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

Extending the acute skin response spectrum to include the far-UVC

Guidance on maximal limits for ultraviolet (UV) exposure has been developed by national and international organizations to protect against adverse effects on human skin and eyes. These guidelines consider the risk of both acute effects (i.e., erythema and photokeratitis) and delayed effects (e.g., skin and ocular cancers) when determining exposure limits, and specify the dose a person can safely receive during an 8-h period without harmful effects. The determination of these exposure limits relies on the action spectra of photobiological responses triggered by UV radiation that quantify the effectiveness of each wavelength at eliciting each of these effects. With growing interest in using far-UVC (200-235 nm) radiation to control the spread of airborne pathogens, recent arguments have emerged about revisiting exposure limits for UV wavelengths. However, the standard erythema action spectrum, which provides some of the quantitative basis for these limits, has not been extended below 240 nm. This study assists to expand the erythema action spectrum to far-UVC wavelengths using a hairless albino mice model. We estimate that inducing acute effects on mouse skin with 222 nm radiation requires a dose of 1162 mJ/cm2, well above the current ACGIH skin exposure limit of 480 mJ/cm2.

Evaluation of an automated far ultraviolet-C light technology for decontamination of surfaces and aerosolized viruses in bathrooms

BACKGROUND

Aerosols generated during toilet flushing are a potential source for transmission of viral and bacterial pathogens in bathrooms. However, manual decontamination of bathrooms after each use is not feasible.

METHODS

We tested the efficacy of a wall-mounted far ultraviolet-C (UV-C) light technology that only delivers far UV-C when people are not present for decontamination of surfaces and aerosolized viral particles in an unoccupied hospital bathroom. A quantitative disk carrier test method was used to test efficacy against organisms on steel disk carriers placed in 9 sites in the bathroom with an exposure time of 45 min and 2 h; Clostridioides difficile spores were also exposed for 24 h. Efficacy against aerosolized bacteriophage MS2 was tested with a 45-minute exposure.

RESULTS

The far UV-C technology reduced methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Candida auris, and bacteriophage MS2 on steel disk carriers by ≥ 1.2 log10 (range, 1.2 to 4.2 log10) at all test sites after 2 h of exposure. The technology reduced C. difficile spores by < 1 log10 after 2 h exposure, but 4 of 9 test locations had ≥ 2 log10 reductions after 24 h exposure. Aerosolized bacteriophage MS2 was reduced by 4 log10 plaque-forming units in 45 min.

CONCLUSIONS

The far UV-C light technology could potentially be useful for automated decontamination of air and surfaces in bathrooms in healthcare and community settings.

A far ultraviolet-C light technology is effective for decontamination of items in proximity to sinks and is enhanced by a far UV-C reflective surface

BACKGROUND

Dispersal of gram-negative bacilli from sink drains has been implicated as a source of transmission in multiple outbreaks.

METHODS

In an acute care hospital, we assessed how often patient care supplies and other frequently touched items were within 1 meter of sink drains. We tested the efficacy of a ceiling-mounted far ultraviolet-C (UV-C) light technology for decontamination of sink bowls and surfaces near sinks with and without a wall-mounted film that reflects far UV-C light.

RESULTS

Of 190 sinks assessed, 55 (29%) had patient care supplies or other frequently touched items within 1 meter of the drain. The far UV-C technology reduced Pseudomonas aeruginosa, Enterobacter cloacae and Candida auris on steel disk carriers by ≥1.5 log10 colony-forming units (CFU) in 45 minutes. On inoculated real-world items, ≥1.9 log10 CFU reductions in P. aeruginosa were achieved on sites in line with the light source versus 0.4-1.8 log10 CFU reductions on shaded surfaces. The addition of the reflective surface significantly enhanced efficacy in shaded sites (P < 0.01).

CONCLUSIONS

In a hospital setting, patient care supplies and other frequently touched items were often in proximity to sinks. The far UV-C light technology could potentially be useful for sink decontamination in high-risk areas.

Evaluation of a wall-mounted far ultraviolet-C light device used for continuous air and surface decontamination in a dental office during routine patient care

A wall-mounted far ultraviolet-C light device used for continuous air and surface decontamination in a dental office reduced aerosolized bacteriophage MS2 and methicillin-resistant Staphylococcus aureus on steel disks by >3 log10 in 2 hours in unshaded areas in a procedure room. Far ultraviolet-C delivery was substantially reduced in shaded areas.

Microbial contamination of spittoons and germicidal effect of irradiation with krypton chloride excimer lamps (Far UV-C 222 nm)

BACKGROUND

In dentistry, instruments, appliances, and body fluids such as saliva or blood are possible sources of infection. Although conventional antiseptic procedures effectively prevent infection, spittoons cannot be sanitized between each treated patient and are usually washed only with running water. However, there is currently no fast and efficient disinfection method that can be implemented between treatments. An optically filtered krypton chloride excimer lamp using ultraviolet light (Far UV-C) in the 200-230 nm wavelength range (innocuous to humans) has been recently used as a virus- and bacteria-inactivating technology. This study aimed to identify the bioburden of a dental spittoon and examine the susceptibility of two oral Streptococcus and two Enterococci to 222-nm Far UV-C by irradiating the spittoon with 222 nm Far UV-C for 5 min before evaluating the disinfection effect.

METHODS

Bacterial analysis and real-time polymerase-chain reaction testing was used to confirm the spittoon's biological contamination. Bacterial susceptibility to a 222-nm Far UV-C was determined with a graded dose irradiation test. After each treatment, the spittoon was irradiated with 222-nm Far UV-C for 5 min, and the disinfecting effect was evaluated. Microbial analysis of the spittoon's surface was performed using the Silva database.

