Health Care Facilities

Chapter
First Online:

Abstract

This chapter addresses applications of ultraviolet germicidal irradiation (UVGI) in health care facilities, including laboratories and animal or veterinary facilities. This chapter does not review the applicable guidelines or standards for air quality in these facilities, which typically do not mention UVGI, but the references and Chapter 11 may be consulted for more detailed information. The types of UV systems covered in this chapter have been addressed in detail in previous chapters and these designs are not revisited here. Instead, this chapter discusses the various applications of UV to the indicated facilities, how they have been applied in the past, what effectiveness they have previously demonstrated, and how new UV systems may be applied to reduce the microbiological hazards associated with each type of facility. Also addressed here are the types of pathogens that are unique to certain facilities and, in particular, nosocomial pathogens and the problem of increasing drug resistance.

Keywords

Acquire Immune Deficiency Syndrome Electric Power Research Institute Airborne Bacterium Acquire Immune Deficiency Syndrome Patient Isolation Room 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

References

  1. Allen K, Green H. 1987. Hospital outbreak of multi-resistant Acinetobacter anitratus: An airborne mode of spread? J Hosp Infect 9:110–119.CrossRefGoogle Scholar
  2. Andersson E, Horal P, Vahlne A, Svennerholm B. 2004. No cross-resistance or selection of HIV-1 resistant mutants in vitro to the antiretroviral tripeptide glycyl-prolyl-glycine-amide. Antiviral Res 61(2):119–124.CrossRefGoogle Scholar
  3. Andrei G, DeClercq E, Snoeck R. 2004. In vitro selection of drug-resistant varicella-zoster virus (VZV) mutants (OKA strain): Differences between acyclovir and penciclovir? Antiviral Res 61(3):181–187.CrossRefGoogle Scholar
  4. Araujo MW, Andreana S. 2002. Risk and prevention of transmission of infectious diseases in dentistry. Quintessence Int 33(5):376–382.Google Scholar
  5. ASHRAE. 1999. Handbook of Applications. Atlanta: ASHRAE.Google Scholar
  6. ASHRAE. 2003. HVAC Design Manual for Hospitals and Clinics. Atlanta: American Society of Heating, Ventilating, and Air Conditioning Engineers.Google Scholar
  7. ASHRAE. 2008. Handbook of Applications:  Chapter 16: Ultraviolet Lamp Systems. Atlanta, GA: American Society of Heating, Refrigerating, and Air-Conditioning Engineers.
  8. Benirschke K, Garner FM, Jones TC, editors. 1978. Pathology of Laboratory Animals. New York: Springer-Verlag.Google Scholar
  9. Berg M, Bergman BR, Hoborn J. 1991. Ultraviolet Radiation Compared to an Ultra-Clean Air Enclosure. Comparison of Air Bacteria Counts in Operating Rooms. JBJS 73(5):811–815.Google Scholar
  10. Berg-Perier M, Cederblad A, Persson U. 1992. Ultraviolet radiation and ultra-clean air enclosures in operating rooms. J Arthroplasty 7(4):457–463.CrossRefGoogle Scholar
  11. Besch EL. 1980. Environmental quality within animal facilities. Lab Animal Sci 30(2):385–398.Google Scholar
  12. Brachman P. 1970. Nosocomial infection – airborne or not?; American Hospital Association, pp. 189–192.Google Scholar
  13. Breathnach A, deRuiter A, Holdworth G, Bateman N, O-Sullivan D, Rees P, Snashall D, Milburn H, Peters B, Watson J et al. 1998. An outbreak of multi-drug-resistant tuberculosis in a London teaching hospital. J Hosp Infect 39:11–17.CrossRefGoogle Scholar
  14. Brown IWJ, Moor GF, Hummel BW, Collins JP. 1996. Toward further reducing wound infections in cardiac operations. Ann Thorac Surg 62(6):1783–1789.CrossRefGoogle Scholar
  15. CDC. 2003. Guidelines for environmental infection control in health-care facilities. MMWR 52(RR-10).Google Scholar
  16. Davis KA, Moran KA, McAllister CK, Gray PJ. 2005. Multi-drug resistant Acinetobacter extremity infections in soldiers. Emerg Infect Dis 11(8):1218–1224.Google Scholar
  17. Del Mundo F, McKhann CF. 1941. Effect of ultra-violet irradiation of air on incidence of infections in an infant’s hospital. Am J Dis Child 61:213–225.Google Scholar
  18. DHHS. 1993. Biosafety in Microbiological and Biomedical Laboratories. Cincinnati, OH: U.S. Department of Health and Human Services.Google Scholar
