Introduction
In healthcare environments, the importance of maintaining a sterile and pathogen-free environment is paramount. Reference Marra, Schweizer and Edmond1 Ultraviolet-C (UV-C) radiation, spanning wavelengths between 100 and 280 nanometers, has emerged as a compelling tool in diverse applications, particularly within healthcare settings where stringent disinfection measures are crucial. Reference Marra, Schweizer and Edmond1,Reference Demeersseman, Saegeman, Cossey, Devriese and Schuermans2
For example, a large-scale evaluation of UV-C disinfection technology in the Veterans Health Administration found an associated 19% reduction in incidence of Gram-negative bacteria after implementation of the systems in 40 acute care hospitals. Reference Goto, Hasegawa, Balkenende, Clore, Safdar and Perencevich3 However, UV-C disinfection has yielded conflicting results in reducing multidrug-resistant organisms. Reference Anderson, Moehring and Weber4,Reference Rock, Hsu and Curless5
UV-C radiation’s ability to induce photochemical reactions and degrade material presents an intriguing avenue for enhancing disinfection practices. Reference Masse, Hartley, Edmond and Diekema6 The potential benefits of harnessing UV-C for decontamination purposes have prompted investigations into the potential secondary negative impact on different types of materials. 7 Understanding the impact of UV-C exposure on materials used in healthcare settings is essential for ensuring the safety, efficacy, and longevity of medical equipment and surfaces subjected to UV-C disinfection protocols. Reference Demeersseman, Saegeman, Cossey, Devriese and Schuermans2,Reference Cullinan, Scott, Linogao, Bradwell, Cooper and McGinn8
Against this backdrop, a scoping literature review becomes imperative to consolidate and critically evaluate existing knowledge regarding the influence of UV-C on material degradation. Reference Demeersseman, Saegeman, Cossey, Devriese and Schuermans2,7 Hence, our objective was to conduct a literature review to synthesize findings from a range of studies, exploring the diverse effects of UV exposure on various materials, including polymers, metals, and composites. Through this scoping literature review, we aim to contribute insights that may inform future research directions and practical applications of UV-C-induced material degradation within healthcare settings.
Methods
Scoping literature review and inclusion and exclusion criteria
This scoping literature review focused on UV-C material degradation and was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Reference Moher, Liberati, Tetzlaff and Altman9 Institutional Review Board approval was not required. Inclusion criteria for studies in this scoping review were as follows: 1) original research manuscripts, studies presented at scientific conferences (eg, abstracts or proceedings), dissertations, and theses; 2) published in peer-reviewed, scientific journals; 3) involving material that may be exposed to UV-C radiation in a typical potential hospital environment; and 4) utilizing observational or experimental study designs. UV-C exposure refers to the act of subjecting a material to UV radiation in the short-wave UV-C spectrum, typically with wavelengths between 100 and 280 nanometers. Reference Cullinan, Scott, Linogao, Bradwell, Cooper and McGinn8 Material degradation was defined as the process by which a material undergoes physical, chemical, or structural deterioration, often resulting in a decrease in its original properties or performance. 7 The literature search included studies published or presented from January 1, 2000 to August 30, 2024. Exclusion criteria comprised editorials, commentaries, reviews, study protocols, and studies analyzing topics beyond UV-C material degradation. Within the category of studies analyzing UV-C material degradation, we excluded studies of UV-C degradation of materials for simulated outdoor environments, articles examining UV-C degradation of portable hospital equipment or medical devices (eg, endoscopes), and the exclusive examination of microplastics.
