Wednesday, 13 November 2024
The recent outbreak of the new strain of Corona Virus (2019-nCoV) has triggered more awareness on the transmission of air and surface viruses, writes Tony Abate, adding that technologies, such as bi-polar ionization, can provide an active component to air cleaning and, further, can interact with contaminants and affect the reproductive ability of pathogens.
Tony Abate
A major concern in any hospital or clinical environment is the potential for acquiring a nonsocomial infection. A nonsocomial infection is defined as that for which there is no evidence that the infection was present or incubating at the time of hospital admission. These infections cause many adverse health effects in patients and cost literally billions of dollars in treatment. The Institute of Medicine, in Washington, DC, reported that nosocomial infections caused approximately 88,000 deaths, annually – one every six minutes, and cost an estimated USD 4.5 billion a year.
Also, since the advent of the Affordable Healthcare Act, hospitals have been held to higher accountability standards and now are required to transparently report the incidences of hospital acquired infections (HAI) and are ranked by that score. This can affect not only the hospital’s reputation and marketability but also deny the healthcare facility Medicare reimbursements for HAI-related costs and extended stays.
There are various ways of transmission of these infections: Direct contact, indirect contact, such as contact with contaminated instruments, and droplets caused by coughing, sneezing and hospital procedures, to name three. While droplets may only be able to propel a short distance, they can often become suspended on particles. Small particles in the PM 2.5 range can stay suspended in air for long periods of time and are too small to be filtered by nasal cilia and are inhaled down into the lungs, allowing viruses to infect and spread.
The recent outbreak of the new strain of Corona Virus (2019- nCoV) has also triggered more awareness on the transmission of air and surface viruses. Corona Virus, if deposited on a non-porous surface or stainless steel, can be viable for up to seven days.
This means an infected person can cough or sneeze and expel droplets into the air that ultimately deposit on surfaces. Anyone contacting the surface with their hands and touching their face can become infected. This strain of Corona Virus can take up to 14 days to incubate, so an infected person will not be symptomatic immediately.
Coronavirus epidemics have occurred before. In 2003, SARS (Severe Acute Respiratory Syndrome), another strain of Corona Virus, infected 8,098 people and was responsible for 774 deaths. In 2012, MERS (Middle Eastern Respiratory Syndrome), yet another strain of the Coronavirus, infected 2,494 people and caused 858 deaths. The 2019-nCov strain has already infected 7,111 people and caused 170 deaths, at the time of writing this article. It will very soon surpass the SARS epidemic. Analysts at the University of Hong Kong, using various modelling techniques, including a SIR model (Susceptible, Infected and Recovered), are estimating the peak of the outbreak will occur in late April 2020 and could result in 43,590 people becoming infected.
Many times, bacterial and viral strains previously thought to be non-aerosolized and capable of spreading only through direct or indirect contact, have shown the ability to spread through the air. A screening of healthcare workers was conducted to detect the presence of MRSA (methicillin resistant staphylococcus areus). Nasal swabs were used to screen 3,638 workers. Of them, 4.3% tested positive; and 55% of those that tested positive were involved in direct patient care; interestingly, 45% of those who tested positive, were non-clinical staff with no direct patient involvement. This suggests airborne transmission of MRSA.
A strategy to address and improve indoor air quality (IAQ) is important to curtail the spread and impact of nosocomial infections. The US EPA has defined three parameters in controlling and improving IAQ: 1) Source Control, 2) Ventilation, 3) Air Cleaning. All healthcare workers involved in patient care should practice standard precautions to minimize the spread of pathogens as much as possible. Adequate ventilation, pressurization and air changes
per hour are vital to ensure clean air enters into a less clean space, and that air cleaning strategies can work to their designed values. Air cleaning is important. Filtration strategies must be designed to remove small range particles from the air entering the space.
Ultra-Violet Light (UV) bulbs can help to disinfect surfaces like air conditioning coils and other surfaces, but care must be exercised when applying UV light, as UV exposure can be dangerous to people, and can be particularly damaging to the eyes.
Also, many beneficial technologies, such as bi-polar ionization, exist that can interact with contaminants within spaces and further reduce particle levels, and affect the reproductive ability of pathogens like Coronavirus, Norovirus, C-Difficile, and Staphylococcus.
Bi-polar ionization also provides an active component to air cleaning. Many air and surface cleaning strategies are passive and, sometimes, temporary. Wiping down of surfaces sanitizes them at that point in time but does not ensure continuous sanitization. Media filters, electronic filters, UV systems or photo catalytic oxidation are passive technologies – they will clean the air that passes through the device.
Bi-polar ionization, on the other hand, is an active technology – air ions are delivered to the occupied space through the air systems and saturate the space. Ions, as in the natural eco- system, will interact with air and surface contaminants and provide air cleaning and air and surface sanitization, a continuous disinfection effect. They work also by means of regular monitoring of IAQ levels.
Awareness of IAQ and air pollutant levels is increasing exponentially. They are many good IAQ monitors that use IoT capabilities to record and store data that can be accessed and used to proactively make adjustments to improve air quality. Cutting-edge air purification systems also use real-time IAQ data to adjust air purification output on a proactive and reactive basis.
What you can’t see in the air can hurt you. However, by identifying areas of concern, developing a proactive strategy to address airborne transmission of contaminants and measuring results in hospitals or other healthcare facilities can reduce the exposure to nosocomial infections and the associated adverse health effects and high treatment costs.
Tony Abate is Vice-President of Operations, AtmosAir Solutions. He may be contacted at tabate@atmosair.com.
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