  19. Dumyahn T, First M. 1999. Characterization of ultraviolet upper room air disinfection devices. Am Ind Hyg Assoc J 60(2):219–227.Google Scholar
  20. Durmaz G, Kiremitci A, Akgun Y, Oz Y, Kasifoglu N, Aybey A, Kiraz N. 2005. The relationship between airborne colonization and nosocomial infections in intensive care units. Mikrobiyol Bul 39(4):465–471.Google Scholar
  21. Duvlis Z, Drescher J. 1980. Investigations on the concentration of air-borne germs in conventionally air-conditioned operating theaters. Zentralbl Bakteriol [B] 170(1–2):185–198.Google Scholar
  22. EPRI. 1996. UVGI for Infection Control in Hospitals. Palo Alto, CA: Electric Power Research Institute. Report nr TA-106887.Google Scholar
  23. EPRI. 1997. UVGI for TB Infection Control in a Hospital. Palo Alto, CA: Electric Power Research Institute. Report nr TA-107885.Google Scholar
  24. Farrington M, Ling T, French G. 1990. Outbreaks of infection with methicillin-resistant Staphylococcus aureus on neonatal and burns units of a new hospital. Epidem Infect 105:215–228.CrossRefGoogle Scholar
  25. Fletcher LA, Noakes CJ, Beggs CB, Sleigh PA. 2004. The Importance of Bioaerosols in Hospital Infections and the Potential for Control Using Germicidal Ultraviolet Radiation. Murcia, Spain.Google Scholar
  26. Gill KE. 1994. HVAC design for isolation rooms. HPAC July:45–52.Google Scholar
  27. Goldner JL, Allen BL. 1973. Ultraviolet light in orthopedic operating rooms at Duke University. Clin Ortho 96:195–205.CrossRefGoogle Scholar
  28. Grieble H, Bird T, Nidea H, Miller C. 1970. Chute-hydropulping waste disposal system: A reservoir of enteric bacilli and Pseudomonas in a modern hospital. J Infect Dis 130:602.Google Scholar
  29. Hart D, Sanger PW. 1939. Effect on wound healing of bactericidal ultraviolet radiation from a special unit: Experimental study. Arch Surg 38(5):797–815.Google Scholar
  30. Higgons RA, Hyde GM. 1947. Effect of ultra-violet air sterilization upon incidence of respiratory infections in a children’s institution. New York State J Med 47(7).Google Scholar
  31. Hunskaar S, Fosse RT. 1993. Allergy to laboratory mice and rats: A review of its prevention, management, and treatment. Lab Anim 27:206–221.CrossRefGoogle Scholar
  32. Jain DL, Agarwal V. 1996. Multi-drug resistant invasive isolates of Haemophilus influenzae: A multi-center study in India: indiaclen ibis study group. J Clin Epidem 50(Suppl.1):16S.Google Scholar
  33. Keikavousi F. 2004. UVC: Florida hospital puts HVAC maintenance under a new light. Engin Sys March:60–66.Google Scholar
  34. Kowalski W, Bahnfleth WP. 1998. Airborne respiratory diseases and technologies for control of microbes. HPAC 70(6):34–48.Google Scholar
  35. Kowalski WJ, Bahnfleth WP, Carey DD. 2002. Engineering control of airborne disease transmission in animal research laboratories. Contemporary Topics in Lab Animal Sci 41(3):9–17.Google Scholar
  36. Kowalski WJ. 2006. Aerobiological Engineering Handbook: A Guide to Airborne Disease Control Technologies. New York: McGraw-Hill.Google Scholar
  37. Kowalski WJ. 2007a. Air-treatment systems for controlling hospital-acquired infections. HPAC Eng 79(1):28–48.Google Scholar
  38. Kowalski WJ. 2007b. Airborne superbugs: Can hospital-acquired infections cause community epidemics? Consult Specif Eng 41(3):28–36, 69.Google Scholar
  39. Kowalski W. 2008a. UVGI for hospital applications. IUVA News 10(4):30–34.Google Scholar
  40. Kowalski W. 2008b. Operating Room Aerobiology in the Alaska Native Medical Center: Air and Surface Sampling Results and Recommendations for Reducing Surgical Site Infections. Anchorage, AK: Alaska Native Medical Center.Google Scholar
  41. Kowalski W, Bahnfleth W, Hernandez M. A Genomic Model for the Prediction of Ultraviolet Inactivation Rate Constants for RNA and DNA Viruses; 2009 May 4–5; Boston, MA. International Ultraviolet Association.Google Scholar
  42. Kraissl CJ, Cimiotti JG, Meleney FL. 1940. Considerations in the use of ultra-violet radiation in operating rooms. Ann Surg 111:161–185.CrossRefGoogle Scholar
  43. Kundsin R. 1976. Operating Room as a Source of Wound Contamination and Infection. National Research Council, National Academy of Sciences, pp. 167–172.Google Scholar
