AI R BORNE T RANSMI S S ION
general effectiveness, with level one being the most effective and level 5 being the least effective.
1) Elimination 2) Substitution
3) Engineering controls 4) Administrative controls 5) Personal protective equipment (PPE)
These hierarchy of controls have enabled the discussions about the adequate ventilation and general quality of the air circulating within the healthcare environment. Certainly level 3 ‘engineering controls’ has opened up the discussion about the use of technology to mitigate the risk of infection.
Can technology reduce surface contamination? Automated room disinfection (ARD) units have become a popular and effective over the last 20 years and provide an effective method for surface disinfection. Their greatest use is for the terminal decontamination of a vacated single room or bay following the discharge of a patient(s) with an infection and thus reducing the risk of infection for the next patient. Although ARD units are extremely efficient, they can only be used in an empty room and the process can take several hours before the room is ready for further use.
There has been an increased use in stand-alone air decontamination units mainly to mitigate the transmission of COVID-19. Interestingly, air decontamination units have been shown to reduce not only contaminants in the air but also surface contamination in the hospital environment because the aerosols found in the air will eventually fall and add to the bioburden of surfaces. Reduced surface contamination will
make surface cleaning easier and therefore reduce the risk of hand contamination from surfaces. Different terminology seems to be interchangeably used with air decontamination, air purification and air cleaning units. Most of these will have some
form of filtration with some having additional benefits of UVC or plasma-based technology that will actually inactivate the micro- organism rather than just filtering these out of the air.
A recently published study carried out
in Turkey found surface contamination was reduced when air purification units were installed in the critical care unit and they also saw a reduction in HCAI.10
This study
looked at the indoor air microbial loads in the immediate surroundings of intensive care unit (ICU) patients in two similarly designed ICUs, and to evaluate the effectiveness of air purifiers installed for filtering microbial loads and preventing healthcare-associated infections. There was a significant positive correlation between the number of colonies detected in the air and surfaces and the rate of hospital-acquired infections in the intervention ICU.
Is air decontamination the missing link?
There is growing evidence to support the view that air decontamination may be the missing link in the relationship between surface and hand contamination. The use of air purifiers in addition to heating, ventilation and air conditioning systems in hospitals may be an effective way to reduce the microbial load in the air and on surfaces,
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