Infectious airborne microbes, including many pathological microbes that cause respiratory infections, are commonly found in medical facilities and constitute a serious threat to human health. Thus, an effective method for reducing the number of microbes floating in the air will aid in the minimization of the incidence of respiratory infectious diseases. Here, we demonstrate that chlorine dioxide (ClO2) gas at extremely low concentrations, which has no detrimental effects on human health, elicits a strong effect to inactivate bacteria and viruses and significantly reduces the number of viable airborne microbes in a hospital operating room. In one set of experiments, a suspension of Staphylococcus aureus, bacteriophage MS2, and bacteriophage ΦX174 were released into an exposure chamber. When ClO2 gas at 0.01 or 0.02 parts per million (ppm, volume/volume) was present in the chamber, the numbers of surviving microbes in the air were markedly reduced after 120 min. The reductions were markedly greater than the natural reductions of the microbes in the chamber. In another experiment, the numbers of viable airborne bacteria in the operating room of a hospital collected over a 24-hour period in the presence or absence of 0.03 ppm ClO2 gas were found to be 10.9 ± 6.7 and 66.8 ± 31.2 colony-forming units/m3 (n = 9, p < 0.001), respectively. Taken together, we conclude that ClO2 gas at extremely low concentrations (≤0.03 ppm) can reduce the number of viable microbes floating in the air in a room. These results strongly support the potential use of ClO2 gas at a non-toxic level to reduce infections caused by the inhalation of pathogenic microbes in nursing homes and medical facilities.

1.
Eames I, Tang JW, Li Y, Wilson P: Airborne transmission of disease in hospitals. J R Soc Interface 2009;6(suppl 6):S697-S702.
2.
Cappelletty D: Microbiology of bacterial respiratory infections. Pediatr Infect Dis J 1998;17(8 suppl):S55-S61.
3.
Wang H, Gu X, Weng Y, Xu T, Fu Z, Peng W, Yu W: Quantitative analysis of pathogens in the lower respiratory tract of patients with chronic obstructive pulmonary disease. BMC Pulm Med 2015;15:94.
4.
Coia JE, Ritchie L, Fry C: Use of respiratory and facial protection. Nurs Times 2014;110:18-20.
5.
Shiomori T, Miyamoto H, Makishima K, Yoshida M, Fujiyoshi T, Udaka T, Inaba T, Hiraki N: Evaluation of bedmaking-related airborne and surface methicillin-resistant Staphylococcus aureus contamination. J Hosp Infect 2002;50:30-35.
6.
Arieta EM, Berg JD: A review of chlorine dioxide in drinking water treatment. J Am Water Works Assoc 1986;78:62-72.
7.
Shimakura H, Ogata N, Kawakita Y, Ohara K, Takeda S: Determination of the structure of liquids containing free radical molecules: inter-molecular correlations in liquid chlorine dioxide. Mol Physics 2013;111:1015-1022.
8.
Ogata N: Denaturation of protein by chlorine dioxide: oxidative modification of tryptophan and tyrosine residues. Biochemistry 2007;46:4898-4911.
9.
Buschini A, Carboni P, Frigerio S, Furlini M, Marabini L, Monarca S, Poli P, Radice S, Rossi C: Genotoxicity and cytotoxicity assessment in lake drinking water produced in a treatment plant. Mutagenesis 2004;19:341-347.
10.
Shtannikov EV, Morozov IAM: [Chlorine dioxide water disinfection]. Gig Sanit 1978;6:23-26.
11.
Jeng DK, Woodworth AG: Chlorine dioxide gas sterilization under square-wave conditions. Appl Environ Microbiol 1990;56:514-519.
12.
Akamatsu A, Lee C, Morino H, Miura T, Ogata N, Shibata T: Six-month low level chlorine dioxide gas inhalation toxicity study with two-week recovery period in rats. J Occup Med Toxicol 2012;7:2.
13.
Ogata N, Koizumi T, Ozawa F: Ten-week whole-body inhalation toxicity study of chlorine dioxide gas in rats. J Drug Metab Toxicol 2013;4:143.
14.
US Department of Labor, Occupational Safety and Health Administration: Occupational safety and health guideline for chlorine dioxide. 2006. http://www.osha.gov/SLTC/healthguidelines/chlorinedioxide/recognition.html.
15.
Dalhamn T: Chlorine dioxide toxicity in animal experiments and industrial risks. AMA Arch Ind Health 1957;15:101-107.
16.
Morino H, Fukuda T, Miura T, Shibata T: Effect of low-concentration chlorine dioxide gas against bacteria and viruses on a glass surface in wet environments. Lett Appl Microbiol 2011;53:628-634.
17.
Ogata N, Shibata T: Protective effect of low-concentration chlorine dioxide gas against influenza A virus infection. J Gen Virol 2008;89(pt 1):60-67.
18.
Mimura S, Fujioka T, Mitsumaru A: Preventive effect against influenza-like illness by low-concentration chlorine dioxide gas. Jpn J Environ Infect 2010;25:277-280.
19.
Ogata N, Shibata T: Effect of chlorine dioxide gas of extremely low concentration on absenteeism of schoolchildren. Int J Med Med Sci 2009;1:288-289.
20.
Ogata N: Inactivation of influenza virus haemagglutinin by chlorine dioxide: oxidation of the conserved tryptophan 153 residue in the receptor-binding site. J Gen Virol 2012;93(pt 12):2558-2563.
21.
Benarde MA, Snow WB, Olivieri VP, Davidson B: Kinetics and mechanism of bacterial disinfection by chlorine dioxide. Appl Microbiol 1967;15:257-265.
22.
Cho M, Kim J, Kim JY, Yoon J, Kim JH: Mechanisms of Escherichia coli inactivation by several disinfectants. Water Res 2010;44:3410-3418.
23.
Berg JD, Roberts PV, Matin A: Effect of chlorine dioxide on selected membrane functions of Escherichia coli. J Appl Bacteriol 1986;60:213-220.
24.
Leung M, Chan AH: Control and management of hospital indoor air quality. Med Sci Monit 2006;12:SR17-SR23.
25.
Bånrud H, Moan J: [Use of short wave ultraviolet radiation for disinfection in operating rooms]. Tidsskr Nor Laegeforen 1999;119:2670-2673.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.