation unit, a volatile organic compound decomposition unit, and an advanced air filtration unit. The purpose of the current article is to provide an overview of the latest research outcomes toward designing these anti-pandemic components and pointing out the future promises and challenges. In addition, the role of personalized ventilation in minimizing the risk of indoor cross-contamination by employing various air terminal devices is discussed. The authors believe that this article will encourage HVAC designers to develop effective anti-pandemic components to minimize the indoor airborne transmission.

Onychomycosis in Older Adults: Prevalence, Diagnosis, and Management

The risk of having onychomycosis increases with age. Data suggest that the prevalence of onychomycosis may be ≥ 20% in subjects aged ≥ 60 years and ≥ 50% in those aged ≥ 70 years. Older males are 2.1 times more prone to onychomycosis than are females. Although most nail dystrophies (approximately 50%) are caused by onychomycosis, proper clinical assessment followed by mycological examination is recommended to exclude other conditions such as nail trauma, lichen planus, and psoriasis. The US FDA-approved onychomycosis treatments are systemic antifungals (terbinafine and itraconazole) for severe onychomycosis and topical antifungals (ciclopirox 8%, efinaconazole 10%, and tavaborole 5%) for mild-to-moderate onychomycosis. Oral fluconazole is used off-label, and itraconazole may be considered for non-dermatophyte onychomycosis. Recently, fosravuconazole was approved in Japan for onychomycosis treatment. Although the treatment options and durations are the same for older patients as for other age groups, a clinical decision should take into account various age-related factors such as comorbidities, polypharmacy, hepatic and renal insufficiency, and noncompliance. Clinicians should also consider possible drug interactions and side effects when choosing a particular antifungal. Since the recurrence rate of onychomycosis is high, older patients should practice sanitization techniques, consider lifestyle changes, and perhaps consider using a topical antifungal as long-term maintenance therapy one to three times per week to prevent the recurrence of onychomycosis or to treat early disease.

Pseudotyped Vesicular Stomatitis Virus-Severe Acute Respiratory Syndrome-Coronavirus-2 Spike for the Study of Variants, Vaccines, and Therapeutics Against Coronavirus Disease 2019

World Health Organization (WHO) has prioritized the infectious emerging diseases such as Coronavirus Disease (COVID-19) in terms of research and development of effective tests, vaccines, antivirals, and other treatments. Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), the etiological causative agent of COVID-19, is a virus belonging to risk group 3 that requires Biosafety Level (BSL)-3 laboratories and the corresponding facilities for handling. An alternative to these BSL-3/-4 laboratories is to use a pseudotyped virus that can be handled in a BSL-2 laboratory for study purposes. Recombinant Vesicular Stomatitis Virus (VSV) can be generated with complementary DNA from complete negative-stranded genomic RNA, with deleted G glycoprotein and, instead, incorporation of other fusion protein, like SARS-CoV-2 Spike (S protein). Accordingly, it is called pseudotyped VSV-SARS-CoV-2 S. In this review, we have described the generation of pseudotyped VSV with a focus on the optimization and application of pseudotyped VSV-SARS-CoV-2 S. The application of this pseudovirus has been addressed by its use in neutralizing antibody assays in order to evaluate a new vaccine, emergent SARS-CoV-2 variants (delta and omicron), and approved vaccine efficacy against variants of concern as well as in viral fusion-focused treatment analysis that can be performed under BSL-2 conditions.

Symmetrization and Amplification of Germicidal Radiation Flux Produced by a Mercury Amalgam UV Lamp in Cylindrical Cavity with Diffusely Reflective Walls

The study focused on increasing the efficiency of germicidal UV radiation by using highly diffuse reflective materials such as PTFE in irradiated cavities of UV air purifiers. In a conventional cylindrically symmetric cavity with a linear amalgam mercury lamp as UV-radiation source on the axis UV-radiation, flux directed from the lamp to the walls dropped from the axis to the periphery. To increase the UV irradiation, the walls are often made mirror-reflective, but the radiation flux distribution remained radially symmetric with a maximum on the source emitting surface in this case as well. When most of the emitted light is returned to the source after one reflection, the conditions of its operation are disturbed. If the walls are made of highly diffuse reflective materials, the radiation flux density inside the cavity increases on average, and its distribution becomes uniform and highly symmetric. Thus, the effect of amplification of the radiation flux due to the highly diffuse reflectivity of the walls increases with radius and reaches a maximum at the wall. Experiments were performed to demonstrate increasing amplification of germicidal UV radiation flux with a diffuse reflection coefficient in cylindrical cavities with walls of PTFE and ePTFE. The irradiation of the cavity wall was observed to increase up to 20 times at the resonant mercury line of 253.7 nm and up to 40 times at some non-resonant lines of the visible range due to highly diffuse reflectivity of the cavity walls. The flux amplification effect was limited by the diffuse reflectivity value of the walls and absorption coefficient of the radiation emitting surface. A formula for calculating the radiation flux amplification factor in a diffusely reflecting cylindrically symmetric cavity was derived for the case of Lambertian source and reflector, including wall reflectivity and source surface absorption coefficients. The effects of heating and cooling of the mercury lamp amalgam directly affected the amplification, and symmetrization of germicidal irradiation was observed and is discussed in the paper. Numerical calculations were performed by the ray tracing method. The calculated model was verified by comparing the numerical results with those of both the approximate theoretical consideration and experiments. The promising use of diffusely reflecting cylindrical cavities for UV air purifiers is discussed. Designs of air inlet and outlet ports that allow effective locking of germicidal radiation inside the UV air purifiers were considered. The results of this work may be of interest for further developments in the UV disinfection technique.

