Biomedical Engineering Reference
In-Depth Information
9.2 Methods
Information for this chapter came primarily from peer reviewed and government
publications. Papers were sought by performing word searches on a variety of
standard internet tools including Medline and Google scholar
. An extensive
library of papers on the associated topics of healthcare infection control, fumiga-
tion, ultraviolet irradiation, and environmental health and safety were compiled for
review and consideration.
Studies of the use of fumigants in settings other than healthcare were also
reviewed. Those studies involving fumigation in healthcare explored their use as an
adjunct to conventional environmental disinfection [
37
,
55
-
58
,
75
-
77
]. Fumigation
tests were performed under a variety of conditions. Some were efficacy tests
in laboratory facilities with controlled environmental conditions, and others were
fumigation effectiveness tests administered in the field under ambient conditions.
Two studies investigated human exposures during fumigation use in agriculture or
residential settings [
78
,
79
]. Fumigation is being marketed as an effective means of
controlling undesirable microorganisms. The challenge faced by fumigation
researchers is to develop an approach that is successful in killing harmful micro-
organisms, while preventing health effects and environmental harm from exposure.
Unfortunately, most studies only addressed the degree of microbial disinfection
efficacy, not safety. Also, with the exception of reports by the Environmental
Protection Agency (EPA), environmental damage from exposure to materials or
equipment was only mentioned occasionally in the studies investigated [
37
,
60
,
80
].
There were many sources that discussed UVC irradiation as a means of upper air
disinfection [
68
,
81
-
83
]. However, in terms of research on UVC for surface
disinfection, the literature was limited, and only laboratory based research was
located [
84
-
87
].
®
9.3 Results
9.3.1 Fumigation Benefits: Efficacy,
Effectiveness and Efficiency
Reports of the efficacy and efficiency of different types of fumigation approaches
were examined. See Table
9.1
for definitions of
Efficacy
,
Effectiveness
, and
Efficiency
. An early method of fumigation was to use a high velocity-fogger to
spray quaternary ammonium compounds in hospital rooms [
53
]. The unit was
operated with the room air conditioners off and the doors and windows closed.
The apparatus was placed in the middle of the hospital room and the fogging cycle
was 10-15 min. Researchers believed that this approach was effective because they
observed a reduction from the average of 10-15 detectable bacteria per cubic foot
(0.0283 m
3
) of air prior to fogging to less than 2 or 3 detectable microorganisms
after fogging. Similar reductions were seen on surface samples.
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