UltraViolet SANitizing System for Sterilization of Ambulances Fleets and for Real-Time Monitoring of Their Sterilization Level
Abstract
:1. Introduction
2. Materials and Methods
2.1. System Description
2.2. Cells
2.3. SARS-CoV-2 Strain
2.4. Inactivation of SARS-CoV-2 by UVC-Irradiation
2.5. SARS-CoV-2 Viral Titration
2.6. UVC Disinfection Test on Ambulance
3. Results
3.1. Evaluation of 254-nm Ultraviolet Light on Disinfecting SARS-CoV-2 Surface Contamination
3.2. On Site Effectiveness of UV-SAN System
3.3. Trial Phase
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
BASS | Business Applications and Space Solutions |
BSL-3 | BioSafety Level-3 |
CCS | Central Control System |
CFU | Colony Forming Unit |
COVID-19 | COronaVIrus Disease 19 |
DB | Data Base |
DMEM | Dulbecco’s Modified Eagles |
ESA | European Space Agency |
FDA | Food and Drug Administration |
GNSS | Global Navigation Satellite System |
ISS | Istituto Superiore di Sanità |
KPC | Carbapenemase-producing Klebsiella pneumoniae |
KPIs | Key Performance Indicators |
LSE | Lighting low pressure mercury vapor lamps |
McF | McFarland standard |
MDR | Multi Drug Resistant |
MRCoNS | Methicillin-Resistant Coagulase-Negative Staphylococci |
MRSA | Methicillin-Resistant Staphylococcus aureus |
SARS-CoV-1 | Severe Acute Respiratory Syndrome CoronaVirus 1 |
SARS-CoV-2 | Severe Acute Respiratory Syndrome CoronaVirus 2 |
SAT-COM | Satellite Communication System |
SAT-NAV | Satellite Navigation System |
SE | Sanitation Equipment |
TCID50 | Tissue Culture Infectious Dose 50 |
UVC | UltraViolet C |
UV-SAN | UltraViolet SANitizing System |
WHO | World Health Organization |
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Material | UVC Dose for Log3 Reduction [J/m2] 95% Confidence Level | p Value | R2 | ||
---|---|---|---|---|---|
Lower | Mean | Upper | |||
Polystyrene | 135 | 184 | 226 | 5.3 × 10−3 | 0.944 |
Metal | 92 | 129 | 164 | 5.7 × 10−3 | 0.947 |
Rubber | 29.9 | 54.4 | 98.3 | 9.3 × 10−2 | 0.66 |
Log Reduction | % Reduction | UVC Dose [J/m2] | ||
---|---|---|---|---|
Polystyrene | Metal | Rubber | ||
Log1 | 90% | 57.3 | 46.2 | 7.8 |
Log2 | 99% | 121 | 87.5 | 23.4 |
Log3 | 99.9% | 184 | 129 | 54.4 |
Log4 | 99.99% | 248 | 170 | 55.8 |
Position | Pathogen and Concentration | Exposure Time [min] | Irradiation [mJ/cm2] | Growth after Incubation | |
---|---|---|---|---|---|
24 h | 48 h | ||||
HeadRest | Kleb. Pne. ESBL+ 0.5, 1, 2 McF * | 10 | 76 | None | None |
20 | 152 | None | None | ||
30 | 228 | None | None | ||
Staph. aur. MRSA 0.5, 1, 2 McF * | 10 | 76 | None | None | |
20 | 152 | None | None | ||
30 | 228 | None | None | ||
Armrest | Kleb. Pne. ESBL+ 0.5, 1, 2 McF * | 10 | 44 | None | None |
20 | 88 | None | None | ||
30 | 132 | None | None | ||
Staph. aur. MRSA 0.5, 1, 2 McF * | 10 | 44 | None | None | |
20 | 88 | None | None | ||
30 | 132 | None | None | ||
Chair | Kleb. Pne. ESBL+ 0.5, 1, 2 McF * | 10 | 45 | None | None |
20 | 90 | None | None | ||
30 | 135 | None | None | ||
Staph. aur. MRSA 0.5, 1, 2 McF * | 10 | 45 | None | None | |
20 | 90 | None | None | ||
30 | 135 | None | None | ||
Urinary catheter zone | Kleb. Pne. ESBL+ 0.5, 1, 2 McF * | 10 | 18 | None | None |
20 | 36 | None | None | ||
30 | 54 | None | None | ||
Staph. aur. MRSA 0.5 McF | 10 | 18 | 2 | 2 | |
20 | 36 | 2 | 2 | ||
30 | 54 | 2 | 2 | ||
Staph. aur. MRSA 1 McF | 10 | 18 | >100 | >100 | |
20 | 36 | 3 | 3 | ||
30 | 54 | 2 | 2 | ||
Staph. aur. MRSA 2 McF | 10 | 18 | >100 | >100 | |
20 | 36 | 3 | 3 | ||
30 | 54 | 2 | 2 |