Facemask Global Challenges: The Case of Effective Synthesis, Utilization, and Environmental Sustainability

Coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a rapidly spreading pandemic and is severely threatening public health globally. The human-to-human transmission route of SARS-CoV-2 is now well established. The reported clinical observations and symptoms of this infection in humans appear in the range between being asymptomatic and severe pneumonia. The virus can be transmitted through aerosols and droplets that are released into the air by a carrier, especially when the person coughs, sneezes, or talks forcefully in a closed environment. As the disease progresses, the use and handling of contaminated personal protective equipment and facemasks have become major issues with significant environmental risks. Therefore, providing an effective method for treating used/contaminated facemasks is crucial. In this paper, we review the environmental challenges and risks associated with the surge in facemask production. We also discuss facemasks and their materials as sources of microplastics and how disposal procedures can potentially lead to the contamination of water resources. We herein review the potential of developing nanomaterial-based antiviral and self-cleaning facemasks. This review discusses these challenges and concludes that the use of sustainable and alternative facemask materials is a promising and viable solution. In this context, it has become essential to address the emerging challenges by developing a new class of facemasks that are effective against the virus, while being biodegradable and sustainable. This paper represents the potentials of natural and/or biodegradable polymers for manufacturing facemasks, such as wood-based polymers, chitosan, and other biodegradable synthetic polymers for achieving sustainability goals during and after pandemics.

UV and violet light can Neutralize SARS-CoV-2 Infectivity

We performed an in-depth analysis of the virucidal effect of discrete wavelengths: UV-C (278 nm), UV-B (308 nm), UV-A (366 nm) and violet (405 nm) on SARS-CoV-2. By using a highly infectious titer of SARS-CoV-2 we observed that the violet light-dose resulting in a 2-log viral inactivation is only 10⁴ times less efficient than UV-C light. Moreover, by qPCR (quantitative Polymerase chain reaction) and fluorescence in situ hybridization (FISH) approach we verified that the viral titer typically found in the sputum of COVID-19 patients can be completely inactivated by the long UV-wavelengths corresponding to UV-A and UV-B solar irradiation. The comparison of the UV action spectrum on SARS-CoV-2 to previous results obtained on other pathogens suggests that RNA viruses might be particularly sensitive to long UV wavelengths. Our data extend previous results showing that SARS-CoV-2 is highly susceptible to UV light and offer an explanation to the reduced incidence of SARS-CoV-2 infection seen in the summer season.

Photocatalytic disinfection of S. aureus using black TiO2−x under visible light

Reduced black TiO2−x was developed by a sol–gel combustion method. Evidence of reactive oxygen species production under visible light was obtained, and the material inactivated S. aureus by photocatalytic means under only visible light irradiation.

A review of methods to reduce the probability of the airborne spread of COVID-19 in ventilation systems and enclosed spaces

COVID-19 forced the human population to rethink its way of living. The threat posed by the potential spread of the virus via an airborne transmission mode through ventilation systems in buildings and enclosed spaces has been recognized as a major concern. To mitigate this threat, researchers have explored different technologies and methods that can remove or decrease the concentration of the virus in ventilation systems and enclosed spaces. Although many technologies and methods have already been researched, some are currently available on the market, but their effectiveness and safety concerns have not been fully investigated. To acquire a broader view and collective perspective of the current research and development status, this paper discusses a comprehensive review of various workable technologies and methods to combat airborne viruses, e.g., COVID-19, in ventilation systems and enclosed spaces. These technologies and methods include an increase in ventilation, high-efficiency air filtration, ionization of the air, environmental condition control, ultraviolet germicidal irradiation, non-thermal plasma and reactive oxygen species, filter coatings, chemical disinfectants, and heat inactivation. Research gaps have been identified and discussed, and recommendations for applying such technologies and methods have also been provided in this article.

