A hospital employee with pre-existing reactive airways disease reported the onset of upper airway irritation and wheezing when in close proximity to a deployed mobile ultraviolet (UV) room sterilizing device. Low-level ozone exposure was suspected as a contributing factor. An investigation was conducted in an effort to further evaluate the situation. The question was whether this device would produce sufficient amounts of ozone to induce symptoms in an employee. Mobile UV room disinfection devices, often employed in hospital settings, have been shown to be effective in reducing the presence of pathogens. These devices are increasingly being used as an adjunct to standard cleaning and disinfection practices in health care settings to dose an enclosed area (ie, patient room, operating room, and so on) with high-intensity UV light utilizing special bulbs that typically emit only UV-C light. They have been used in an effort to combat hospital-acquired infections due to bacteria such as Clostridium difficile, Acinetobacter spp., Vancomycin-resistant enterococcus, and methicillin-resistant Staphylococcus aureus, as well as fungi and viruses. These devices are also effective against the Ebola virus. Employing environmental controls can limit hospital employee, patient, and visitor exposure to the small amounts of ozone produced by these mobile high-intensity UV-C room-sterilizing devices. Setting the ventilation system to provide negative pressure inside the room, if available, and taping the door jambs with painter's tape when the device is deployed will help prevent leak of ozone outside of the room under treatment. Limiting employee, patient, and visitor foot traffic in the area where and when the devices are deployed will also reduce the potential for unexpected exposure to trace ozone. For occupational medicine physicians responsible for promoting and preserving the health and safety of hospital employees, this is one potential environmental health hazard that should be considered. As technology advances to improve health care and reduce hospital-acquired infections, more such hazards may emerge. This case of an unintentional health care employee ozone exposure is an example of the need for continued vigilance for environmental and other health hazards on the part of occupational medicine physicians.
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