Objective: Personal protective equipment (PPE) is urgently sought during public health crises. It is necessary for the safety of both the patient and the healthcare professional. Yet during the recent COVID-19 pandemic, PPE scarcity in many countries, including the United States, has impacted the level of care for patients and the safety of healthcare personnel. Additionally, the implementation of mandatory mask mandates for the general public in many countries forced individuals to either reuse PPE, which can contribute to poor hygiene, or buy PPE in bulk and thereby contribute to the scarcity of PPE. In this study, we investigate the possibility of using a cost-effective ozone sterilization unit on contaminated N95 masks as an alternative to current sterilization methods.Method: This protocol examined ozone's ability to decontaminate N95 mask fabric that was exposed to a surrogate virus (Escherichia coli bacteriophage MS2). Once the sterilization unit achieves an ozone concentration of ~30 ppm, a 60-minute or 120-minute sterilization cycle commences. Following the sterilization cycle, we investigated the amount of viable virus on the slide using a viral plaque assay and compared it to a non-sterilized, control slide. Furthermore, we carried out trials to investigate the safety of an ozone sterilization device, by measuring the levels of ozone exposure that individuals may experience when operating the sterilization unit post-cycle.Results: We showed that a 120-minute sterilization cycle at ~30 ppm achieves a 3-log reduction in viral activity, thereby complying with industry and U.S. Food and Drug Administration (FDA) standards. Further, we demonstrated that when following our protocol, the ozone exposure levels for a simple sterilization unit to be used at home complied with federal and industry standards. Conclusion:Ozone may have the potential to decontaminate masks and other PPE.

Compliance to hand-hygiene guidelines in healthcare facilities remains disappointingly low for a variety of human-factors (HF) reasons. A device HF-engineered for convenient and effective use even under high-workload conditions could contribute to better compliance, and consequently to reduction in healthcare-acquired infections. We present an overview of the efficacy of a passive hand-spray device that uses solubilized ozone-a strong, safe, non-irritant biocide having broad-spectrum antimicrobial properties-on glass surface, pigskin, and synthetic human skin matrix.

The most frequent adverse event in the healthcare delivery system is acquisition of an infection within a healthcare facility. Since infection control measures are known, simple, and low-cost, we examine why the problem of healthcare-associated infections persists. Hundreds of millions of patients each year are affected by a healthcare-associated infection, with negative medical outcome and financial cost. It is a major public health problem even in countries with advanced healthcare systems. This is a bit perplexing, given that hygienic practices have been known and actively promoted. The objective is to address the question: doesn't the use of disinfection, sterilization, handwashing, and alcohol rubs prevent the spread of pathogenic organisms? We conclude that the persistent high prevalence of nosocomial infections despite known hygienic practices is attributable to two categories of factors: biological and inherent shortcomings of some practices (considered in Part 1), and human factors (considered in Part 2). A new approach is presented in Part 3.

A healthcare-associated infection (defined as an infection acquired within a healthcare facility), such as due to transmission via medical equipment or by healthcare providers is the most frequent adverse event in the healthcare delivery system. But why does the problem persist, when infection control measures are known, simple, and low-cost? We reviewed some biologicaland treatment-factors in Part 1, and we now review some human-factors. Healthcare-associated infections are a major public health problem even in advanced healthcare systems. They affect hundreds of millions of patients each year, and are responsible for increased morbidity, mortality, and financial burden. This is perplexing, since good-hygiene practices are known and promoted. Disinfection, sterilization, handwashing, and alcohol rubs should be more effective, but human-factors interfere. The persistent high prevalence of nosocomial infections, despite known hygienic practices, is attributable to two categories of factors: biological and inherent shortcomings of some practices (considered in Part 1), and human factors (considered here). A new approach is considered in Part 3.