From the January 2007 edition of JEMS:
By Paul A. Berlin, MS, EMT-P

Pandemic flu, TB, common colds, MRSA ... are you doing all you can to prevent these and other infectious pathogens from contaminating your patient compartment and medical devices? If not, it might be time to consider the benefits of adding ultraviolet C-band (UV-C) lighting to your ambulance disinfection procedures.

UV-C lights have been used for years in various sanitation/sterilization processes and are commonly found in air cleaning systems in hospitals, labs and other places where airborne pathogens may be present. UV-C has also been effectively used in the purification of water that may contain various pathogens such as E. coli. Today, in addition to disinfecting air and water, UV-C is being used in a novel way—for disinfecting surfaces.

How UV-C works: Microorganisms can be classified into basic groups of bacteria, viruses, fungi, protozoa and algae. The genetic material DNA (deoxyribonucleic acid) or RNA (ribonucleic acid) is the target of the UV-C light. It penetrates the coating of the organism, disrupting the DNA or RNA in the nucleus, rendering the cell incapable of reproducing.

UV-C is rarely found on Earth’s surface because the atmosphere actively screens it out. To take advantage of the germicidal potential of UV-C, an alternate means of producing UV light has been achieved using a design similar to standard fluorescent lamps—with the notable exception that UV lamps are typically manufactured with “hard glass” quartz, which allows for a UV transmittance of more than 90% of the radiated energy.

UV-C lights have many advantages. They’re environmentally friendly with no dangerous materials to handle or store, so employees won’t need to handle any toxic chemicals. The lights are also immediately effective, economical and operator friendly.

(Just flip a switch.) Maintenance is easy— periodic cleaning and annual lamp replacement should do it. Installation involves only simple wiring, timer switches and a power connection. UV-C is also more effective against viruses than chlorine.

Some precautions: It will disinfect only illuminated air and surfaces. (Shaded areas, such as under the stretcher, will not be effectively disinfected.) You’ll need to integrate safety systems with the operation of the UV-C to prevent inappropriate exposures. Brief exposure is not considered harmful but is not recommended because it may cause minor skin and eye irritation. Prolonged exposure to UV-C is considered harmful to humans.

Gig Harbor (Wash.) Fire & Medic One has worked with its ambulance manufacturer, Braun Northwest Inc., and the manufacturer of Lumalier (the UV-C light) to install the lights in its ambulances. The system has been using the lights for more than a year and includes them within its standard ambulance specifications.

The UV-C unit is mounted in the ceiling of the patient compartment of the ambulance. It’s wired so that the ambulance must be plugged into an A/C shoreline. All patient compartment doors must be closed during the “on” phase, which is controlled by a timer switch mounted out of the way so it won’t be confused with an interior light switch. Additional shading was added to patient compartment windows to further prevent inadvertent exposure to the staff.

The patient compartment is “treated” with UV-C at least once per shift, and after any call with potentially infected patients. It runs for five to 10 minutes with the stretcher in place and such reusable items as BP cuffs and pulse oximeter probes on the bench so they’re also treated. The UV-C is then run again with the stretcher removed to capture any previously shaded areas.

The UV-C light doesn’t replace any current cleaning practices used by Gig Harbor Fire & Medic One; it supplements the cleaning procedures to get to those missed bugs.

UV-C has been used for many years to sterilize air, water and visibly exposed surfaces. Available science has shown that it’s effective against a variety of potentially harmful organisms. It’s scientifically valid to employ it in one of the most contamination- prone environments used for patient transport: Your ambulance. Consider adding it to your armamentarium of infection control devices and procedures.

For more information on Gig Harbor Fire & Medic One’s UV-C program, contact pberlin@ piercefire.org. Contact Braun Northwest Inc. at 800/245.6303 or visit www.braunnorthwest.com. Visit www.lumalier.com to learn more about the UV-C device, Lumalier.

Paul A. Berlin, MS, EMT-P, is the medical division chief for Gig Harbor (Wash.) Fire & Medic One and a practicing paramedic with 35 years’ experience in emergency medicine.

102 JEMS | JANUARY 2007