Control of airborne infectious disease in buildings: Evidence and research priorities

The evolution of SARS-CoV-2 virus has resulted in variants likely to be more readily transmitted through respiratory aerosols, underscoring the increased potential for indoor environmental controls to mitigate risk. Use of tight-fitting face masks to trap infectious aerosol in exhaled breath and reduce inhalation exposure to contaminated air is of critical importance for disease control. Administrative controls including the regulation of occupancy and interpersonal spacing are also important, while presenting social and economic challenges. Indoor engineering controls including ventilation, exhaust, air flow control, filtration, and disinfection by germicidal ultraviolet irradiation can reduce reliance on stringent occupancy restrictions. However, the effects of controls-individually and in combination-on reducing infectious aerosol transfer indoors remain to be clearly characterized to the extent needed to support widespread implementation by building operators. We review aerobiologic and epidemiologic evidence of indoor environmental controls against transmission and present a quantitative aerosol transfer scenario illustrating relative differences in exposure at close-interactive, room, and building scales. We identify an overarching need for investment to implement building controls and evaluate their effectiveness on infection in well-characterized and real-world settings, supported by specific, methodological advances. Improved understanding of engineering control effectiveness guides implementation at scale while considering occupant comfort, operational challenges, and energy costs.

UltraViolet SANitizing System for Sterilization of Ambulances Fleets and for Real-Time Monitoring of Their Sterilization Level

BACKGROUND

The contamination of ambulances with pathogenic agents represents a potential threat for the public health, not only for common pathogens but also for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this project was to exploits the germicidal effect of the UVC radiation at 254 nm to sanitize the patient's compartment of ambulances with an advanced UltraViolet SANitizing System (UV-SAN) and assess its relevance for avoiding the spread of COVID-19 and other drug resistant pathogens.

METHODS

The system is equipped with UVC lamps that are activated when the ambulance compartment is empty and sanitize the environment in less than 15 min. An Ozone sensor continuously monitors the gas concentration, ensuring it does not exceed threshold value harmful for patients and operators' health. The system is relying on GNSS data and a satellite communication link, which allow to monitor and record traceability (when, where and what) of all the sanitation operations performed. This information is real-time monitored from a dedicated web-application.

RESULTS

UVC irradiation efficiently reduced SARS-CoV-2 virus titer (>99.99%), on inanimate surfaces such as plastic, stainless steel or rubber, with doses ranging from 5.5 to 24.8 mJ/cm2 and the UV-SAN system is effective against multi drug resistant (MDR) bacteria up to >99.99%, after 10 to 30 min of irradiation.

CONCLUSIONS

UV-SAN can provide rapid, efficient and sustainable sanitization procedures of ambulances.

Inactivation of Foodborne Viruses by UV Light: A Review

Viruses on some foods can be inactivated by exposure to ultraviolet (UV) light. This green technology has little impact on product quality and, thus, could be used to increase food safety. While its bactericidal effect has been studied extensively, little is known about the viricidal effect of UV on foods. The mechanism of viral inactivation by UV results mainly from an alteration of the genetic material (DNA or RNA) within the viral capsid and, to a lesser extent, by modifying major and minor viral proteins of the capsid. In this review, we examine the potential of UV treatment as a means of inactivating viruses on food processing surfaces and different foods. The most common foodborne viruses and their laboratory surrogates; further explanation on the inactivation mechanism and its efficacy in water, liquid foods, meat products, fruits, and vegetables; and the prospects for the commercial application of this technology are discussed. Lastly, we describe UV’s limitations and legislation surrounding its use. Based on our review of the literature, viral inactivation in water seems to be particularly effective. While consistent inactivation through turbid liquid food or the entire surface of irregular food matrices is more challenging, some treatments on different food matrices seem promising.

The effectiveness of commercial household ultraviolet C germicidal devices in Thailand

Ultraviolet C (UVC), or ultraviolet germicidal irradiation (UVGI), is known for its effective air, water, and surface disinfectant properties. With the rise of global awareness about public sanitation and personal hygiene due to the emergence of the current coronavirus disease 2019 pandemic, several applications of UVC were introduced to the commercial market. The present experimental study aimed to evaluate the effectiveness of commercial household UVC germicidal devices for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inactivation. Ten UVC devices were included in the study comprising of 7 low-pressure mercury lamps (LPMLs) and 3 UVC- light-emitting diodes (LEDs). Considering applications, 3 were handheld UVGI surface disinfection equipment, 4 were UVGI disinfection chambers, and 3 were movable UVGI air and surface purifiers. To determine SARS-CoV-2 inactivation performance, UVC irradiance (mW/cm²) was measured 3 times repeatedly at distance and duration corresponding to manufacturers’ usage instructions. The required UVC dosage could not be achieved by either of UVC-LED devices (1 handheld UVGI surface disinfection equipment and 2 UVGI disinfection chambers). Five of seven LPMLs can sufficiently emit UVC irradiance for SARS-CoV-2-inactivation. A lack of standardization in the distance and cycle duration for each UVC application was observed. Standard usage guidelines for UVC devices are required to improve the effectiveness of UVC irradiance for SARS-CoV-2 inactivation as well as to minimize the potential side effects of UVC.

