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"TB can be spread in many places, such as homes or worksites. Tb can also be transmitted in health care facilities. TB is most likely to be transmitted when health care workers and patinets come in contact with patients who have unsuspected TG disease, who are not receiving adequate treatment, and who have not been isolated from others. All heatlh care facilities should take measures to prevent the spread of TB."

Sept. 24, 1997:
National Tuberculosis Center


"Infectiousness
and Infection Control
"

"TB is transmitted through the air. A person with TB disease of the lungs or larynx can release droplets containing Mycobacterium tuberculosis (M. tb) into the air by coughing, sneezing, talking, or breathing. These droplets, called droplet nuclei, can cause TB infection if inhaled by anyone who shares air with the person who has TB."

"Ultraviolet Germicidal Irradiation (UVGI)."
"UVGI is the use of a type of UV radiation, known as UV-C, which has been shown to kill or in- activate M. tb in air. UVGI is generated by specially designed fixtures using bulbs that often Look something like a fluorescent light. ...."

"Upper-room UVGI is the use of UVGI lamps directly in a room where there is a risk of M. tb being transmitted. It is a useful infection control technique for crowded spaces that may be occupied by a person with TB, such as prison day rooms, homeless shelters, and waiting rooms."

Francis J. Curry National
Tuberculosis Center
"How can UV Lamps
be used in
TB Control
?"

"GUIDELINES FOR THE PREVENTION OF TUBERCULOSIS IN HEALTH CARE FACILITIES:
Ultraviolet germicidal irradiation
In some climates or in certain high-risk areas of a facility, use of natural and mechanical ventilation may not be feasible. In these situations, ultraviolet germicidal irradiation (UVGI)... may provide a less expensive alternative to more expensive environmental measures that require structural alterations of a facility.

... If HCWs [health care workers] and patients are in the room, continuous upper air irradiation can be used in which shielding placed below the UVGI sources prevents injury to occupants.

An additional more expensive option involves the use of UVGI in combination with a closed mechanical system;

Continuous upper air irradiation is the most applicable of the above methods in most resource-limited countries. The advantage of this technology is that the upper air is continuously being irradiated; thus, it provides some protection to the HCW while the infectious patient is in the room. This requires good air mixing to be effective.

The quality of UVGI lamps is very important. Usually a good one will last 5,000 to 10,000 hours (7-14 months). After that, the irradiance drops off rapidly. Responsibility should be assigned to ensure the lamps are cleaned and monitored properly to avoid adverse HCWs and patients exposure, that air flow patterns maximize M. tuberculosis UVGI killing, and that UVGI output is adequate."

"Environmental Control
Measures"

World Health
Organization - 1999

WHO/CDS/TB/99.269

"UV air cleaners and upper-room air ultraviolet germicidal irradiation for controlling airborne bacteria and fungal spores"
"In-room air cleaners (ACs) and upper-room air ultraviolet germicidal irradiation (UVGI) are engineering control technologies that can help reduce the concentrations of airborne bacteria and fungal spores in the indoor environment."

Journal Occupational Environmental Hygiene. 2006 Oct;3(10):536-46

Dept. of Civil,
Environmental and
Architectural Engineering
- University of Colorado
at Boulder

"An unrecognized opportunity exists to integrate UVGI as a subsystem within existing buildings and those under design post-September 11, 2001. Upper room UVGI can be easily installed in vulnerable areas within buildings at a small fraction of the cost of installing high efficiency filtration."

"Bioterrorism concerns have caused an enhanced interest in the development of UVGI in indoor public spaces and large buildings."

Public Health Reports /
March-April 2003 /
Volume 118

"The Application of Ultraviolet Germicidal Irradiation to Control Transmission of Airborne Disease: Bioterrorism Measure"

"Definitions: Avian (or bird) flu (AI) is caused by influenza viruses that occur naturally among wild birds. Low pathogenic AI is common in birds and causes few problems. H5N1 is highly pathogenic, deadly to domestic fowl, and can be transmitted from birds to humans. There is no human immunity and no vaccine is available.

Pandemic flu is virulent human flu that causes a global outbreak, or pandemic, of serious illness. Because there is little natural immunity, the disease can spread easily from person to person."