RESULTS

We found that > 97% of the microbes consisted of six bacterial phyla, whereas no viruses were found. Pseudomonas aeruginosa was frequently detected. The 1-log reduction value of two oral-derived Streptococci and two Enterococci species at 222-nm Far UV-C was 4.5-7.3 mJ/cm2. Exposure of the spittoon to 222-nm Far UV-C at 3.6-13.5 mJ/cm2 significantly decreased bacterial counts (p < 0.001).

CONCLUSIONS

Irradiation with 222-nm Far UV-C at 3.6-13.5 mJ/cm2 significantly eliminates bacteria in spittoons, even when they are only rinsed with water. Hence, 222-nm Far UV-C irradiation may inhibit the risk of bacterial transmission from droplets in sink surfaces.

Far-ultraviolet irradiation at 222 nm destroys and sterilizes the biofilms formed by periodontitis pathogens

BACKGROUND

Periodontal disease is the leading cause of tooth loss, and an association between periodontal disease and non-oral systemic diseases has been shown. Formation of biofilm by periodontal pathogens such as Fusobacterium nucleatum, Porphyromonas gingivalis, and Streptococcus mutans and their resistance to antimicrobial agents are at the root of persistent and chronic bacterial infections.

METHODS

The bactericidal effect of far-ultraviolet (F-UV) light irradiation at 222 nm on periodontal bacteria was assessed qualitatively and quantitatively. The effect of biofilm disruption by F-UV light on periodontal bacteria was examined by crystal violet staining, and the morphologic changes of the biofilm after F-UV irradiation were explored by confocal laser microscopy and scanning electron microscopy. We developed a thin fiber-type 222 nm F-UV irradiator and studied its safety and effect of reducing bacteria in rodent models.

RESULTS

F-UV light at 222 nm had a bactericidal effect on F. nucleatum, P. gingivalis, and S. mutans. Irradiation with F-UV light reduced the biofilm formed by the bacteria and sterilized them from within. Confocal laser microscopy showed a clear reduction in biofilm thickness, and scanning electron microscopy confirmed disintegration of the biofilm architecture. F-UV irradiation was less damaging to DNA and less cytotoxic than deep-ultraviolet light, and it reduced bacterial counts on the tooth surface.

CONCLUSION

F-UV irradiation has the potential to destroy biofilm and act as a bactericide against pathogenic bacteria in the biofilm.

Far-UVC: The impact of optical filters on real-world deployment

In 2015, a study showed that Krypton-Chloride (KrCl) excimer lamps could induce erythema and basal layer DNA damage in human skin. Later studies found that filtering out longer wavelength emissions from these lamps resulted in no acute skin effects. However, there is a limited understanding of how much to reduce unwanted emissions and which wavelengths are important. Accurate spectral irradiance data is therefore crucial for safety, as variance in optical filtering significantly affects the weighted irradiance of a lamp. To simplify the risk assessment process for Far-UVC lamps, we highlight the usefulness of the lamp exposure limit (HLEL) and present this in the context of spectral emission data for 14 commercially available Far-UVC lamps. Our results demonstrate that relying solely on a radiometric measurement and a single-wavelength exposure limit at 222 nm could lead to over-exposure. The HLEL is a practical metric which can be utilized to determine the exposure time before reaching the exposure limit. It can also be used in the determination of the minimum ceiling height for compliance with standards like UL 8802. Manufacturers are urged to provide HLEL for their products; installers should adhere to HLEL; and standards and regulatory bodies should insist on this information in new guidance.

Intermittent low-dose far-UVC irradiation inhibits growth of common mold below threshold limit value

Mold infestations in buildings pose significant challenges to human health, affecting both private residences and hospitals. While molds commonly trigger asthma and allergies in the immunocompetent, they can cause life-threatening diseases in the immunocompromised. Currently, there is an unmet need for new strategies to reduce or prevent mold infestations. Far-UVC technology can inactivate microorganisms while remaining safe for humans. This study investigates the inhibitory efficacy of far-UVC light at 222 nm on the growth of common mold-producing fungi, specifically Penicillium candidum, when delivered in low-dose on-off duty cycles, a configuration consistent with its use in real-world settings. The inhibitory effect of the low-dose duty cycles was assessed on growth induced by i) an adjacent spore-producing P. candidum donor and ii) P. candidum spores seeded directly onto agar plates. In both setups, the far-UVC light significantly inhibited both vertical and horizontal growth of P. candidum, even when the UV doses were below the Threshold Value Limit of 23 mJ/cm2. These results suggest that far-UVC light holds the potential to improve indoor air quality by reducing or preventing mold growth, also when people are present.

Far-Ultraviolet Light at 222 nm Affects Membrane Integrity in Monolayered DLD1 Colon Cancer Cells

222 nm far-ultraviolet (F-UV) light has a bactericidal effect similar to deep-ultraviolet (D-UV) light of about a 260 nm wavelength. The cytotoxic effect of 222 nm F-UV has not been fully investigated. DLD-1 cells were cultured in a monolayer and irradiated with 222 nm F-UV or 254 nm D-UV. The cytotoxicity of the two different wavelengths of UV light was compared. Changes in cell morphology after F-UV irradiation were observed by time-lapse imaging. Differences in the staining images of DNA-binding agents Syto9 and propidium iodide (PI) and the amount of cyclobutane pyrimidine dimer (CPD) were examined after UV irradiation. F-UV was cytotoxic to the monolayer culture of DLD-1 cells in a radiant energy-dependent manner. When radiant energy was set to 30 mJ/cm2, F-UV and D-UV showed comparable cytotoxicity. DLD-1 cells began to expand immediately after 222 nm F-UV light irradiation, and many cells incorporated PI; in contrast, PI uptake was at a low level after D-UV irradiation. The amount of CPD, an indicator of DNA damage, was higher in cells irradiated with D-UV than in cells irradiated with F-UV. This study proved that D-UV induced apoptosis from DNA damage, whereas F-UV affected membrane integrity in monolayer cells.

