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Using ozone for disinfecting PPE

Margo Roman, DVM, CVA, COT, CPT Karen Gellman, DVM, PhD

October 7, 2020

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Being able to safely clean our valuable Personal Protective Equipment (PPE) so it can be reused is vital any time, but especially during the COVID-19 pandemic. Here’s how medical ozone does the job.

This is a transcript of Dr. Margo Roman’s instructional video for first responders and other medical workers on how to safely clean Personal Protective Equipment (PPE) using ozone, so the equipment can be reused.

“Hello, I’m Dr. Margo Roman, and I want to tell you about a simple technology, easily accessed, that can help protect our frontline healthcare workers and first responders in this COVID-19 pandemic.

“Medical ozone is a treatment modality that has been around globally, used by doctors and dentists, for over 30 years. Not only can it be used to combat infection and chronic disease in humans, but I have [also] used medical ozone in my veterinary practice since 2003. Our team has [performed] over 70,000 treatments in that time, and we are using it for all types of medical conditions, including severe viral and bacterial infections as well as for sterilizing our own Personal Protective Equipment, our masks and our gowns.

“Medical ozone means utilizing the power of oxygen radicals to disrupt biological organisms like bacteria and viruses. Oxidizing is the primary way our bodies break down toxins and invaders. The oxygen we breathe, the O₂, is very stable and safe. Oxygen is needed for our survival. Ozone molecules have an extra oxygen atom which makes them very unstable. They can quickly break down into stable O₂, an active oxygen molecule. We can create ozone molecules by using electricity to stimulate pure surgical oxygen. This is done in a simple apparatus called an ozone generator. The ozone gas created in the generator can now be used in medical applications.

“In this video, I will demonstrate the simple procedures of using ozone gas to help sterilize our PPE. The protective gear [that] medical staff need is in short supply. Gowns, masks, helmets, and gloves can be all sterilized quickly by bathing them in a high concentration of ozone. For most of these procedures, we use gaseous ozone at a concentration of 75 micrograms per milliliter. The concentration of ozone is a product of setting your generator and your speed of airflow. The slower the oxygen flow, the more concentrated the ozone. For this reason, we typically use a pediatric regulator on the oxygen tank so we can get the flows as low as 1/32 liter per minute. The ozone gas created in the generator can now be used in medical applications, [such as] disinfecting water and Personal Protective Equipment, and even treating infectious disease directly. The key to successful disinfection is not mixing up the contaminated and clean gear equipment. I recommend that you wear gloves and wash and disinfect the gloves after handling the contaminated PPE.

“The simplest ozone system is a tank of medical oxygen, a pediatric regulator valve, a tube between the oxygen source and the generator, and an outflow tube from the generator carrying ozone. It is important that the ozone carrying tube be made of silicon because a standard plastic or rubber tube will degrade from contact with the ozone. Line a bin with a plastic garbage bag, making sure you have a generous cuff around the outside. This will enable you to not touch the contaminated [interior] of the bag when you close it up later. Load all your gowns, helmets, and visors into the bags. The smaller PPE, such as personal masks, can be put in a smaller bag and marked with the owner’s name. We recommend disinfecting your gear with at least 70 micrograms per milliliter of ozone. On this unit we need a flow of 1/8 liter of oxygen per minute to get that strength.

“Wash and disinfect your hands after loading your PPE and before handling your ozone generator and oxygen tank. When you are ready to begin, open the valve on your oxygen tank, set your regulator to the desired flow rate, in this case 1/8 of a liter per minute. Be sure you have good ventilation in the room [where] you are working and don’t breathe the ozone gas directly. Insert the ozone tube into your personal PPE bag, flatten out the excess room air and zip the bag closely around the tube. Now turn the ozone generator on and you are making an ozone/oxygen mixture.

“When there is visible air in your bag, remove the ozone tube, seal the bag, and place it into a larger gear bag. In this way, both the inside and outside of your personal gear bag will be disinfected. Remove the larger gear bag from the bin, handling only the outside of the bag. Insert your ozone tube into the end of the bag. Use a zip tie to hold your ozone tube tightly within the bag so no ozone will escape while filling. Once there is a visible fill in the bag, carefully remove the tube and reseal your bag, fluffing the contents so that the surfaces are in contact with the ozone, and set aside. Since the outside of your ozone tube may be contaminated from contact with the inside of the bag, disinfect it right away with alcohol or disinfectant wipes.

“Leave the bag for one hour. It’s best to open bags outdoors or in an area with an effective outflow fan. Ozone in this state should not be breathed directly as it’s irritating to the lungs. Once your bag is opened, fluff it several times to disperse the remaining gas. Now your gear is clean and ready for reuse.

“Medical ozone is a powerful virucide that can protect first responders and

health care providers as well as dramatically improve patient outcomes during this pandemic and beyond. On the screen are links to multiple ozone societies, groups of doctors using oxidative therapies in their clinics every day. There are also links to companies that make, distribute, and sell ozone generating equipment. These innovative technologies can be scaled up to decontaminate PPE on a major scale, whether using O₃ or H₂O₂ as the oxidative source. Ozone can also be used to revolutionize food safety with ozonated water to decontaminate supermarket produce.

The value of medical oxidative therapies has been scientifically proven. Now it is time to make it a critical part of COVID-19 prevention and treatment. Please contact me, Dr. Margo Roman, to connect with resources and answer your questions. Thank you.”