Search strategy
We performed literature searches in PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Embase (Elsevier Platform), Cochrane Central Register of Controlled Trials, Scopus (which includes EMBASE abstracts), Web of Science, and ProQuest Dissertations and Theses. The entire search strategy is described in Supplementary Appendix 1. This study uses the PICO framework, Reference Eriksen and Frandsen10 focusing on materials used in healthcare settings (P) and exposure to UV-C radiation (100–280 nanometers) (I), with the comparison not explicitly stated but implicitly made to materials not exposed to UV-C radiation or to baseline conditions before UV-C exposure (C). The primary outcome of interest (O) was to detect any physical, chemical, or structural degradation of materials resulting in decreased performance properties. After applying the exclusion criteria, we reviewed 56 papers, out of which 14 met the inclusion criteria and were included in the scoping literature review (Figure 1).
Figure 1. Literature search for articles on the impact of UV-C exposure on material degradation.
Data abstraction
Titles and abstracts of all articles were screened to assess whether they met the inclusion criteria. Abstract screening was performed by two reviewers (DS and ARM). Of four independent reviewers (DS, SMHS, KCD, and ARM), two independently abstracted data for each article using a standardized abstraction form. Reviewers resolved disagreements by consensus.
The reviewers abstracted data on study design, location, time of UV-C exposure (min/hours), characteristics of UV-C exposure, type of material reported to UV-C degradation, method to detect the surface or material changes due to UV-C exposure, type of degradation detected on the surface or material changes, and conclusions if available.
Results
Characteristics of included studies
Of 56 studies reviewed in further detail, 14 met the inclusion criteria for this scoping literature review. Reference Aboamer, Algethami and Hakami11–Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 All included articles were experimental designs carried out in laboratories rather than field environments. These studies primarily used UV-C radiation exposure in controlled laboratory settings to simulate material degradation under various conditions. Notably, these studies provided quantifiable data on exposure times (ranging from 1 h to 2 700 h), irradiance levels (from 52.5 µW/cm2 to 12,000 µW/cm2), and source distances (5 cm–1.5 m), offering concrete thresholds for material degradation.
Documented effects of UV-C exposure on polymeric materials
The documented effects of UV-C exposure on polymeric materials (Table 1) were consistent across multiple studies. Reference Aboamer, Algethami and Hakami11–Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20–Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 A common effect was color change, with materials such as polycarbonate and high-density polyethylene (HDPE) exhibiting significant yellowing and a loss of transparency when exposed to UV-C radiation. Surface cracking and microfractures were also widely reported, especially in plastics like polycarbonate, where cellular cracking became more pronounced as exposure time increased. Quantitative analysis revealed that polycarbonate exposed to 88 µW/cm2 at 1.5 m showed measurable yellowing within 72 h, while HDPE developed surface cracks after 144 h at similar irradiance. Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 Mechanical property degradation was a common result, with many materials, including polycarbonate and polylactic acid (PLA), showing reduced stress and strain at break.
Table 1. Examples of polymeric and non-polymeric materials
Time-dependent degradation
UV-C degradation was consistently found to be time-dependent across various materials. Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Wolf, Kauffman and Sqrow23,Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 Polycarbonate, for instance, exhibited progressive mechanical and molecular changes over 72–216 h of UV-C exposure. The material’s stress at break and strain at break decreased over time, with more severe reductions occurring at longer exposure times. Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 Similarly, polylactic acid (PLA) demonstrated a reduction in tensile and compressive strength, with the most significant changes occurring after 24 h of exposure. Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 Other materials like polyethylene terephthalate (PET) and high-density polyethylene (HDPE) also displayed substantial degradation over extended periods of UV-C exposure, indicating that prolonged exposure leads to more significant material damage. Reference Wolf, Kauffman and Sqrow23
Dose-response relationship between the intensity of UV-C irradiation and the degree of material degradation
A clear dose-response relationship was observed between UV-C intensity and the degree of material degradation. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Amza, Zapciu, Baciu and Radu13 Materials exposed to higher UV-C irradiance levels exhibited increased surface degradation, such as deeper craters and greater surface roughness. Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Wolf, Kauffman and Sqrow23 Heating, ventilation, and air conditioning (HVAC) components exposed to >1,000 µW/cm2 showed accelerated mass loss, Reference Kauffman and Wolf15 while polycarbonate developed surface craters 2–3 times deeper at 12,000 µW/cm2 compared to 310 µW/cm2. Reference Wolf, Kauffman and Sqrow23 These quantitative relationships emphasize the need for careful irradiance control in clinical settings.