Far-UVC (222 nm) irradiation effectively inactivates ssRNA, dsRNA, ssDNA, and dsDNA viruses as compared to germicidal UVC (254 nm)

Ultraviolet-C (UVC) irradiation is being used as an effective approach for the disinfection of pathogenic viruses present in air, surfaces, and water. Recently, far-UVC radiation (222 nm) emitted by KrCl* (krypton-chloride) excimer lamps have been recommended for disinfecting high-risk public spaces to reduce the presence and transmission of infectious viruses owing to limited human health exposure risks as compared to germicidal UVC (254 nm). In this study, the UVC inactivation performances of individual filtered KrCl* excimer lamp (222 nm) and germicidal UVC lamp (254 nm) were determined against four viruses, bacteriophages MS2, Phi6, M13, and T4, having different genome compositions (ssRNA, dsRNA, ssDNA and dsDNA, respectively) and shapes (i.e., spherical (Phi6), linear (M13), and icosahedral (MS2 and T4)). Here, the disinfection efficacies of filtered KrCl* excimer lamp (222 nm) and germicidal UVC lamp (254 nm) were evaluated for highly concentrated virus droplets that mimic the virus-laden droplets released from the infected person and deposited on surfaces as fomites. Filtered KrCl* excimer (222 nm) showed significantly better inactivation against all viruses having different genome compositions and structures compared to germicidal UVC (254 nm). The obtained sensitivity against the filtered KrCl* excimer (222 nm) was found to be in the order, T4 > M13 > Phi6 > MS2 whereas for the germicidal UVC (254 nm) it was T4 > M13 > MS2 > Phi6. These results provide a strong basis to promote the use of filtered KrCl* excimer lamps (222 nm) in disinfecting contagious viruses and to limit the associated disease spread in public places and other high-risk areas.

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.

Photo-neuro-immuno-endocrinology: How the ultraviolet radiation regulates the body, brain, and immune system

Ultraviolet radiation (UVR) is primarily recognized for its detrimental effects such as cancerogenesis, skin aging, eye damage, and autoimmune disorders. With exception of ultraviolet B (UVB) requirement in the production of vitamin D3, the positive role of UVR in modulation of homeostasis is underappreciated. Skin exposure to UVR triggers local responses secondary to the induction of chemical, hormonal, immune, and neural signals that are defined by the chromophores and extent of UVR penetration into skin compartments. These responses are not random and are coordinated by the cutaneous neuro-immuno-endocrine system, which counteracts the action of external stressors and accommodates local homeostasis to the changing environment. The UVR induces electrical, chemical, and biological signals to be sent to the brain, endocrine and immune systems, as well as other central organs, which in concert regulate body homeostasis. To achieve its central homeostatic goal, the UVR-induced signals are precisely computed locally with transmission through nerves or humoral signals release into the circulation to activate and/or modulate coordinating central centers or organs. Such modulatory effects will be dependent on UVA and UVB wavelengths. This leads to immunosuppression, the activation of brain and endocrine coordinating centers, and the modification of different organ functions. Therefore, it is imperative to understand the underlying mechanisms of UVR electromagnetic energy penetration deep into the body, with its impact on the brain and internal organs. Photo-neuro-immuno-endocrinology can offer novel therapeutic approaches in addiction and mood disorders; autoimmune, neurodegenerative, and chronic pain-generating disorders; or pathologies involving endocrine, cardiovascular, gastrointestinal, or reproductive systems.

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.

Far-UV-C irradiation promotes synergistic bactericidal action against adhered cells of Escherichia coli and Staphylococcus epidermidis

The contamination of indoor areas is a global health problem that can cause the dispersion of infectious diseases. In that sense, it is urgent to find new strategies applying a lower concentration of the traditional chemicals used for cleaning and disinfection. Ultraviolet radiation (UV), in particular far-UV-C (200-225 nm), has emerged as a successful, powerful, easy-to-apply, and inexpensive approach for bacterial eradication that still requires scientific assessment. This study investigated new strategies for disinfection based on far-UV-C (222 nm) combined with chlorine and mechanical cleaning, providing an innovative solution using low doses. The bactericidal activity of far-UV-C (222 nm) was tested at an intensity of irradiation from 78.4 μW/cm2 to 597.7 μW/cm2 (for 1 min) against Escherichia coli and Staphylococcus epidermidis adhered on polystyrene microtiter plates. It was further tested in combination with mechanical cleaning (ultrasounds for 1 min) and free chlorine (0.1, 0.5, and 1 mg/L for 5 min). The triple combination consisting of mechanical cleaning + free chlorine (0.5 mg/L) + far-UV-C (54 mJ/cm2) was tested against cells adhered to materials found in hospital settings and other public spaces: polyvinyl chloride (PVC), stainless steel (SS), and polyetheretherketone (PEEK). Disinfection with far-UV-C (54 mJ/cm2) and free chlorine at 0.5 mg/L for 5 min allowed a total reduction of culturable E. coli cells and a logarithmic reduction of 2.98 ± 0.03 for S. epidermidis. The triple combination of far-UV-C, free chlorine, and mechanical cleaning resulted in a total reduction of culturable cells for both adhered bacteria. Bacterial adhesion to PVC, SS, and PEEK occurred at distinct extents and influenced the bactericidal activity of the triple combination, with logarithmic reductions of up to three. The overall results highlight that, based on culturability assessment, far-UV-C (54 mJ/cm2) with chlorine (0.5 mg/L; 5 min) and mechanical cleaning (1 min) as an efficient disinfection strategy using mild conditions. The combination of culturability and viability assessment of disinfection is recommended to detect regrowth events and increase the effectiveness in microbial growth 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.

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.

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.

