The Resurgence of Deep Ultraviolet Technology in Healthcare
The idea of using of ultraviolet light to kill (or “inactivate”) pathogens in healthcare facilities may sound futuristic, however scientists first noted and published as far back at the late 1800’s how sunlight could be used to eliminate bacteria. Subsequent research using prisms and colored glass screens to separate sunlight into distinct wavelengths, showed that the bacterial inactivation was wavelength-dependent and in fact, was caused by the blue, violet and ultraviolet (UV) segments of the light spectrum. This realization led to Niels Ryberg Finsen being awarded the Nobel prize for Medicine and Physiology in 1903 for his use of ultraviolet light to treat Lupus vulgaris (Tuberculosis skin lesions).
Over the course of the next several decades, more in-depth research and study led to the realization that deep ultraviolet radiation (“UVC”) proved to be most effective at killing microbes, by damaging their DNA. This work coincided with several important developments —the production of low-pressure mercury lamps, which emit radiation in the UVC range at 254 nm, and the discovery by William F. Wells of the spread of airborne infection by droplet nuclei, which demonstrated the ability of ultraviolet germicidal irradiation (UVGI) to prevent such spread. With this knowledge, UVGI was effectively employed to treat Tuberculosis and deployed in several modes; by irradiating the upper-room air only and treating air as it passes through enclosed air-circulation and conditioning (HVAC) systems. UVGI fell out of favor in the 1950’s with the popular use of antibiotics, and instead found broad use in treating water and surfaces.
Fast forward to today. The goal for healthcare-associated infections (HAIs) has shifted to zero recordables. The Association for Professionals in Infection Control and Epidemiology (APIC) developed its Strategic Plan 2020 with initiatives centered on standardizing infection data collection, and promoting the development of new methods and technologies to prevent infection.
Direct patient access is ground zero for infection prevention as hospital staff routinely move from room to room conducting bedside visits while administering care. According to the Centers for Disease Control (CDC), 80 percent of infectious diseases are spread by human touch, so point-of-care disinfection is key. UVC LEDs are being widely assessed for these applications, because they afford the opportunity for medical device manufacturers to develop portable tools which integrate proven disinfection, on demand and at the point-of-care.
For example, vascular access points are a common pathway for catheter-associated bloodstream. Delivering a quantifiable recordable dose of UVC energy with the push of a button, in lieu of manual alcohol-based wipe protocols, provides hospital staff a faster, more consistent and reliable approach to keeping patients safe, while capturing critical compliance data that infection control professionals look for when conducting surveillance audits.
Reusable medical devices help control cost and reduce medical waste, but by the very nature of reusing them they pose health concerns. The Spaulding Classification was originally developed in the 1950s and classifies medical devices into three categories based on how the device is used and how the device comes into contact with the body.
There are three classifications: Critical, semi-critical and noncritical devices. Critical devices, such as surgical forceps, come in contact with blood or normally sterile tissue and pose a high risk for infection if contaminated. Semi-critical devices are those that come in contact with mucus membranes, such as medical instrument blades. Finally, non-critical devices come into contact with unbroken skin, such as stethoscopes. Critical and semi-critical devices must go through thorough cleaning and disinfection or sterilization between uses.
Outpatient facilities perform countless exams where medical devices such as stethoscopes, otoscopes, ophthalmoscopes, penlights, abdominal ultrasound probes and blood pressure cuffs are routinely reused. However, because these tools are used on unbroken skin, they are classified as non-critical devices and are therefore not required to go through a full sterilization between uses. This is a good example for where UVC LEDs can serve as an alternative for sterilization by providing fast, dependable disinfection between patients to reduce the risk of infection.
UVC LED technology has opened the door to new infection prevention devices in healthcare, and third-party testing now supports new applications for preventing the spread of HAIs. It is not by itself the “silver bullet” to end all infections, but rather a new tool to be incorporated into a bundled approach to achieving zero recordable infections performed in a hospital or patient care facility. Strict compliance around hand hygiene and prudent use of antibiotics have made significant inroads to reducing HAIs. Taking the next step forward in infection prevention requires going back to the tried-and-true approach of that was once first developed more than 100 years ago.