Distance-dependent degradation patterns
Several studies systematically evaluated distance effects on UV-C degradation. At close ranges (5–50 cm), materials showed accelerated damage—polycarbonate developed 2.1 times faster yellowing at 50 cm versus 1.5 m, Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 while PLA exhibited 13% greater tensile loss. Reference Amza, Zapciu, Baciu, Vasile and Popescu12 Polyvinyl chloride (PVC) demonstrated cytotoxic effects only at ≤50 cm distances. Reference Haishima, Isama, Hasegawa, Yuba and Matsuoka14 Only acrylonitrile butadiene styrene-polycarbonate copolymer (ABS-PC) blends maintained stability during 24-hour exposures in irradiation chambers. Reference Amza, Zapciu, Baciu and Radu13
Impact of material properties
The impact of UV-C exposure on material properties varied depending on the type of material. Reference Amza, Zapciu, Baciu, Vasile and Popescu12–Reference Kauffman and Wolf15,Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17,Reference Rainer, Centola and Spadaccio19,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 The impact appears to be material-dependent. Color changes were the most common visible effect, with materials such as polycarbonate and high-density polyethylene (HDPE) undergoing significant yellowing. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 Surface cracks and microfractures were also frequently observed, particularly in polycarbonate and polylactic acid (PLA). In terms of mechanical properties, several materials exhibited reduced stress and strain at break after UV-C exposure, suggesting that UV radiation weakened the molecular structure, making them more fragile. Reference Amza, Zapciu, Baciu, Vasile and Popescu12–Reference Kauffman and Wolf15,Reference Rainer, Centola and Spadaccio19,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 While the color change and fading were often considered aesthetic issues, these changes did not always correlate with a loss of functional properties. Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17 Processing of materials (e.g. method of 3D printing, veneer production method) was found to affect the degradation process. Reference Amza, Zapciu, Baciu, Vasile and Popescu12
Methods to detect material degradation exposed to UV-C radiation
Various methods were employed to detect material degradation caused by UV-C exposure. Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 Visual inspection was a common technique used across studies to identify color changes and surface damage, such as cracks and discoloration. Microscopic methods, such as optical microscopy and scanning electron microscopy (SEM), were frequently used to examine the finer details of surface degradation, such as microfractures, roughness, and changes in the microstructure of the materials. Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 Infrared spectroscopy was another key method used to detect molecular changes in the materials, such as bond dissociation and chain reorganization, which occurred as a result of UV-C exposure. Reference Teska, Dayton, Li, Lamb and Strader22 Additionally, nanoindentation was utilized to measure changes in material hardness, helping to assess whether a material became more brittle or softened after UV exposure. Reference Teska, Dayton, Li, Lamb and Strader22
Mitigation strategies
Some studies discussed potential mitigation strategies to reduce the effects of UV-C degradation. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Olewnik-Kruszkowska, Skopińska-Wiśniewska and Richert18 The use of additives, such as UV stabilizers and antioxidants, was suggested as a method to slow down the degradation process in materials like polycarbonate and PLA. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Olewnik-Kruszkowska, Skopińska-Wiśniewska and Richert18
Discussion
This scoping review examined the available literature on the degradation of polymeric materials following UV-C radiation exposure, with particular focus on hospital-relevant contexts. While UV-C technology is increasingly adopted for disinfection purposes in healthcare settings, the collateral impact on material, especially polymers, warrants thorough understanding to guide evidence-based procurement and maintenance strategies including cost-effectiveness analysis.
