[Literature review on efficacy and safety of ultraviolet light and ozone for surface disinfection (Update)]

García Carpintero EE, Cárdaba Arranz M, Sánchez Gómez LM
Record ID 32018005206
Original Title: Revisión bibliográfica sobre eficacia y seguridad de la luz ultravioleta y ozono para la desinfección de superficies. Actualización
Authors' objectives: The aim of this systematic review is to analyze available information about effectiveness and safety of ultraviolet (UV) light and ozone devices for virus disinfection, especially in SARS-CoV-2 disinfection.
Authors' results and conclusions: Results: The bibliographic search has made it possible to include 15 studies on the effectiveness of ultraviolet light and ozone in the disinfection of viruses. A subsequent update made it possible to include 18 more studies on UV light and 1 more study on ozone. All but one of these studies were laboratory tests. To analyse the efficacy of UV radiation, 22 primary studies, 4 SR and one health technology assessment report have been included. One SR and 8 primary studies analysed the efficacy of UV light for the inactivation of SARS-CoV-2, of which the SR and 6 primary studies analysed the efficacy of UV light for the decontamination of FFP masks. These studies concluded that UV light was a suitable technology for the inactivation of SARS-CoV-2. However, it was observed that the inactivation of SARS-CoV-2 depended on the environment in which it was found, and in the case of FFP masks on the model and material from which they were made. Some studies indicated that the dose of UV light used was not sufficient to completely inactivate SARS-CoV-2. Only one study evaluated the efficacy of light under real conditions, in particular in the hospital environment, but no analysis was made of the disinfection of SARS-CoV2. This study carried out an analysis of the effectiveness of UV radiation in disinfecting rooms in a paediatric hospital and concluded that this type of device can reduce the incidence of upper respiratory tract infections in children. Two of the included studies analysed the effectiveness of UV radiation for disinfection and reuse of masks. Results from studies evaluating disinfection of other pathogens indicated that the effectiveness of UV light depends on the type of pathogen. In all these studies it was concluded that UV would be effective in reducing pathogens, although it would be more effective for disinfecting bacteria than viruses, as in some cases complete inactivation of the virus was not achieved. Seven studies have been included that analyze the effectiveness of ozone in disinfecting viruses on a laboratory scale. No studies assessing the efficacy of ozone in disinfecting SARS-CoV-2, or any other coronavirus, have been identified. Nor have any studies been identified that analyze the effectiveness of virus disinfection in the health field. The included studies conclude that ozone reduces the viral load of the surface where it is applied, although the reduction depends on the dose of ozone administered, the contact time and the relative humidity, among other factors. Both devices present health risks. UV radiation can cause damage to the skin and eye tissue. Ozone can cause severe skin burns, eye damage, and even organ damage if exposure is prolonged or repeated. Conclusions: The evidence suggests that UV devices could inactivate SARS-CoV-2 easily and quickly. However, the available evidence is still scarce and very heterogeneous. Ozone devices can reduce the virus population on surfaces. However, no evidence has been found on the effectiveness and safety of ozone SARS-CoV-2 disinfection. Both devices imply health risks, as they can cause eye damage, skin damage or respiratory tract irritation. In both cases, the use of the devices must be controlled. The personnel who use them have to accredit professional training for the use of these devices and must be adequately equipped, to minimize the risk of exposure. Further studies are needed to evaluate the effectiveness of both devices in disinfecting SARS-CoV-2 in the health sector, in order to know the optimum doses of UV radiation or ozone needed to achieve disinfection, as well as to know the side effects of using them.
Authors' methods: A systematic review of the scientific information collected in the main biomedical databases, PubMed, EMBASE and Cochrane Library, as well as in the WoS and CRD databases, has been carried out. A search of the databases of the main health technology assessment agencies was also carried out.
Project Status: Completed
Year Published: 2020
Requestor: Spanish Ministry of Health
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Infection Control
  • SARS-CoV-2
  • Ozone
  • Ultraviolet Rays
  • Coronavirus
  • Disinfection
  • COVID-19
  • Viruses
  • Ultraviolet Light
  • ozone
  • disinfection
Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias
Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;
Contact Name: Luis M. Sánchez Gómez
Contact Email: luism.sanchez@isciii.es
Copyright: <p>Agencia de Evaluacion</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.