Efficacy of a far-ultraviolet-C light technology for continuous decontamination of air and surfaces

A wall-mounted, far-ultraviolet-C light technology reduced aerosolized bacteriophage MS2 by >3 log10 plaque-forming units within 30 minutes. Vegetative bacterial pathogens on steel disk carriers in the center of the room were reduced by >3 log10 after 45 minutes of exposure, but Candida auris and Clostridioides difficile spores were not.

222 nm Far-UVC from filtered Krypton-Chloride excimer lamps does not cause eye irritation when deployed in a simulated office environment

Far-UVC, from filtered Krypton-Chloride lamps, is promising for reducing airborne transmission of disease. While significant research has been undertaken to investigate skin safety of these lamps, less work has been undertaken on eye safety. There is limited data on human eye safety or discomfort from the deployment of this germicidal technology. In this pilot study, immediate and delayed eye discomfort were assessed in a simulated office environment with deployment of Krypton-Chloride lamps, located on the ceiling and directed downwards into the occupied room. Discomfort was assessed immediately postexposure and several days after exposure using validated, Standard Patient Evaluation Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) questionnaires. Our results show no significant eye discomfort or adverse effects from the deployment of Far-UVC in this simulated office environment, even when lamps were operated continuously with participants receiving head exposures of up to 50 mJ cm-2 . In addition, a statistically significant reduction in bacteria and fungi of 52% was observed. Far-UVC in this simulated office environment did not cause any clinically significant eye discomfort and was effective at reducing pathogens in the room. These results contribute an important step to further investigation of the interaction of Far-UVC with the human eye.

Irradiation of human oral mucosa by 233 nm far UV-C LEDs for the safe inactivation of nosocomial pathogens

The inactivation of multi resistant pathogens is an important clinical need. One approach is UV-C irradiation, which was previously not possible in vivo due to cytotoxicity. Recently, far UV-C irradiation at λ < 240 nm was successfully used on skin with negligible damage. A potential application site is the nasal vestibule, where MRSA accumulates and cannot be treated using antiseptics. We irradiated 3D mucosa models and excised human mucosa with 222 and 233 nm far UV-C in comparison to 254 nm and broadband UV-B. Eradication efficiency was evaluated by counting colony forming units; irritation potential was evaluated by hen's egg-chorioallantoic membrane assay and trans epithelial electrical resistance; cell viability was assessed by MTT. DNA damage and cell protective mechanisms were evaluated immunohistopathologically. On mucosa models, MRSA reduced by ≈ 5 log10 for 60 mJ/cm2 irradiation at 233 nm. A slightly increased cell viability was observed after 24 h. Lower doses showed lower irritation potential than the positive controls or commercial mouthwash, while 80 mJ/cm2 had strong irritation potential. DNA damage occurred only superficially and decreased after 24 h. On excised human mucosa, < 10% of keratinocytes were affected after 150 mJ/cm2 222 nm or 60 mJ/cm2 233 nm.

Efficacy of a filtered far-UVC handheld disinfection device in reducing the microbial bioburden of hospital surfaces

BACKGROUND

The filtered far-UV-C (FFUV) handheld disinfection device is a small portable device that emits far UV-C at 222 nm. The objective of this study was to evaluate the device's ability to kill microbial pathogens on hospital surfaces and compare it to manual disinfection using germicidal sodium hypochlorite wipes.

METHODS

A total of 344 observations (4 observations from 86 objects' surfaces) were sampled with 2 paired samples per surface: a pre- and a post-sodium hypochlorite and FFUV sample. The results were analyzed via a Bayesian multilevel negative binomial regression model.

RESULTS

The estimated mean colony counts for the sodium hypochlorite control and treatment groups were 20.5 (95% uncertainty interval: 11.7-36.0) and 0.1 (0.0-0.2) colony forming units (CFUs), respectively. The FFUV control and treatment groups had mean colony counts of 22.2 (12.5-40.1) and 4.1 (2.3-7.2) CFUs. The sodium hypochlorite group and the FFUV group had an estimated 99.4% (99.0%-99.7%) and 81.4% (76.2%-85.7%) reduction in colony counts, respectively.

CONCLUSIONS

The FFUV handheld device effectively reduced the microbial bioburden on surfaces in the health care setting. The major benefit of FFUV is likely seen when manual disinfection is not possible or when supplementing cleaners or disinfectants with the low-level disinfection properties.

Continuous surface and air decontamination technologies: Current concepts and controversies

Effective and safe continuous surface and air decontamination technologies could be a useful adjunct to routine cleaning and disinfection in health care settings. Continuously active quaternary ammonium disinfectants that provide residual antimicrobial activity on undisturbed surfaces for up to 24.ßhours have been shown to reduce the recovery of clinically important pathogens in some but not all real-world studies. Although quaternary ammonium-based supplemental coatings have been reported to provide prolonged residual efficacy in patient care settings, there is concern that some of these products may be removed by routine cleaning and disinfection. To address this concern, the Environmental Protection Agency has recently issued updated guidance requiring demonstration of efficacy after multiple abrasion and chemical exposures for registration of supplemental residual antimicrobial coatings. Far-ultraviolet-C and direct irradiation below exposure limits are promising technologies for continuous air and surface decontamination in occupied spaces, but additional studies are needed to evaluate their long-term safety and efficacy. Given the increasing use of electronic air cleaning technologies in community and health care settings, there is a need for studies to assess real-world efficacy and safety.

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.

