Airborne infection
between the chemistry and biology. We need to understand, if there is a downside – and everything does have a downside – when and where this downside is acceptable and when and where it is not.” For example, she explained that if this
technology was placed in the toilets, she would be less concerned than if it was placed in an area where healthcare workers were working continuously. While further research is required, Prof. Noakes described Far UVC as a very interesting technology that is “worth watching”. So, what can be done now? New guidance
from NHS England was published in May 2023.5 The guidance states that both HEPA filters and enclosed UVC devices can be effective. Devices which incorporate other technologies should be checked for safety and effectiveness, while the addition of devices should be to boost ventilation; they are not a reason to reduce ventilation. The guidance also outlines how to select
devices with the Ventilation Safety Group and IPC. It is important to consider: l Performance (eACH) – including test data. l Noise. l Physical size. l Ease of use. l Ease and frequency of maintenance. l Safety. l Cost effectiveness.
Consideration also needs to be given to: l Location (airflow effectiveness to enable good flow; practicality – i.e. access to power sockets; and patient comfort).
l Safety (access, trip hazards, ligature risks, toppling etc).
l Verification on installation and maintenance (checking filters are properly installed – i.e. pressure drop, checking UV lamps are operating correctly, revalidating if relocated).
This should form part of a risk assessment. Training is essential on why the devices are present, the practicalities on how to use the technology, and the day-to-day cleaning and manging of any issues. Maintenance should include annual checks as a minimum. Ultimately, ventilation is part of the mitigation strategy and germicidal UV is one way to enhance it. Prof. Noakes acknowledged that germicidal UV cannot ‘solve’ an unventilated space, however. “Enclosed units are easier and there is guidance available, but you need the right system for the space. It is pathogen specific, so you need to understand the performance, and safety is a major consideration. This
may affect public acceptance. Ultimately, Far UVC shows promise, but it is still emerging technology. It is important to remember that there are no magic bullets,” Prof. Noakes concluded.
CSJ
References 1. W. F. Wells, M. W. Wells, T. S. Wilder, The environmental control of epidemic contagion: An epidemiologic study of radiant disinfection of air in day schools, American Journal of Epidemiology, Volume 35, Issue 1, January 1942, Pages 97–121,
https://doi.org/10.1093/ oxfordjournals.aje.a118789
2. Riley RL. Airborne pulmonary tuberculosis. Bacteriol Rev. 1961 Sep;25(3):243-8. doi: 10.1128/ br.25.3.243-248.1961. PMID: 14492301; PMCID: PMC441100.
3. Escombe AR, Moore DA, Gilman RH, Navincopa
M, Ticona E, Mitchell B, Noakes C, Martínez C, Sheen P, Ramirez R, Quino W, Gonzalez A, Friedland JS, Evans CA. Upper-room ultraviolet light and negative air ionization to prevent tuberculosis transmission. PLoS Med. 2009 Mar 17;6(3):e43. doi: 10.1371/
journal.pmed.1000043. PMID: 19296717; PMCID: PMC2656548.
4. Eadie E, Hiwar W, Fletcher L, Tidswell E, O’Mahoney P, Buonanno M, Welch D, Adamson CS, Brenner DJ, Noakes C, Wood K. Far-UVC (222 nm) efficiently inactivates an airborne pathogen in a room-sized chamber. Sci Rep. 2022 Mar 23;12(1):4373. doi: 10.1038/s41598-022- 08462-z. PMID: 35322064; PMCID: PMC8943125.
5. NETB 2023/01A: Local HEPA filters and NETB 2023/01B: Local enclosed UVC devices. https://
www.england.nhs.uk/long-read/application- of-hepa-filter-devices-for-air-cleaning-in- healthcare-spaces-guidance-and-standards/
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