  44. Lidwell OM, Lowbury EJL, Whyte W, Blowers R, Stanley SJ, Lowe D. 1983. Airborne contamination of wounds in joint replacement operations: the relationship to sepsis rates. J Hosp Infect 4:111–131.CrossRefGoogle Scholar
  45. Linscomb M. 1994. AIDS clinic HVAC system limits spread of TB. HPAC February.Google Scholar
  46. Lowell J, Kundsin R. 1980. Ultraviolet Radiation: Its Beneficial Effect on the Operating Room Environment and the Incidence of Deep Wound Infcetion Following Total Hip and Total Knee Arthroplasty. Murray Hill, NJ: American Ultraviolet Company. Report nr A-810.Google Scholar
  47. Lowell JD, Kundsin RB, Schwartz CM, Pozin D. 1980. Ultraviolet radiation and reduction of deep wound infection following hip and knee arthroplasty. In: Kundsin RB, editor. Airborne Contagion, Annals of the New York Academy of Sciences. New York: NYAS, pp. 285–293.Google Scholar
  48. Luciano JR. 1977. Air Contamination Control in Hospitals. New York: Plenum Press.Google Scholar
  49. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, HICPAC. 1999. Guideline for prevention of surgical site infection. Am J. Infect Control 27(2): 97–132.CrossRefGoogle Scholar
  50. McLean R. 1961. The effect of ultraviolet radiation upon the transmission of epidemic influenza in long-term hospital patients. Am Rev Resp Dis 83:36–38.Google Scholar
  51. Miller WR, Jarrett ET, Willmon TL, Hollaender A, Brown EW, Lewandowski T, Stone RS. 1948. Evaluation of ultra-violet radiation and dust control measures in control of respiratory disease at a naval training center. J Infect Dis 82:86–100.Google Scholar
  52. Moggio M, Goldner JL, McCollum DE, Beissinger SF. 1979. Wound Infections in Patients Undergoing Total Hip Arthroplasty. Ultraviolet Light for the Control of Airborne Bacteria. Arch Surg 114(7):815–823.Google Scholar
  53. Overholt RH, Betts RH. 1940. A comparative report on infection of thoracoplasty wounds. J Thoracic Surg 9:520–529.Google Scholar
  54. Ritter M, Olberding E, Malinzak R. 2007. Ultraviolet Lighting During Orthopaedic Surgery and the Rate of Infection. J Bone Joint Surg 89:1935–1940.CrossRefGoogle Scholar
  55. Robertson EC, Doyle ME, Tisdall FF, Koller LR, Ward FS. 1943. Use of ultra-violet radiation in reduction of respiratory cross-infections in a children’s hospital. JAMA 121:908–914.Google Scholar
  56. Sauer LW, Minsk LD, Rosenstern I. 1942. Control of cross infections of respiratory tract in nursery for young infants. JAMA 118:1271–1274.Google Scholar
  57. Schneider M, Schwartenberg L, Amiel JL, Cattan A, Schlumberger JR, Hayat M, deVassal F, Jasmin CL, Rosenfeld CL, Mathe G. 1969. Pathogen-free isolation unit – three years' experience. Brit Med J 29 March:836–839.CrossRefGoogle Scholar
  58. Sommer HE, Stokes J. 1942. Studies on air-borne infection in a hospital ward. J Pediat 21:569–576.CrossRefGoogle Scholar
  59. Tuffery AA, editor. 1995. Laboratory Animals: An Introduction for Experimenters. Chichester: John Wiley & Sons.Google Scholar
  60. Wells WF. 1938. Air-borne infections. Mod Hosp 51:66–69.Google Scholar
  61. Wells WF. 1955. Airborne Contagion and Air Hygiene. Cambridge, MA: Harvard University Press.Google Scholar
  62. Wheeler SM, Ingraham HS, Hollaender A, Lill ND, Gershon-Cohen J, Brown EW. 1945. Ultra-violet light control of airborne infections in a naval training center. Am J Pub Health 35: 457–468.CrossRefGoogle Scholar
  63. WHO. 1988. Indoor air quality: Biological contaminants. Copenhagen, Denmark: World Health Organization. Report nr European Series 31.Google Scholar
  64. Woodhall B, Neill R, Dratz H. 1949. Ultraviolet radiation as an adjunct in the control of post-operative neurosurgical infection. Clinical experience 1938–1948. Ann Surg 129:820–825.Google Scholar
  65. Wright R, Burke J. 1969. Effect of ultraviolet radiation on post-operative neurosurgical sepsis. J Neurosurg 31:533–537.CrossRefGoogle Scholar
  66. Young DP. 1991. Ultraviolet Lights for Surgery Suites. Mooresville: St. Francis Hospital.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  1. 1.Immune Building Systems, Inc.New YorkUSA

Personalised recommendations