Evaluation of DNA lesions and radicals generated by a 233 nm far-UVC LED in superficial ex vivo skin wounds

The application of a far-ultraviolet C (UVC) light emitting diode (LED) of 233 nm showed significant bactericidal efficacy at an applied dose between 20 and 80 mJ cm-2 as reported recently. In addition, only minor epidermal DNA lesions were observed in ex vivo human skin and in vitro epidermal models <10% of the minimal erythema dose of UVB radiation. To broaden the potential range of applications of such systems, e.g. to include postoperative application on wounds for the purpose of decontamination, we assessed how a disruption of normal anatomic skin structure and function influences the skin damage induced by light from 233 nm far-UVC LEDs. Thus, we induced superficial skin wounds by mechanical detachment of the stratum corneum in ex vivo human skin. Barrier-disruption of the skin could be successfully determined by measuring an increase in the transepidermal water loss (TEWL) and the stratum corneum loss could be determined morphologically by 2-photon microscopy (2-PM). After far-UVC irradiation of the skin, we screened the tissue for the development of cyclobutane pyrimidine dimers (CPDs) and 6-4 photoproducts (6-4PPs). The abundance of DNA lesions was elevated in wound skin in comparison to intact skin after irradiation with far-UVC. However, no increase in DNA lesions was detected when artificial wound exudate consisting of cell culture medium and serum was applied to the disrupted skin surface prior to irradiation. This effect agrees with the results of ray tracing simulations of the absorption of far-UVC light incident on a superficial skin wound. Interestingly, no significant deviations in radical formation between intact skin and superficially wounded skin were detected after far-UVC irradiation as analyzed by electron paramagnetic resonance (EPR) spectroscopy. In conclusion, 233 nm LED light at a dose of 60 mJ/cm2 could be applied safely on superficial wounds for the purpose of skin antisepsis as long as the wounds are covered with wound fluid.

RT-qPCR-Based Assessment of the Efficacy of 222 nm UVC Irradiation in Reducing SARS-CoV-2 Surface Contamination

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has emerged as a serious threat to human health worldwide. The effective disinfection of surfaces contaminated with SARS-CoV-2 may help prevent its spread. The aim of this study is to determine the duration required for viral RNA elimination by 222 nm far ultraviolet light using RT-qPCR as a tool. This study investigated the effect of 222 nm UVC irradiation on SARS-CoV-2 RNA in an in vitro experiment. The results showed that the copy number of SARS-CoV-2 RNA did not change even after 300 s of 222 nm UVC irradiation at 0.1 mW/cm², but extending the exposure to more than 600 s reduced the number of copies of SARS-CoV-2 virus significantly. However, to fully validate the results and enhance the robustness of the findings, it is crucial to increase the number of samples analyzed in future experiments.

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.

Tailoring Photoprotection of Polylactide with New Isobornyl Derivatives of Phenol and Aniline

This article is devoted to the development of new photostabilizers for polylactide (PLA), a polymer that is an environmentally friendly alternative to polymers and is based on fossil raw materials. We have elucidated the role of the reaction center of two potential PLA photoprotectors: N-isobornylaniline and 2-isobornylphenol, in reactions occurring in a polymer matrix under the action of UV-C radiation. PLA samples with the photostabilizers were irradiated under a wavelength of 253.7 nm for 4, 8 and 12 h. The effectiveness of the photostabilizers was evaluated based on FTIR spectrometric data, ¹H and ¹³C NMR, scanning electron microscopy and simultaneous thermal analysis (TG-DSC). Both stabilizers led to the protection of ester bonds between monomer units of PLA. However, 2-isobornylphenol proved to be more effective at a concentration of 0.05 wt.%, while the optimal concentration of N-isobornylaniline was 0.5 wt.% by weight. TG-DSC showed that the addition of N-isobornylaniline led to an increase in PLA resistance to thermal decomposition; the temperature of the onset of weight loss increased by 2.8 °C at 0.05 wt.% and by 8.1 °C at 0.5 wt.% of N-isobornylaniline. The photoprotector 2-isobornylphenol, on the contrary, reduced the thermal stability of PLA.

Synergistic disinfection of aerosolized bacteria and bacteriophage by far-UVC (222-nm) and negative air ions

Air ionizers and 222-nm krypton-chlorine (KrCl) excilamp have proven to be effective disinfection apparatus for bacteria and viruses with limited health risks. We determined inactivation efficiencies by operating them individually and in combined modules. Gram-positive and gram-negative bacteria, non-enveloped dsDNA virus, and enveloped dsRNA virus were examined in a designed air disinfection system. Our results showed that the bioaerosols were inactivated efficiently by negative ionizers and far-UVC (222-nm), either used individually or in combination. Among which the combined modules of negative ionizers and KrCl excilamp had the best disinfection performance for the bacteria. The aerosolized virus P22 and Phi 6 were more susceptible to 222-nm emitted by KrCl excilamp than negative air ions. Significant greater inactivation of bacterial bioaerosols were identified after treated by combined treatment of negative air ion and far-UVC for 2 minutes (Escherichia coli, 6.25 natural log (ln) reduction; Staphylococcus epidermidis, 3.66 ln reduction), as compared to the mean sum value of inactivation results by respective individual treatment of negative ionizers and KrCl excilamp (Escherichia coli, 4.34 ln; Staphylococcus epidermidis, 1.75 ln), indicating a synergistic inactivation effect. The findings provide important baseline data to support the design and development of safe and high-efficient disinfection systems.

