Preclinical safety evaluation of continuous UV-A lighting in an operative setting

Rachael Guenter; Rui Zheng-Pywell; Brendon Herring; Madisen Murphy; Jeremy Foote; Kevin Benner; J Bart Rose

doi:10.1371/journal.pone.0291083

Preclinical safety evaluation of continuous UV-A lighting in an operative setting

PLoS One. 2023 Nov 17;18(11):e0291083. doi: 10.1371/journal.pone.0291083. eCollection 2023.

Authors

Rachael Guenter¹, Rui Zheng-Pywell¹, Brendon Herring¹, Madisen Murphy¹, Jeremy Foote², Kevin Benner³, J Bart Rose¹

Affiliations

¹ Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
² Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
³ GE Current, a Daintree Company, East Cleveland, Ohio, United States of America.

Abstract

Background: Germicidal ultraviolet (UV-C) light has been shown as an effective modality for disinfection in laboratory settings and in the operative room. Traditionally, short-wavelength UV-C devices, which have previously been shown to cause DNA damage, are utilized only for disinfection in pre- and post-operative settings and are not continuously active during operations. Continuous use of intraoperative UV light has potential to decrease pathogens and subsequent surgical site infections (SSIs), which arise in approximately 5-15% of operative cases. SSIs are a significant determinant of patient morbidity, readmission rates, and overall cost. Therefore, a method of UV light disinfection with a low risk of DNA damage is needed so that greater antimicrobial protection can be afforded to patients during the entirety of their surgical procedures. A new disinfection device that harnesses longer-wavelength UV-A light to disinfect the surgical field throughout the entirety of the procedure, including pre- and post-operation has been developed.

Methods: This study aimed to determine if UV-A light administered intraoperatively was safe, as defined by the minimal presence of DNA damage and safe amounts of reflection upon medical personnel. Using in vitro models, we examined the differential impacts of UV-C and UV-A light on DNA damage and repair pathways. In a murine model, we looked at the production of DNA damage photoproduction in relation to UV-A versus UV-C exposure.

Results: Our results show UV-A light does not induce a significant amount of DNA damage at the cellular or tissue level. Furthermore, a preclinical porcine study showed that surgical personnel were exposed to safe levels of UV-A irradiance from an overhead UV-A light used during an operation. The amount of UV-A transmitted through surgical personal protective equipment (PPE) also remained within safe levels.

Conclusions: In conclusion, we found that UV-A may be safe for intraoperative use.

Copyright: © 2023 Guenter et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Animals
Disinfection / methods
Humans
Lighting* / adverse effects
Mice
Swine
Ultraviolet Rays*

Grants and funding

J.B.R. received a research grant from GE Current that funded this study. K.J.B. is an employee of GE Current, a Daintree company, and has filed intellectual property on behalf of GE Current, a Daintree company and General Electric Company that pertains to aspects of this work. The funders had assisted with study design, data collection and analysis, decision to publish, or preparation of the manuscript.