207-nm UV Light-A Promising Tool for Safe Low-Cost Reduction of Surgical Site Infections. II: In-Vivo Safety Studies

PRSS3/mesotrypsin as a putative regulator of the biophysical characteristics of epidermal keratinocytes in superficial layers

Mesotrypsin, encoded by the PRSS3 gene, is a distinctive trypsin isoform renowned for its exceptional resistance to traditional trypsin inhibitors and unique substrate specificity. Within the skin epidermis, this protein primarily expresses in the upper layers of the stratified epidermis and plays a crucial role in processing pro-filaggrin (Pro-FLG). Although prior studies have partially elucidated its functions using primary cultured keratinocytes, challenges persist due to these cells' differentiation-activated cell death program. In the present study, HaCaT keratinocytes, characterized by minimal endogenous mesotrypsin expression and sustained proliferation in differentiated states, were utilized to further scrutinize the function of mesotrypsin. Despite the ready degradation of the intact form of active mesotrypsin in these cells, fusion with Venus, flanked by a peptide linker, enables evasion from the protein elimination machinery, thus facilitating activation of the Pro-FLG processing system. Inducing Venus-mesotrypsin expression in the cells resulted in a flattened phenotype and reduced proliferative capacity. Moreover, these cells displayed altered F-actin assembly, enhanced E-cadherin adhesive activity, and facilitated tight junction formation without overtly influencing epidermal differentiation. These findings underscore mesotrypsin's potentially pivotal role in shaping the characteristic cellular morphology of upper epidermal layers.

Assessing the safety of new germicidal far-UVC technologies

The COVID-19 pandemic underscored the crucial importance of enhanced indoor air quality control measures to mitigate the spread of respiratory pathogens. Far-UVC is a type of germicidal ultraviolet technology, with wavelengths between 200 and 235 nm, that has emerged as a highly promising approach for indoor air disinfection. Due to its enhanced safety compared to conventional 254 nm upper-room germicidal systems, far-UVC allows for whole-room direct exposure of occupied spaces, potentially offering greater efficacy, since the total room air is constantly treated. While current evidence supports using far-UVC systems within existing guidelines, understanding the upper safety limit is critical to maximizing its effectiveness, particularly for the acute phase of a pandemic or epidemic when greater protection may be needed. This review article summarizes the substantial present knowledge on far-UVC safety regarding skin and eye exposure and highlights research priorities to discern the maximum exposure levels that avoid adverse effects. We advocate for comprehensive safety studies that explore potential mechanisms of harm, generate action spectra for crucial biological effects and conduct high-dose, long-term exposure trials. Such rigorous scientific investigation will be key to determining safe and effective levels for far-UVC deployment in indoor environments, contributing significantly to future pandemic preparedness and response.

Feasibility analysis of inactivating influenza A(H1N1) virus using UVC robot in classroom environment

Background

Starting from 2009, H1N1 has been one of the respiratory diseases that afflict the global population. Concurrently, due to the influence of COVID-19, it has become widely accepted that preventing the virus's spread necessitates personal protection measures and disinfection in public spaces.

Experiments

This study conducted two experiments. In the classroom experiment, six UVC dose test points were calibrated to test whether the UVC dose at each testing point met the standards for inactivating IAVs and the time required to meet the standards. In the simulated classroom experiment, seven square slides made of IAVs were placed. After 10 min of robot movement, irradiated sterile square slides were made into suspension and injected into chicken embryos. Cultivate chicken embryos and conduct IAVs testing.

Results

Classroom experiment has shown that 5 testing points can meet the standards for inactivating IAVs(3 mJ/cm2), with a required time of 80 min, 40 min, 15 min, 5 min and 10 min. The UVC dose for testing points that do not meet the standards in 80 min is only 0.5 mJ/cm2. The simulation classroom experiment outcomes revealed that 99.99 % of IAVs were deactivated. Furthermore, this study established both a desktop control group and a chair arm control group, both of which yielded identical results, indicating an inactivation logarithm of IAVs≥4log.

Conclusion

The study presented that IAVs on the surface of an object can be effectively and rapidly deactivated at an irradiation density of 1.8 mW/cm2. Meanwhile, the study provides evidence of the feasibility of using the GXU robot to inactivate IAVs in a classroom environment.

The new 222-nm far ultraviolet-C lowers bacterial contamination to endoscopists during esophagogastroduodenoscopy

Objectives

This study aimed to clarify the disinfectant efficacy of the 222-nm far ultraviolet-C (UV-C) during esophagogastroduodenoscopy using bacterial cultures.

Methods

The endoscopists performed esophagogastroduodenoscopy wearing a gown with a tryptic soy agar medium plate on their epigastric region and were divided into two groups: 222-nm far UV-C irradiation (UV group) and non-UV irradiation (non-UV group). As a control group, tryptic soy agar medium plates were placed about 110 cm above the floor. The incidence of bacterial contamination was determined by positive bacterial culture. The cultured bacteria were identified by 16S rRNA sequencing. Additionally, the actual UV exposure dose was measured using the UV-indicator card which changed colors upon exposure to 222 nm far UV-C.

Results

The bacterial culture positivity in the UV group (5.03%) was significantly lower than that in the non-UV group (25.76%), p < 0.0001. Most of the bacteria identified in the UV and non-UV groups were normal constituents of the oral flora, including Streptococcus salivarius and Staphylococci. Conversely, pathogenic microbes were found in the control group. The actual exposure doses of 222-nm far UV-C at the endoscopists' face, neck, and epigastric region were 2.09 ± 0.29, 5.89 ± 0.49, and 7.36 ± 0.58 mJ/cm2, respectively.

Conclusions

The 222-nm far UV-C irradiation reduced bacterial contamination for endoscopists. It can be used with conventional physical coverings to provide more effective infection control.

222 nm far-UVC light markedly reduces the level of infectious airborne virus in an occupied room

An emerging intervention for control of airborne-mediated pandemics and epidemics is whole-room far-UVC (200-235 nm). Laboratory studies have shown that 222-nm light inactivates airborne pathogens, potentially without harm to exposed occupants. While encouraging results have been reported in benchtop studies and in room-sized bioaerosol chambers, there is a need for quantitative studies of airborne pathogen reduction in occupied rooms. We quantified far-UVC mediated reduction of aerosolized murine norovirus (MNV) in an occupied mouse-cage cleaning room within an animal-care facility. Benchtop studies suggest that MNV is a conservative surrogate for airborne viruses such as influenza and coronavirus. Using four 222-nm fixtures installed in the ceiling, and staying well within current recommended regulatory limits, far-UVC reduced airborne infectious MNV by 99.8% (95% CI: 98.2-99.9%). Similar to previous room-sized bioaerosol chamber studies on far-UVC efficacy, these results suggest that aerosolized virus susceptibility is significantly higher in room-scale tests than in bench-scale laboratory studies. That said, as opposed to controlled laboratory studies, uncertainties in this study related to airflow patterns, virus residence time, and dose to the collected virus introduce uncertainty into the inactivation estimates. This study is the first to directly demonstrate far-UVC anti-microbial efficacy against airborne pathogens in an occupied indoor location.

