Source: CLEANTOTAL
In the fight against bacteria, viruses and fungi, disinfection is used. This can be done chemically, thermally and with light. Especially this last option (UV-C disinfection) is much talked about. Lamp manufacturers are growing like crazy and the potential is seen worldwide. However, the Netherlands seems to be lagging behind.
A short refresher course on UV-C light and its disinfecting properties. It has been known for over a hundred years that light can be disinfecting. This was discovered by Nils Finsen and he used low-intensity UV-C light to stop the TB outbreak in the year 1893, with success. Today, high-intensity, short-wavelength light is used to quickly and effectively break down DNA. Thus, viruses, bacteria and fungi die off and become harmless.
To deploy UV-C effectively, there are a number of snags to consider. Exposure to UV-C light is harmful to the skin and causes eye irritation. So when disinfecting a room, care must be taken at all times to ensure that there are no people in the room. The devices deployed in hospitals are therefore fully automatic and controlled remotely by an operator via a tablet. Movement sensors ensure that humans and/or animals cannot come into contact with the harmful radiation.
UV-C disinfection is demonstrably effective
UV-C disinfection is being embraced worldwide in the fight against the SARS-CoV-2 virus. This is because the virus is easy to combat with UV-C light. Many hospitals disinfect dozens of rooms every day. An excellent time to deploy the robot is after an infectious patient's visit to the emergency room or after an admission. Since three years, these robots have been successfully deployed in the Netherlands. But only a few hospitals have taken the plunge yet, which is striking to say the least. According to YOUVC director Beerend Westerbeek, many professionals still hide behind the dated WIP guidelines. “Sometimes I also hear that the experts or microbiologists don't believe in them. And that is strange. Countless conclusive scientific studies and clinical trials demonstrate the effect and added value of UV-C disinfection.”
WIP guidelines
According to Westerbeek, the WIP guidelines, among others, can be labelled a ‘culprit’. “After all, these guidelines set the standards framework. However, the problem is that these guidelines have not been updated since 2009,” Westerbeek argues. So the guidelines are dated and because they are only guidelines, you can deviate from them if it is well substantiated. Westerbeek continues: “But that might be exciting. Also, we have not yet seen any position or guidelines from the scientific professional association. You might wonder what the IGJ's position is. Does it review solely on the basis of the guidelines and scientific associations or does it have other views? It now seems that the IGJ tolerates the use of UVC provided it is provided with a package of management measures on the use of UVC. As far as I know, neither the IGJ, RIVM or NVMM have publicly expressed positive views on UV-C. That stands in the way of embracing it.”
Community money for UV-C robots
Perhaps things will change in the near future. In November 2020, the European Commission announced to invest 12 million euros in UV-C disinfection robots to help healthcare facilities fight coronavirus. In the week following the writing of this article, hospitals Isala (Zwolle) and Rijnstate (Arnhem) will receive the first two robots to test with. Operational manager disinfection team at Isala Hospital Justin Eilander can't wait to get started with them. “Proper cleaning is the most important thing to provide a safe environment for employees, patients and visitors. Since 2018, we have already had our eye on disinfection with UV-C for patient rooms, but as this was not allowed due to WIP guidelines, we ultimately opted for atomising hydrogen peroxide at the time.”
To tackle this properly, every room needs to be airtight. This is not the case everywhere, and in this respect UV-C would be a method that could be used everywhere. The corona pandemic changed the opinion about UV-C among experts at the hospital. Eilander: “When the European Commission announced that money was being made available for UV-C disinfection robots for healthcare environments, we immediately put together a multidisciplinary team to draw attention to this. Together with innovation manager Jos Knapen, we switched with Rijnstate in Arnhem and the application was submitted.”
Robots or machines?
The devices deployed in hospitals are robots that drive themselves to the respective rooms, where they are turned on by an operator and guided via a tablet. To avoid shadowing areas, the robot moves through the room fully automatically to touch all surfaces. Eilander: “So the robot sees obstacles by itself and adjusts its speed and distance in relation to the surface to be disinfected. We will do our own research on effectiveness. In other words, we will put samples on culture to determine whether the results are sufficient in shaded areas.” Westerbeek is clear on this: “If you understand UV-C technology, and the (im)possibilities of the different types of robots properly, and you also deploy them in the right way, then effective disinfection is guaranteed. Importantly, intelligent room scanning technology of the robot can calculate the right UV-C dose and treatment time. This removes the human component. In short: accurate dose determination every time.’’
For Eilander, by the way, the preference is always for fully autonomous robots. Because, he outlines, that is simply too future. “In about five years, we are going to see a lot more of that in cleaning, only these techniques still have to prove themselves, which is why we also make a comparison between a robot and a manual machine. That a robot could independently drive to a room or possibly take the lift, that's heartening, but doesn't add any value.” Eilander also makes it clear that UV-C should not be seen as the holy grail. “I see it as a wonderful addition within our disinfection team, where it is ultimately about the whole process with good cleaning and hygiene as the starting point. This is partly why we very consciously choose disposable cleaning with Vileda's products and have a disinfection team with permanent employees who have the right training, knowledge and skills.”
Lasting disinfection with ceiling lights
UV-C is also on the rise when it comes to permanent disinfection. For instance, the London Underground installed fixtures, which resulted in a 50 per cent reduction in coronavirus infections. The PSV stadium in Eindhoven will also disinfect the air in the dressing rooms and medical treatment rooms with ceiling lamps. Emile van Dijks, director of Signify, part of Philips and manufacturer of UV-C ceiling lamps, recently indicated in Het Parool that interest in education is also growing. Although the lamps are not cheap, installation would be cheaper than installing proper ventilation.
RIVM acknowledges effectiveness of UV-C but is cautious
The article further reveals that RIVM now acknowledges that the effectiveness of UV-C cannot be doubted, yet it too remains reluctant to recommend the lamps. This is due to the safety aspect. UV-C light is dangerous, so it is important to build safety features into disinfection machines and position ceiling lamps so that no direct light falls on those present.
proliferation of UV-C products
A random Google search yields a random selection of suppliers and products for both the business and consumer markets that disinfect with UV-C. This worries Westerbeek: “There is a huge proliferation of suppliers who logically want to hitch a ride on the attention UV-C is now getting. Many devices were developed in the past corona period and immediately offered on the market without any validation and control measures. And that is immediately the problem. There is no form of standardisation that indicates the minimum safety requirements that devices must meet in order to be sold. For good reason, people in Belgium are very reluctant to use UV-C. The High Health Council recommended in May 2020 that UV-C should not be used outside the controlled environment of the hospital sector. It is therefore necessary to insist on safety, quality, training and education to ensure safe use. The total picture has to be right and then success is guaranteed.”
Incidentally, Signify does claim that the ceiling lights are safe to use. Why? The ceiling lights are suspended below the ceiling and radiate horizontally, say sideways, past the ceiling. Thus, attendees in waiting rooms, for example, are not directly irradiated. Moreover, after each installation, the values would have to be measured at a certain height to guarantee safety. Incidentally, in addition to Signify, Westerbeek advocates having the luminaires installed only by certified installation companies.
UV-C thus offers countless opportunities to reduce viruses, bacteria and fungi. While Signify and similar companies are growing like crazy worldwide, as the products are used in many places, the Netherlands is still lagging behind somewhat. Although a start has been made. Partly thanks to the already running UVC robots in hospitals and the embrace of UV-C disinfection by the European Commission, which has purchased UV-C Robots with European community money.
English (UK)