PRODUCTS & SERVICES yet lacking in independent evidence for effi cacy, effi cient use and safety. This can create signif- icant confusion for healthcare professionals to assess and to determine which technologies are truly effective.” Guzman credits two agencies for capable assistance. Groups such as the American Society of Heating Refrigeration and Air-conditioning Engineers (ASHRAE) and the International Ultraviolet Association (IUVA) stepped up as “unbiased resources” for the general public, he noted. Further, the interNational Association of Lighting Management Companies (Nalmco) started offering a three-tiered training program to certify installers, maintenance professionals and design engineers working on UV applications, which will help in further educating the public and will lead to more successful installations, he added. “In the midst of the confusion, independent lab testing at real-world times and distances and peer-reviewed, published evidence is still the best, black-and-white proof for effective- ness,” Steely said.


Kristine Steely Even though UV technology technically hasn’t changed


in terms of effi cacy, which is to deliver the right amount of radiation to the targeted areas of interest to inactivate the specifi ed pathogen, the number of systems entering the mar- ketplace has risen signifi cantly, according to Steve Baiocchi, COO, Steriliz LLC. “The challenge for the end-user is to be able to validate the effectiveness of the UV system(s) currently available— this includes both mobile and automated UV disinfection technologies,” Baiocchi said. “UV systems fl ooded the marketplace during the pandemic and proved that not all systems are created equally. There continues to be mis- leading claims being made throughout the UV marketplace which proves to be a challenge for end-users.” To overcome this, Baiocchi encourages infection preven- tion and environmental services to work together to better understand system capabilities, such as total UVC output, dose measurement capabilities, effi cacy, throughput and other specifi cations. “The industry should really compare and contrast multi-


Steven Baiocchi


ple UV systems for the best fi t and cost,” he recommended. “Validation questions absolutely should be raised during the sourcing and evaluation process. For example, a number of ‘automated’ UV systems are entering the marketplace claiming the facilities do not need a full-time equivalent (FTE) to operate when compared to mobile UV systems—which is simply not the case. There are a number of issues with automated UV systems, including charging time, facility mobility to address outbreaks, system output limited to the battery, no-measurement capabil- ities etc.—that sourcing needs to be made aware of.”


Disinfection theater noise Morris Miller, CEO, Xenex Disinfection Services, foresees signifi cant changes coming to the UV technology industry—one of which involves standards. “During the pandemic, new UV companies emerged and many of them made false claims which created a lot of market confusion—eight seconds to disinfect an entire room, UV wands,


UV portals, etc.,” Miller noted. “There were companies selling UV technology on Amazon! We call that the ‘theater of disin- fection,’ and it’s not good for patient safety or public health. We want higher standards for the UV industry.” The number of new companies entering the market “causes noise for our customers,” echoed Brian Donahue, vice presi- dent, Sales & Operations, The Americas, Finsen Technologies. “Many customers are now weary of learning more about some of the new advances, so they stick with the top incumbents or just replace what they bought before,” he said. “I strongly recommend that customers spend two weeks to learn who else is out there, and budget for a new system. The technology they buy should specify the ‘how’ of the unit—how does it measure or calculate adequate UVC dose each cycle. Price is a massive consideration, and as a result, the top companies have allowed imports to enter at a fraction of their price and performance, compounding the confusion.” Like Guzman and Miller, Donahue emphasized the need for standards, citing the British Standard BS 8628:2022 for UVC used in a hospital setting as particularly helpful. To counter any skepticism and cynicism about market oppor- tunists, James Clements, director of Channel Management, Product Marketing, Excelitas Technologies, reassured about the effi cacy, safety and utility of UV technology. “UVC tools and technologies are remark-


Brian Donahue


ably versatile and fl exible for disinfection and pathogen inactivation applications ranging from water purifi cation and food safety to health- care-associated infection control,” he said. “UVC disinfection—also referred to as ultraviolet germicidal irradiation or UVGI—utilizes equipment that has been used suc- cessfully for decades and comes in a wide array of form factors.” Clements blames some of the initial concerns about UV technology as a COVID-19 eradicator on a fundamental lack of knowledge about the emerging virus and its respiratory transmission pathway. “At the onset of the COVID-19 pandemic, the mechanism of coronavirus (SARS-CoV-2) disease transmission was not yet well understood, and UVC product development strate- gies focused heavily on surface disinfection through conven- tional pulsed xenon, and low-pressure mercury tools,” he said. “These tools are very effective for some pathogens in certain applications but had little effect on controlling the spread of this particular disease since the coronavirus transmission route is primarily through the inhalation of infectious particles (i.e., short range aerosol or airborne transmission). Once the mechanism of coronavirus infection was better understood, UVC global research and product development refocused on strategies that had been used earlier to combat another respi- ratory-transmitted disease—tuberculosis. “Equipment providers developed products designed to inac-


James Clements


tivate pathogens in the air, producing truly effective tools to help control the spread of pathogens in occupied settings, and wherever individuals may be vulnerable to airborne infectious pathogens,” Clements continued. Still, Clements acknowledges that end-user education, public


Morris Miller


acceptance and the need for industry standards will challenge greater adoption. “Adoption will improve when end users understand the mechanisms of UVC disinfection, trust the


44 October 2023 • HEALTHCARE PURCHASING NEWS • hpnonline.com


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