222 nm far-UVC efficiently introduces nerve damage in Caenorhabditis elegans

Far-ultraviolet radiation C light (far-UVC; 222 nm wavelength) has received attention as a safer light for killing pathogenic bacteria and viruses, as no or little DNA damage is observed after irradiation in mammalian skin models. Far-UVC does not penetrate deeply into tissues; therefore, it cannot reach the underlying critical basal cells. However, it was unclear whether far-UVC (222-UVC) irradiation could cause more biological damage at shallower depths than the 254 nm UVC irradiation (254-UVC), which penetrates more deeply. This study investigated the biological effects of 222- and 254-UVC on the small and transparent model organism Caenorhabditis elegans. At the same energy level of irradiation, 222-UVC introduced slightly less cyclobutane pyrimidine dimer damage to naked DNA in solution than 254-UVC. The survival of eggs laid during 0-4 h after irradiation showed a marked decrease with 254-UVC but not 222-UVC. In addition, defect of chromosomal condensation was observed in a full-grown oocyte by 254-UVC irradiation. In contrast, 222-UVC had a significant effect on the loss of motility of C. elegans. The sensory nervous system, which includes dopamine CEP and PVD neurons on the body surface, was severely damaged by 222-UVC, but not by the same dose of 254-UVC. Interestingly, increasing 254-UVC irradiation by about 10-fold causes similar damage to CEP neurons. These results suggest that 222-UVC is less penetrating, so energy transfer occurs more effectively in tissues near the surface, causing more severe damage than 254-UVC.

Ozone Generation from a Germicidal Ultraviolet Lamp with Peak Emission at 222 nm

Recent interest in commercial devices containing germicidal ultraviolet lamps with a peak emission wavelength at 222 nm (GUV222) has focused on mitigating virus transmission indoors while posing minimum risk to human tissue. However, 222 nm light can produce ozone (O3) in air. O3 is an undesirable component of indoor air because of health impacts from acute to chronic exposure and its ability to degrade indoor air quality through oxidation chemistry. In seven four-hour experiments we measured O3 produced from a single filtered GUV222 lamp in a 31.5 m3 stainless steel chamber. Using an emission model, we determined an O3 generation rate of 19.4 ppbv h-1 ± 0.3 ppbv h-1 (equivalent to 1.22 mg h-1 ± 0.02 mg h-1). We estimated the fluence rate from the lamp using two methods: (1) chemical actinometry using tetrachloroethylene (actinometry) and (2) geometric projection of the irradiance field from radial and angular distribution measurements of the GUV222 lamp fluence (irradiance). Using the estimated lamp fluence rates of 2.2 μW cm-2 (actinometry) and 3.2 μW cm-2 (irradiance) we predicted O3 production in our chamber within 20 % of the average measured mixing ratio. Future studies should evaluate the indoor air quality impacts of GUV222 technologies.

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.

Safety Evaluation of Far-UV-C Irradiation to Epithelial Basal Cells in the Corneal Limbus

Basal cells in the corneal limbus play an important role in the turnover cycle because they are the source of all cells that constitute the corneal epithelium. We examined the penetration depth of ultraviolet (UV) light in the corneal limbus and assessed the safety of Far-UV-C on stem cells in the basal area of the corneal limbus. Rats were irradiated with UV at peaks of 207, 222, 235, 254 and 311 nm while under anesthesia. The UV penetration depth in the rat corneal limbal epithelium was wavelength dependent: 311 nm UV-B and 254 nm UV-C reached the basal cells of the epithelium, and 235 nm radiation reached the middle area; however, 207 and 222 nm UV-C reached only the superficial layer of the epithelium. Porcine cornea, which is similar to the human eye in size and structure, were irradiated with 222 and 254 nm UV-C. As in rats, 222 nm UV-C reached only the superficial layer of the porcine corneal limbal epithelium. These results indicate that Far-UV-C, such as radiation of wavelengths of 207 and 222 nm, could not reach corneal epithelial stem cells, i.e. the cells remained intact. It is unlikely that the turnover of the corneal epithelium is obstructed or disrupted by exposure to Far-UV-C.

Evaluation of UVC Excimer Lamp (222 nm) Efficacy for Coronavirus Inactivation in an Animal Model

The current pandemic caused by severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) has encouraged the evaluation of novel instruments for disinfection and lowering infectious pressure. Ultraviolet subtype C (UVC) excimer lamps with 222 nm wavelength have been tested on airborne pathogens on surfaces and the exposure to this wavelength has been considered safer than conventional UVC. To test the efficacy of UVC excimer lamps on coronaviruses, an animal model mimicking the infection dynamics was implemented. An attenuated vaccine based on infectious bronchitis virus (IBV) was nebulized and irradiated by 222 nm UVC rays before the exposure of a group of day-old chicks to evaluate the virus inactivation. A control group of chicks was exposed to the nebulized vaccine produced in the same conditions but not irradiated by the lamps. The animals of both groups were sampled daily and individually by choanal cleft swabs and tested usign a strain specific real time RT-PCR to evaluate the vaccine replication. Only the birds in the control group were positive, showing an active replication of the vaccine, revealing the efficacy of the lamps in inactivating the vaccine below the infectious dose in the other group.

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.

222-Nanometer Far-UVC Exposure Results in DNA Damage and Transcriptional Changes to Mammalian Cells

Ultraviolet (UV) germicidal tools have recently gained attention as a disinfection strategy against the COVID-19 pandemic, but the safety profile arising from their exposure has been controversial and impeded larger-scale implementation. We compare the emerging 222-nanometer far UVC and 277-nanometer UVC LED disinfection modules with the traditional UVC mercury lamp emitting at 254 nm to understand their effects on human retinal cell line ARPE-19 and HEK-A keratinocytes. Cells illuminated with 222-nanometer far UVC survived, while those treated with 254-nanometer and 277-nanometer wavelengths underwent apoptosis via the JNK/ATF2 pathway. However, cells exposed to 222-nanometer far UVC presented the highest degree of DNA damage as evidenced by yH2AX staining. Globally, these cells displayed transcriptional changes in cell-cycle and senescence pathways. Thus, the introduction of 222-nanometer far UVC lamps for disinfection purposes should be carefully considered and designed with the inherent dangers involved.