The literature consistently demonstrates that certain polymeric material are more susceptible to UV-C-induced degradation. Reference Aboamer, Algethami and Hakami11–Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 Importantly, three key factors emerged: exposure time, irradiance dose, and distance from UV-C sources (Table 2). Polycarbonate and high-density polyethylene (HDPE), for instance, showed considerable vulnerability, including pronounced yellowing, surface cracking, and reduction in mechanical integrity. Reference Amza, Zapciu, Baciu and Radu13,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Wolf, Kauffman and Sqrow23 These effects were evident across a range of exposure times (24–72 h for significant polymer degradation) Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Amza, Zapciu, Baciu and Radu13,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 and intensities (e.g. >1,000 µW/cm2 for HVAC components), Reference Kauffman and Wolf15 underscoring the material-specific nature of UV-C damage. Polymeric materials such as polyactic acid (PLA) also demonstrated substantial performance loss, particularly in tensile strength and elasticity. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24
Table 2. Summary of characteristics of studies included in the scoping literature review
Abbreviations: 1H NMR = proton nuclear magnetic resonance; ABV = Acid Blue V; ABS = acrylonitrile butadiene styrene; ABS-PC = ABS-polycarbonate copolymer; ARG = Acid Red GR; ATR-FTIR = attenuated total reflectance FTIR; BPT = black panel temperature; BPX-5=non-polar GC column; CA = chromosome aberration; CIE L * a * b*=International Commission on Illumination color space; cm−1=wavenumber; DEHP = di(2-ethylhexyl) phthalate; EDS = energy-dispersive X-ray spectroscopy; FTIR = Fourier-transform infrared spectroscopy; GC-MS = gas chromatography-mass spectrometry; GE = General Electric; GPC = gel permeation chromatography; GandR Labs 221 UV meter=UVC radiometer; HDPE = high-density polyethylene; h = h; HVAC = heating, ventilation, air conditioning; IC50=half-maximal inhibitory concentration; ILT = International Light Technologies; kN=kilonewton; kg=kilograms; kV=kilovolt; LED = light-emitting diode; LZC-ICH2=Luzchem photoreactor; MDF = medium-density fiberboard; MEHP = mono(2-ethylhexyl) phthalate; MEHP-Me=carboxyl-methylated MEHP; MEX = material extrusion 3D printing; MFR = melt flow rate; mm=millimeters; m = meter; MPa=megapascals; MMT = montmorillonite; Mw=molecular weight; mJ/cm2=millijoules/cm2; μW/cm2=microwatts/cm2; N = newtons; nm=nanometer; NR = not reported; OM = optical microscopy; PC = polycarbonate; PBT = polybutylene terephthalate; PCL = polycaprolactone; PET = polyethylene terephthalate; PETG = PET glycol-modified; PLA = polylactic acid; PLLA = poly(L-lactic acid); PP = polypropylene; PVC = polyvinyl chloride; RGB = red-green-blue; rpm=revolutions/minute; RT = room temperature; RTV = room-temperature vulcanizing; SEM = scanning electron microscopy; Tg=glass transition temperature; Tm=melting temperature; torr≈1 mmHg; TMA = thermomechanical analyzer; TUV30W=Philips 30W UV-C lamp (254 nm); UV-C=ultraviolet-C; UV-Vis=ultraviolet-visible spectroscopy; W = watts; XPS = X-ray photoelectron spectroscopy; XRD = X-ray diffraction; yr=years; ↓=decreased; ↑=increased; g/cm3=grams/cm3.
UV-C-associated degradation was clearly shown to be time-dependent. The cumulative exposure to UV-C radiation correlates with a progressive decline in mechanical properties and increased surface and molecular damage. For example, polycarbonate and PLA demonstrated decreased stress at break, microstructural disruption, and more severe physical deformation with longer exposure times. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 This trend suggests that even intermittent use of UV-C disinfection methods could pose long-term risks to the durability of installed material, particularly in high-turnover clinical environments.
