In the air disinfection technology is applied in today’s hospital environment, TiO2 / UVC technology is one of the air disinfection technology is appreciated and promising. In this study, we performed evaluation effectively reduce microorganisms in air environment at hospitals using the technology of TiO2 / UVC of Airocide air purifer applied on a total of 12 units of hospitals nationwide with a total of 13 operating rooms and 10 ICU rooms through microbiological monitoring methods in the air. The research results show that technology TiO2 / UVC of Airocide have ability in removement bacteria, fungi, bacterial hemolysis. The optimal efficiency average at 86 % and 83.31% in the operating room and recovery room respectively after 7 days of using Airocide. Besides, TiO2 / UVC technology help improve the quality of environment environment and comply WHO 2012 standard & V.Omelanskii standard for clean room,
Keywords: TiO2 / UVC technology, infection control, Airocide
HAIs has been a burden for patients, clinics and treatment around the globe, particularly in the least developed countries and developing countries like Vietnam because of increased morbidity , mortality, prolonged hospitalization, increased use of antibiotics and the cost of treatment before the status healthcare system in our country is still facing many constraints and organizational infrastructure. Therefore, in addition to capacity building organization, finding the disinfection technology brings high efficiency in BCC hospital is essential.
Currently, technology TiO2 / UVC is considered technologies are more developed and has many advantages than some air sterilizing technologies as using ultraviolet light (UV), spray disinfection, membrane technology, positive pressure / negative pressure. For HEPA filter technology is only capable of eliminating the pollution factor of size greater than or equal 0,3μm such as tobacco smoke, mold spores, bacteria, dust, pollen, and can not filter viruses and volatile organic compounds in the air; processing efficiency decreases when the filters clogging risk creating bacteria accumulate on membrane. While disinfection technology using ultraviolet light (UV) disinfection capable, simple operation, low cost. However, the method is only effective in area where the light come. Besides, UV radiation is rick on human health. Most of the UV system installed glass bulbs without UV protection, a broken bulb could release mercury, causing potential risks to health and the environment2,3. The disinfection system air negative pressure, positive pressure can use filters, ultraviolet light also encountered disadvantages of membrane technology and UV above; which not to mention demanding technical installation and investment costs and maintain very large. Meanwhile, spray disinfection technology should require isolation, when implemented and must use some disinfectant chemicals can cause risks to health, corrosive3,4.
According to several studies abroad has been done shows that TiO2 / UVC technology is considered the disinfected technology efficiently at the hospital environment with the ability to operate continuously 24/24 hours without isolation. Besides, the technology to ensure safety for people and the environment. On this basis, this study was conducted to evaluate the effectiveness of reducing microorganisms in the hospital environment in Vietnam.
This method was based on a process monitoring air quality at the test site through the identification of indicators of aerobic bacteria, mold, hemolytic Streptococc in the air with 314 air samples total.
Sampling procedures in compliance with technical regulations for routine labor Institutes of Health and Sanitation, Koch dust deposition method. The results were evaluated based on the criteria of air quality comply with WHO 2012, V.Omelanskii standard for clean rom. The data used in the article is the result of observation and analysis of the Institute of Health Occupation and Environmental Medicine, Academy of Sciences Pauster HCMC and microbiology at some hospitals involved.
2.2. Effect of reducement microorganisms in the operating room
Evaluation results of air quality through observation of microorganisms on a total of 13 operating rooms of 06 units Hospital obtained show that technology TiO2 / UVC applications on the device Airocide can reduce microorganisms in the operating room efficiency. The results are classified into 3 cases evaluated for apparent treatment efficiency and the ability to maintain the stability of the technology TiO2 / UVC is expressed through the typical results in a hospital unit as follows :
Case 1: Compare the operating room have airocide with no airocide
Monitoring data shown below is done sampling at 04 operating rooms of Tropical Hospital, which has 02 operating room control (not use the device Airocide) and 02 operating rooms using Airocide. At the same time, showed remarkably efficient processor technology TiO2 / UVC when used in combination with other methods of disinfection has been used at the test site. Results are presented in Table 1 and Figure 1.
Technology using TiO2 / UVC applications on the device is shown Airocide capable of handling microorganisms quite effectively by the ability to work seamlessly. Total aerobic bacteria and fungi in the operating room control ranged from 123-164CFU / m3 and in room that used Airocide rooms ranging 51-72CFU / m3 (Table 1). For hemolytic Streptococcus not detected in this case.
In addition, based on the survey results the fact that the operating room testing in Hospital Dentistry TW has been used simultaneously several technologies sterilizing air as the technology of positive pressure and sanitation mechanics frequently during use Airocide. The operating room install Airocide (microorganisms <312CFU / m3) while control room is 312-1250CFU / m3 according to standard V. Omelanskii6. Therefore, the addition Airocide in the operating room is essential.
