UV-C: The most Efficient way to Mitigate the Spread of Disease in Homeless Shelters & Prisons
Homelessness dramatically increases one's risk of illness, injury and death. Indoor airborne transmission is a common method for many naturally occurring illnesses, and it frequently occurs in deprived shelter environments. For every age group, the unhoused are three times more likely to die than the general population. Middle-aged homeless men and young homeless women are at particularly increased risk. The average age of death of homeless persons is about 50 years, the age at which Americans commonly died in 1900. Today, non-homeless Americans can expect to live to age 78.3. Homeless people suffer the same illnesses experienced by people with homes, but at rates three to six times higher. This includes potentially lethal communicable diseases such as HIV/AIDS, tuberculosis and influenza, as well as cancer, heart disease, diabetes and hypertension. Homeless persons die from illnesses that can be treated or prevented by UV-C air sterilization technology. Over-crowded, poorly-ventilated living conditions, found in most shelters, and prisons, promote the spread of airborne disease. Physical health conditions such as heart problems or cancer are more likely to lead to an early death for the unhoused. The difficulty getting rest, maintaining medications, eating well, staying clean and staying warm prolong and exacerbate illnesses, sometimes to the point where they are life threatening.
Society is adversely impacted by these illnesses, as crowded conditions, pollution, and poor air circulation enhance the risk of airborne organism transmission from one person to another. Infectious illnesses that are spread through the air might evolve and develop antibiotic resistance. So, what can be done to mitigate the spread of dangerous airborne pathogens in homeless shelters, and prisons?
Installing upper-room, enclosed, UV-C disinfection lighting at homeless shelters and prisons across the world is the best solution, yet our governments seem to be asleep at the wheel when it comes to deploying technology focused on pathogen mitigation in our shelters, and prisons.
UVGI is endorsed to disinfect indoor environments by the WHO, FDA, CDC and ASHRAE, respectively. However, UV-C supporters have long contended that in situations when other infection control strategies are challenging to apply, UV-C may be the most effective air sterilization control tool. No matter what kind of bacterium it may be, germicidal UVGI acts to destroy the DNA of dangerous pathogens like TB or SARS-CoV-2. Large enough quantities of energy are delivered into the microorganisms that it shines on whether they are on a surface or in the air to damage their DNA and inactivate their vital cellular activities.
In order to determine the viability and effectiveness of employing UV-C to stop the spread of tuberculosis (TB) in homeless shelters, a national project has been started. Participating homeless shelters in the study include those in New York City and Birmingham, Alabama. As data are acquired over the course of the next five years, shelters in four other cities are expected to join them. Not only this project, but a laboratory is also working together with collaborators at Harvard University and Brigham and Women’s Hospital to assist direct the sustainable adoption of this airborne infection control on a worldwide scale. Researchers have safely and efficiently applied ultraviolet germicidal irradiation (UVGI) devices to disinfect huge volumes of shared air in preventing the spread of airborne disease, and UVGI has been demonstrated to be effective in lowering TB transmission by 80% in high-risk environments.
Camillus House Miami
UV-C was crucial during the SARS-CoV-2 pandemic in addition to helping stop the spread of TB in homeless shelters. As the pandemic continues to spread, the Camillus House homeless shelter in downtown Miami made the early decision to rigorously restrict entry. Customers were transported for testing and temporarily confined in one of Camillus House’s six new isolation rooms if they had coronavirus symptoms. UV lights and negative pressure have been added to these rooms. The best implementation strategy for preventing the transmission of infectious pathogens within rooms uses wall- or ceiling-mounted fixtures that direct UV-C radiation above the heads of room occupants, as opposed to UVGI within ventilation systems. Mechanical air mixing that is already present or is introduced to a room transfers infectious aerosols into the germicidal beam and returns clean air back down to the breathing zone. These facilities allow the shelter to function smoothly amid a virus- infested crisis and significantly lower the rate of virus transmission inside the shelter.
The use of upper-room UVGI has prompted worries about potential harm to room occupants ever since it was first introduced more than 60 years ago, particularly to the eyes (photokeratoconjunctivitis) and skin (photodermatitis). The Tuberculosis Ultraviolet Shelter Study (TUSS), which took undertaken at 14 homeless shelters in six American cities from 1997 to 2004, was a double-blind, placebo-controlled field trial of upper-room UVGI. A total of 3,611 interviews with questions concerning itching of the eyes and skin were conducted. In 223 of them, or 6% of the interviews, a report of a skin or eye symptom was made. Although months might occasionally pass between interviews, it was not always able to tell whether complaints of eye or skin problems had been totally experienced during a placebo or active UV period. 95 of the 223 complaints of eye or skin symptoms and 92 of the reports of skin or eye symptoms exclusively occurred during active UV hours. The timing of the symptoms in the remaining 36 patients was ambiguous. 6% of individuals in each of the three periods had symptoms involving their eyes or skin. The majority of symptoms reported during the active time, such as eczema, or bacterial infections showed that they were unlikely to be brought on by UV exposure.
It is believed that non-enclosed UV-C light may harm exposed skin and eyes more than longer wavelengths of sunlight, since 254 nm UV is a very active photochemical wavelength. Covspect does not recommend any sort of UVGI or UV-C upper room systems to shelters, prisons or refugee centers unless the UV lamps are entirely enclosed.
With the appropriate planning, installation, and maintenance, modern upper-room UVGI or Far UV technologies may be installed safely in a variety of interior areas, even in structures as diverse as homeless shelters, as shown by the TUSS project. Upper- room UVGI is particularly well-suited for retrofitting older buildings and has the ability to provide considerable protection at a cheap cost, especially when there has never been a bigger risk of airborne contamination in environments where people congregate from infections including TB, pandemic influenza, severe acute respiratory syndrome, and bioterrorism agents like smallpox. Worries about safety—in particular the potential for Photokeratitis and skin erythema from high UV-C exposure—should not prevent the use of correctly constructed and maintained upper-room UVGI systems according to the findings presented above. The entire capability of this technology to enhance control of person-to-person transmission of human airborne infections in buildings should be achieved once the use of UVGI is better understood.
The homeless community and the imprisoned are society’s most vulnerable groups because they do not have access to the same hygienic indoor spaces, or sanitation that the rest of society has access to. Federal, State/Provincial and Municipal governments should be investing tax payers’ dollars in disinfecting our shelters and prisons with UV-C. Let’s do more to protect the unhoused, and imprisond, and mitigate the spread of airborne disease by mass deploying enclosed UV-C, or Far UV upper room lighting devices to our homeless shelters and prison systems.
Written by Pathologist, Yuqi "Christy" Ouyang BMedSci and Steve Grabenheimer
Sources:
https://labs.icahn.mssm.edu/vincentlab/
https://www.reliasmedia.com/articles/55731-national-uv-light-study-in-homeless-shelters
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2099326/
https://angelusnews.com/news/nation/uv-lights-ozone-cleaners-sanitizers-help-
shelter-keep-homeless-safe/
https://nhchc.org/wp-content/uploads/2019/08/HardColdFacts.pdf