(Managed by the
Department of Health
and Human Services)

http://www.pandemicflu.gov

"My fellow Americans,

Once again, nature has presented us with a daunting challenge: the possibility of an influenza pandemic.....

A new strain of influenza virus has been found in birds in Asia, and has shown that it can infect humans. If this virus undergoes further change, it could very well result in the next human pandemic...

While your government will do much to prepare for a pandemic, individual action and individual responsibility are necessary for the success of any measures...."

GEORGE W. BUSH -
THE WHITE HOUSE -
November 1, 2005"


The President's Letter

"Disrupting the Transmission of Influenza A: Face Masks and Ultraviolet Light as Control Measures"

Martin Meyer Weiss, MD, Peter D. Weiss, MD, Danielle E. Weiss, MD and Joseph B. Weiss, MD

"In the event of an influenza pandemic, where effective vaccine and antiviral drugs may be lacking, disrupting environmental transmission of the influenza virus will be the only viable strategy to protect the public.

We discuss 2 such modalities, respirators (face masks) and ultraviolet (UV) light. Largely overlooked, the potential utility of each is underappreciated. .... UV light, directed overhead, may be beneficial in hospitals and nursing homes."

Martin Weiss is with the Veterans Administration, Sepulveda, Calif, and the School of Medicine, University of California, Los Angeles. Peter D. Weiss is with the School of Medicine, University of California, Los Angeles. Danielle E. Weiss is with Scripps Mercy Medical Center, San Diego, Calif. Joseph B. Weiss is with the School of Medicine, University of California, San Diego.

April 2007, Vol 97,
No. Supplement_1 |
American Journal of
Public Health S32-S37
© 2007 American Public
Health Association
DOI: 10.2105/AJPH.2006.096214

Health Policy and Ethics

"Overall, our data demonstrate that the upper room-air UVGI system tested was able to inactivate airborne bacteria spores and mycobacteria and significantly decrease their culturable airborne cell concentrations."

Centers for Disease Control -
NIOSH - Report 10, 2002

"Efficacy of Ultraviolet Radiation
in Controlling the
Spread of Tuberculosis
"

"....In conclusion, we have found that upper-room UVGI can significantly reduce the concentration of airborne microorganisms (S. marcescens and BCG) aerosolized in a saliva simulant in a typical mechanically ventilated hosital isolation room."

Environmental Health Perspectives - Articles; Department of Environmental Health, Harvard School of Public Health, Boston, MA-
"Upper-room UVGI in Preventing the Transmission of Airborne Diseases"

"The use of ultraviolet germicidal irradiation (UVGI) for the sterilization of microorganisms has been studied since the 1930's. Microbes are uniquely vulnerable to the effects of light at wavelenfgths at or near 2537 Angstroms due the resonance of this wavelength with molecular structures."

Penn. State U. Grad.
School of
Architectual Engineering
and Dept. of Biology

Aerobiological Engineering

"Ultraviolet Germicidal Irradiation

"Recent research conducted at the National Institutes of Health (NIH) by Farhad Memarzadeh, MD, with assistance from Andrew Manning, MD, indicates that UVGI, used in the proper configuration with adequate ventilation flow rate, can have a significant impact on reducing the number of viable TB bacteria in a patient room. Memarzadeh and Manning also found that the UVGI can reduce the total airflow required, resulting in a first-cost savings in the ventilation system, as well as an overall operational cost savings because of the reduced air change requirement. This study further indicates that wintertime baseboard heating in a TB isolation room, in conjunction with a properly arranged ventilation system and effective UVGI, can significantly reduce the number of viable particles in the room."

Article -
Infection Control Today
- David R. Linamen, P.E.

"Research Indicates UVGI
is an Effective
Supplement to
Ventilation for Eliminating TB bacteria

"What is the future of upper room UVGI?"
"Upper room UVGI is likely to become a common feature of buildings. Upper room UVGI is an effective method for cleansing the air of many types of viruses and bacteria, including some of those suggested as weapons for bioterrorism. The technology is well-developed. It can be easily retrofitted in many buildings. It has been shown to be effective in the laboratory and is currently undergoing an extensive test of its effectiveness for preventing the spread of tuberculosis in representative environments."

Lighting Research Center,
Rensselaer Polytechnic
Institute

"Controlling Tuberculosis
Transmission with
Ultraviolet Irradiation
"