Ameliorative and Disinfection Effects of Ultraviolet-C Radiation on Experimentally Induced and Infected Skin Wounds: A Mice Model Study

Only ultraviolet-C (UV-C) from UV lights, which are emitted by the sun and absorbed by the atmosphere's ozone layer, does not reach the Earth's surface. UV-C is a powerful disinfection method that is commonly used to sterilize fluids, air, and surfaces. There is a little knowledge of the effects of UV-C radiation on living bodies. The purpose of this study is to examine the ameliorative effect of UV-C on skin lesions in mice that have been experimentally created and infected with Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus sp. In total, 32 mice were used, and 4 mm skin defects were created and lesions infected with bacteria. Half of the mice in each group were treated with 254 nm UV-C twice a day for 4 days before being euthanatized. Blood samples were collected for hematological analysis, while skin samples were collected for microbiological, pathological, and immunohistochemical examinations. In addition, pathological examinations were performed on visceral organ samples. UV-C treatment caused rapid healing and complete or significant disinfection of skin lesions. Moreover, UV-C treatment reduced caspase-3 expressions in lesioned areas, according to immunochemistry. There were no pathological findings in visceral organs as a result of UV-C treatment. This study found that UV-C can be used to treat and disinfect infected skin lesions in short period and repeated doses.

Germicidal efficacy of continuous and pulsed ultraviolet-C radiation on pathogen models and SARS-CoV-2

Ultraviolet radiation's germicidal efficacy depends on several parameters, including wavelength, radiant exposure, microbial physiology, biological matrices, and surfaces. In this work, several ultraviolet radiation sources (a low-pressure mercury lamp, a KrCl excimer, and four UV LEDs) emitting continuous or pulsed irradiation were compared. The greatest log reductions in E. coli cells and B. subtilis endospores were 4.1 ± 0.2 (18 mJ cm-2) and 4.5 ± 0.1 (42 mJ cm-2) with continuous 222 nm, respectively. The highest MS2 log reduction observed was 2.7 ± 0.1 (277 nm at 3809 mJ cm-2). Log reductions of SARS-CoV-2 with continuous 222 nm and 277 nm were ≥ 3.4 ± 0.7, with 13.3 mJ cm-2 and 60 mJ cm-2, respectively. There was no statistical difference between continuous and pulsed irradiation (0.83-16.7% [222 nm and 277 nm] or 0.83-20% [280 nm] duty rates) on E. coli inactivation. Pulsed 260 nm radiation (0.5% duty rate) at 260 nm yielded significantly greater log reduction for both bacteria than continuous 260 nm radiation. There was no statistical difference in SARS-CoV-2 inactivation between continuous and pulsed 222 nm UV-C radiation and pulsed 277 nm radiation demonstrated greater germicidal efficacy than continuous 277 nm radiation. Greater radiant exposure for all radiation sources was required to inactivate MS2 bacteriophage. Findings demonstrate that pulsed irradiation could be more useful than continuous UV radiation in human-occupied spaces, but threshold limit values should be respected. Pathogen-specific sensitivities, experimental setup, and quantification methods for determining germicidal efficacy remain important factors when optimizing ultraviolet radiation for surface decontamination or other applications.

Preventing Respiratory Viral Illness Invisibly (PRiVII): protocol for a pragmatic cluster randomized trial evaluating far-UVC light devices in long-term care facilities to reduce infections

BACKGROUND

Respiratory viral illness (RVI)-e.g., influenza, COVID-19-is a serious threat in long-term care (LTC) facilities. Standard infection control measures are suboptimal in LTC facilities because of residents' cognitive impairments, care needs, and susceptibility to loneliness and mental illness. Further, LTC residents living with high degrees of frailty who contract RVIs often develop the so-called atypical symptoms (e.g., delirium, worse mobility) instead of typical cough and fever, delaying infection diagnosis and treatment. Although far-UVC (222 nm) light devices have shown potent antiviral activity in vitro, clinical efficacy remains unproven.

METHODS

Following a study to assay acceptability at each site, this multicenter, double-blinded, cluster-randomized, placebo-controlled trial aims to assess whether far-UVC light devices impact the incidence of RVIs in LTC facilities. Neighborhoods within LTC facilities are randomized to receive far-UVC light devices (222 nm) or identical placebo light devices that emit only visible spectrum light (400-700 nm) in common areas. All residents are monitored for RVIs using both a standard screening protocol and a novel screening protocol that target atypical symptoms. The 3-year incidence of RVIs will be compared using intention-to-treat analysis. A cost-consequence analysis will follow.

DISCUSSION

This trial aims to inform decisions about whether to implement far-UVC light in LTC facilities for RVI prevention. The trial design features align with this pragmatic intent. Appropriate additional ethical protections have been implemented to mitigate participant vulnerabilities that arise from conducting this study. Knowledge dissemination will be supported through media engagement, peer-reviewed presentations, and publications.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05084898. October 20, 2021.

Fluence-dependent degradation of fibrillar type I collagen by 222 nm far-UVC radiation

For more than 100 years, germicidal lamps emitting 254 nm ultraviolet (UV) radiation have been used for drinking-water disinfection and surface sterilization. However, due to the carcinogenic nature of 254 nm UV, these lamps have been unable to be used for clinical procedures such as wound or surgical site sterilization. Recently, technical advances have facilitated a new generation of germicidal lamp whose emissions centre at 222 nm. These novel 222 nm lamps have commensurate antimicrobial properties to 254 nm lamps while producing few short- or long-term health effects in humans upon external skin exposure. However, to realize the full clinical potential of 222 nm UV, its safety upon internal tissue exposure must also be considered. Type I collagen is the most abundant structural protein in the body, where it self-assembles into fibrils which play a crucial role in connective tissue structure and function. In this work, we investigate the effect of 222 nm UV radiation on type I collagen fibrils in vitro. We show that collagen's response to irradiation with 222 nm UV is fluence-dependent, ranging from no detectable fibril damage at low fluences to complete fibril degradation and polypeptide chain scission at high fluences. However, we also show that fibril degradation is significantly attenuated by increasing collagen sample thickness. Given the low fluence threshold for bacterial inactivation and the macroscopic thickness of collagenous tissues in vivo, our results suggest a range of 222 nm UV fluences which may inactivate pathogenic bacteria without causing significant damage to fibrillar collagen. This presents an initial step toward the validation of 222 nm UV radiation for internal tissue disinfection.

Skin optical properties from 200 to 300 nm support far UV-C skin-safety in vivo

The growing threat of multi-drug resistant pathogens and airborne microbial diseases has highlighted the need to improve or develop novel disinfection methods for clinical environments. Conventional ultraviolet C (UV-C) lamps effectively inactivate microorganisms but are harmful to human skin and eyes upon exposure. The use of new 233 nm far UV-C LEDs as an antiseptic can overcome those limitations. In this research, the light penetration into the skin was elucidated for the UV-C region (<300 nm) by measuring the scattering and absorption of skin layers and inverse Monte Carlo simulation, and further confirmed by the first clinical pilot trial in which healthy volunteers were irradiated with a dose of 60 mJ/cm2 at 233 nm. The radiation is strongly absorbed in the stratum corneum, resulting in minimal skin damage without inducing inflammatory responses. The results suggest that 233 nm far UV-C light emitting diodes (LEDs) could effectively inactivate microorganisms, while being safe and soft for the skin.

Light tolerance of extended spectrum β-lactamase producing Escherichia coli strains after repetitive exposure to far-UVC and blue LED light

AIMS

The aim of this study was to investigate dual far-UVC (Ultraviolet-C) (222 nm) and blue LED (Light Emitting Diode) (405 nm) light on the inactivation of extended spectrum β-lactamase-producing Escherichia coli (ESBL-Ec) and to determine if repetitive exposure to long pulses of light resulted in changes to light tolerance, and antibiotic susceptibility.

