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      Safety of 222 nm UVC Irradiation to the Surgical Site in a Rabbit Model

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          ABSTRACT

          For the prevention of surgical site infection (SSI), continuous disinfection could be helpful. Short wavelength ultraviolet radiation C (UVC) is highly bactericidal but shows cytotoxicity. Radiation of UVC with a wavelength of 222 nm to the skin is considered to be safe because it only reaches the stratum corneum. However, the safety of 222 nm irradiation to the surgical field not covered with skin is unknown. The purpose of this study was to examine the safety of 222 nm UVC irradiation on a surgical field in a rabbit model. Five types of tissue were surgically exposed and irradiated with 222 or 254 nm UVC. Immunohistological assessment against cyclobutane pyrimidine dimer (CPD), an index of DNA damage by UVC, was performed. The CPD‐positive cell rate was significantly higher in the 254 nm group than in the other groups in all tissues. A 222 nm group showed significantly more CPD than control in fat tissue, but no significant difference in all other tissues. In fat tissue collected 24 h after irradiation, the 254 nm group showed higher CPD than the other groups, while the 222 nm group had reduced to the control level. These data suggest that 222 nm UVC irradiation could be a new method to safely prevent SSI.

          Abstract

          To prevent surgical site infection, continuous disinfection could be helpful. Short wavelength UVC is highly bactericidal but shows cytotoxicity. Radiation of UVC with a wavelength of 222 nm to the skin is considered to be safe because it only reaches the stratum corneum. However, the safety of 222 nm irradiation to the surgical field not covered with skin is unknown. In this study, five types of tissue were exposed and irradiated with 222 nm or 254 nm UVC. An immunohistological assessment of DNA damage was performed. The results suggest that 222 nm UVC irradiation could be a new method to safely prevent surgical site infection.

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          Most cited references30

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          Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses

          A direct approach to limit airborne viral transmissions is to inactivate them within a short time of their production. Germicidal ultraviolet light, typically at 254 nm, is effective in this context but, used directly, can be a health hazard to skin and eyes. By contrast, far-UVC light (207–222 nm) efficiently kills pathogens potentially without harm to exposed human tissues. We previously demonstrated that 222-nm far-UVC light efficiently kills airborne influenza virus and we extend those studies to explore far-UVC efficacy against airborne human coronaviruses alpha HCoV-229E and beta HCoV-OC43. Low doses of 1.7 and 1.2 mJ/cm2 inactivated 99.9% of aerosolized coronavirus 229E and OC43, respectively. As all human coronaviruses have similar genomic sizes, far-UVC light would be expected to show similar inactivation efficiency against other human coronaviruses including SARS-CoV-2. Based on the beta-HCoV-OC43 results, continuous far-UVC exposure in occupied public locations at the current regulatory exposure limit (~3 mJ/cm2/hour) would result in ~90% viral inactivation in ~8 minutes, 95% in ~11 minutes, 99% in ~16 minutes and 99.9% inactivation in ~25 minutes. Thus while staying within current regulatory dose limits, low-dose-rate far-UVC exposure can potentially safely provide a major reduction in the ambient level of airborne coronaviruses in occupied public locations.
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            Existing and potential applications of ultraviolet light in the food industry - a critical review

            Short-wave ultraviolet light (UVC, 254 nm) can reduce dramatically the microbial load in air or on hard surfaces free from food residues, and can eliminate pathogens from potable water filtered to remove organic residues and 'clumps' of bacteria. More recently, approval of the Food and Drug Administration (USA) has been sought for a system for the destruction of pathogenic bacteria in fruit juices using UVC, and the same approach could perhaps be applied to remove spoilage organisms from cider or wines. In contrast, long-wave UV light (UVA, >320 nm) has limited microbiocidal properties, and for practical applications its effectiveness has to be enhanced by the presence of photosensitive compounds (eg furocoumarins) that will diffuse into a microbial cell prior to irradiation. The penetration of UVA into water is better than that of UVC, and its bacteriocidal action in the presence of photosensitisers can be rapid. However, pure furocoumarins are expensive and their addition to foodstuffs might be questioned on safety grounds. © 2000 Society of Chemical Industry.
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              Far-UVC light: A new tool to control the spread of airborne-mediated microbial diseases

              Airborne-mediated microbial diseases such as influenza and tuberculosis represent major public health challenges. A direct approach to prevent airborne transmission is inactivation of airborne pathogens, and the airborne antimicrobial potential of UVC ultraviolet light has long been established; however, its widespread use in public settings is limited because conventional UVC light sources are both carcinogenic and cataractogenic. By contrast, we have previously shown that far-UVC light (207–222 nm) efficiently inactivates bacteria without harm to exposed mammalian skin. This is because, due to its strong absorbance in biological materials, far-UVC light cannot penetrate even the outer (non living) layers of human skin or eye; however, because bacteria and viruses are of micrometer or smaller dimensions, far-UVC can penetrate and inactivate them. We show for the first time that far-UVC efficiently inactivates airborne aerosolized viruses, with a very low dose of 2 mJ/cm2 of 222-nm light inactivating >95% of aerosolized H1N1 influenza virus. Continuous very low dose-rate far-UVC light in indoor public locations is a promising, safe and inexpensive tool to reduce the spread of airborne-mediated microbial diseases.
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                Author and article information

                Contributors
                tniikura@med.kobe-u.ac.jp
                Journal
                Photochem Photobiol
                Photochem Photobiol
                10.1111/(ISSN)1751-1097
                PHP
                Photochemistry and Photobiology
                John Wiley and Sons Inc. (Hoboken )
                0031-8655
                1751-1097
                15 April 2022
                Nov-Dec 2022
                : 98
                : 6 ( doiID: 10.1111/php.v98.6 )
                : 1365-1371
                Affiliations
                [ 1 ] Department of Orthopaedic Surgery Kobe University Graduate School of Medicine Kobe Japan
                [ 2 ] Ushio Inc. Tokyo Japan
                [ 3 ] Laser Research Centre Faculty of Health Science University of Johannesburg Johannesburg South Africa
                Author notes
                [*] [* ] Corresponding author email: tniikura@ 123456med.kobe-u.ac.jp (Takahiro Niikura)

                Author information
                https://orcid.org/0000-0001-9795-9549
                https://orcid.org/0000-0001-6431-4605
                Article
                PHP13620
                10.1111/php.13620
                9790646
                35313036
                9340884c-d982-463f-822c-d466415a2b6c
                © 2022 The Authors. Photochemistry and Photobiology published by Wiley Periodicals LLC on behalf of American Society for Photobiology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 10 March 2022
                : 27 December 2021
                : 14 March 2022
                Page count
                Figures: 7, Tables: 0, Pages: 1371, Words: 6890
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                November/December 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.3 mode:remove_FC converted:25.12.2022

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