TB Infection Control

TB in Homeless Shelters: Reducing the Risk through
Ventilation, Filters, and UV.
http://www.nationaltbcenter.edu/catalogue/downloads/tbhomelessshelters.pdf

From the Francis J Curry National TB Center.

Some of the suggestions might be of use for hospitals in lower resource settings

Having worked in the clinic at Pine Street Inn for many years, I feel a pang of nostalgia in reading about the UV lights.
While we believed that the UV lights had some efficacy against TB, in truth I am not sure that it was ever definitively proven as the lights were put in at the same time that we were implementing other measures against TB. Other strategies we used to decrease TB in conjunction with the use of UV lights included adequate bed spacing in the dormitories, morning clinic evaluation of guests with night time cough,referral if appropriate to Barbara McInnis our TB nurse and Dr Barnard our TB physician, close monitoring of staff as well as guests for ppd conversions.

At one point we experienced an increase in staff conversions in those without direct care duties despite no significant increase in active TB cases
in our clients. During this period the building was undergoing renovations ...

TB in Homeless Shelters: Reducing the Risk through
Ventilation, Filters, and UV.
http://www.nationaltbcenter.edu/catalogue/downloads/tbhomelessshelters.pdf

From the Francis J Curry National TB Center.

Some of the suggestions might be of use for hospitals in lower resource settings

Having worked in the clinic at Pine Street Inn for many years, I feel a pang of nostalgia in reading about the UV lights.
While we believed that the UV lights had some efficacy against TB, in truth I am not sure that it was ever definitively proven as the lights were put in at the same time that we were implementing other measures against TB. Other strategies we used to decrease TB in conjunction with the use of UV lights included adequate bed spacing in the dormitories, morning clinic evaluation of guests with night time cough,referral if appropriate to Barbara McInnis our TB nurse and Dr Barnard our TB physician, close monitoring of staff as well as guests for ppd conversions.

At one point we experienced an increase in staff conversions in those without direct care duties despite no significant increase in active TB cases
in our clients. During this period the building was undergoing renovations with an associated increase in dust and decrease in air circulation. After a mechanical ventilation system was installed, the conversions dropped despite the continued renovation work.

As long as precautions are taken with the UV lights, it doesn't cause harm and may be of benefit.

Sincerely,
Elizabeth Glaser, ACRN,RN,C, MS IHPM
Doctoral student, Social Policy and Management
Global Health and Development concentration
Heller School for Social Policy and Management
Brandeis University
Waltham, Massachusetts 02254

Thanks for your question. There are two new studies on the efficacy of upper room germicidal UV. Rod Escombe showed about 70% effiacy in a real ward in Lima, Peru over an extended period of time, using infections in sentinel guinea pigs as surrogates for health care workers and other patients. We have done a similar study, just completed, and not yet published, showing somewhat higher efficacy over a 2 month period with real MDR patients in South Africa. The study on homeless shelters, unfortunately, was inconclusive because there were too few instances of TB infection and great difficulty keeping track of the homeless subjects. However, these new studies, together with lots of room studies in the past, there is no longer any doubt about the efficacy of upper room UVGI. The major challenge is implementation. We need to develop easy planning and maintenance guidelines, encourage the manufacture of safe and effective fixtures in developing countries, and conduct research not on efficacy, but on further improving the technology