METHODS AND RESULTS

Antimicrobial efficiency of dual and individual light wavelengths and development of light tolerance in E. coli was evaluated through a spread plate method after exposure to light at 25 cm. Dual light exposure for 30 min resulted in a 5-6 log10 CFU mL-1 reduction in two ESBL-Ec and two antibiotic-sensitive control E. coli strains. The overall inhibition achieved by dual light treatment was always greater than the combined reductions (log10 CFU) observed from exposure to individual light wavelengths (combined 222-405 nm), indicating a synergistic relationship between blue LED and far-UVC light when used together. Repetitive long pulses of dual and individual far-UVC light exposure resulted in light tolerance in two ESBL-Ec strains but not the antibiotic-sensitive E. coli strains. Subsequent passages of repetitive light-treated ESBL-Ec strains continued to exhibit light tolerance. Antibiotic susceptibility was determined through a standard disk diffusion method. No changes were observed in the antibiotic susceptibility profiles for any of the four strains after exposure to either dual or individual wavelengths.

CONCLUSIONS

Dual light exposure was effective in the disinfection of ESBL-Ec in solution; however, antibiotic-resistant E. coli were able to develop light tolerance after repetitive exposure to light.

Filter-Free, Harmless, and Single-Wavelength Far UV-C Germicidal Light for Reducing Airborne Pathogenic Viral Infection

Germicidal lamps that primarily emit 254 nm ultraviolet (UV) radiation have been effectively utilized for surface sterilization, but they cannot be used on human skin and eyes due to their harmful and genotoxic activity. Recent reports have shown that far UV-C light (207-222 nm) can efficiently kill pathogens with potentially no harm to exposed human tissues. However, these methods still require additional filtering and/or further protective equipment. In this study, we demonstrate a filter-free, harmless, and single-wavelength far UV-C 207 nm germicidal light source that can be used to inactivate different respiratory viruses. It can be exploited as a safe and effective disinfection tool for various airborne viruses. We successfully developed a single-wavelength far UV-C source that produces an exact wavelength of 207 nm. We examined its safety on human skin and corneal cell lines, as well as its effects on inactivating different airborne viruses, such as coronavirus, adenovirus, and vaccinia virus. We expect that our far UV-C lamps can be safely and conveniently used to reduce COVID-19 infections and protect both our living spaces and hospitals from the threat of contamination by possible new or mutant viruses.

Different biological effects of exposure to far-UVC (222 nm) and near-UVC (254 nm) irradiation

Ultraviolet C (UVC) light has long been used as a sterilizing agent, primarily through devices that emit at 254 nm. Depending on the dose and duration of exposure, UV 254 nm can cause erythema and photokeratitis and potentially cause skin cancer since it directly modifies nitrogenated nucleic acid bases. Filtered KrCl excimer lamps (emitting mainly at 222 nm) have emerged as safer germicidal tools and have even been proposed as devices to sterilize surgical wounds. All the studies that showed the safety of 222 nm analyzed cell number and viability, erythema generation, epidermal thickening, the formation of genetic lesions such as cyclobutane pyrimidine dimers (CPDs) and pyrimidine-(6-4)-pyrimidone photoproducts (6-4PPs) and cancer-inducing potential. Although nucleic acids can absorb and be modified by both UV 254 nm and UV 222 nm equally, compared to UV 254 nm, UV 222 nm is more intensely absorbed by proteins (especially aromatic side chains), causing photooxidation and cross-linking. Here, in addition to analyzing DNA lesion formation, for the first time, we evaluated changes in the proteome and cellular pathways, reactive oxygen species formation, and metalloproteinase (MMP) levels and activity in full-thickness in vitro reconstructed human skin (RHS) exposed to UV 222 nm. We also performed the longest (40 days) in vivo study of UV 222 nm exposure in the HRS/J mouse model at the occupational threshold limit value (TLV) for indirect exposure (25 mJ/cm²) and evaluated overall skin morphology, cellular pathological alterations, CPD and 6-4PP formation and MMP-9 activity. Our study showed that processes related to reactive oxygen species and inflammatory responses were more altered by UV 254 nm than by UV 222 nm. Our chronic in vivo exposure assay using the TLV confirmed that UV 222 nm causes minor damage to the skin. However, alterations in pathways related to skin regeneration raise concerns about direct exposure to UV 222 nm.

Spatial immunization to abate disease spreading in transportation hubs

Proximity social interactions are crucial for infectious diseases transmission. Crowded agglomerations pose serious risk of triggering superspreading events. Locations like transportation hubs (airports and stations) are designed to optimize logistic efficiency, not to reduce crowding, and are characterized by a constant in and out flow of people. Here, we analyze the paradigmatic example of London Heathrow, one of the busiest European airports. Thanks to a dataset of anonymized individuals' trajectories, we can model the spreading of different diseases to localize the contagion hotspots and to propose a spatial immunization policy targeting them to reduce disease spreading risk. We also detect the most vulnerable destinations to contagions produced at the airport and quantify the benefits of the spatial immunization technique to prevent regional and global disease diffusion. This method is immediately generalizable to train, metro and bus stations and to other facilities such as commercial or convention centers.

Pollution free UV-C radiation to mitigate COVID-19 transmission

The high rate of transmission of the COVID-19 virus has brought various types of disinfection techniques, for instance, hydrogen peroxide vaporization, microwave generating steam, UV radiation, and dry heating, etc. to prevent the further transmission of the virus. The chemical-based techniques are predominantly used for sanitization of hands, buildings, hospitals, etc. However, these chemicals may affect the health of humans and the environment in unexplored aspects. Furthermore, the UV lamp-based radiation sanitization technique had been applied but has not gained larger acceptability owing to its limitation to penetrate different materials. Therefore, the optical properties of materials are especially important for the utilization of UV light on such disinfection applications. The germicidal or microorganism inactivation application of UV-C has only been in-use in a closed chamber, due to its harmful effect on human skin and the eye. However, it is essential to optimize UV for its use in an open environment for a larger benefit to mitigate the virus spread. In view of this, far UV-C (222 nm) based technology has emerged as a potential option for the sanitization in open areas and degradation of microorganisms present in aerosol during the working conditions. Hence, in the present review article, efforts have been made to evaluate the technical aspects of UV (under the different spectrum and wavelength ranges) and the control of COVID 19 virus spread in the atmosphere including the possibilities of the human body sanitization in working condition.

No Evidence of Induced Skin Cancer or Other Skin Abnormalities after Long-Term (66 week) Chronic Exposure to 222-nm Far-UVC Radiation

Far-UVC radiation, typically defined as 200-235 nm, has similar or greater anti-microbial efficacy compared with conventional 254-nm germicidal radiation. In addition, biophysical considerations of the interaction of far-UVC with tissue, as well as multiple short-term safety studies in animal models and humans, suggest that far-UVC exposure may be safe for skin and eye tissue. Nevertheless, the potential for skin cancer after chronic long-term exposure to far-UVC has not been studied. Here, we assessed far-UVC induced carcinogenic skin changes and other pathological dermal abnormalities in 96 SKH-1 hairless mice of both sexes that were exposed to average daily dorsal skin doses of 400, 130 or 55 mJ cm^-2 of 222 nm far-UVC radiation for 66 weeks, 5 days per week, 8 h per day, as well as similarly-treated unexposed controls. No evidence for increased skin cancer, abnormal skin growths or incidental skin pathology findings was observed in the far-UVC-exposed mice. In addition, there were no significant changes in morbidity or mortality. The findings from this study support the long-term safety of long-term chronic exposure to far-UVC radiation, and therefore its potential suitability as a practical anti-microbial approach to reduce airborne viral and bacterial loads in occupied indoor settings.

