Environmental Control for Tuberculosis
2010
NIOSH Docket Number 196
The purpose of this document is to reduce the potential exposure of health care workers (and the general public) to tuberculosis.
Material Under Consideration
Reviews
Peer Reviewers’ Comments – posted December 31, 2009 [PDF – 24 KB]
Response to Peer Reviewers’ Comments – posted December 31, 2009 [PDF – 22 KB]
Peer Review
Title: Environmental Control for Tuberculosis: Basic Upper-Room Ultraviolet Germicidal Irradiation Guidelines for Healthcare Settings
Subject: Evaluation of upper-room ultraviolet irradiation systems to remove Mycobacterium tuberculosis
Purpose: To reduce the potential exposure of health care workers (and the general public) to tuberculosis
Timing of Review: Early 2005
Primary Disciplines or Expertise Needed for Review: Engineering, health science, industrial hygiene
Type of Review: Individual
Number of Reviewers: 13
Reviewers Selected by: NIOSH
Public Nominations Requested for Reviewers: No
Opportunities for the Public to Comment: No
Peer Reviewers Provided with Public Comments Before Their Review: No
Peer Reviewers:
Peter Broden
Organizational Affiliation: R&D Manager – Applied Research, Research and Development, Underwriters Laboratories, Inc., Northbrook, IL
Areas of Expertise, Discipline, or Relevant Experience: Provided insight into the Underwriters Laboratories (UL) process for approving equipment such as UVGI fixtures
Recommended by: NIOSH
Lloyd Chapman
Organizational Affiliation: Philips Lighting Company, Somerset, NJ
Areas of Expertise, Discipline, or Relevant Experience: UVGI lamps
Recommended by: NIOSH
David Dubiel
Organizational Affiliation: Associate Research Engineer, Research and Development, Underwriters Laboratories Inc., Northbrook, IL
Areas of Expertise, Discipline, or Relevant Experience: Provided insight into the Underwriters Laboratories (UL) process for approving equipment such as UVGI fixtures
Recommended by: NIOSH
Charles Dunn Sr.
Organizational Affiliation: President, Commercial Lighting Design, Inc. (Lumalier), Memphis, TN
Areas of Expertise, Discipline, or Relevant Experience: Mr. Dunn’s company manufacturers and installs upper-room UVGI fixtures, including fixtures that were used in the NIOSH-funded study at the University of Colorado
Recommended by: NIOSH
Melvin First
Academic and Professional Credentials: Ph.D.
Organizational Affiliation: Professor Emeritus of Environmental Health Engineering, Department of Environmental Health, Harvard University
Areas of Expertise, Discipline, or Relevant Experience: Designed and operates a facility for conducting tests to evaluate the effectiveness of upper-room UVGI systems against tuberculosis surrogates
Recommended by: NIOSH
Wladyslaw Kowalski
Academic and Professional Credentials: Ph.D., P.E.
Organizational Affiliation: Research Associate Department of Architectural Engineering The Pennsylvania State University
Areas of Expertise, Discipline, or Relevant Experience: Dr. Kowalski has published numerous articles on UV germicidal irradiation and is considered an expert in mathematical modeling and design of UVGI systems
Recommended by: NIOSH
Kevin Landkrohn
Academic and Professional Credentials: M.S.
Organizational Affiliation: Industrial Hygienist, Occupational Safety and Health Administration, U.S. Department of Labor; Member of the CDC Advisory Council for the Elimination of Tuberculosis and the ACGIH Infectious Agents Committee
Areas of Expertise, Discipline, or Relevant Experience: Industrial hygiene; also provided insight into OSHA’s perspective on TB and upper-room UVGI systems
Recommended by: NIOSH
Shelly Miller
Academic and Professional Credentials: Ph.D.
Organizational Affiliation: Assistant Professor, Mechanical Engineering Department, University of Colorado at Boulder
Areas of Expertise, Discipline, or Relevant Experience: Dr. Miller is the lead researcher on the NIOSH contract that formed the basis of the NIOSH guideline document and is an expert on the installation and use of upper-room UVGI systems
Recommended by: NIOSH
Edward Nardell
Academic and Professional Credentials: M.D.
Organizational Affiliation: Associate Professor, Departments of Environmental Health and Immunology and Infectious Diseases, Harvard University
Areas of Expertise, Discipline, or Relevant Experience: Currently involved in ongoing research projects on the effectiveness of various controls for tuberculosis, including upper-room UVGI systems
Recommended by: NIOSH
Paul Ninomura
Academic and Professional Credentials: B.S., P.E.
Organizational Affiliation: Mechanical Engineer, Indian Health Service, Seattle, WA; Serves on several ASHRAE committees
Areas of Expertise, Discipline, or Relevant Experience: Co-authored the ventilation recommendations for the 2001 Guidelines for Design and Construction of Health Care Facilities
Recommended by: NIOSH
Nicholas Pavelchak
Academic and Professional Credentials: M.S., C.I.H.
Organizational Affiliation: Industrial Hygienist, New York State Department of Health
Areas of Expertise, Discipline, or Relevant Experience: Industrial hygiene; has been involved in studying hospital isolation rooms designed for tuberculosis cases
Recommended by: NIOSH
Stephen Rudnick
Academic and Professional Credentials: Sc.D.
Organizational Affiliation: Lecturer on Industrial Hygiene Engineering, Department of Environmental Health, Harvard University
Areas of Expertise, Discipline, or Relevant Experience: Specializes in aerosols, particularly in relation of sampling, analysis, and engineering control of particles in the occupational setting; present area of study is the use of upper-room UVGI systems
Recommended by: NIOSH
Michael Soganich
Organizational Affiliation: Philips Lighting Company, Somerset, NJ
Areas of Expertise, Discipline, or Relevant Experience: UVGI lamps
Recommended by: NIOSH
Charge to Reviewers:
Specific Questions
- Is the guideline provided for average UVGI intensity (30-50FW/cm2) in the upper-room air appropriate? Would it be better to use a minimum average intensity (e.g., 30 FW/cm2)? Would some other guideline be more useful?
- Is the guideline for installing louvered fixtures that provide 0.17 UV-C watts per each ft2 in a room appropriate? Is the guideline of 0.085 UV-C watts per ft2 for fixtures without louvers in rooms with 9 ft or higher ceilings appropriate?
- Other than the information provided in the draft document, what other methods are available for obtaining Aspot measurements@ of the upper-air UVGI intensity when the UVGI system is composed of multiple fixtures?
- Is it appropriate to provide a guideline that states UV lamps should be replaced when the lamps start to emit approximately 70% of their original output? What is the best way to measure the output of the UV lamps in a fixture? Under “air mixing guidelines” it is stated in the draft that fans should be used to continually mix the air if there is any question about vertical air mixing between the upper and lower portion of a room. Will the use of mixing fans have any affect on other infection control issues?
General Questions
- Is the information presented adequate? If not, what further information should be provided? What additional tables or graphs would you suggest?
- What information, if any, would you delete and why?
- Has all of the relevant information been considered for the topic(s)? If you believe other citations should be included for completeness, please identify and provide a copy of the reference(s).