Ozone use in surface disinfection: an integrative review

A search was carried out in the SciELO, MEDLINE, LILACS, PubMed, Science Direct databases. Eleven articles published January 2010 to August 2021 were analyzed. All employed the experimental laboratory research model and achieved different levels of disinfection by O₃, however, with varied surfaces and products tested, in addition to different methodological procedures.

Results

The majority had an inhibition rate by O₃ equal to or greater than 90%, thus proving the effectiveness of this agent as a surface disinfectant, even with variations in parameter values such as concentration and exposure time, in all selected articles, even those that did not prove the effectiveness of O_3.

Conclusion

This review shows the inhibitory power that O₃ has on different pathogens, even if there are variables in the factors used for this purpose, highlighting it in front of other disinfectants. Thus, it corroborates the composition of surface disinfection protocols and decision-making among managers and committees about sanitizing technologies.

Desinfection; Disinfectants; Ozone; Cross infection; Infection control

Classification	Database	Title	Authors/year	Objective
A1	SciELO	Ação antimicrobiana do gás ozônio em superfícies e na aeromicrobiota	Caetano, MH et al. (2021)(⁹9. Caetano MH, Siqueira JP, Andrade D, Sousa AF, Rigotti MA, Diniz MO, et al. Antimicrobial action of ozone gas on surfaces and in the air. Acta Paul Enferm. 2021;34:eAPE02712.), Brazil.	To assess O₃’s antimicrobial action on surfaces and artificially acclimatized ambient air.
A2	PubMed	Pseudoviruses for the assessment of coronavirus disinfection by ozone	Zucker, I et al. (2021), (¹⁴14. Zucker I, Lester Y, Alter J, Werbner M, Yecheskel Y, Gal-Tanamy M, et al. Pseudoviruses for the assessment of coronavirus disinfection by ozone. Environ Chem Lett. 2021;19(2):1779–85.) Israel.	To test using pseudoviruses as a model to assess O₃ disinfection of the coronavirus at ozone concentrations of 30, 100 and 1,000 ppmv.
A3	PubMed	Disinfection of Pseudomonas aeruginosa from N95 respirators with ozone: a pilot study	Manning, EP et al. (2021), (¹⁵15. Manning EP, Stephens MD, Dufresne S, Silver B, Gerbarg P, Gerbarg Z, et al. Disinfection of Pseudomonas aeruginosa from N95 respirators with ozone: a pilot study. BMJ Open Respir Res. 2021;8(1):e000781.) EUA.	To seek the necessary conditions for O₃ to disinfect N95 respirators for reuse and the effects of multiple exposure cycles.
A4	PubMed	Inactivation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by gaseous ozone treatment	Yano, H et al. (2020), (¹⁶16. Yano H, Nakano R, Suzuki Y, Nakano A, Kasahara K, Hosoi H. Inactivation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by gaseous ozone treatment. J Hosp Infect. 2020;106(4):837–8.) Japan.	To assess the effectiveness of O₃ for SARS-CoV-2 inactivation.
A5	PubMed	Development and improvement of an effective method for air and surfaces disinfection with ozone gas as a decontaminating agent	Moccia, G et al. (2020), (¹⁷17. Moccia G, De Caro F, Pironti C, Boccia G, Capunzo M, Borrelli A, et al. Development and improvement of an effective method for air and surfaces disinfection with ozone gas as a decontaminating agent. Medicina (Kaunas). 2020;56(11):578.) Italy.	To develop and implement a cleaning and sanitizing procedure for O₃ critical clinical environments to prevent hospital infections by eliminating all toxic and harmful microorganisms from the air and ensure safe use for operators and patients.
A6	PubMed	Utilização de gás ozônio na desinfecção de resíduos de serviços de saúde	Gonzaga, T. N., Kozusny-Andreani, D. I. (2018). (¹⁸18. Gonzaga TN. Kozusny-Andreani DI. Utilização de gás ozônio na desinfecção de resíduos de serviços de saúde. RIES. 2018;7(2):125-39.) Brazil.	To assess the technical feasibility of applying O₃ as a bactericide and fungicide in samples of potentially infectious health care waste.
A7	PubMed	Ozônio no controle de micro-organismos em resíduos de serviços de saúde	Martins, C. C.; Kozusny-Andreani, D. I.; Mendes, E. C. B. (2015). (¹⁹19. Martins CC, Kozusny-Andreani DI, Batista Mendes EC. Ozônio no controle de micro-organismos em resíduos de serviços de saúde. Rev Baiana Enferm. 2015; 29(4):318-27.) Brazil.	To verify the effectiveness of O₃ in the control of pathogenic microorganisms isolated from health service waste (RSW).
A8	PubMed	Inactivation of human coronavirus by FATHHOME’s dry sanitizer device: rapid and eco-friendly ozone-based disinfection of SARS-CoV-2	Uppal, T et al. (2021), (²⁰20. Uppal T, Khazaieli A, Snijders AM, Verma SC. Inactivation of human coronavirus by FATHHOME’s dry sanitizer device: rapid and eco-friendly ozone-based disinfection of SARS-CoV-2. Pathogens. 2021;10(3):339.) USA.	To test the inactivation of human coronavirus by FATHHOM’s O₃-based dry disinfection device.
A9	PubMed	Comparison of the effects of formaldehyde and gaseous ozone on HBV-contaminated hospital quilts	Guo, D et al. (2015), (²¹21. Guo D, Li Z, Jia B, Che X, Song T, Huang W. Comparison of the effects of formaldehyde and gaseous ozone on HBV-contaminated hospital quilts. Int J Clin Exp Med. 2015;8(10):19454–9.) China.	To investigate the clinical efficacy of formaldehyde and O₃ for the terminal cleaning of HBV-contaminated hospital quilts.
A10	PubMed	SARS-CoV-2 viability on different surfaces after gaseous ozone treatment: a preliminary evaluation	Percivalle, E et al. (2021), (²²22. Percivalle E, Clerici M, Cassaniti I, Vecchio Nepita E, Marchese P, Olivati D, et al. SARS-CoV-2 viability on different surfaces after gaseous ozone treatment: a preliminary evaluation. J Hosp Infect. 2021;110:33–6.) Italy.	To report an investigation into O₃ use as a potentially effective hygiene method against the new coronavirus
A11	PubMed	Evaluation of the effectiveness of two automated room decontamination devices under real-life conditions	Knobling, B et al. (2021)(²³23. Knobling B, Franke G, Klupp EM, Belmar Campos C, Knobloch JK. Evaluation of the effectiveness of two automated room decontamination devices under real-life conditions. Front Public Health. 2021;9:618263.), Germany	To assess the effectiveness of two automated room decontamination devices under real-life conditions.

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[1] Corresponding author: Irinéia Bacelar de Oliveira Simplício E-mail: irineiabacelar12@hotmail.com