Ambulance disinfection using Ultraviolet Germicidal Irradiation (UVGI): Effects of fixture location and surface reflectivity.
Ambulance disinfection using Ultraviolet Germicidal Irradiation (UVGI): Effects of fixture location and surface reflectivity.
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DOI：
10.1080/15459624.2017.1376067
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发表时间：
2018-01
影响因子：
2
通讯作者：
Noti JD
中科院分区：
文献类型：
--
作者：
Lindsley WG;McClelland TL;Neu DT;Martin SB Jr;Mead KR;Thewlis RE;Noti JD
救护车经常被病人在运输过程中脱落的传染性微生物污染，这些微生物可以转移给随后的病人和紧急医疗服务人员。手动去污是繁琐和耗时的，并且即使在清洁之后，持续污染也是常见的。紫外线杀菌辐照（UVGI）已被提议作为救护车病人隔间的终端消毒方法。然而，没有发表的研究测试了救护车上使用UVGI的情况。本研究的目的是调查UVGI系统在救护车病人车厢的有效性，并检查UVGI夹具位置和内表面的紫外线反射率对消毒所需时间的影响。将UVGI夹具放置在救护车患者隔间的前部、中部或后部，并在49个位置处测量UV辐照度。添加铝板和紫外线反射涂料，以检查增加表面反射率对消毒时间的影响。使用枯草芽孢杆菌孢子作为病原体的替代物进行消毒试验。我们的研究结果表明，紫外辐照度变化很大，这取决于表面位置。例如，当UVGI固定装置处于后部位置并且没有添加UV反射表面时，照射最多的位置在16秒内接收到足以消毒的UVGI剂量，但是照射最少的位置需要15小时。由于对所有内表面进行消毒所需的总时间取决于对接受最低辐照水平的表面进行消毒所需的时间，因此不同UVGI配置的患者隔室消毒时间范围为16.5小时至59分钟，具体取决于UVGI夹具位置和内表面反射率。这些结果表明，UVGI系统可以减少救护车车厢内的微生物表面污染，但该系统必须在部署前进行严格的验证。优化UVGI夹具位置和增加内表面的UV反射率可以显著提高UVGI系统的性能并减少消毒所需的时间。
Ambulances are frequently contaminated with infectious microorganisms shed by patients during transport that can be transferred to subsequent patients and emergency medical service workers. Manual decontamination is tedious and time-consuming, and persistent contamination is common even after cleaning. Ultraviolet germicidal irradiation (UVGI) has been proposed as a terminal disinfection method for ambulance patient compartments. However, no published studies have tested the use of UVGI in ambulances. The objectives of this study were to investigate the efficacy of a UVGI system in an ambulance patient compartment and to examine the impact of UVGI fixture position and the UV reflectivity of interior surfaces on the time required for disinfection. A UVGI fixture was placed in the front, middle or back of an ambulance patient compartment, and the UV irradiance was measured at 49 locations. Aluminum sheets and UV-reflective paint were added to examine the effects of increasing surface reflectivity on disinfection time. Disinfection tests were conducted using Bacillus subtilis spores as a surrogate for pathogens. Our results showed that the UV irradiance varied considerably depending upon the surface location. For example, with the UVGI fixture in the back position and without the addition of UV-reflective surfaces, the most irradiated location received a dose of UVGI sufficient for disinfection in 16 seconds, but the least irradiated location required 15 hours. Because the overall time required to disinfect all of the interior surfaces is determined by the time required to disinfect the surfaces receiving the lowest irradiation levels, the patient compartment disinfection times for different UVGI configurations ranged from 16.5 hours to 59 minutes depending upon the UVGI fixture position and the interior surface reflectivity. These results indicate that UVGI systems can reduce microbial surface contamination in ambulance compartments, but the systems must be rigorously validated before deployment. Optimizing the UVGI fixture position and increasing the UV reflectivity of the interior surfaces can substantially improve the performance of a UVGI system and reduce the time required for disinfection.
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