Safety and Effectiveness Assessment of Ultraviolet-C Disinfection in Aircraft Cabins.

INTRODUCTION: Aircraft cabins, susceptible to disease transmission, require effective strategies to minimize the spread of airborne diseases. This paper reviews the James Reason Swiss Cheese Theory in mitigating these risks, as implemented by the International Civil Aviation Organization during the COVID-19 pandemic. It also evaluates the use of airborne ultraviolet-C (UV-C) light as an additional protective measure.METHODS: Our approach involved a thorough literature review by experts and a detailed risk-vs.-benefit analysis. The review covered existing research to understand the scientific foundation, while the analysis used established techniques to assess the impact of influenza and COVID-19 in terms of infections, deaths, and economic costs.RESULTS: Integrating UV-C light in aircraft cabins, when applied with appropriate scientific understanding and engineering safeguards, has the potential to reduce in-flight disease transmission. This additional mitigation strategy can work synergistically with existing measures.DISCUSSION: The research and risk-vs.-benefit analysis present strong evidence for the safety and effectiveness of continuous UV-C disinfection in aircraft cabins. It suggests that UV-C light, maintained below exposure limits, can be a valuable addition to existing measures against disease transmission during flights.Belland K, Garcia D, DeJohn C, Allen GR, Mills WD, Glaudel SP. Safety and effectiveness assessment of ultraviolet-C disinfection in aircraft cabins. Aerosp Med Hum Perform. 2024; 95(3):147-157.

Inactivation of Pathogens in Air Using Ultraviolet Direct Irradiation Below Exposure Limits.

A method is described for inactivation of pathogens, especially airborne pathogens, using ultraviolet (UV) radiation emitted directly into occupied spaces and exposing occupants to a dose below the accepted actinic exposure limit (EL). This method is referred to as direct irradiation below exposure limits, or DIBEL. It is demonstrated herein that low-intensity UV radiation below exposure limits can achieve high levels of equivalent air changes per hour (ACHeq) and can be an effective component of efforts to combat airborne pathogens such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). An ACHeq of 4 h-¹ is presently achievable over a continuous 8 h period for the SARS-CoV-2 virus with UV-C light-emitting diodes (LEDs) having peak wavelength at 275 nm, and future improvements in LED technology and optics are anticipated to enable improvements up to 150 h-¹ in the coming decade. For example, the actinic EL is 60 J/m² at 254 nm, and human coronaviruses, including SARS-CoV-2, have a UV dose required for 90 % inactivation of about 5 J/m² at 254 nm. Irradiation by 254 nm UV-C at the EL is expected to provide 90 % inactivation of these organisms in air in about 40 min when the UV-C is delivered at a constant irradiance over 8 h, or in about 5 min if the UV-C is delivered at a constant irradiance over 1 h. Since the irradiation is continuous, the inactivation of initial contaminants accumulates to 99 % and then 99.9 %, and it also immediately begins inactivating any newly introduced (e.g., exhaled) pathogens at the same rate throughout the 8 h period. The efficacy for inactivating airborne pathogens with DIBEL may be expressed in terms of ACHeq, which may be compared with conventional ventilation-based methods for air disinfection. DIBEL may be applied in addition to other disinfection methods, such as upper room UV germicidal irradiation, and mechanical ventilation and filtration. The ACHeq of the separate methods is additive, providing enhanced cumulative disinfection rates. Conventional air disinfection technologies have typical ACHeq values of about 1 h-¹ to 5 h-¹ and maximum practical values of about 20 h-¹. UV-C DIBEL currently provides ACHeq values that are typically about 1 h-¹ to 10 h-¹, thus either complementing, or potentially substituting for, conventional technologies. UV-C DIBEL protocols are forecast herein to evolve to >100 ACHeq in a few years, potentially surpassing conventional technologies. UV-A (315 nm to 400 nm) and/or UV-C (100 nm to 280 nm) DIBEL is also efficacious at inactivating pathogens on surfaces. The relatively simple installation, low acquisition and operating costs, and unobtrusive aesthetic of DIBEL using UV LEDs contribute value in a layered, multi-agent disinfection strategy.