Airborne infection
Managing airborne infection risks in healthcare
The Infection Prevention Society recently held its annual conference at the ACC in Liverpool. Central themes, this year, included ‘Antimicrobial Resistance, Preparedness and Environment’. In the wake of the pandemic, innovative technologies aimed at reducing the risk of airborne infection came to the fore and IP2023 highlighted some promising potential strategies going forward. Louise Frampton reports.
With lessons learnt from the pandemic, airborne infection risks were high on the agenda at IP2023 – new technologies are currently being explored, but what do IPC teams need to know to ensure risk is managed effectively? Is ventilation enough or do we need to look to other solutions? A leading voice in this field is Professor Cath Noakes – a high profile expert in ventilation, indoor air quality and infection control. Prof. Noakes received an OBE in 2020 for Services to the COVID-19 Pandemic – from April 2020-2022, she co-chaired the Environment and Modelling sub-group of the UK Scientific Advisory Group for Emergencies (SAGE) focusing on the science underpinning environmental transmission of COVID-19. In recent years, Prof. Noakes has undertaken
key research projects looking at technology solutions to mitigate risks associated with airborne transmission of infection. The focus of her most recent research has included exploring the potential use of ultraviolet technology to manage airborne infection risk in healthcare. Speaking at IP2023, Prof. Noakes provided a
valuable insight into a promising solution, in a presentation titled: ‘Into the blue - is ultraviolet the solution to managing airborne infection risk in healthcare?’
Why do we need air cleaners? Prof. Noakes opened her discussion with an explanation of why air cleaning technology is important: “COVID pushed us to recognise that air matters more than we thought and there is wider recognition that air matters for more pathogens, rather than just a handful of specialist diseases,” she commented. She added that air quality also matters
throughout a hospital – not just in specialist spaces. Following the pandemic, hospital ventilation came under intense scrutiny. A large
percentage of healthcare ventilation may not meet current guidance. Prof. Noakes pointed out that ‘air cleaning’ may be more energy efficient than increasing ventilation. Nevertheless, she did not expect air cleaning to replace the use of ventilation – instead, it could offer an additional layer of protection. “I would never say to turn your ventilation
down…It is important to point out that air cleaners are not a ubiquitous solution. We are not going to put them everywhere. It needs to be the right solution in the right place,” she continued. She pointed out that the greatest risk with airborne transmission is when you are in close proximity to someone who is infectious. Prof. Noakes pointed out that air cleaning mostly deals with circulation in the room rather than what happens in close proximity. However, there is evidence to suggest that some air cleaners may impact on transmission from surfaces (the fomite route), as airborne contamination can land on surfaces. “It may have some effect at close range, but it is debatable, and I certainly wouldn’t rely on this. Air cleaners are not a replacement for
the precautions you should take when in close proximity to someone who is infectious,” she warned. She pointed out that there is increasing
interest in germicidal UVC: “When used in germicidal applications, UVC is usually in the 230-280nm wavelength range. “There is also a range of around 180nm, used
in water disinfection, which generates ozone. Then we have the range of 200-230nm which is known as the Far UV range,” Prof. Noakes commented. She explained that there are two different
types of lamps – GUV lamps (254nm wavelength, usually low-pressure mercury lamps) and Far UVC (222nm wavelength, Krypton Chloride [KrCl] excimer lamps, which are emerging technology).
Health and harms Prof. Noakes went on to point out the health and harms associated with UV light. Some impacts on human health are positive and some are negative. “We need to keep this in mind in any selection of devices,” she cautioned. Most UVC that is used in healthcare settings is 254nm. It is not safe for direct exposure and
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