Phototherapy and optical waveguides for the treatment of infection

With rapid emergence of multi-drug resistant microbes, it is imperative to seek alternative means for infection control. Optical waveguides are an auspicious delivery method for precise administration of phototherapy. Studies have shown that phototherapy is promising in fighting against a myriad of infectious pathogens (i.e. viruses, bacteria, fungi, and protozoa) including biofilm-forming species and drug-resistant strains while evading treatment resistance. When administered via optical waveguides, phototherapy can treat both superficial and deep-tissue infections while minimizing off-site effects that afflict conventional phototherapy and pharmacotherapy. Despite great therapeutic potential, exact mechanisms, materials, and fabrication designs to optimize this promising treatment option are underexplored. This review outlines principles and applications of phototherapy and optical waveguides for infection control. Research advances, challenges, and outlook regarding this delivery system are rigorously discussed in a hope to inspire future developments of optical waveguide-mediated phototherapy for the management of infection and beyond.

Brought to Light: How Ultraviolet Disinfection Can Prevent the Nosocomial Transmission of COVID-19 and Other Infectious Diseases

The novel coronavirus disease 2019 (COVID-19) pandemic has brought to light the role of environmental hygiene in controlling disease transmission. Healthcare facilities are hot spots for infectious pathogens where physical distancing and personal protective equipment (PPE) are not always sufficient to prevent disease transmission. Healthcare facilities need to consider adjunct strategies to prevent transmission of infectious pathogens. In combination with current infection control procedures, many healthcare facilities are incorporating ultraviolet (UV) disinfection into their routines. This review considers how pathogens are transmitted in healthcare facilities, the mechanism of UV microbial inactivation and the documented activity of UV against clinical pathogens. Emphasis is placed on the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) as well as multidrug resistant organisms (MDROs) that are commonly transmitted in healthcare facilities. The potential benefits and limitations of UV technologies are discussed to help inform healthcare workers, including clinical studies where UV technology is used in healthcare facilities.

Solar simulated ultraviolet radiation inactivates HCoV-NL63 and SARS-CoV-2 coronaviruses at environmentally relevant doses

The germicidal properties of short wavelength ultraviolet C (UVC) light are well established and used to inactivate many viruses and other microbes. However, much less is known about germicidal effects of terrestrial solar UV light, confined exclusively to wavelengths in the UVA and UVB regions. Here, we have explored the sensitivity of the human coronaviruses HCoV-NL63 and SARS-CoV-2 to solar-simulated full spectrum ultraviolet light (sUV) delivered at environmentally relevant doses. First, HCoV-NL63 coronavirus inactivation by sUV-exposure was confirmed employing (i) viral plaque assays, (ii) RT-qPCR detection of viral genome replication, and (iii) infection-induced stress response gene expression array analysis. Next, a detailed dose-response relationship of SARS-CoV-2 coronavirus inactivation by sUV was elucidated, suggesting a half maximal suppression of viral infectivity at low sUV doses. Likewise, extended sUV exposure of SARS-CoV-2 blocked cellular infection as revealed by plaque assay and stress response gene expression array analysis. Moreover, comparative (HCoV-NL63 versus SARS-CoV-2) single gene expression analysis by RT-qPCR confirmed that sUV exposure blocks coronavirus-induced redox, inflammatory, and proteotoxic stress responses. Based on our findings, we estimate that solar ground level full spectrum UV light impairs coronavirus infectivity at environmentally relevant doses. Given the urgency and global scale of the unfolding SARS-CoV-2 pandemic, these prototype data suggest feasibility of solar UV-induced viral inactivation, an observation deserving further molecular exploration in more relevant exposure models.

