{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:33Z","timestamp":1787841633904,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Infection prevention in hospitals is a highly discussed and regulated process for endoscopy in Otolaryngology. The current standard for endoscopes involves high level disinfection (HLD). The UV\u2010SMART D60 disinfection machine utilizes Impelux UV\u2010C light technology. This study aimed to evaluate the environmental impact of the D60 machine within an otolaryngology department in comparison to current HLD protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Three equipment, materials, and disposables audits were conducted where the turnover and HLD process of a single non\u2010channeled laryngoscope was analyzed. Every item involved in the cleaning process was documented for both standard HLD and D60 workflows. Water quantity was documented and a power meter was used to determine the wattage of the machinery used. Additionally, scope turnover time was documented and CO\n                      <jats:sub>2<\/jats:sub>\n                      emissions were calculated from known quantities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Results demonstrated a significant reduction in material usage with the D60 including reduced PPE. The total water usage was about 45\u2009L more per scope for traditional HLD. Power analysis demonstrated a reduction of 250 watts per scope. Additionally, the D60 reduced CO\n                      <jats:sub>2<\/jats:sub>\n                      emissions by over a factor of 3500. Scope turnover time was 109\u2009min less for the D60.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Environmental analysis demonstrates a significant amount of usage of disposables, water, and energy per non\u2010channeled nasolaryngoscope with current HLD protocols. UV\u2010C HLD resulted in less consumption of these resources. The marked reduction in turnover time and scope handling represents a significant opportunity for clinical efficiency, cost reduction, and resource consumption and will merit further investigation when FDA approval is granted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70537","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:05:11Z","timestamp":1786345511000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Environmental Impact of a Novel\n                    <scp>UV<\/scp>\n                    \u2010C Disinfection Machine for Non\u2010Channel Flexible Laryngoscopes"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5030-4844","authenticated-orcid":false,"given":"Abhishek","family":"Mahesh","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Bryson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Cleveland Clinic Lerner College of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Centers for Disease Control and Prevention \u201cA Rational Approach to Disinfection and Sterilization \u201d 2016 https:\/\/www.cdc.gov\/infection\u2010control\/hcp\/disinfection\u2010sterilization\/rational\u2010approach.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/disinfection\/rational\u2010approach.html."},{"key":"e_1_2_10_3_1","volume-title":"Global Guidelines for the Prevention of Surgical Site Infection","year":"2018"},{"key":"e_1_2_10_4_1","volume-title":"StatPearls [Internet]","author":"Alvi S.","year":"2026"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181ac1080"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.06.029"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28826"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2023.01.001"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.11.004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1539\/joh.48.75"},{"key":"e_1_2_10_11_1","unstructured":"National Institute for Occupational Safety and Health \u201cGlutaraldehyde: Occupational Hazards in Hospitals \u201d 2001."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.04.031"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2016.09.008"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1355819614534836"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_347_16"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157014"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010020\u201005978\u2010w"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.1190"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1088\/1748\u20109326\/ab19e1"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2024.105053"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eehl.2022.04.004"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.31478\/202504b"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex098"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.1362"}],"container-title":["Laryngoscope 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