Exploratory clinical trial on the safety and bactericidal effect of 222-nm ultraviolet C irradiation in healthy humans

PLoS One. 2020 Aug 12;15(8):e0235948. doi: 10.1371/journal.pone.0235948. eCollection 2020.

Abstract

Introduction: Surgical site infection is one of the most severe complications of surgical treatments. However, the optimal procedure to prevent such infections remains uninvestigated. Ultraviolet radiation C (UVC) with a short wavelength has a high bactericidal effect; however, it is cytotoxic. Nonetheless, given that UVC with a wavelength of 222 nm reaches only the stratum corneum, it does not affect the skin cells. This study aimed to investigate the safety of 222-nm UVC irradiation and to examine its skin sterilization effect in healthy volunteers.

Methods: This trial was conducted on 20 healthy volunteers. The back of the subject was irradiated with 222-nm UVC at 50-500 mJ/cm2, and the induced erythema (redness of skin) was evaluated. Subsequently, the back was irradiated with a maximum amount of UVC not causing erythema, and the skin swabs before and after the irradiation were cultured. The number of colonies formed after 24 hours was measured. In addition, cyclobutene pyrimidine dimer (CPD) as an indicator of DNA damage was measured using skin tissues of the nonirradiated and irradiated regions.

Results: All subjects experienced no erythema at all doses. The back of the subject was irradiated at 500 mJ/cm2, and the number of bacterial colonies in the skin swab culture was significantly decreased by 222-nm UVC irradiation. The CPD amount produced in the irradiated region was slightly but significantly higher than that of the non-irradiated region.

Conclusion: A 222-nm UVC at 500 mJ/cm2 was a safe irradiation dose and possessed bactericidal effects. In the future, 222-nm UVC irradiation is expected to contribute to the prevention of perioperative infection.

Publication types

  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Back
  • Biopsy
  • Colony Count, Microbial
  • DNA Damage / radiation effects*
  • Erythema / diagnosis
  • Erythema / etiology
  • Healthy Volunteers
  • Humans
  • Male
  • Microbiota / radiation effects*
  • Pyrimidine Dimers / analysis
  • Pyrimidine Dimers / radiation effects
  • Skin / microbiology
  • Skin / radiation effects*
  • Sterilization / methods*
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control
  • Treatment Outcome
  • Ultraviolet Rays / adverse effects*

Substances

  • Pyrimidine Dimers

Grants and funding

This study is mainly funded by Department of Orthopaedic surgery, Kobe University Graduate School of Medicine and partially supported by Ushio Inc. including rental of UVC irradiation equipment. The funding agency provided support in the form of salaries for the authors (H.O., M.S., and T.I.). The specific roles of them are as follows; H.O.: data curation and methodology, M.S.: investigation and methodology, T.I.: conceptualization and data curation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.