UVC-based photoinactivation as an efficient tool to control the transmission of coronaviruses

The ongoing COVID-19 pandemic made us re-realize the importance of environmental disinfection and sanitation in indoor areas, hospitals, and clinical rooms. UVC irradiation of high energy and short wavelengths, especially in the 200-290-nm range possesses the great potential for germicidal disinfection. These properties of UVC allow to damage or destruct the nucleic acids (DNA/RNA) in diverse microbes (e.g., bacteria, fungi, and viruses). UVC light can hence be used as a promising tool for prevention and control of their infection or transmission. The present review offers insights into the historical perspective, mode of action, and recent advancements in the application of UVC-based antiviral therapy against coronaviruses (including SARS CoV-2). Moreover, the application of UVC lights in the sanitization of healthcare units, public places, medical instruments, respirators, and personal protective equipment (PPE) is also discussed. This article, therefore, is expected to deliver a new path for the developments of UVC-based viricidal approach.

Scalable, effective, and rapid decontamination of SARS-CoV-2 contaminated N95 respirators using germicidal ultraviolet C (UVC) irradiation device

Particulate respirators such as N95s are an essential component of personal protective equipment (PPE) for front-line workers. This study describes a rapid and effective UVC irradiation system that would facilitate the safe re-use of N95 respirators and provides supporting information for deploying UVC for decontamination of SARS-CoV-2 during the COVID-19 pandemic. To assess the inactivation potential of the proposed UVC germicidal device as a function of time by using 3 M 8211-N95 particulate respirators inoculated with SARS-CoV-2. A germicidal UVC device to deliver tailored UVC dose was developed and test coupons (2.5 cm2) of the 3 M-N95 respirator were inoculated with 106 plaque-forming units (PFU) of SARS-CoV-2 and were UV irradiated. Different exposure times were tested (0-164 s) by fixing the distance between the lamp and the test coupon to 15.2 cm while providing an exposure of at least 5.43 mWcm-2. Primary measure of outcome was titration of infectious virus recovered from virus-inoculated respirator test coupons after UVC exposure. Other measures included the method validation of the irradiation protocol, using lentiviruses (biosafety level-2 agent) and establishment of the germicidal UVC exposure protocol. An average of 4.38 × 103 PFU ml-1 (SD 772.68) was recovered from untreated test coupons while 4.44 × 102 PFU ml-1 (SD 203.67), 4.00 × 102 PFU ml-1 (SD 115.47), 1.56 × 102 PFU ml-1 (SD 76.98) and 4.44 × 101 PFU ml-1 (SD 76.98) was recovered in exposures 2, 6, 18 and 54 s per side respectively. The germicidal device output and positioning was monitored and a minimum output of 5.43 mW cm-2 was maintained. Infectious SARS-CoV-2 was not detected by plaque assays (minimal level of detection is 67 PFU ml-1) on N95 respirator test coupons when irradiated for 120 s per side or longer suggesting 3.5 log reduction in 240 s of irradiation, 1.3 J cm-2. A scalable germicidal UVC device to deliver tailored UVC dose for rapid decontamination of SARS-CoV-2 was developed. UVC germicidal irradiation of N95 test coupons inoculated with SARS-CoV-2 for 120 s per side resulted in 3.5 log reduction of virus. These data support the reuse of N95 particle-filtrate apparatus upon irradiation with UVC and supports use of UVC-based decontamination of SARS-CoV-2 during the COVID-19 pandemic.

A Paradigm Shift in the Treatment and Management of Onychomycosis

There is an increase in the incidence of onychomycosis, especially in at-risk populations. Onychomycosis is difficult to treat, as the efficacy of most antifungal agents is relatively low. Nondermatophyte molds (NDMs) and mixed infection (dermatophyte plus NDM) onychomycosis are contributing to growing antifungal resistance, as they are often underestimated and ignored due to incorrect diagnosis. There is a need for a paradigm shift in the management of onychomycosis to a patient-centered, holistic approach with an emphasis on laboratory diagnosis prior to initiating treatment, which enables the rational choice of the antifungal agent. Additionally, in the case of resistant infections, antifungal susceptibility testing is recommended. Strategies for effective management of onychomycosis include disinfection of fungal reservoirs in shoes and socks and prophylaxis posttreatment using topical antifungal agents. These measures may reduce the recurrence of onychomycosis and improve long-term clinical success.

