The University of New Mexico (UNM) Comprehensive Cancer Center recently replaced traditional light bulbs in its operating rooms with antibacterial LEDs for a visible-light continuous environmental disinfection (CED) system.
Research suggests the fixtures can continuously kill harmful bacteria on high-risk surfaces, which should be an improvement over intermittent cleaning, explains Stewart Livsie, manager of maintenance and construction at UNM Comprehensive Cancer Center.
Another common option, ultraviolet (UV) lighting, is not safe for human exposure and can only sanitize spaces once patients and staff leave the room, Livsie says. The germicidal properties of UV light are well established. Many healthcare organizations use it to destroy microorganisms, but the usefulness of visible violet-blue 405 nm light has been recognized only recently for addressing environmental contamination.
The common light disinfection method uses the UV-C (250 nm) wavelength to kill pathogens by causing photodegradation of DNA. That same process is harmful to humans. Hospitals are limited to using UV light disinfection to clean rooms and equipment without exposing people to the light. Usually, these UV devices are used when rooms are cleaned between patients or on a regular schedule, Livsie explains.
UV also can degrade some plastics and other materials. The visible light disinfection systems kill pathogens through a different process and are not harmful to humans, meaning they can be employed in ways that provide visible-light CED in which people will be exposed to the light, Livsie says.
The visible light requires longer to disinfect surfaces than the UV light. Still, because the UNM Comprehensive Cancer Center is the state’s only National Cancer Institute-certified facility, leaders try to stay on the cutting edge of technology, Livsie says.
“Our patients make up the most immunocompromised population. Whatever we can do to try to keep them safe is a priority for us,” he says. “I was at a healthcare design conference where a big focus was on how to use the built environment to help patients and facilitate quality improvement. This was one of the strategies that was presented ... [CED] seemed to be most advantageous to us from our infection control personnel’s perspective.”
Most pathogens that concerned leaders at the UNM Comprehensive Cancer Center are contact transmissible. They were attracted to a technological solution that promised continuous surface cleaning.
As part of a service line change, the cancer center was bringing in interventional radiologists to help with port placements and similar needs. Thus, the center needed to renovate its operating rooms. The surgical suites had not been updated since they were built in 2009. The cancer center was ready to make structural improvements in addition to accommodating interventional radiologists.
UNM Comprehensive Cancer Center decided to replace the old fluorescent light fixtures with LED lighting because it provides better light quality and is more energy efficient. “As we were doing that project, it seemed kind of a no-brainer to use the visible light continuous disinfection LEDs because this was the most critical area in our facility,” Livsie reports. “Even if it didn’t work for disinfection, we’d still have LED lights in our operating facility. We really didn’t feel like we had anything to lose by trying it.”
The cancer center is still piloting CED, so there are no data yet to show effectiveness. However, Livsie says the research behind the disinfection technique makes leaders optimistic that they will see substantial reductions in colony counts. “We’re going to keep our environmental services processes exactly the same. We’re not changing anything there,” he says. “This is more of a belt-and-suspenders type of approach. We will be doing everything we’ve always done to control infections. But we also have this lighting system that is working to kill bugs and germs any time the lights are on, and everywhere the light touches a surface.”
Research on the effectiveness of the particular product used at UNM Comprehensive Cancer Center was performed largely in coastal regions, so Livsie and infection control leaders at the facility are curious to see if the drier air in New Mexico has any impact. Lower humidity tends to favor the growth of spores and some other pathogens, he notes.
“Any reduction will be good. The cost for the lights was less than what the cost of a traditional light fixture would have been. For me, there was really no risk in that sense,” Livsie says. “If we start seeing that there is a significant reduction in colony counts, we will start looking at rolling these lights out to other critical areas of the facility, like the bone marrow and stem cell transplant unit and the infusion suite.”