KPI | Definition | Type of Measure | Expected Result | Result |
---|---|---|---|---|
KPI 1 | SARS-CoV-2 and MDR pathogen inactivation | Laboratory Test On-Site Test | Reduction >99% | Confirmed in about 10 min |
KPI 2 | Monitoring & Traceability | Analysis of DB data | <1% loss of data | <0.1% |
KPI 3 | Real Time Monitoring | Analysis of DB data transmitted with standard comms link | <1 min | <30 s |
KPI 4 | SAT-COM data transmission | Analysis of DB data of data transmitted with SAT-COM | <3 min | <150 s |
KPI 5 | Safety Check (ozone, human presence) | Reports from Pilot User | <1% | No problem detected |
KPI6 | Time & Work-load Reduction | Report from Pilot User | No downtime of ambulance service | Confirmed |
Sanitation Procedure for Transportation of COVID-19 Patients | |||
---|---|---|---|
Pandemic Period 2020 | Pandemic Period 2021 | UV-SAN | |
Procedure | Sanitation performed after the transportation of each COVID-19 patient:
| Sanitation performed only at the end of the shift:
| Sanitation performed at any time when the compartment is empty |
Time needed for the sanitation | 2 h | Time needed for the sanitation | |
Service down-time | 2 h for each transport | None (sanitation performed at the end of the shift) | None |
Location | Depot | Depot | Everywhere |
Staff needed | 1 person fully employed | 1 person fully employed | 1 person partially employed (start and stop sanitation) |
Traceability | Manually recorded | Manually recorded | Automatic |
Surface Characteristics | Time for Log Reduction [s] | |||||
---|---|---|---|---|---|---|
Position | Material | Irradiance [W/cm2] | Log1 | Log2 | Log3 | Log4 |
Instruments shelf | Plastic | 1 | 46 | 88 | 129 | 170 |
Stretcher base | Metal | 0.45 | 127 | 269 | 410 | 551 |
Back Door | Plastic | 0.24 | 193 | 365 | 537 | 709 |
Lateral seat | Plastic | 1 | 46 | 88 | 129 | 170 |
Seat | Plastic | 0.35 | 132 | 250 | 368 | 486 |
Floor 1 | Rubber | 0.65 | 12 | 36 | 84 | 132 |
Headrest | Plastic | 1.27 | 36 | 69 | 101 | 134 |
Floor 2 | Rubber | 0.65 | 12 | 36 | 84 | 132 |
Stretcher Armrest (right) | Metal | 0.74 | 77 | 163 | 249 | 335 |
Stretcher Armrest (left) | Metal | 0.72 | 80 | 168 | 256 | 344 |
Seat Armrest (right) | Plastic | 0.75 | 62 | 117 | 172 | 227 |
Seat Armrest (left) | Plastic | 1.34 | 34 | 65 | 96 | 127 |
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Michelini, Z.; Mazzei, C.; Magurano, F.; Baggieri, M.; Marchi, A.; Andreotti, M.; Cara, A.; Gaudino, A.; Mazzalupi, M.; Antonelli, F.; et al. UltraViolet SANitizing System for Sterilization of Ambulances Fleets and for Real-Time Monitoring of Their Sterilization Level. Int. J. Environ. Res. Public Health 2022, 19, 331. https://doi.org/10.3390/ijerph19010331
Michelini Z, Mazzei C, Magurano F, Baggieri M, Marchi A, Andreotti M, Cara A, Gaudino A, Mazzalupi M, Antonelli F, et al. UltraViolet SANitizing System for Sterilization of Ambulances Fleets and for Real-Time Monitoring of Their Sterilization Level. International Journal of Environmental Research and Public Health. 2022; 19(1):331. https://doi.org/10.3390/ijerph19010331
Chicago/Turabian StyleMichelini, Zuleika, Chiara Mazzei, Fabio Magurano, Melissa Baggieri, Antonella Marchi, Mauro Andreotti, Andrea Cara, Alessandro Gaudino, Marco Mazzalupi, Francesca Antonelli, and et al. 2022. "UltraViolet SANitizing System for Sterilization of Ambulances Fleets and for Real-Time Monitoring of Their Sterilization Level" International Journal of Environmental Research and Public Health 19, no. 1: 331. https://doi.org/10.3390/ijerph19010331