Green-McKenzie, Judith, MD, MPH, FACOEM

Lewis, Philip G., MD, MPH, FACOEM

Vrablik, Kevin A., MD, MPH, FACOEM

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineA Potential Source of Ozone with ConcomitantHealth Effects in the Hospital EnvironmentKevin A. Vrablik MD, MPH, FACOEMLehigh Valley Health Network, kevin.vrablik@lvhn.orgPhilip G. Lewis MD, MPH, FACOEMJudith Green-McKenzie MD, MPH, FACOEMFollow this and additional works at: https://scholarlyworks.lvhn.org/medicinePart of the Medical Sciences Commons, and the Occupational Health and Industrial HygieneCommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtVrablik, K., Lewis, P., & Green-McKenzie, J. (2014, April 27-30). A potential source of ozone with concomitant health effects in the hospitalenvironment. Poster presented at: The American Occupational Health Conference, San Antonio, TX.Objective Materials Introduction Results (Continued) A Potential Source of Ozone with Concomitant Health Effects in the Hospital Environment • Mobile ultraviolet room sterilization devices, when used either alone, or in tandem, do not produce significant amounts of ozone • The ozone levels did exceed odor thresholds, but were magnitudes under the OSHA PEL inside the treatment area • However, this does not mean that ALL individuals are protected from ill effects of ozone • Individuals with underlying pulmonary disease may be more sensitive • Utilizing engineering and administrative controls such as signage, negative pressure room settings, taping door jambs and limiting foot traffic in the area MAY be mitigating measures Conclusions Kevin A. Vrablik, MD, PH Certificate, FACOEM Philip G. Lewis, MD, MPH, FACOEM Judith Green-McKenzie, MD, MPH, FACOEM Results Methods • Two mobile ultraviolet room sterilization units • 2B Technologies 202B direct reading ozone meter • Ozone monitoring forms for written data collection • Unoccupied hospital patient rooms already terminally cleaned • Deploy mobile ultraviolet sterilization unit(s) in typical hospital patient rooms after terminal cleaning has been completed • Test single and double unit deployment (this strategy is used to reduce area treatment time) • Measure proximate ozone levels before, during and after deployment • Baseline ozone measurements were ≤ 0.3 ppb • Single unit peak ozone level, after 25 minutes of deployment, was 6 ppb • Double unit peak ozone level, after 37 minutes of deployment, was 3.7 ppb Limitations Discussion • Only two trials were performed due to time and logistics constraints • The two patient rooms had different cubic volumes • Study did not control for air exchange rates • Ozone extinction levels could have been measured for longer period • Ozone levels were not measured outside patient rooms, but were noted to be above the odor threshold by the investigator The author would like to acknowledge and thank Mr. Timothy Docherty, MBA, CIH, Director of Occupational Safety Management at LVHN for his assistance with this project. This research was supported in part by training grants from the National Institute of Occupational Safety and Health - grant number: 5-TO1-0H008628, and the Health Resources and Services Administration - grant number: D33HP25770-01-00. 0.01.02.03.04.05.06.07.01 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61parts per billion minutes 0.01.02.03.04.01 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 55 58 61 64 67 70 73 76 79 82 85 88 91 94 97 100parts per billion minutes Two Units Burn Unit, 3K-48, 12/20/2012 Unit 1 off 35 mins, Unit 2 off 88 mins Burn Unit, 3K-31, 12/12/2012 Unit Deactivated at 44:39 Single Unit • The OSHA PEL is 100 ppb TWA  • This level does not guarantee zero risk • A Quantitative Risk Analysis was performed • Assumed 98% worker protection • Maximum ozone level measured inside the patient room • This was 6 ppb which is 17X lower than OSHA PEL • If one assumes a 2% ill effect, then ~12 in 10,000 may have symptoms at this level • Those with underlying respiratory diagnoses may be more susceptible To determine if mobile high-intensity ultraviolet C devices used to sterilize hospital patient rooms produce significant amounts of ozone that might induce symptoms in employees • Mobile ultraviolet devices are increasingly being used to sterilize hospital facilities • Ozone can be produced from atmospheric oxygen in the presence of intense ultraviolet light • Ozone has a short half-life and can be a respiratory tract irritant • The odor threshold is variable (1-50 ppb) • OSHA Permissible Exposure Limit is 100 ppb TWA Case A hospital employee with reactive airway disease reported developing shortness of breath and wheezing when in the vicinity where an ultraviolet sterilizing device was deployed Ozone Levels 

A Potential Source of Ozone with Concomitant Health Effects in the Hospital Environment

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A Potential Source of Ozone with Concomitant Health Effects in the Hospital Environment

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