Structural and biological engineering of 3D hydrogels for wound healing

Chronic wounds have become one of the most important issues for healthcare systems and are a leading cause of death worldwide. Wound dressings are necessary to facilitate wound treatment. Engineering wound dressings may substantially reduce healing time, reduce the risk of recurrent infections, and reduce the disability and costs associated. In the path of engineering of an ideal wound dressing, hydrogels have played a leading role. Hydrogels are 3D hydrophilic polymeric structures that can provide a protective barrier, mimic the native extracellular matrix (ECM), and provide a humid environment. Due to their advantages, hydrogels (with different architectural, physical, mechanical, and biological properties) have been extensively explored as wound dressing platforms. Here we describe recent studies on hydrogels for wound healing applications with a strong focus on the interplay between the fabrication method used and the architectural, mechanical, and biological performance achieved. Moreover, we review different categories of additives which can enhance wound regeneration using 3D hydrogel dressings. Hydrogel engineering for wound healing applications promises the generation of smart solutions to solve this pressing problem, enabling key functionalities such as bacterial growth inhibition, enhanced re-epithelialization, vascularization, improved recovery of the tissue functionality, and overall, accelerated and effective wound healing.

The Paradoxical Role of far-Ultraviolet C (far-UVC) in Inactivation of SARS-CoV-2: The Issue of Droplet Size

The Omicron variant is spreading at a rate we have never observed with any previous variant. A lot of efforts have been taken to inactivate SARS-CoV-2, especially the omicron variant. Specific wavelength ranges of electromagnetic radiation can be exploited to inactivate coronaviruses. Previous studies show that 222-nm far-Ultraviolet C (far-UVC) light inactivates airborne influenza virus efficiently. Considering the similar genomic sizes of all human coronaviruses, other human coronaviruses, such as SARS-CoV-2, would be expected to be inactivated by far-UVC with a similar efficacy. Taking this into account, it is concluded that exposure to far-UVC can be introduced as a safe method that significantly reduces the ambient level of airborne coronaviruses in crowded places. Biomolecules, particularly proteins, strongly absorb ultraviolet radiation at a wavelength of around 200 nm. Given this consideration, far-UVC has a limited ability to permeate biological materials. Thus, for example, in only around 0.3 mm of tissue, the intensity of 200-nm UV radiation is decreased by half, compared to tissue penetration of about 3 mm at 250 nm. This paper aims to answer the key question of whether far-UVC can penetrate SARS-CoV-2 inside inhalable respiratory droplets (with diameters up to 100 µm).

One-Year Ocular Safety Observation of Workers and Estimations of Microorganism Inactivation Efficacy in the Room Irradiated with 222-Nm far Ultraviolet-C Lamps

Two krypton-chloride germicidal excimer lamp units (Care222 TRT-104C11-UI-U3, USHIO Inc.) were installed in the examination room of an ophthalmology department. The irradiation dose was set not to exceed the former (i.e., before 2022) threshold limit value (TLV) (22 mJ/cm² /8 hours) recommended by the ACGIH. Section 1: The eyes and lids of the 6 ophthalmologists (5 wore glasses for myopic correction) who worked in the room for a mean stay of 6.7 hours/week were prospectively observed for 12 months. Slitlamp examinations revealed neither acute adverse events such as corneal erosion, conjunctival hyperemia, lid skin erythema nor chronic adverse events such as pterygium, cataract, or lid tumor. The visual acuity, refractive error, corneal endothelial cell density remained unchanged during the study. Section 2: The irradiation of samples placed on the table or floor using the same fixtures in the room (5-7.5 mJ/cm² ) was associated with >99% inhibition of φX174 phage and >90% inhibition of S. aureus. In conclusion, no acute or chronic health effects in human participants was observed in a clinical setting of full-room ultraviolet germicidal irradiation by 222-nm lamp units and high efficacy in deactivation of microorganisms was determined in the same setting.

Evaluation of Genetic Damage and Antigenotoxic Effect of Ascorbic Acid in Erythrocytes of Orochromis niloticus and Ambystoma mexicanum Using Migration Groups as a Parameter

The comet assay system is an efficient method used to assess DNA damage and repair; however, it currently provides the average result and, unfortunately, the heterogeneity of DNA damage loses relevance. To take advantage of this heterogeneity, migration groups (MGs) of cell comets can be formed. In this study, genetic damage was quantified in erythrocytes of Oreochromis niloticus and Ambystoma mexicanum exposed to ethyl methanesulfonate (ethyl methanesulfonate (EMS) 2.5, 5, and 10 mM over two hours) and ultraviolet C radiation (UV-C) for 5, 10, and 15 min using the tail length, tail moment, and migration group parameters. Additionally, blood cells were exposed to UV-C radiation for 5 min and treated post-treatment at 5, 10, and 15 mM ascorbic acid (AA) for two hours. With the MG parameter, it was possible to observe variations in the magnitude of genetic damage. Our data indicate that MGs help to detect basal and induced genetic damage or damage reduction with approximately the same efficiency of the tail length and tail moment parameters. MGs can be a complementary parameter used to assess DNA integrity in species exposed to mutagens.

Inactivation Rates for Airborne Human Coronavirus by Low Doses of 222 nm Far-UVC Radiation

Recent research using UV radiation with wavelengths in the 200–235 nm range, often referred to as far-UVC, suggests that the minimal health hazard associated with these wavelengths will allow direct use of far-UVC radiation within occupied indoor spaces to provide continuous disinfection. Earlier experimental studies estimated the susceptibility of airborne human coronavirus OC43 exposed to 222-nm radiation based on fitting an exponential dose–response curve to the data. The current study extends the results to a wider range of doses of 222 nm far-UVC radiation and uses a computational model coupling radiation transport and computational fluid dynamics to improve dosimetry estimates. The new results suggest that the inactivation of human coronavirus OC43 within our exposure system is better described using a bi-exponential dose–response relation, and the estimated susceptibility constant at low doses—the relevant parameter for realistic low dose rate exposures—was 12.4 ± 0.4 cm²/mJ, which described the behavior of 99.7% ± 0.05% of the virus population. This new estimate is more than double the earlier susceptibility constant estimates that were based on a single-exponential dose response. These new results offer further evidence as to the efficacy of far-UVC to inactivate airborne pathogens.

Transcriptome analysis of molecular response to UVC irradiation in zebrafish embryos

Ultraviolet (UV) rays can be both harmful and beneficial to humans. This study aimed to investigate the toxicity and safety of ultraviolet C (UVC) exposure in living organisms and the corresponding biodefense molecular mechanisms. Zebrafish embryos, at an early developmental stage (5-6 h post-fertilization), were irradiated with increasing UVC dosages using high-efficiency deep-ultraviolet light-emitting diodes (278 nm). Morphological phenotypes including survival rate, hatching rate, heart rate, and malformation rate were evaluated. Compared to un-irradiated controls, all zebrafish embryos exposed to 4.5 mJ/cm² UVC survived and showed no significant difference in hatching and heart rate. However, 7.5 mJ/cm² of UVC irradiation caused a significantly decreased survival rate (37.5%) and an increased malformation rate (81.8%). Therefore, 4.5 mJ/cm² was chosen as the limit dosage that the internal biodefense system of zebrafish embryos can protect against UVC radiation. Transcriptome analysis (RNA sequencing) performed on 3 min and 3 days post-irradiation embryos (4.5 mJ/cm²) revealed the molecular mechanisms underlying the response of zebrafish embryos to irradiation. The embryos quickly responded to UVC-induced stress by activating the p53 signaling pathway. In addition, after 3 days of recuperation, the embryos showed activation of signal transducer and activator of transcription (STAT) signaling pathway. To our knowledge, this is the first study to evaluate the toxicological effects and the molecular mechanism of biodefense in zebrafish embryos upon 278 nm UVC irradiation.