Turn Up the Lights, Leave them On and Shine them All Around-Numerical Simulations Point the Way to more Efficient Use of Far-UVC Lights for the Inactivation of Airborne Coronavirus

It has been demonstrated in laboratory environments that ultraviolet‐C (UVC) light is effective at inactivating airborne viruses. However, due to multiple parameters, it cannot be assumed that the air inside a room will be efficiently disinfected by commercial germicidal ultraviolet (GUV) systems. This research utilizes numerical simulations of airflow, viral spread, inactivation by UVC and removal by mechanical ventilation in a typical classroom. The viral load in the classroom is compared for conventional upper‐room GUV and the emerging “Far‐UVC.” In our simulated environment, GUV is shown to be effective in both well and poorly ventilated rooms, with greatest benefit in the latter. At current exposure limits, 18 commercial Far‐UVC systems were as effective at reducing viral load as a single upper‐room GUV. Improvements in Far‐UVC irradiation distribution and recently proposed increases to exposure limits would dramatically increase the efficacy of Far‐UVC devices. Modifications to current Far‐UVC devices, which would improve their real‐world efficacy, could be implemented now without requiring legislative change. The prospect of increased safety limits coupled with our suggested technological modifications could usher in a new era of safe and rapid whole room air disinfection in occupied indoor spaces.

Recent research on expiratory particles in respiratory viral infection and control strategies: A review

The global spread of coronavirus disease 2019 poses a significant threat to human health. In this study, recent research on the characteristics of expiratory particles and flow is reviewed, with a special focus on different respiratory activities, to provide guidance for reducing the viral infection risk in the built environment. Furthermore, environmental influence on particle evaporation, dispersion, and virus viability after exhalation and the current methods for infection risk assessment are reviewed. Finally, we summarize promising control strategies against infectious expiratory particles. The results show that airborne transmission is a significant viral transmission route, both in short and long ranges, from infected individuals. Relative humidity affects the evaporation and trajectories of middle-sized droplets most, and temperature accelerates the inactivation of SARS-CoV-2 both on surfaces and in aerosols. Future research is needed to improve infection risk models to better predict the infection potential of different transmission routes. Moreover, further quantitative studies on the expiratory flow features after wearing a mask are needed. Systematic investigations and the design of advanced air distribution methods, portable air cleaners, and ultraviolet germicidal irradiation systems, which have shown high efficacy in removing contaminants, are required to better control indoor viral infection.

Factors affecting aerosol SARS-CoV-2 transmission via HVAC systems; a modeling study

The role of heating, ventilation, and air-conditioning (HVAC) systems in the transmission of SARS-CoV-2 is unclear. To address this gap, we simulated the release of SARS-CoV-2 in a multistory office building and three social gathering settings (bar/restaurant, nightclub, wedding venue) using a well-mixed, multi-zone building model similar to those used by Wells, Riley, and others. We varied key factors of HVAC systems, such as the Air Changes Per Hour rate (ACH), Fraction of Outside Air (FOA), and Minimum Efficiency Reporting Values (MERV) to examine their effect on viral transmission, and additionally simulated the protective effects of in-unit ultraviolet light decontamination (UVC) and separate in-room air filtration. In all building types, increasing the ACH reduced simulated infections, and the effects were seen even with low aerosol emission rates. However, the benefits of increasing the fraction of outside air and filter efficiency rating were greatest when the aerosol emission rate was high. UVC filtration improved the performance of typical HVAC systems. In-room filtration in an office setting similarly reduced overall infections but worked better when placed in every room. Overall, we found little evidence that HVAC systems facilitate SARS-CoV-2 transmission; most infections in the simulated office occurred near the emission source, with some infections in individuals temporarily visiting the release zone. HVAC systems only increased infections in one scenario involving a marginal increase in airflow in a poorly ventilated space, which slightly increased the likelihood of transmission outside the release zone. We found that improving air circulation rates, increasing filter MERV rating, increasing the fraction of outside air, and applying UVC radiation and in-room filtration may reduce SARS-CoV-2 transmission indoors. However, these mitigation measures are unlikely to provide a protective benefit unless SARS-CoV-2 aerosol emission rates are high (>1,000 Plaque-forming units (PFU) / min).

Prevention of SARS-CoV-2 (COVID-19) transmission in residential aged care using ultraviolet light (PETRA): a two-arm crossover randomised controlled trial protocol

Background

SARS-CoV-2 poses a considerable threat to those living in residential aged care facilities (RACF). RACF COVID-19 outbreaks have been characterised by the rapid spread of infection and high rates of severe disease and associated mortality. Despite a growing body of evidence supporting airborne transmission of SARS-CoV-2, current infection control measures in RACF including hand hygiene, social distancing, and sterilisation of surfaces, focus on contact and droplet transmission. Germicidal ultraviolet (GUV) light has been used widely to prevent airborne pathogen transmission. Our aim is to investigate the efficacy of GUV technology in reducing the risk of SARS-CoV-2 infection in RACF.