Mitigation of Air Pollutants by UV-A Photocatalysis in Livestock and Poultry Farming: A Mini-Review

Ultraviolet (UV)-based photocatalysis has been the subject of numerous investigations focused on mitigating undesirable pollutants in the gas phase. Few works report on applications beyond the proof of the concept. Even less is known about the current state of the art of UV photocatalysis in the context of animal agriculture. A growing body of research published over the last 15 years has advanced the knowledge and feasibility of UV-A photocatalysis for swine and poultry farm applications. This review paper summarizes UV-A photocatalysis technology’s effectiveness in mitigating targeted air pollutants in livestock and poultry farms. Specifically, air pollutants include odor, odorous VOCs, NH3, H2S and greenhouse gases (CO2, CH4, N2O). We trace the progression of UV-A photocatalysis applications in animal farming since the mid-2000 and developments from laboratory to farm-scale trials. In addition, this review paper discusses the practical limitations and outlines the research needs for increasing the technology readiness and practical UV application in animal farming.

Effect of ultraviolet C emitted from KrCl excimer lamp with or without bandpass filter to mouse epidermis

It has been reported that 222-nm ultraviolet C (UVC) exerts a germicidal effect on bacteria and viruses as well as UV radiation emitted from a conventional germicidal lamp but is less toxic to the mammalian cells than that from a germicidal lamp. An excimer lamp filled with krypton chloride (KrCl) gas principally emits 222-nm UVC. However, the lamp also emits a wide band of wavelengths other than 222 nm, especially UVC at a longer wavelength than 222 nm and ultraviolet B, which cause DNA damage. There are some reports on the critical role of bandpass filters in reducing the harmful effect of UVC emitted from a KrCl excimer lamp in a human skin model and human subjects. However, the effectiveness of a bandpass filter has not been demonstrated in animal experiments. In the present study, mice were irradiated with UVC emitted from a KrCl excimer lamp with or without a bandpass filter. UVC emitted from an unfiltered KrCl lamp at doses of 50, 150 and 300 mJ/cm² induced cyclobutyl pyrimidine dimer (CPD)-positive cells, whereas UVC emitted from a filtered lamp did not significantly increase CPD-positive cells in the epidermis. The present study suggested that the bandpass filter serves a critical role in reducing the harmful effect of emission outside of 222 nm to mouse keratinocytes.

Modeling of ultraviolet propagation from air to human epidermis with wavelength range of 200-300 nm

Ultraviolet (UV) technology plays an important role in the fields of sterilization, disinfection, and short-range wireless optical communications. In this Letter, a theoretical model to determine the UV radiation intensity (UVRI) on human skin is put forward based on the Monte Carlo method, where the UV wavelength ranges from 200 to 300 nm. Meanwhile, the UVRI evaluation algorithm is provided to reproduce the simulation results. Furthermore, the penetration depth of UV radiation in the human epidermis is investigated, which can be used to assess whether UV radiation causes damage to human health. Simulation results coincide with the existing experimental results that the 222-nm UV radiation is harmless to humans at the given dose of 1.7 mJ/cm². This work provides theoretical guidelines for the power control of a UV system when humans are in the vicinity.

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.

Far-UVC (222 nm) efficiently inactivates an airborne pathogen in a room-sized chamber

Many infectious diseases, including COVID-19, are transmitted by airborne pathogens. There is a need for effective environmental control measures which, ideally, are not reliant on human behaviour. One potential solution is Krypton Chloride (KrCl) excimer lamps (often referred to as Far-UVC), which can efficiently inactivate pathogens, such as coronaviruses and influenza, in air. Research demonstrates that when KrCl lamps are filtered to remove longer-wavelength ultraviolet emissions they do not induce acute reactions in the skin or eyes, nor delayed effects such as skin cancer. While there is laboratory evidence for Far-UVC efficacy, there is limited evidence in full-sized rooms. For the first time, we show that Far-UVC deployed in a room-sized chamber effectively inactivates aerosolised Staphylococcus aureus. At a room ventilation rate of 3 air-changes-per-hour (ACH), with 5 filtered-sources the steady-state pathogen load was reduced by 98.4% providing an additional 184 equivalent air changes (eACH). This reduction was achieved using Far-UVC irradiances consistent with current American Conference of Governmental Industrial Hygienists threshold limit values for skin for a continuous 8-h exposure. Our data indicate that Far-UVC is likely to be more effective against common airborne viruses, including SARS-CoV-2, than bacteria and should thus be an effective and "hands-off" technology to reduce airborne disease transmission. The findings provide room-scale data to support the design and development of effective Far-UVC systems.

Illuminating Human Norovirus: A Perspective on Disinfection of Water and Surfaces Using UVC, Norovirus Model Organisms, and Radiation Safety Considerations

Human noroviruses (HuNoVs) are a major cause of gastroenteritis and are associated with high morbidity because of their ability to survive in the environment and small inoculum size required for infection. Norovirus is transmitted through water, food, high touch-surfaces, and human-to-human contact. Ultraviolet Subtype C (UVC) light-emitting diodes (LEDs) can disrupt the norovirus transmission chain for water, food, and surfaces. Here, we illuminate considerations to be adhered to when picking norovirus surrogates for disinfection studies and shine light on effective use of UVC for norovirus infection control in water and air and validation for such systems and explore the blind spot of radiation safety considerations when using UVC disinfection strategies. This perspective also discusses the promise of UVC for norovirus mitigation to save and ease life.

Clinical application of 222 nm wavelength ultraviolet C irradiation on SARS CoV-2 contaminated environments

This was a preliminary study on ultraviolet C (UVC) irradiation for SARS-CoV-2-contaminated hospital environments. Forty-eight locations were tested for SARS-CoV-2 using RT-PCR (33.3% contamination rate). After series dosages of 222-nm UVC irradiation, samples from the surfaces were negative at 15 s irradiation at 2 cm length (fluence: 81 mJ/cm²).

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.

