In the MIDI Innovation Vault™, Paradigm Shift Required; INFECTION PREVENTION series, we have learned about the methods of preventing the spread of hospital-acquired infections and how the knowledge gained from them contribute to the efforts to control COVID-19. We have also discussed the environments that require the most protection both inside and outside of healthcare facilities, as well as how automation plays into infection prevention.In this final installment, we are joined by MIDI Medical Product Development President and co-owner Chris Montalbano and Christian Davis, Vice President of Product Development and Technology at Seal Shield, to explore the technology that is proving itself to be the future of infection prevention: UVC wavelength. While there are many new technologies recently emerging, such as antimicrobial materials and surfaces or chemical disinfectants, UVC has many proven advantages supported by research.

The Margin of Error
One important thing to understand about the need for and execution of innovation in infection prevention at this time is how and why the methods currently in practice fall short of their goal. While there are a few key reasons for this, Chris and Christian agree that the most important is the variability of compliance that occurs with manual disinfection. Some individuals neglect their disinfection duties altogether, while some perform those duties in a way that is incorrect or unthorough. The efficacy of manual methods relies on the performer, meaning that a level of human error is to be expected. But with resilient, highly contagious, and potentially deadly diseases like COVID-19, this margin of error can be unacceptable.
One issue contributing to this pinpointed by Christian is users’ inability to understand the IFUs, or instructions for use, that come with most manual disinfectants. Chemical applications such as sprays and wipes come with clear instructions supported by reviews published along with the product and its EPA registration. However, because instructions can vary drastically from chemical to chemical, they can often be difficult to understand, which may contribute to a higher margin of error. This, combined with human variability, time constraints, and inability to audit methods, makes traditional manual disinfection ineffective as a one-and-done infection prevention method.

UVC and Its Applications
However, manual disinfection can be layered with new technologies to create an “airtight” system that supports adoption and compliance. On the forefront of these emerging technologies is the application of UVC light, identified by Chris and Christian, which can take the form of fluorescent-like bulbs or printer circuit board mounted LED applications. The primary reason for UVC’s, more specifically the UVC LEDs’, predominance over chemical disinfectants and most other infection prevention methods lies in its ability to destroy the DNA of pathogens, permanently eliminating them. Yet, it possesses several other advantages as well. Its compact size allows for a wider range of packaging possibilities, and devices are lighter in weight than other applications. These devices are also more energy-efficient, require virtually no maintenance, and are ready to be used at full efficacy as soon as they are turned on.
A crucial element of UVC application is understanding and being able to produce the nanometers required for peak sanitization. When referring to UV radiation or radiant flux, nanometers are used as the unit to measure wavelengths. The efficacy and efficiency of UVC LEDs are dependent on their ability to produce the wavelength necessary for proper sanitization. As Christian explains, the wavelength output of UVC generators are measured at their peak, with many less advanced generators, such as mercury or xenon lamps, peaking at 254 nm. The problem with this is that, per Christian, research has found that the ideal germicidal wavelength is 262 nm. UVC LEDs present themselves as the solution to this problem as their output can be carefully controlled, unlike bulb type generators.

Examples and Evidence
One excellent example of the successful application of UVC technology is a device designed by Seal Shield used to eliminate pathogens associated with hospital-acquired infections on the surfaces of iPads and cellphones used by healthcare workers. This device, Christian says, was developed with the goal of “taking the variability and guesswork [out] of standardization efforts,” meaning it was integrated with an intelligent system capable of several things. The system is able to control the exact UVC dosage within the electric wave used, as well as articulate the LEDs to ensure the device being sanitized is doing so on all of its surfaces, rather than the front or back alone. According to Christian, however, the most important feature of this system is its ability to track sanitization cycles with RFID passive technology to monitor usage. This provides organizations with the assurance that the device is in use and infection prevention standards are being met. It will even notify end-users if they are not in compliance.
The efficacy of UVC LED applications has already received support from peer-reviewed research. One Seal Shield study, cited by Christian, examined the effectiveness of UVC LEDs in sanitizing iPads used by hospital staff to track patient information. These iPads would have traveled all over the hospital, and the staff in possession of them would have seen multiple patients. In a randomized study with a sample size of ten tablets, microbial burden found on the iPads were measured after they had been in use for four hours. Half of the devices were disinfected with a combination of isopropyl alcohol (IPA) wipes and the ElectroClave, while the other half were only wiped with IPA. It was found that devices on which the ElectroClave was used had a reduced microbial burden of eighty percent. This heavily supports the efficacy of UVC applications, while highlighting the necessity of combining these applications with more traditional methods to produce the most effective results.

As we continue battling the spread of COVID-19, it is increasingly important that technology such as Seal Shield’s permeates beyond healthcare environments and into our daily lives, in restaurants, schools, offices, and beyond. The key to this will be creating innovative technologies that promote the adoption of infection prevention methods, an endeavor that MIDI as well as Seal Shield are committed to. With MIDI actively developing products for their clients aimed at this, both companies advance towards the goal of producing infection control solutions that will make a “real, measurable difference” in the world.

With this, we conclude the MIDI Innovation Vault™ series on Device Infection Prevention. For those seeking more information about infection prevention solutions, visit midipd.com.