Methods

A multicentre, two-arm double-crossover, randomised controlled trial will be conducted to determine the efficacy of GUV devices to reduce respiratory viral transmission in RACF, as an adjunct to existing infection control measures. The study will be conducted in partnership with three aged care providers in metropolitan and regional South Australia. RACF will be separated into paired within-site zones, then randomised to intervention order (GUV or control). The initial 6-week period will be followed by a 2-week washout before crossover to the second 6-week period. After accounting for estimated within-zone and within-facility correlations of infection, and baseline infection rates (10 per 100 person-days), a sample size of n = 8 zones (n = 40 residents/zone) will provide 89% power to detect a 50% reduction in symptomatic infection rate. The primary outcome will be the incidence rate ratio of combined symptomatic respiratory infections for intervention versus control. Secondary outcomes include incidence rates of hospitalisation for complications associated with respiratory infection; respiratory virus detection in facility air and fomite samples; rates of laboratory confirmed respiratory illnesses and genomic characteristics.

Discussion

Measures that can be deployed rapidly into RACF, that avoid the requirement for changes in resident and staff behaviour, and that are effective in reducing the risk of airborne SARS-CoV-2 transmission, would provide considerable benefit in safeguarding a highly vulnerable population. In addition, such measures might substantially reduce rates of other respiratory viruses, which contribute considerably to resident morbidity and mortality.

Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12621000567820 (registered on 14th May, 2021).

The value of photomedicine in a global health crisis: Utilizing ultraviolet C to decontaminate N95 respirators during the COVID-19 pandemic

One early problem during the height of the COVID‐19 global pandemic, caused by severe acute respiratory syndrome 2 (SARS‐CoV‐2), was the shortage of personal protective equipment donned by healthcare workers, particularly N95 respirators. Given the known virucidal, bactericidal, and fungicidal properties of ultraviolet irradiation, in particular ultraviolet C (UVC) radiation, our photomedicine and photobiology unit explored the role of ultraviolet germicidal irradiation (UVGI) using UVC in effectively decontaminating N95 respirators. The review highlights the important role of photobiology and photomedicine in this pandemic. Namely, the goals of this review were to highlight: UVGI as a method of respirator disinfection—specifically against SARS‐CoV‐2, adverse reactions to UVC and precautions to protect against exposure, other methods of decontamination of respirators, and the importance of respirator fit testing.

Impact of an automated multiple emitter whole-room ultraviolet-C disinfection system on hospital acquired infections: A quasi-experimental study

A quasi-experimental study performed in a pediatric hematology-oncology unit demonstrated that whole-room ultraviolet-C disinfection was associated with a significant reduction in hospital-onset Clostridioides difficile infection (P< .01, trend and level), but not healthcare-associated viral respiratory infections (P= .06 for trend, P= .36 for level) or central line-associated bloodstream infections (P> 0.75, trend and level).

Covid-19 and the impact on young athletes

The Covid-19 pandemic has disrupted organised sport in the community as authorities cancelled, greatly modified or postponed sporting participation as part of a strategy to reduce transmission of the virus. This had a significant impact on young athletes and their families in relation to their psycho-social, physical and career progression considerations. The disruption is likely to continue for some years, considering the constraints of lockdowns, the need to overcome dysfunctional national logistics for delivery of medical care, fund and implement an efficacious vaccine programme locally, nationally and worldwide, develop sufficient herd immunity and create an environment of confidence in the safety of returning to sports for participants, coaches, umpires, administrators and observers. This article will consider the interim challenges regarding the physical and psychosocial importance of maintaining an active sporting programme for young athletes, reflect on safety measures for modifying sporting equipment and environmental protections to allow safest participation in training and competition and provide advice on protocols for a gradual return to sport for the young athlete after infection with Covid-19.

Preparation of flame-retardant, hydrophobic, ultraviolet protective, and luminescent transparent wood

Transparent wood with multifunctional properties has recently attracted more attention as an efficient building product. Here, we describe the development of transparent wood with long-persistent phosphorescence, tough surface, high durability, photostability, and reversibility without fatigue, and with ultraviolet shielding, superhydrophobicity, and flame-retardant activity. This long-persistent phosphorescent, or glow-in-the-dark, smart wood exhibited an ability to continue emitting light for prolonged periods of time. The photoluminescent translucent wooden substrate was prepared by immobilizing lignin-modulated wooden bulk with an admixture of methylmethacrylate (MMA), ammonium polyphosphate (APP), and lanthanide-doped strontium aluminate (LSA; SrAl₂ O₄ :Eu²⁺ ,Dy³⁺ ) phosphor nanoparticles. The photoluminescent transparent wood displayed a colour switch from colourless to bright white beneath ultraviolet (UV) light and greenish-yellow in the dark as reported by Commission Internationale de l'Éclairage laboratory colorimetric space coordinates. The generated phosphorescent wooden substrates demonstrated an absorbance band at 365 nm and an emission band at 516 nm. The phosphorescent transparent wood was improved flame-retardant properties, ultraviolet shielding, and superhydrophobic properties, as well as a reversible long-persistent phosphorescent responsiveness to UV light without fatigue. The current approach demonstrated a potential large-scale production strategy for multifunctional transparent wooden substrates for a range of applications such as smart windows, gentle indoor and outdoor lighting, and safety directional signs in buildings.