Wavelength-dependent DNA Photodamage in a 3-D Human Skin Model over the far-UVC and Germicidal-UVC Wavelength Ranges from 215 to 255 nm

The effectiveness of UVC to reduce airborne‐mediated disease transmission is well established. However, conventional germicidal UVC (~254 nm) cannot be used directly in occupied spaces because of the potential for damage to the skin and eye. A recently studied alternative with the potential to be used directly in occupied spaces is far UVC (200–235 nm, typically 222 nm), as it cannot penetrate to the key living cells in the epidermis. Optimal far‐UVC use is hampered by limited knowledge of the precise wavelength dependence of UVC‐induced DNA damage, and thus we have used a monochromatic UVC exposure system to assess wavelength‐dependent DNA damage in a realistic 3‐D human skin model. We exposed a 3‐D human skin model to mono‐wavelength UVC exposures of 100 mJ/cm², at UVC wavelengths from 215 to 255 nm (5 nm steps). At each wavelength, we measured yields of DNA‐damaged keratinocytes, and their distribution within the layers of the epidermis. No increase in DNA damage was observed in the epidermis at wavelengths from 215 to 235 nm, but at higher wavelengths (240–255 nm) significant levels of DNA damage was observed. These results support use of far‐UVC radiation to safely reduce the risk of airborne disease transmission in occupied locations.

222 nm ultraviolet radiation C causes more severe damage to guard cells and epidermal cells of Arabidopsis plants than does 254 nm ultraviolet radiation

Lamps that emit 222 nm short-wavelength ultraviolet (UV) radiation can be safely used for sterilization without harming human health. However, there are few studies on the effects of 222 nm UVC (222-UVC) radiation exposure on plants compared with the effects of germicidal lamps emitting primarily 254 nm UVC (254-UVC) radiation. We investigated the growth inhibition and cell damage caused by 222-UVC exposure to Arabidopsis plants, especially mitochondrial dynamics, which is an index of damage caused by UVB radiation. Growth inhibition resulted from 254-UVC or 222-UVC exposure depending on the dose of UVC radiation. However, with respect to the phenotype of 222-UVC-irradiated plants, the leaves curled under 1 kJ m⁻² and were markedly bleached under 10 kJ m⁻² compared with those of plants irradiated with 254-UVC. The cellular state, especially the mitochondrial dynamics, of epidermal and mesophyll cells of Arabidopsis leaves exposed to 254-UVC or 222-UVC radiation was investigated using Arabidopsis plants expressing mitochondrial matrix-targeted yellow fluorescent protein (MT-YFP) under the control of Pro35S to visualize the mitochondria. 222-UVC (1 or 5 kJ m⁻²) severely damaged the guard cells within the epidermis, and YFP signals and chloroplast autofluorescence in guard cells within the epidermis exposed to 222-UVC (1 or 5 kJ m⁻²) were not detected compared with those in cells exposed to 254-UVC radiation. In addition, 222-UVC irradiation led to mitochondrial fragmentation in mesophyll cells, similar to the effects of 254-UVC exposure. These results suggest that 222-UVC severely damages guard cells and epidermal cells and that such damage might have resulted in growth inhibition.

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.

Pulsed blue light inactivates two strains of human coronavirus

Emerging evidence suggests that blue light has the potential to inactivate viruses. Therefore, we investigated the effect of 405 nm, 410 nm, 425 nm and 450 nm pulsed blue light (PBL) on human alpha coronavirus HCoV-229 E and human beta coronavirus HCoV-OC43, using Qubit fluorometry and RT-LAMP to quantitate the amount of nucleic acid in irradiated and control samples. Like SARS-CoV-2, HCoV-229E and HCoV-OC43 are single stranded RNA viruses transmitted by air and direct contact; they have similar genomic sizes as SARS-CoV-2, and are used as surrogates for SARS-CoV-2. Irradiation was carried out either at 32.4 J cm^-2 using 3 mW cm^-2 irradiance or at 130 J cm^-2 using 12 mW cm^-2 irradiance. Results: (1) At each wavelength tested, PBL was antiviral against both coronaviruses. (2) 405 nm light gave the best result, yielding 52.3% (2.37 log₁₀) inactivation against HCoV-OC43 (p < .0001), and a significant 1.46 log ₁₀ (44%) inactivation of HCoV-229E (p < .01). HCoV-OC43, which like SARS-CoV-2 is a beta coronavirus, was more susceptible to PBL irradiation than alpha coronavirus HCoV-229E. The latter finding suggests that PBL is potentially antiviral against multiple coronavirus strains, and that, while its potency may vary from one virus to another, it seems more antiviral against beta coronaviruses, such as HCoV-OC43. (3) Further, the antiviral effect of PBL was better at a higher irradiance than a lower irradiance, and this indicates that with further refinement, a protocol capable of yielding 100% inactivation of viruses is attainable.

Disinfection capabilities of a 222 nm wavelength ultraviolet lighting device: a pilot study

OBJECTIVE

To demonstrate the efficacy of the SafeZone UVC (Ushio Inc., Japan) 222 nm ultraviolet C (UVC) light to reduce bacterial burden in pressure ulcers (PUs) in human patients. This research is the first human clinical trial using 222 nm UVC in eradicating bacteria in human wounds.

METHOD

Patients with Stage 2 or 3 (as defined by the revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System) sacral or gluteal pressure ulcers (PUs) were subjected to four sessions of 222 nm UVC light therapy over two weeks. Pre- and post-UVC therapy, wound cultures were taken and quantitative analysis of bacterial colony forming units (CFU) were performed.

RESULTS

A total of 68 UV light sessions across 16 different patients were conducted. Of these sessions, 59 (87.0%) sessions showed a reduction in CFU counts, with 20 (29.4%) showing complete eradication of bacteria. Bacteria identified included meticillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella Pneumoniae. The overall median reduction in CFU of the 68 sessions was 78.9%. No adverse events were reported in any of the UV sessions.

CONCLUSION

In this study, 222 nm UVC light was safe and effective in reducing bacterial CFU counts in sacral and gluteal PUs across numerous different species of bacteria.

Environmental survival of SARS-CoV-2 - A solid waste perspective

The advent of COVID-19 has kept the whole world on their toes. Countries are maximizing their efforts to combat the virus and to minimize the infection. Since infectious microorganisms may be transmitted by variety of routes, respiratory and facial protection is required for those that are usually transmitted via droplets/aerosols. Therefore this pandemic has caused a sudden increase in the demand for personal protective equipment (PPE) such as gloves, masks, and many other important items since, the evidence of individual-to-individual transmission (through respiratory droplets/coughing) and secondary infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). But the disposal of these personal protective measures remains a huge question mark towards the environmental impact. Huge waste generation demands proper segregation according to waste types, collection, and recycling to minimize the risk of infection spread through aerosols and attempts to implement measures to monitor infections. Hence, this review focuses on the impact of environment due to improper disposal of these personal protective measures and to investigate the safe disposal methods for these protective measures by using the safe, secure and innovative biological methods such as the use of Artificial Intelligence (AI) and Ultraviolet (UV) lights for killing such deadly viruses.

