{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:34:36Z","timestamp":1786649676940,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      Disinfecting contaminated ambulances presents a challenge to emergency medical services. The process relies on a manual cleaning step or the use of foggers and gas generators. Equipment requires training, power supply, and access to reagent refills. Chlorine dioxide (ClO\n                      <jats:sub>2<\/jats:sub>\n                      ) gas is an affordable, easy-to-use alternative.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We field-tested ClO\n                      <jats:sub>2<\/jats:sub>\n                      dry inside an ambulance against a surrogate for SARS-CoV-2. MS2 bacteriophage was aerosolized inside of an enclosed. Airborne MS2 concentrations were measured before and after ClO\n                      <jats:sub>2<\/jats:sub>\n                      applications to compare reductions in viable virus. ClO\n                      <jats:sub>2<\/jats:sub>\n                      gas was generated using ICA-TriNova UltraShok\u2122 2-part media in different concentrations and time courses. Petri dishes were used to determine the surface deposition of residual MS2 phage. ClO\n                      <jats:sub>2<\/jats:sub>\n                      gas was monitored using a PortaSens III gas detector with high and low range sensors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      MS2 bacteriophage measured at 15-min averaged 99.99% in both 100 g and 130 g applications, compared to 83.48% in controls. At 60-min, air MS2 percent reductions averaged 99.99% in 100 g applications compared to 98.05% in controls. Mean surface MS2 counts within protocols using ClO\n                      <jats:sub>2<\/jats:sub>\n                      gas ranged from 245 to 5110 plaque-forming unit (PFU)\/petri-dish compared to 13,900\u201344,900 PFU\/petri-dish in controls. ClO\n                      <jats:sub>2<\/jats:sub>\n                      gas concentrations fell below OSHA 15-min short-term exposure limit of 0.3 PPM within 5 min of passive ventilation in all tests. There were no observed detrimental impacts on materials and surfaces.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      ClO\n                      <jats:sub>2<\/jats:sub>\n                      gas produced using ICA-TriNova UltraShok\u2122 2-part media is an effective air disinfection technique for contaminated ambulance settings. Integration with manual cleaning permits safe, rapid decontamination of ambulance vehicles.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jets.jets_103_24","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T17:00:09Z","timestamp":1766595609000},"page":"161-165","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Disinfection of Simulated Residual SARS-CoV-2 in Air by Chlorine Dioxide Gas in an Ambulance Setting"],"prefix":"10.4103","volume":"18","author":[{"given":"Shawn","family":"Jones","sequence":"first","affiliation":[{"name":"Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Lukasik","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Sarasota Memorial Hospital, Florida State University College of Medicine Emergency Medicine Residency Program, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagar","family":"Galwankar","sequence":"additional","affiliation":[{"name":"Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Bourgeois","sequence":"additional","affiliation":[{"name":"Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Harbinson","sequence":"additional","affiliation":[{"name":"Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"R1-20260107","doi-asserted-by":"crossref","first-page":"407","DOI":"10.2147\/OAEM.S324568","article-title":"Emergency medical services (EMS) calls during COVID-19:early lessons learned for systems planning (A narrative review)","volume":"13","author":"Al Amiry","year":"2021","journal-title":"Open Access Emerg Med"},{"key":"R2-20260107","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s12873-021-00489-1","article-title":"Management of COVID-19-related challenges faced by EMS personnel:A qualitative study","volume":"21","author":"Mohammadi","year":"2021","journal-title":"BMC Emerg Med"},{"key":"R3-20260107","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1038\/s41467-021-21918-6","article-title":"SARS-CoV and SARS-CoV-2 are transmitted through the air between ferrets over more than one meter distance","volume":"12","author":"Kutter","year":"2021","journal-title":"Nat Commun"},{"key":"R4-20260107","doi-asserted-by":"crossref","first-page":"107788","DOI":"10.1016\/j.buildenv.2021.107788","article-title":"Probable airborne transmission of SARS-CoV-2 in a poorly ventilated restaurant","volume":"196","author":"Li","year":"2021","journal-title":"Build Environ"},{"key":"R5-20260107","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1001\/jamainternmed.2020.5225","article-title":"Community outbreak investigation of SARS-CoV-2 transmission among bus riders in Eastern China","volume":"180","author":"Shen","year":"2020","journal-title":"JAMA