Making Sense of Ultraviolet Devices and Electrostatic Disinfecting Technologies

The dynamics of healthcare disinfection are constantly changing, especially as a result of the ongoing COVID-19 pandemic. Given the large volume of environmental surfaces that can become contaminated during the routine delivery of clinical care, healthcare facilities are constantly evaluating the most efficient solutions for large-scale disinfection.

There are multiple different modalities that healthcare providers and Environmental Services (EVS) technicians can use to disinfect commonly contaminated environmental surfaces. Most notably, ultraviolet (UV) light devices and electrostatic sprayers are being used on a large scale across the United States to combat potential COVID-19 transmission. Both of these solutions afford the ability to more effectively and easily disinfect large surface areas, especially for terminal turnover of patient care environments.

Healthcare facilities may even use a combination of these different types of devices across the health system to meet specific disinfection needs. During pandemics like the COVID-19 pandemic in high-flow patient settings such as Emergency Departments, room turnover time is a key metric for healthcare delivery efficiency. The use of technologies such as UV devices or electrostatic sprayers can be extremely beneficial as part of an overall Environment of Care and Infection Prevention and Control program.

When using these types of technologies, users should receive specific training on the appropriate use of the technology prior to deploying it in the facility. Additionally, both UV devices and electrostatic sprayers require the patient care room to be unoccupied to maintain patient safety while the technologies are being used. The healthcare marketplace is filled with various different devices that each have unique capabilities. When selecting an electrostatic device, healthcare and EVS leaders should evaluate all technologies using a standardized approach which includes a review of:

• Efficacy: Does the device work and inactivate pathogens? Electrostatic sprayers, for example, require a constant power supply in order to equally disperse the germicide, approved by the Environmental Protection Agency (EPA) for use through electrostatic sprayers, onto the surface. When the power supply is variable during the application of the germicide, this can significantly reduce the efficacy of the product. Products that are EPA-approved to use through electrostatic sprayers are validated for efficacy and safety when used through an electrostatic sprayer.  Products such as UV devices are only approved for adjunctive use, meaning that they are only to be utilized following a manual cleaning process.
• Safety: Is this device safe to use? What type, if any, of Personal Protective Equipment (PPE) is required for safe handling of the device? How long the product requires the space to be unoccupied can impact the overall room turnover time and the ability for the space to be earning revenue for the healthcare facility. Some disinfectant devices such as foggers, misters, and certain UV devices require the room to remain empty for long periods of time. Disinfectant solutions such as foggers and misters are not the same as electrostatic sprayers and many of these older technologies have extended re-entry times which negatively impact room turnover. Ready-to-use and validated disinfectants that hold EPA registration for use with electrostatic sprayers should ideally be used with electrostatic sprayers to prevent workplace injury and illness and to maximize room throughput.
• Compatibility: Does the use of the device breakdown the commonly found environmental surfaces? Ensuring that the EPA-registered germicide is compatible with the facility’s most common types of environmental surfaces will prevent surface and device degradation. Certain disinfecting solutions such as UV can have cumulative negative impacts on certain environmental surfaces and medical devices leading to surface degradation.
• Regulatory Review and Efficacy Claims: The EPA generally has regulatory authority and oversight for disinfectants and disinfecting devices. While traditional disinfection technologies such as ready-to-use germicidal wipes are strictly regulated by the EPA, this is not true for UV devices. The EPA does not currently require registration for UV devices, which can lead to highly variable efficacy and performance for each UV device in the market. The EPA also does not validate UV manufacturers’ efficacy and safety claims, which can be problematic for healthcare systems. In regard to electrostatic sprayers, some like the Clorox® Total 360® System have met the EPA’s criteria and the germicides approved to use with the system received EPA registration for use with electrostatic sprayers. This validation ensures consistent efficacy, device performance and safety criteria are met. While this is not yet an EPA requirement, electrostatic devices that have met these criteria are tested and proven to effectively meet infection control needs for the Environment of Care program across the entire healthcare continuum of care. Most germicides are not validated to be sprayed through electrostatic sprayer devices, which means that the germicide’s efficacy and safety is no longer validated since the properties of the germicide may change as it passes through the device and onto the treated environmental surface. Users should confirm the chemical they use with an electrostatic sprayer is approved for use with the system.

Novel technologies such as UV devices and electrostatic sprayers are important aspects of a comprehensive Environment of Care program and the reduction of healthcare-associated infections. These technologies must be carefully evaluated prior to use, implemented and used according to the manufacturer’s instructions for use, and then environmental monitoring principles should be followed in accordance with the recommendations from the Centers for Disease Control and Prevention. Whether during a pandemic or for regular disinfection purposes, electrostatic sprayer technologies are playing a larger role in the reduction of cross transmission across both healthcare and non-healthcare sectors.

For additional information:

• https://www.cloroxpro.com/resource-center/evaluating-electrostatic-sprayers-for-surface-disinfection-white-paper/
• U.S. Environmental Protection Agency. Expedited Review for Adding Electrostatic Spray Application Directions for Use to Antimicrobial Product Registrations https://www.epa.gov/pesticide-registration/expedited-review-adding-electrostatic-spray-application-directions-use 
• U.S. Environmental Protection Agency. Can I use fumigation or wide-area spraying to help control COVID-19? https:// www.epa.gov/coronavirus/can-i-use-fumigation-or-wide-area-spraying-help-control-covid-19 
• U.S. Environmental Protection Agency. Can I apply a product using a method that is not specified in the directions for use? https://www.epa.gov/coronavirus/can-i-apply-product-using-method-not-specified-directions-use 

Dr. Hudson Garrett Jr. is a paid consultant for Clorox Healthcare.