Improved Spectral Purity of 222-nm Irradiation Eliminates Detectable CPD Formation in Skin Reconstructs even at High and Repetitive Disinfecting Doses

UVC222nm has germicidal effects with potential clinical applications. However, UVC irradiation is capable of inducing DNA damage like cyclobutylpyrimidine dimers (CPD). Although new devices have emission peaks in the short-wavelength region of UVC (~222nm), the remaining "collateral" radiation at longer wavelengths could be harmful to human health. We investigated the DNA damage caused by far-UVC 222nm KrCl exciplex radiation on human skin reconstructs after additional filtering using silica filters. The skin reconstructs were irradiated with 100mJ/cm² , 500mJ/cm² , and 3x500mJ/cm² unfiltered and filtered (230 - 270 nm suppressed) far-UVC or UVB (308nm) radiation. UVB and non-filtered UVC irradiation induced a significant amount of CPDs, compared to the background. Filtered far-UVC lowered the CPD amount compared to unfiltered UVC and UVB treatments. Repetitive UVC irradiation did not result in the accumulation of CPDs compared to UVB treatment. Reduction in excess of 99.9% of E. coli, S. aureus and C. albicans was detected after applying far-UVC radiation. This identifies a therapeutic window in which microorganisms are killed but tissue is still alive and not damaged, which could give rise to new clinical applications.

Safety of 222 nm UVC Irradiation to the Surgical Site in a Rabbit Model

For the prevention of surgical site infection (SSI), continuous disinfection could be helpful. Short wavelength ultraviolet radiation C (UVC) is highly bactericidal but shows cytotoxicity. Radiation of UVC with a wavelength of 222 nm to the skin is considered to be safe because it only reaches the stratum corneum. However, the safety of 222 nm irradiation to the surgical field not covered with skin is unknown. The purpose of this study was to examine the safety of 222 nm UVC irradiation on a surgical field in a rabbit model. Five types of tissue were surgically exposed and irradiated with 222 or 254 nm UVC. Immunohistological assessment against cyclobutane pyrimidine dimer (CPD), an index of DNA damage by UVC, was performed. The CPD-positive cell rate was significantly higher in the 254 nm group than in the other groups in all tissues. A 222 nm group showed significantly more CPD than control in fat tissue, but no significant difference in all other tissues. In fat tissue collected 24 h after irradiation, the 254 nm group showed higher CPD than the other groups, while the 222 nm group had reduced to the control level. These data suggest that 222 nm UVC irradiation could be a new method to safely prevent SSI.

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.

A systematic scoping review of ultraviolet C (UVC) light systems for SARS-CoV-2 inactivation

A significant amount of epidemiological evidence has underlined that human-to-human transmission due to close contacts is considered the main pathway of transmission, however since the SARS-CoV-2 can also survive in aerosols, water, and surfaces, the development and implementation of effective decontamination strategies are urgently required. In this regard, ultraviolet germicidal irradiation (UVGI) using ultraviolet C (UVC) has been proposed to disinfect different environments and surfaces contaminated by SARS-CoV-2. Herein, we performed a systematic scoping review strictly focused on peer-reviewed studies published in English that reported experimental results of UVC-based technologies against the SARS-CoV-2 virus. Studies were retrieved from PubMed and the Web of Science database. After our criterious screening, we identified 13 eligible articles that used UVC-based systems to inactivate SARS-CoV-2. We noticed the use of different UVC wavelengths, technologies, and light doses. The initial viral titer was also heterogeneous among studies. Most studies reported virus inactivation in well plates, even though virus persistence on N95 respirators and different surfaces were also evaluated. SARS-CoV-2 inactivation reached from 90% to 100% depending on experimental conditions. We concluded that there is sufficient evidence to support the use of UVC-based technologies against SARS-CoV-2. However, appropriate implementation is required to guarantee the efficacy and safety of UVC strategies to control the COVID-19 pandemic.

Extenuating role of lycopene against 254-nm UV-C radiation-mediated damages in Allium cepa L. roots

UV-C exposure has become a crucial risk for living organisms due to its widespread use in sterilization. In this study, the mitigating potential of lycopene was investigated against UV-C-mediated toxicity in Allium cepa L. roots. Allium bulbs were separated into six groups which treated with tap water, 215 mg/L lycopene, 430 mg/L lycopene, 254-nm UV radiation, 215 mg/L lycopene + 254-nm UV radiation, and 430 mg/L lycopene + 254-nm UV radiation. Germination percentage, root length, weight gain, mitotic index, micronucleus frequency, and other chromosomal aberrations as well as meristematic cell damages were investigated in all groups. Malondialdehyde level and the activities of superoxide dismutase and catalase enzymes were also analyzed to understand the severity of oxidative stress. UV-C radiation was revealed to negatively affect all parameters investigated, while the mitigating activities of lycopene against UV-C-mediated toxicity were dose-dependent. Therefore, the study evidently demonstrated the promising potential of lycopene in the protection against the detrimental effects of UV-C exposure in A. cepa.

Skin tolerant inactivation of multiresistant pathogens using far-UVC LEDs

Multiresistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) cause serious postoperative infections. A skin tolerant far-UVC (< 240 nm) irradiation system for their inactivation is presented here. It uses UVC LEDs in combination with a spectral filter and provides a peak wavelength of 233 nm, with a full width at half maximum of 12 nm, and an irradiance of 44 µW/cm2. MRSA bacteria in different concentrations on blood agar plates were inactivated with irradiation doses in the range of 15-40 mJ/cm2. Porcine skin irradiated with a dose of 40 mJ/cm2 at 233 nm showed only 3.7% CPD and 2.3% 6-4PP DNA damage. Corresponding irradiation at 254 nm caused 15-30 times higher damage. Thus, the skin damage caused by the disinfectant doses is so small that it can be expected to be compensated by the skin's natural repair mechanisms. LED-based far-UVC lamps could therefore soon be used in everyday clinical practice to eradicate multiresistant pathogens directly on humans.