Biofilm describes a microbially-derived sessile community in which microbial cells are firmly attached to the substratum and embedded in extracellular polymeric matrix. Microbial biofilms account for up to 80% of all bacterial and fungal infections in humans. Biofilm-associated pathogens are particularly resistant to antibiotic treatment, and thus novel antibiofilm approaches needed to be developed. Antimicrobial Photodynamic therapy (aPDT) had been recently proposed to combat clinically relevant biofilms such as dental biofilms, ventilator associated pneumonia, chronic wound infections, oral candidiasis, and chronic rhinosinusitis. aPDT uses non-toxic dyes called photosensitizers (PS), which can be excited by harmless visible light to produce reactive oxygen species (ROS). aPDT is a multi-stage process including topical PS administration, light irradiation, and interaction of the excited state with ambient oxygen. Numerous in vitro and in vivo aPDT studies have demonstrated biofilm-eradication or substantial reduction. ROS are produced upon photo-activation and attack adjacent targets, including proteins, lipids, and nucleic acids present within the biofilm matrix, on the cell surface and inside the microbial cells. Damage to non-specific targets leads to the destruction of both planktonic cells and biofilms. The review aims to summarize the progress of aPDT in destroying biofilms and the mechanisms mediated by ROS. Finally, a brief section provides suggestions for future research.

/pdf/antimicrobial-photodynamic-therapy-to-control-clinically-5bek8xonso.pdf

Antimicrobial Photodynamic Therapy to Control Clinically Relevant Biofilm Infections.

Objective: Photodynamic therapy (PDT) as a medical treatment for cancers is an increasing practice in clinical settings, as new photosensitizing chemicals and light source technologies are developed and applied. PDT involves dosing patients with photosensitizing drugs, and then exposing them to light using a directed energy device in order to manifest a therapeutic effect. Healthcare professionals providing PDT should be aware of potential occupational health and safety hazards posed by these treatment devices and photosensitizing agents administered to patients. Materials and methods: Here we outline and identify pertinent health and safety considerations to be taken by healthcare staff during PDT procedures. Results: Physical hazards (for example, non-ionizing radiation generated by the light-emitting device, with potential for skin and eye exposure) and chemical hazards (including the photosensitizing agents administered to patients that have the potential for exposure via skin, subcutaneous, ingestion, or inhalation routes) must be considered for safe use of PDT by the healthcare professional. Conclusions: Engineering, administrative, and personal protective equipment controls are recommendations for the safe use and handling of PDT agents and light-emitting technologies.

/pdf/photodynamic-therapy-occupational-hazards-and-preventative-1wc0rdxwvn.pdf

Photodynamic therapy: occupational hazards and preventative recommendations for clinical administration by healthcare providers.

Workplace exposure to optical radiation from artificial sources is regulated in Europe under the Artificial Optical Radiation Directive 2006/25/EC implemented in the UK as The Control of Artificial Optical Radiation at Work Regulations 2010. The entertainment environment often presents an extremely complex situation for the assessment of occupational exposures. Multiple illumination sources, continuously changing illumination conditions and people moving during performances add further complexity to the assessment. This document proposes a methodology for assessing the risks arising from exposure to optical radiation and presents detailed case studies of practical assessment for two large entertainment venues.

Assessment of personal exposures to optical radiation in large entertainment venues.

Light emitting diodes (LEDs) are increasingly being used in toys. An assessment methodology is described for determining the accessible emission limits for the optical radiation from the toys, which takes account of expected use and reasonably foreseeable misuse of toys. Where data are available, it may be possible to assess the toy from the data sheet alone. If this information is not available, a simple measurement protocol is proposed.

Safety of light emitting diodes in toys.

In this paper the Authors describe and discuss the results of an extensive evaluation campaign of optical radiation emitted by equipment provided with incoherent sources, commonly used in the hospitals of the Tuscany Region (Italy). The results of the evaluation campaign can be a useful database of technical information for the personnel involved in the risk assessment.

Risk assessment arising from exposure to artificial optical radiation: Results of an extensive evaluation campaign in the hospitals of Tuscany (Italy)

Workplace exposure to coherent and incoherent optical radiation from artificial sources is regulated under the Artificial Optical Radiation Directive (AORD) 2006/25/EC, now implemented in the UK under the Control of Artificial Optical Radiation at Work Regulations (AOR) 2010. These regulations set out exposure limit values. Implementing the AOR (2010 Health and Safety Statutory Instrument No 1140 www.legislation.gov.uk/uksi/2010/1140/pdf/uksi_20101140_en.pdf) requirements in a hospital environment is a potentially complex problem because of the wide variety of sources used for illumination, diagnosis and therapy. A survey of sources of incoherent optical radiation in a large hospital is reported here. The survey covers examples of office lighting, operating theatre lighting, examination lamps, and sources for ultraviolet phototherapy and visible phototherapies, including photodynamic therapy and neonatal blue-light therapy. The results of the survey are used to inform consideration of the strategy that a hospital might reasonably adopt both to demonstrate compliance with the AOR (2010) and to direct implementation effort.

http://iopscience.iop.org/article/10.1088/0952-4746/30/3/004/pdf

A survey of the optical hazards associated with hospital light sources with reference to the Control of Artificial Optical Radiation at Work Regulations 2010.

The radiance equation is applied in this study to model the ultraviolet (UV) radiation dose distribution over the skin in paediatric and adult patients treated in a whole-body phototherapy cabin. This approach extends a previously published model of UV radiation dose based on thermal radiation exchange between surfaces (Colemanet al2020Biomed. Phys. Eng. Express6055023). The new model makes it feasible to predict the distribution of UV irradiance over the head, trunk and legs in patients of varying height. The modelled irradiance distributions to directly lamp-facing skin surfaces agree to within 10% of those measured in simulated clinical paediatric treatments in a modern narrowband UVB treatment cabin. For a 10 year old (of height 1.36 m), for example, the model and the clinical measurements both show a UV radiation dose to the face that is around 25% more than that in an adult (of height 1.8 m). The dose to the crown of the head of a 10 year old is both predicted and measured to be more than double that of an adult. The automated dosimetry system, incorporated within the treatment cabin, is also predicted to overestimate irradiance to the body by between 10% and 25% in patients aged between 10 and 4 years (height 1.36-1.0 m). The value of the model and its implications for paediatric whole-body UV treatment in adult-size whole-body treatment cabins are considered.

A model of the UV skin dose distribution in paediatric whole-body phototherapy.

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A survey of the optical hazards associated with hospital light sources with reference to the Control of Artificial Optical Radiation at Work Regulations 2010.

A model of the UV skin dose distribution in paediatric whole-body phototherapy.