Intern Med"},{"key":"R6-20260107","doi-asserted-by":"crossref","first-page":"115010","DOI":"10.1016\/j.envpol.2020.115010","article-title":"Persistence of SARS-CoV-2 in the environment and COVID-19 transmission risk from environmental matrices and surfaces","volume":"265","author":"Carraturo","year":"2020","journal-title":"Environ Pollut"},{"key":"R7-20260107","doi-asserted-by":"crossref","first-page":"105794","DOI":"10.1016\/j.envint.2020.105794","article-title":"Estimation of airborne viral emission:Quanta emission rate of SARS-CoV-2 for infection risk assessment","volume":"141","author":"Buonanno","year":"2020","journal-title":"Environ Int"},{"key":"R8-20260107","year":"2020","journal-title":"Considerations on the Proper Decontamination of Emergency Vehicles"},{"key":"R9-20260107","doi-asserted-by":"crossref","first-page":"e9914","DOI":"10.7717\/peerj.9914","article-title":"Combating SARS-CoV-2:Leveraging microbicidal experiences with other emerging\/re-emerging viruses","volume":"8","author":"Ijaz","year":"2020","journal-title":"PeerJ"},{"key":"R10-20260107","doi-asserted-by":"crossref","first-page":"13646","DOI":"10.3390\/ijerph192013646","article-title":"SARS-CoV-2 contamination of ambulance surfaces and effectiveness of routine decontamination procedure:A classic hygiene lesson for a novel pathogen","volume":"19","author":"Baldovin","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"R11-20260107","doi-asserted-by":"crossref","first-page":"e0257434","DOI":"10.1371\/journal.pone.0257434","article-title":"Evaluation of electrostatic sprayers and foggers for the application of disinfectants in the era of SARS-CoV-2","volume":"16","author":"Wood","year":"2021","journal-title":"PLoS One"},{"key":"R12-20260107","doi-asserted-by":"crossref","first-page":"401","DOI":"10.3109\/10903127.2013.792889","article-title":"Evaluation of ambulance decontamination using gaseous chlorine dioxide","volume":"17","author":"Lowe","year":"2013","journal-title":"Prehosp Emerg Care"},{"key":"R13-20260107","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4081\/ecj.2023.11646","article-title":"The organization of ambulance decontamination during the COVID-19 pandemic:A process analysis based on the Lean Thinking philosophy","volume":"19","author":"Imbriaco","year":"2023","journal-title":"Emerg Care J"},{"key":"R14-20260107","doi-asserted-by":"crossref","first-page":"206","DOI":"10.4236\/odem.2022.103016","article-title":"Virucidal efficacy of chlorine dioxide interventions on MS2 phage bioaerosol in a laboratory chamber","volume":"10","author":"Jones","year":"2022","journal-title":"Occup Dis Environ Med"},{"key":"R15-20260107","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1093\/jaoac\/90.6.1655","article-title":"Hierarchy of susceptibility of viruses to environmental surface disinfectants:A predictor of activity against new and emerging viral pathogens","volume":"90","author":"Sattar","year":"2007","journal-title":"J AOAC Int"},{"key":"R16-20260107","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1080\/15459624.2013.818241","article-title":"Decontamination of a hospital room using gaseous chlorine dioxide:Bacillus anthracis, Francisella tularensis, and Yersinia pestis","volume":"10","author":"Lowe","year":"2013","journal-title":"J Occup Environ Hyg"},{"key":"R17-20260107","doi-asserted-by":"crossref","first-page":"2596","DOI":"10.3390\/ijerph10062596","article-title":"Impact of chlorine dioxide gas sterilization on nosocomial organism viability in a hospital room","volume":"10","author":"Lowe","year":"2013","journal-title":"Int J Environ Res Public Health"},{"key":"R18-20260107","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.serj.2016.04.009","article-title":"Evaluation of disinfection efficiency in pet's hospital by using chlorine dioxide","volume":"26","author":"Hsu","year":"2016","journal-title":"Sustain Environ Res"},{"key":"R19-20260107","doi-asserted-by":"crossref","first-page":"103","DOI":"10.4265\/bio.15.103","article-title":"Environmental monitoring and bactericidal efficacy of chlorine dioxide gas in a dental office","volume":"15","author":"Kuroyama","year":"2010","journal-title":"Biocontrol Sci"},{"key":"R20-20260107","doi-asserted-by":"crossref","first-page":"569","DOI":"10.30802\/AALAS-JAALAS-18-000105","article-title":"Low-cost, small-scale decontamination of laboratory equipment by using chlorine dioxide gas","volume":"58","author":"Mitchell","year":"2019","journal-title":"J Am Assoc Lab Anim Sci"}],"container-title":["Journal of Emergencies, Trauma, and Shock"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jets.jets_103_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:56:55Z","timestamp":1786647415000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jets.jets_103_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jets.jets_103_24","relation":{},"ISSN":["0974-2700","0974-519X"],"issn-type":[{"value":"0974-2700","type":"print"},{"value":"0974-519X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2024-08-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}