A dose-response relationship was evident in several studies, indicating that higher irradiance or prolonged exposure leads to more pronounced degradation. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Amza, Zapciu, Baciu and Radu13,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Wolf, Kauffman and Sqrow23 This was particularly evident in the degree of surface roughness, crater formation, and chemical bond breakdown observed in materials subjected to high-intensity UV-C doses. Reference Wolf, Kauffman and Sqrow23 This finding is important in guiding thresholds for UV-C use in clinical setting and emphasizes the importance of dose control when designing disinfection protocols. Reference Masse, Hartley, Edmond and Diekema6
These findings suggest that equipment or surfaces consisting of certain polymers undergoing daily UV-C disinfection (typically 15–30 mins per cycle) may reach critical degradation thresholds within months of use. However, importantly, it is not yet clear how the findings from this review apply to materials commonly used in hospitals. It is not known whether any equipment, furnishings, or surfaces typically used in hospitals are manufactured from the specific polymers described in the studies that were reviewed, or whether or to what extent protective coatings or degradation-mitigating manufacturing processes are used in hospital equipment, furnishings, or surfaces. Before applying findings from this review to hospital materials, more research on materials used in hospital environments must be done to identify the composition and relevant manufacturing or post-manufacturing processes that could affect materials’ response to UV-C exposure.
The critical role of distance emerged across studies, following inverse-square law dynamics. PVC’s cytotoxic threshold at ≤50 cm Reference Haishima, Isama, Hasegawa, Yuba and Matsuoka14 and polycarbonate’s 39% slower degradation at 1.5 m Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 suggest hospitals should establish minimum safe distances for sensitive equipment. These findings compel reconsideration of UV-C device placement, particularly for mobile units operating <1 m from surfaces. Future standards should incorporate distance-specific thresholds alongside time/dose parameters, especially for polymers like PLA and PVC where proximity dramatically alters degradation kinetics.
Material properties, including molecular structure, composition, and surface treatment, played a significant role in the degree of degradation observed. 25 In general, more transparent and lightweight plastics such as polycarbonate were particularly prone to both visual and structural damage. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 Common surface changes including yellowing, loss of transparency, cracking, and the development of microfractures. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17,Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20 While color change may appear cosmetic, its occurrence was often associated with deeper structural changes and loss of mechanical integrity. Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17
A wide range of methodologies were employed to detect and characterize material degradation, with varying degrees of sensitivity and specificity. Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17,Reference Rainer, Centola and Spadaccio19 Visual inspection and microscopy (optical and scanning electron) were commonly used for detecting color changes and surface cracks. Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 While visual inspection remains the most practical method for routine monitoring in healthcare settings, detecting obvious changes like yellowing in polycarbonate or surface cracks in PLA, Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 its limitations are well-documented. The subjective nature of visual assessment leads to inter-observer variability, and more importantly, it often fails to identify early-stage molecular degradation before mechanical properties are compromised. Reference Mitxelena-Iribarren, Mondragon, Pérez-Lorenzo, Smerdou, Guillen-Grima, Sierra-Garcia, Rodriguez-Merino and Arana17,Reference Teska, Dayton, Li, Lamb and Strader22 Molecular alterations were identified using infrared spectroscopy, which revealed bond scission and polymer chain reorganization. Reference Haishima, Isama, Hasegawa, Yuba and Matsuoka14,Reference Liu, Gao, Guo, Chen, Cheng and Via16,Reference Olewnik-Kruszkowska, Skopińska-Wiśniewska and Richert18–Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Teska, Dayton, Li, Lamb and Strader22 In addition, nanoindentation techniques quantified changes in hardness, further supporting evidence of material embrittlement or softening post-exposure. Reference Teska, Dayton, Li, Lamb and Strader22 These methods offer a multifaceted approach to monitoring degradation, and their integration could enhance preventive maintenance programs in healthcare facilities. For comprehensive monitoring, we recommend a tiered approach: routine visual inspections could be supplemented with periodic instrumental analyses—infrared spectroscopy for molecular changes Reference Haishima, Isama, Hasegawa, Yuba and Matsuoka14,Reference Liu, Gao, Guo, Chen, Cheng and Via16,Reference Olewnik-Kruszkowska, Skopińska-Wiśniewska and Richert18–Reference Redjala, Aït Hocine, Ferhoum, Gratton, Poirot and Azem20,Reference Teska, Dayton, Li, Lamb and Strader22 and nanoindentation for hardness measurements Reference Teska, Dayton, Li, Lamb and Strader22—particularly when materials approach critical exposure thresholds identified in our review (eg, after 24 h cumulative UV-C for PLA Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 ). This combined methodology would balance practicality with detection accuracy, enabling healthcare facilities to implement standardized degradation assessment protocols that account for both visible changes and underlying material integrity.
