Tufts University School of Engineering, Medford, Massachusetts, 02155, United States.
Environ Sci Technol. 2021 Apr 6;55(7):4162-4173. doi: 10.1021/acs.est.0c05651. Epub 2020 Nov 23.
We conducted a systematic review of hygiene intervention effectiveness against SARS-CoV-2, including developing inclusion criteria, conducting the search, selecting articles for inclusion, and summarizing included articles. Overall, 96 268 articles were screened and 78 articles met inclusion criteria with outcomes in surface contamination, stability, and disinfection. Surface contamination was assessed on 3343 surfaces using presence/absence methods. Laboratories had the highest percent positive surfaces (21%, = 83), followed by patient-room healthcare facility surfaces (17%, = 1170), non-COVID-patient-room healthcare facility surfaces (12%, = 1429), and household surfaces (3%, = 161). Surface stability was assessed using infectivity, SARS-CoV-2 survived on stainless steel, plastic, and nitrile for half-life 2.3-17.9 h. Half-life decreased with temperature and humidity increases, and was unvaried by surface type. Ten surface disinfection tests with SARS-CoV-2, and 15 tests with surrogates, indicated sunlight, ultraviolet light, ethanol, hydrogen peroxide, and hypochlorite attain 99.9% reduction. Overall there was (1) an inability to align SARS-CoV-2 contaminated surfaces with survivability data and effective surface disinfection methods for these surfaces; (2) a knowledge gap on fomite contribution to SARS-COV-2 transmission; (3) a need for testing method standardization to ensure data comparability; and (4) a need for research on hygiene interventions besides surfaces, particularly handwashing, to continue developing recommendations for interrupting SARS-CoV-2 transmission.
我们对针对 SARS-CoV-2 的卫生干预措施的有效性进行了系统评价,包括制定纳入标准、进行检索、选择纳入的文章以及总结纳入的文章。总体而言,筛选了 96268 篇文章,其中 78 篇文章符合纳入标准,其结果涉及表面污染、稳定性和消毒。使用存在/不存在方法评估了 3343 个表面的污染情况。实验室阳性表面的百分比最高(21%, = 83),其次是患者病房医疗保健设施表面(17%, = 1170)、非 COVID 患者病房医疗保健设施表面(12%, = 1429)和家庭表面(3%, = 161)。使用感染力评估表面稳定性,SARS-CoV-2 在不锈钢、塑料和丁腈上的半衰期为 2.3-17.9 小时。半衰期随温度和湿度的升高而降低,与表面类型无关。对 SARS-CoV-2 进行了 10 项表面消毒测试,对替代品进行了 15 项测试,表明阳光、紫外线、乙醇、过氧化氢和次氯酸盐可达到 99.9%的减少率。总体而言,存在以下问题:(1)无法将 SARS-CoV-2 污染的表面与这些表面的存活数据和有效表面消毒方法联系起来;(2)对载体物对 SARS-COV-2 传播的贡献的认识差距;(3)需要对测试方法进行标准化,以确保数据的可比性;(4)需要研究除表面以外的卫生干预措施,特别是洗手,以继续为中断 SARS-CoV-2 传播提出建议。