Re-Evaluation of Rat Corneal Damage by Short-Wavelength UV Revealed Extremely Less Hazardous Property of Far-UV-C†

Corneal damage‐induced various wavelength UV (311, 254, 235, 222 and 207 nm) was evaluated in rats. For 207 and 222‐UV‐C, the threshold radiant exposure was between 10 000 and 15 000 mJ cm⁻² at 207 nm and between 3500 and 5000 mJ cm⁻² at 222 nm. Penetrate depth to the cornea indicated by cyclobutene pyrimidine dimer (CPD) localization immediately after irradiation was dependent on the wavelength. 311 and 254 nm UV penetrate to corneal endothelium, 235 nm UVC to the intermediate part of corneal stroma, 222 and 207 nm UVC only to the most outer layer of corneal epithelium. CPD observed in corneal epithelium irradiated by 222 nm UVC disappeared until 12 h after. The minimum dose to induce corneal damage of short‐wavelength UV‐C was considerably higher than the threshold limit value (TLV^®) promulgated by American Conference of Governmental Industrial Hygienists (ACGIH). The property that explains why UV‐C radiation at 207 and 222 nm is extremely less hazardous than longer UV wavelengths is the fact that this radiation only penetrates to the outermost layer of the corneal epithelium. These cells typically peel off within 24 h during the physiological turnover cycle. Hence, short‐wavelength UV‐C might be less hazardous to the cornea than previously considered until today.

A Need to Revise Human Exposure Limits for Ultraviolet UV-C Radiation†

The COVID‐19 pandemic has greatly heightened interest in ultraviolet germicidal irradiation (UVGI) as an important intervention strategy to disinfect air in medical treatment facilities and public indoor spaces. However, a major drawback of UVGI is the challenge posed by assuring safe installation of potentially hazardous short‐wavelength (UV‐C) ultraviolet lamps. Questions have arisen regarding what appear to be unusually conservative exposure limit values in the UV‐C spectral band between 180 and 280 nm. We review the bases for the current limits and proposes some adjustments that would provide separate limits for the eye and the skin at wavelengths less than 300 nm and to increase both skin and eye limits in the UV‐C below 250 nm.

Service Robots in the Healthcare Sector

Traditionally, advances in robotic technology have been in the manufacturing industry due to the need for collaborative robots. However, this is not the case in the service sectors, especially in the healthcare sector. The lack of emphasis put on the healthcare sector has led to new opportunities in developing service robots that aid patients with illnesses, cognition challenges and disabilities. Furthermore, the COVID-19 pandemic has acted as a catalyst for the development of service robots in the healthcare sector in an attempt to overcome the difficulties and hardships caused by this virus. The use of service robots are advantageous as they not only prevent the spread of infection, and reduce human error but they also allow front-line staff to reduce direct contact, focusing their attention on higher priority tasks and creating separation from direct exposure to infection. This paper presents a review of various types of robotic technologies and their uses in the healthcare sector. The reviewed technologies are a collaboration between academia and the healthcare industry, demonstrating the research and testing needed in the creation of service robots before they can be deployed in real-world applications and use cases. We focus on how robots can provide benefits to patients, healthcare workers, customers, and organisations during the COVID-19 pandemic. Furthermore, we investigate the emerging focal issues of effective cleaning, logistics of patients and supplies, reduction of human errors, and remote monitoring of patients to increase system capacity, efficiency, resource equality in hospitals, and related healthcare environments.

Effect of UV Irradiation and TiO2-Photocatalysis on Airborne Bacteria and Viruses: An Overview

Current COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has put a spotlight on the spread of infectious diseases brought on by pathogenic airborne bacteria and viruses. In parallel with a relentless search for therapeutics and vaccines, considerable effort is being expended to develop ever more powerful technologies to restricting the spread of airborne microorganisms in indoor spaces through the minimization of health- and environment-related risks. In this context, UV-based and photocatalytic oxidation (PCO)-based technologies (i.e., the combined action of ultraviolet (UV) light and photocatalytic materials such as titanium dioxide (TiO2)) represent the most widely utilized approaches at present because they are cost-effective and ecofriendly. The virucidal and bactericidal effect relies on the synergy between the inherent ability of UV light to directly inactivate viral particles and bacteria through nucleic acid and protein damages, and the production of oxidative radicals generated through the irradiation of the TiO2 surface. In this literature survey, we draw attention to the most effective UV radiations and TiO2-based PCO technologies available and their underlying mechanisms of action on both bacteria and viral particles. Since the fine tuning of different parameters, namely the UV wavelength, the photocatalyst composition, and the UV dose (viz, the product of UV light intensity and the irradiation time), is required for the inactivation of microorganisms, we wrap up this review coming up with the most effective combination of them. Now more than ever, UV- and TiO2-based disinfection technologies may represent a valuable tool to mitigate the spread of airborne pathogens.

Germicidal UV Sources and Systems†

The COVID‐19 pandemic has generated great interest in reviving an old intervention technology, particularly for air disinfection—ultraviolet germicidal irradiation (UVGI). Since UVGI was developed and refined more than 80–90 years ago, the ultraviolet source of choice has been almost exclusively the low‐pressure mercury vapor discharge lamp. Today, with new lamp technologies, there has been significant interest in the application of ultraviolet light‐emitting diodes and excimer lamps that emit in the UV‐C (180–280 nm) spectral band. This paper reviews these competing technologies with the aim of giving a sound basis for decisions on how to choose and install UV systems for disinfection of air and surfaces given the COVID‐19 pandemic.

The impact of far-UVC radiation (200-230 nm) on pathogens, cells, skin, and eyes - a collection and analysis of a hundred years of data

Background: The ongoing coronavirus pandemic requires new disinfection approaches, especially for airborne viruses. The 254 nm emission of low-pressure vacuum lamps is known for its antimicrobial effect, but unfortunately, this radiation is also harmful to human cells. Some researchers published reports that short-wavelength ultraviolet light in the spectral region of 200-230 nm (far-UVC) should inactivate pathogens without harming human cells, which might be very helpful in many applications. Methods: A literature search on the impact of far-UVC radiation on pathogens, cells, skin and eyes was performed and median log-reduction doses for different pathogens and wavelengths were calculated. Observed damage to cells, skin and eyes was collected and presented in standardized form. Results: More than 100 papers on far-UVC disinfection, published within the last 100 years, were found. Far-UVC radiation, especially the 222 nm emission of KrCl excimer lamps, exhibits strong antimicrobial properties. The average necessary log-reduction doses are 1.3 times higher than with 254 nm irradiation. A dose of 100 mJ/cm2 reduces all pathogens by several orders of magnitude without harming human cells, if optical filters block emissions above 230 nm. Conclusion: The approach is very promising, especially for temporary applications, but the data is still sparse. Investigations with high far-UVC doses over a longer period of time have not yet been carried out, and there is no positive study on the impact of this radiation on human eyes. Additionally, far-UVC sources are unavailable in larger quantities. Therefore, this is not a short-term solution for the current pandemic, but may be suitable for future technological approaches for decontamination in rooms in the presence of people or for antisepsis.