Another important finding in a subset of studies was the potential of mitigation strategies, particularly chemical additives such as UV stabilizers and antioxidants. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Olewnik-Kruszkowska, Skopińska-Wiśniewska and Richert18 These interventions showed promise in slowing or preventing degradation in polymers like polycarbonate and PLA. Reference Amza, Zapciu, Baciu, Vasile and Popescu12,Reference Olewnik-Kruszkowska, Skopińska-Wiśniewska and Richert18 Incorporating such protective additives may improve the resilience of materials routinely exposed to UV-C, offering a potential path forward in material selection and procurement.
As noted above, one limitation of our review is that included articles are all experimental research, Reference Aboamer, Algethami and Hakami11–Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 and thus the data contained in the review articles does not represent the real world of hospital environments and the actual processes of UV-C exposure of materials in hospital environments. Furthermore, a formal assessment of risk of bias was not conducted. This is consistent with the methodological framework of scoping reviews, which aims to map the available evidence rather than evaluate study quality. Additionally, there is currently no validated quality assessment tool specifically suited for experimental studies conducted in laboratory settings, further justifying the absence of a risk of bias appraisal in this review. Reviewed papers identify changes as a result of UV-C exposure to materials that may occur in items potentially found in hospitals. Reference Aboamer, Algethami and Hakami11–Reference Zapciu, Amza, Ciolacu, Francalanza, Rauch, Matt, Vidoni, Rauch and Dallasega24 However, it is not clear exactly how these experimental study results carry over to materials in actual hospital environments. Similarly, exposures described may not be similar to typical UV-C healthcare exposures, and those themselves may vary depending on area within the hospital and by the hospital depending on policies, resources, and practices. Reference Friberg Walhof, Racilla and Hockett Sherlock26 The combinations of materials in hospitals may vary. Additionally, from the set of included papers, it is not possible to identify potential variation in degradation that may occur as a combination of UV-C exposure and other disinfection processes also used in hospital settings. Therefore, more research needs to be done. All included articles were experimental designs carried out in laboratories rather than field environments. This allowed for controlled conditions that could isolate the effects of UV-C radiation on various materials. While field studies could provide additional insights into real-world degradation, the laboratory settings of these studies were important to understanding the fundamental process of material degradation under UV-C exposure.
This review highlights that UV-C radiation, while effective for disinfection, poses a material degradation risk, particularly for polymeric substances commonly used in healthcare infrastructure. The degradation is material-specific, dose-dependent, and progressive over time. Future research should focus on standardizing assessment methods, quantifying damage thresholds, and developing UV-resistant materials or coatings. Understanding the trade-offs between disinfection efficacy and material durability is crucial for optimizing both patient safety and facility maintenance.
Supplementary material
The supplementary material for this article can be found at https://doi.org/10.1017/ash.2025.10114.
Acknowledgements
We thank Jennifer Deberg, MLS, from the Hardin Library for the Health Sciences, University of Iowa Libraries, for assistance with the search methods. The views expressed in this presentation are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
Financial support
This work was funded by the Department of Veterans Affairs Quality Enhancement Research Initiative (QUERI) Award QUE 20-016.
Competing interests
All authors report no conflict of interest relevant to this article.
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