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Next-to-last sites go on line in national project
A nationwide project to test the efficacy of ultraviolet germicidal irradiation got a Texas-size reception this past February when it rolled out two more sites in the Lone Star State, one in Houston and the other in the Rio Grande Valley.
"I’ve got three TV channels coming, and we’re about to have a reception for 50 people in a room that only holds 40," said a slightly breathless-sounding Kathleen Becan-McBride, EdD, MT (ASTP), site coordinator for the UV light project in Houston. She also is director of the office of communication at the University of Texas Health Sciences Center in Houston, where she’s a professor in the university hospital’s department of family practice.
In a ceremony complete with balloons, a big banner ordered for the occasion, and a handful of dignitaries who had flown in from the nation’s capitol for the event, lights were turned on in three Houston-area homeless shelters. Just two days before, the switches had been flipped in two more shelters in Harlingen and Brownsville. "The papers here are also going to do a whole series on TB," Becan-McBride added.
It’s been a long and at times arduous road for the UV lights project, the brainchild of Philip W. Brickner, MD, chair of the department of community medicine at St. Vincent’s Hospital in New York City, and Edward Nardell, MD, chief of pulmonary medicine at the Cambridge Hospital of Harvard Medical School and medical advisor to the TB control program of Massachusetts.
The project’s aim is to establish, once and for all, whether germicidal radiation can be harnessed to help prevent TB transmission. Homeless shelters were deemed among the best places to put the radiation to a test, because that population is at especially high risk for TB. The project will measure skin-test conversion rates at shelters with UV lights against those with placebo lights.
Since the spring of 1998, the project has opened sites in New York City; Birmingham, AL; and New Orleans. Now that the two Texas sites are up and running, that leaves only Los Angeles to go.
It’s often been a struggle to piece together all the necessary funds and resources for the costly project. But in Houston, reports Becan-McBride proudly, the locals have responded with both enthusiasm and generosity.
The local electrical utility company picked up part of the tab for the UV lights, which are custom-made to fit the buildings in which they’re installed. A county hospital agreed to provide personnel to do twice-weekly skin testing and readings at city shelters. The state and county TB programs kicked in a supply of skin-test antigens. A burger chain even donated free coupons to provide incentives for shelter residents to come back for their skin-test readings.
Dodging low bids and crossed wires
That didn’t mean it was smooth sailing all the way, adds Becan-McBride. "For one thing, I had to explain to the [university] purchasing committee why we were proposing to put UV lights in a homeless shelter — and then why we weren’t willing to take bids on them," she says. (Only one company in the country makes the lights in the correct wavelength spectrum, she explained patiently.)
Then she had to reassure the school’s ethics committee that the lights wouldn’t harm the shelter residents in any way, even though specifications call for protective baffles to make sure no one’s eyes or skin are injured by the radiation.
By comparison, selling the shelter operators and residents on the idea of having the lights installed was a cinch, because an infectious case of TB had only recently been identified at one of the shelters, with the result that several staff members were apparently infected and are now taking preventive therapy. Because the fixtures must be wired separately, Becan-McBride spent time with the electrical contractors explaining how important it was "not to get the wiring crossed up."
Becan-McBride notes that one worry still lies ahead. With a homeless population whose ranks are periodically swollen by migration by both northerners in search of warm weather and southerners seeking jobs in the city’s booming economy, shelters typically are hard-pressed to keep up with demand, Becan-McBride says. "We keep having to expand the shelters, which means we have to allocate more funds, get the contractors to come back again, and rewire the additions," she says.