Evaluation of Acute Reactions on Mouse Skin Irradiated with 222 and 235 nm UV-C

Biological response and DNA damage following irradiation with shorter wavelengths in the UV‐C range were evaluated to investigate the safety at three wavelengths because of the recent emergence of germicidal equipment emitting short‐wavelength UV‐C for various purposes, including medical uses. To estimate an acceptable safety dose for human skin in the UV‐C range, especially short UV‐C, we studied the biological effects of 207, 222 and 235 nm UV‐C using albino hairless mice and evaluated the inflammatory reactions in the skin. To explore an appropriate indicator to evaluate the biological response, we employed determination of the minimal perceptible response dose (MPRD), by which any subtle cutaneous response; erythema, edema and scale could be observed by visual inspection. Erythema was rarely observed, but edema and scale formation were evident for short UV‐C wavelengths. The MPRD at 207, 222 and 235 nm was determined to be > 15, 15 and 2.0 kJ m⁻², respectively. These values could be thresholds and indicators for possible safety assessments. Our data suggest that the current human exposure limits for short UV‐C wavelengths below 254 nm are overly restrictive and should be reconsidered for future disinfection lamps with short UV‐C wavelengths.

Red ginseng oil promotes hair growth and protects skin against UVC radiation

Background

A wide range of environmental factors, such as diseases, nutritional deficiencies, ageing, hormonal imbalances, stress, and ultraviolet (UV) radiation, may affect the structure and function of the skin that covers the entire surface of the human body. In this study, we investigated roles of red ginseng oil (RGO) in enhancing skin functions, including hair growth and skin protection, using mouse models.

Methods

For hair growth experiment, shaved dorsal skins of C57BL/6 mice were topically applied with vehicle, RGO, RGO's major compounds, or minoxidil for consecutive 21 days and skin tissues were examined the hair growth promoting capacity. For skin protection experiment, SKH-1 hairless mice were topically applied with vehicle or RGO twice a day for three days prior to exposure to UVC radiation at 20 kJ/cm². Skin tissues were collected to evaluate skin protective effects of RGO.

Results

Topical application of RGO to C57BL/6 mice effectively promoted hair regeneration by inducing early telogen-to-anagen transition and significantly increasing the density and bulb diameter of hair follicles. Major compounds, including linoleic acids and β-sitosterol, contributed to RGO-promoted hair growth. Treatment with RGO as well as its major components upregulated expression of hair growth–related proteins. Furthermore, in SKH-1 hairless mice, RGO had a protective effect against UVC-induced skin damage by inhibiting inflammation and apoptosis, as well as inducing cytoprotective systems.

Conclusion

These data suggest that RGO may be a potent agent for improving skin health and thereby preventing and/or treating hair loss and protecting skin against UV radiation.

Improved Ultraviolet Radiation Film Dosimetry Using OrthoChromic OC-1 Film†

There is growing interest in far-UVC lighting, defined as wavelengths from 200 to 230 nm, because research has demonstrated these wavelengths to be an effective antimicrobial technology while posing a minimal hazard to human health. Far-UVC lighting is now being installed to directly irradiate spaces where humans are present, and it will be important to perform measurements to verify far-UVC lighting installations are operating within widely accepted exposure guidelines. In this work, we explore the use of a commercially available film, known as OrthoChromic OC-1, to measure ultraviolet radiation exposure. The film was tested with a variety of ultraviolet wavelengths and irradiance conditions, and the color change of the film was analyzed for increasing levels of radiant exposure. The film response extended over a dynamic range that was greater than the recommended exposure limits for far-UVC radiation so it can potentially be useful for health hazard monitoring. The spectrum of the incident ultraviolet radiation strongly affected the response of the film; therefore, for accurate measurements we recommend the measured spectrum match the spectrum used for calibration. Overall, dosimetry with this film provides a simple, accurate, and inexpensive method of quantifying ultraviolet radiation exposure that is suitable for far-UVC measurements.

Antimicrobial Blue Light versus Pathogenic Bacteria: Mechanism, Application in the Food Industry, Hurdle Technologies and Potential Resistance

Blue light primarily exhibits antimicrobial activity through the activation of endogenous photosensitizers, which leads to the formation of reactive oxygen species that attack components of bacterial cells. Current data show that blue light is innocuous on the skin, but may inflict photo-damage to the eyes. Laboratory measurements indicate that antimicrobial blue light has minimal effects on the sensorial and nutritional properties of foods, although future research using human panels is required to ascertain these findings. Food properties also affect the efficacy of antimicrobial blue light, with attenuation or enhancement of the bactericidal activity observed in the presence of absorptive materials (for example, proteins on meats) or photosensitizers (for example, riboflavin in milk), respectively. Blue light can also be coupled with other treatments, such as polyphenols, essential oils and organic acids. While complete resistance to blue light has not been reported, isolated evidence suggests that bacterial tolerance to blue light may occur over time, especially through gene mutations, although at a slower rate than antibiotic resistance. Future studies can aim at characterizing the amount and type of intracellular photosensitizers across bacterial species and at assessing the oxygen-independent mechanism of blue light-for example, the inactivation of spoilage bacteria in vacuum-packed meats.

Predicting airborne coronavirus inactivation by far-UVC in populated rooms using a high-fidelity coupled radiation-CFD model

There are increased risks of contracting COVID-19 in hospitals and long-term care facilities, particularly for vulnerable groups. In these environments aerosolised coronavirus released through breathing increases the chance of spreading the disease. To reduce aerosol transmissions, the use of low dose far-UVC lighting to disinfect in-room air has been proposed. Unlike typical UVC, which has been used to kill microorganisms for decades but is carcinogenic and cataractogenic, recent evidence has shown that far-UVC is safe to use around humans. A high-fidelity, fully-coupled radiation transport and fluid dynamics model has been developed to quantify disinfection rates within a typical ventilated room. The model shows that disinfection rates are increased by a further 50-85% when using far-UVC within currently recommended exposure levels compared to the room's  ventilation alone. With these magnitudes of reduction, far-UVC lighting could be employed to mitigate SARS-CoV-2 transmission before the onset of future waves, or the start of winter when risks of infection are higher. This is particularly significant in poorly-ventilated spaces where other means of reduction are not practical, in addition social distancing can be reduced without increasing the risk.

Use of Ultraviolet Blood Irradiation Against Viral Infections

Ultraviolet blood irradiation (UBI) was used with success in the 1930s and 1940s for a variety of diseases. Despite the success, the lack of understanding of the detailed mechanisms of actions, and the achievements of antibiotics, phased off the use of UBI from the 1950s. The emergence of novel viral infections, from HIV/AIDS to Ebola, from SARS and MERS, and SARS-CoV-2, bring back the attention to this therapeutical opportunity. UBI has a complex virucidal activity, mostly acting on the immune system response. It has effects on lymphocytes (T-cells and B-cells), macrophages, monocytes, dendritic cells, low-density lipoprotein (LDL), and lipids. The Knott technique was applied for bacterial infections such as tuberculosis to viral infections such as hepatitis or influenza. The more complex extracorporeal photopheresis (ECP) is also being applied to hematological cancers such as T-cell lymphomas. Further studies of UBI may help to create a useful device that may find applications for novel viruses that are resistant to known antivirals or vaccines, or also bacteria that are resistant to known antibiotics.

UV-C light: A powerful technique for inactivating microorganisms and the related side effects to the skin

Hospital-associated infections have led to a significant increment of morbidity and mortality among patients. As a result, the public health had concentrated on preventing the transmission of infection using environmental controls. UV-C radiation or ultraviolet germicidal irradiation (UVGI) had caught interest for decades as it can potentially degrade many kinds of microorganisms. This review aims to highlight the current information regarding the ability of UV-C radiation in terms of disinfection and focuses on its application and safety in the medical field.