Case 2: Evaluating air quality room before and after using Airocide
Perform monitoring in the operating room No. 2, Department of Anesthetics of Central Lung Hospital. Time of sampling was conducted before and after using the device Airocide after 11h, 82h, 7 days before performing surgery first and sampled before and after using the device Airocide after 14h, 91h, 7 days after all in the same day surgery in the operating room to be surveyed. The density of microbial monitoring for the operating room at the time before performing the first surgery and after the surgery ultimately objectively assessing treatment effectiveness of disinfection technologies; by the operating room is a unit of special requirements of purity and sterility is highly recommended that the air in the room must always meet certain standards and have always maintained stable during the period before, during and after each operation.
Based on that, the following results have proven technology TiO2 / UVC applications on the device Airocide a solution really useful in controlling air quality operating room (Table 2 and Table 3) .
Microorganism density in the operating room before and after surgery were significantly reduced when using disinfection technology TiO2 / UVC device Airocide than before using. The red line and the blue line in Figure 2 shows the corresponding density of bacteria at the time of observation before and after surgery (Figure 2). Total bacteria decreased rapidly and evenly over time using the device at the time of observation. In particular, high levels of bacteria before surgery after using Airocide are lower than when not turned on. Similarly, the ability to handle quite effective bacteria after the surgery, viral load reductions quickly and evenly over time. After 7 days of use, density VKHK before and after surgery respectively only 21CFU / m3 and 51CFU / m3 for treatment efficiency reached 88.5% average. Technology TiO2 / UVC treatment is also effective mold removal and high (Figure 3) for the average processing efficiency of over 83, 85% after 7 days on the machine. Thus, effective treatment of microorganisms in the air in the operating room using technology TiO2 / UVC average of 86% Airocide reach after 7 days.
Moreover, we can see the total density of microorganisms in the operating room before and after surgery 07 days after disinfection technology using Airocide ranged from 92-116CFU / m3 standard operating room clean Grade D (WHO 2012 ) and is only about 1/6 times more than the time before surgery when parked Airocide (707CFU / m3). With this result indicates that the use of combined technology disinfection TiO2 / UVC of Airocide in the operating room ensures air quality clean room and help improve CLKK better than the case of not using Airocide Pending implementation of the operation.
TH3: Evaluating air quality room during use Airocide
The rating is done for the purpose consider the maintenance of the stability of processing efficiency of disinfection technology. Performance venues surveyed in 03 of the 02 operating room hospital units, including ITO and Saigon Hospital Thong Nhat Hospital in HCM City, the results of monitoring are carried out by the Institute Pauster HCMC.
ITO Saigon Hospital, conducted monitoring in the operating room No. 3 is in the process used Airocide. Microbiological monitoring density in the late afternoon (18h00) on 10/09/17 and early morning (06h30) ngay10 / 10/17 respectively 114CFU / m3 and 25CFU / m3 (Table 5). The measured results were achieved Grade D of WHO, 2012 standards.
For hospitals Reunification, conducted monitoring in the operating room operating room No. 1 and No. 4 in the process of using the device Airocide. The operating room was observed at 2 time before and after the implementation of the operation room. Microbial density at all time points for observation were good results, meet the standards of clean operating rooms Grade D (WHO 2012) (micro <200CFU / m3) (Table 4). Obviously, when using the combined technology of TiO2 / UVC in infection control in the operating room for effective treatment much better.
3.2. Effectively reduce microorganisms in the ICU room
This test is research in 10 rooms over a total of 08 units hospital. Similar to the assessments for the operating room, the monitoring data in the resuscitation room was also evaluated in 3 cases.
The monitoring results of air quality assessment shows that the TiO2 / UVC technology of Airocide remove microorganisms in the ICU room efficiently. Amount of bacteria and fungi tend to decline when using equipment Airocide after the experimental time in the 02 hospital units (Figure 6 & Figure 7). After 7 days of operation, the average efficient of Airocide at 83.31%.
TH3: Evaluating air quality room during use Airocide
Experiments were performed evaluation in large recovery room under the care unit, hospital Unified HCM City. Time monitoring takes place in the early afternoon (14h00) at the test site after 01 months of using the process technology TiO2 disinfection / UVC device Airocide. Amount micro reaches 200CFU / m3 meet quality standards Cleanroom Grade D (WHO, 2012).
4. Conclusions and Recommendations
Conclusion: With the advantages typical outperformed other technologies as well as the ability and bactericidal effect through the results of empirical research shows, TiO2 / UVC technology of airocide help reduce microorganisms effective in the operating room at 86% and 83.31% in the ICU room after 7 days operating. In additon, Airocide help improve air quality in the room comply to standards for clean room as WHO 2012 & V.Omelanskii during use. Effective treatment will be better if airocide is used long-term as well as help prevent infectious disease.
Recommendation: Technology photochemical catalytic of airocide is a new technology has been highly appreciated by the ability and has many advantages compared to other technologies . This is the basis and premise for a solution useful in the prevention of hospital infections now, so it would need to be considered and put into implementation research, widely used in the healthcare environment hospital in Vietnam.