Solar simulated ultraviolet radiation inactivates HCoV-NL63 and SARS-CoV-2 coronaviruses at environmentally relevant doses

The germicidal properties of short wavelength ultraviolet C (UVC) light are well established and used to inactivate many viruses and other microbes. However, much less is known about germicidal effects of terrestrial solar UV light, confined exclusively to wavelengths in the UVA and UVB regions. Here, we have explored the sensitivity of the human coronaviruses HCoV-NL63 and SARS-CoV-2 to solar-simulated full spectrum ultraviolet light (sUV) delivered at environmentally relevant doses. First, HCoV-NL63 coronavirus inactivation by sUV-exposure was confirmed employing (i) viral plaque assays, (ii) RT-qPCR detection of viral genome replication, and (iii) infection-induced stress response gene expression array analysis. Next, a detailed dose-response relationship of SARS-CoV-2 coronavirus inactivation by sUV was elucidated, suggesting a half maximal suppression of viral infectivity at low sUV doses. Likewise, extended sUV exposure of SARS-CoV-2 blocked cellular infection as revealed by plaque assay and stress response gene expression array analysis. Moreover, comparative (HCoV-NL63 versus SARS-CoV-2) single gene expression analysis by RT-qPCR confirmed that sUV exposure blocks coronavirus-induced redox, inflammatory, and proteotoxic stress responses. Based on our findings, we estimate that solar ground level full spectrum UV light impairs coronavirus infectivity at environmentally relevant doses. Given the urgency and global scale of the unfolding SARS-CoV-2 pandemic, these prototype data suggest feasibility of solar UV-induced viral inactivation, an observation deserving further molecular exploration in more relevant exposure models.

Analytical modeling of three-stage inactivation of viruses within droplets and solid porous particles

Various viruses can hide within fluid and solid structures and thus successfully cross different distances, causing the spread of viral infections. Analytical modeling of the triple treatment of virus within a small liquid droplet and within a solid porous particle is the basic research polygon of this paper. The three-stage treatment aims to maximize the efficacy of deactivating viruses indoors. In order to achieve this, viruses undergo treatment by infrared heating, ultraviolet deactivation and ionization-electrostatic deactivation by negative ions. When the droplets are treated with infrared heating, incomplete evaporation occurs, reducing their initial diameter by 10 times; an initial diameter of droplets is 0.01 mm, 0.03 mm and 0.05 mm. Thermal inactivation of viruses inside the droplets is almost negligible, due to short exposure time and a maximum temperature of 100 °C. On the other hand, when solid porous particles are heated to a much higher temperature at the same exposure time, this causes significant thermal inactivation of viruses inside them. Reducing the diameter of the droplet (due to evaporation) by 10 times causes a multiple increase in UV-C deactivation of viruses inside the droplets. The effect of UV-C radiation on viruses within solid porous particles is not included in this paper.

Efficiency of an air circulation decontamination device for micro-organisms using ultraviolet radiation

BACKGROUND

The concern with environmental security to avoid contamination of individuals was intensified with the crisis established by SARS-CoV-2. The COVID-19 pandemic has shown the necessity to create systems and devices capable of clearing the air in an environment of micro-organisms more efficiently. The development of systems that allow the removal of micro-droplets mainly originating from breathing or talking from the air was the motivation of this study.

AIM

This article describes a portable and easy-to-operate system that helps to eliminate the droplets or aerosols present in the environment by circulating air through an ultraviolet-C (UV-C) reactor.

METHODS

An air circulation device was developed, and a proof-of-principle study was performed using the device against bacteria in simulated and natural environments. The microbiological analysis was carried out by the simple sedimentation technique. In order to compare the experimental results and the expected results for other micro-organisms, the reduction rate values for bacteria and viruses were calculated and compared with the experimental results based on technical parameters (clean air delivery rate (CADR) and air changes per hour (ACH)).

FINDINGS

Results showed that the micro-organisms were eliminated with high efficiency by the air circulation decontamination device, with reductions of 99.9% in the proof-of-principle study, and 84-97% in the hospital environments study, contributing to reducing contamination of individuals in environments considered to present risk.

CONCLUSION

This study resulted in a low-cost and relatively simple device, which was shown to be effective and safe, and could be replicated, especially in low-income countries, respecting the standards for air disinfection using UV-C technologies.