sporoforms like Clostridioides difficile on surfaces and in air. Their
abilities to disinfect the air is particularly valuable as research increas-
ingly demonstrates the extent to which contaminated air plays a role
in environmental infection transmission. Specialized machines release
the vapors or mists into the air of a sealed room, letting them reach
and disinfect all surfaces, regardless of their distance from the unit.
A key drawback to hydrogen peroxide systems: They are toxic to
humans, so the treated room must not only be unoccupied, but also
tightly sealed so that no vapors or mists escape. Trained personnel are
required to oversee a treatment, which can run as long as 2 to 3 hours,
presenting logistical challenges for both OR and housekeeping staff.
Like UV-C, repeated exposure to hydrogen peroxide vapors and
mists can corrode plastics and polymers. Also like UV-C, these
vapors/mists can only provide intermittent disinfection, effectively
addressing contamination during treatment, but not in between or
during cases.
• Ozone. Ozone disinfection systems catalytically convert oxygen in
the air into ozone, which is a highly potent biocide against vegetative
bacteria in the air and on surfaces. Ozone quickly degrades back into
breathable oxygen after use, but the concentration of ozone required
for disinfection is toxic to humans, so the room must be unoccupied
and sealed during treatment. These systems generally don't require a
significant capital expenditure, but do require staff to oversee and
operate. Ozone has also been shown to be corrosive to metals and
rubber. This, in combination with its limited efficacy against bacterial
spores and fungi, has hindered its widespread use in healthcare set-
tings.
Continuous disinfection
For continuous disinfection in both occupied and vacant spaces, con-
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