Exploratory clinical trial on the safety and bactericidal effect of 222-nm ultraviolet C irradiation in healthy humans

Introduction

Surgical site infection is one of the most severe complications of surgical treatments. However, the optimal procedure to prevent such infections remains uninvestigated. Ultraviolet radiation C (UVC) with a short wavelength has a high bactericidal effect; however, it is cytotoxic. Nonetheless, given that UVC with a wavelength of 222 nm reaches only the stratum corneum, it does not affect the skin cells. This study aimed to investigate the safety of 222-nm UVC irradiation and to examine its skin sterilization effect in healthy volunteers.

Methods

This trial was conducted on 20 healthy volunteers. The back of the subject was irradiated with 222-nm UVC at 50–500 mJ/cm², and the induced erythema (redness of skin) was evaluated. Subsequently, the back was irradiated with a maximum amount of UVC not causing erythema, and the skin swabs before and after the irradiation were cultured. The number of colonies formed after 24 hours was measured. In addition, cyclobutene pyrimidine dimer (CPD) as an indicator of DNA damage was measured using skin tissues of the nonirradiated and irradiated regions.

Results

All subjects experienced no erythema at all doses. The back of the subject was irradiated at 500 mJ/cm², and the number of bacterial colonies in the skin swab culture was significantly decreased by 222-nm UVC irradiation. The CPD amount produced in the irradiated region was slightly but significantly higher than that of the non-irradiated region.

Conclusion

A 222-nm UVC at 500 mJ/cm² was a safe irradiation dose and possessed bactericidal effects. In the future, 222-nm UVC irradiation is expected to contribute to the prevention of perioperative infection.

Back to Normal: An Old Physics Route to Reduce SARS-CoV-2 Transmission in Indoor Spaces

We advocate the widespread use of UV-C light as a short-term, easily deployable, and affordable way to limit virus spread in the current SARS-CoV-2 pandemic. Radical social distancing with the associated shutdown of schools, restaurants, sport clubs, workplaces, and traveling has been shown to be effective in reducing virus spread, but its economic and social costs are unsustainable in the medium term. Simple measures like frequent handwashing, facial masks, and other physical barriers are being commonly adopted to prevent virus transmission. However, their efficacy may be limited, particularly in shared indoor spaces, where, in addition to airborne transmission, elements with small surface areas such as elevator buttons, door handles, and handrails are frequently used and can also mediate transmission. We argue that additional measures are necessary to reduce virus transmission when people resume attending schools and jobs that require proximity or some degree of physical contact. Among the available alternatives, UV-C light satisfies the requirements of rapid, widespread, and economically viable deployment. Its implementation is only limited by current production capacities, an increase of which requires swift intervention by industry and authorities.

Harmless Effects of Sterilizing 222-nm far-UV Radiation on Mouse Skin and Eye Tissues

In this issue, Yamano et al. provide further evidence that germicidal 222-nm far UV light has no immediate and delayed harmful effects on the skin and ocular tissue of rats. The safety of 222-nm krypton-chlorine excimer lamps, highlighted in the commentary article, has already received relevant applications in the treatment of surgical site infections and in the control of airborne and foodborne pathogens.

Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses

A direct approach to limit airborne viral transmissions is to inactivate them within a short time of their production. Germicidal ultraviolet light, typically at 254 nm, is effective in this context but, used directly, can be a health hazard to skin and eyes. By contrast, far-UVC light (207–222 nm) efficiently kills pathogens potentially without harm to exposed human tissues. We previously demonstrated that 222-nm far-UVC light efficiently kills airborne influenza virus and we extend those studies to explore far-UVC efficacy against airborne human coronaviruses alpha HCoV-229E and beta HCoV-OC43. Low doses of 1.7 and 1.2 mJ/cm² inactivated 99.9% of aerosolized coronavirus 229E and OC43, respectively. As all human coronaviruses have similar genomic sizes, far-UVC light would be expected to show similar inactivation efficiency against other human coronaviruses including SARS-CoV-2. Based on the beta-HCoV-OC43 results, continuous far-UVC exposure in occupied public locations at the current regulatory exposure limit (~3 mJ/cm²/hour) would result in ~90% viral inactivation in ~8 minutes, 95% in ~11 minutes, 99% in ~16 minutes and 99.9% inactivation in ~25 minutes. Thus while staying within current regulatory dose limits, low-dose-rate far-UVC exposure can potentially safely provide a major reduction in the ambient level of airborne coronaviruses in occupied public locations.

Viability evaluation of layered cell sheets after ultraviolet light irradiation of 222 nm

Introduction

The objective of this study was to evaluate the cell viability of layered cell sheets, irradiated with 222 nm UV light.

Methods

UV transmittance of 222 nm and 254 nm was evaluated when the cell sheets of NCTC Clone 929 cells were irradiated UV light. Cell viability was evaluated after irradiation of 222 nm using 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay. Following irradiation of two layered cell sheets at 500 mJ/cm², the cell damage of lower layers was evaluated by a colony formation and MTT assays.

Results

The UV transmittance of 222 nm was 10 times less than that of 254 nm. A MTT assay revealed that cells of cell sheets irradiated at 222 nm was less damaged than those at 254 nm, when irradiated at 5 mJ/cm². Cell colonies were formed for cells of lower layers irradiated at 222 nm whereas no colony formation was observed for those irradiated at 254 nm. Significantly higher MTT activity was observed for cells of lower layers irradiated at 222 nm than at 254 nm.

Conclusions

It is concluded that 222 nm irradiation is biologically safe for cell viability.

•

The cell viability of two-layered cell sheets was evaluated after irradiation of UV light at 222 nm.

•

UV light at 222 nm is safer to the lower layer than the conventional UV light at 254 nm.

•

The reason can be attributed to the lower transmission of UV light at 222 nm through cell sheets.

•

UV light at 222 nm could be one of promising tools to be required for the sterilization in the field of regenerative therapy.

Long-term Effects of 222-nm ultraviolet radiation C Sterilizing Lamps on Mice Susceptible to Ultraviolet Radiation

Germicidal lamps that emit primarily 254 nm ultraviolet radiation (UV) are routinely utilized for surface sterilization but cannot be used for human skin because they cause genotoxicity. As an alternative, 222‐nm UVC has been reported to exert sterilizing ability comparable to that of 254‐nm UVC without producing cyclobutane pyrimidine dimers (CPDs), the major DNA lesions caused by UV. However, there has been no clear evidence for safety in chronic exposure to skin, particularly with respect to carcinogenesis. We therefore investigated the long‐term effects of 222‐nm UVC on skin using a highly photocarcinogenic phenotype mice that lack xeroderma pigmentosum complementation group A (Xpa‐) gene, which is involved in repairing of CPDs. CPDs formation was recognized only uppermost layer of epidermis even with high dose of 222‐nm UVC exposure. No tumors were observed in Xpa‐knockout mice and wild‐type mice by repetitive irradiation with 222‐nm UVC, using a protocol which had shown to produce tumor in Xpa‐knockout mice irradiated with broad‐band UVB. Furthermore, erythema and ear swelling were not observed in both genotype mice following 222‐nm UVC exposure. Our data suggest that 222‐nm UVC lamps can be safely used for sterilizing human skin as far as the perspective of skin cancer development.