Bioterrorism is an area of increasing public health concern. The intent of this article is to review the air cleansing technologies available to protect building occupants from the intentional release of bioterror agents into congregate spaces (such as offices, schools, auditoriums, and transportation centers), as well as through outside air intakes and by way of recirculation air ducts. Current available technologies include increased ventilation, filtration, and ultraviolet germicidal irradiation (UVGI) UVGI is a common tool in laboratories and health care facilities, but is not familiar to the public, or to some heating, ventilation, and air conditioning engineers. Interest in UVGI is increasing as concern about a possible malicious release of bioterror agents mounts. Recent applications of UVGI have focused on control of tuberculosis transmission, but a wide range of airborne respiratory pathogens are susceptible to deactivation by UVGI. In this article, the authors provide an overview of air disinfection technologies, and an in-depth analysis of UVGI-its history, applications, and effectiveness.

These findings demonstrate that careful application of upper-room UVGI can be achieved without an apparent increase in the incidence of the most common side effects of accidental UV overexposure.

The Chelsea‐Village Program (CVP) is a long‐term home healthcare program for a largely isolated and impoverished frail homebound aged population, based at Saint Vincent's Hospital in New York City. Since January 1973, our CVP teams of physicians, nurses, and social workers have cared for the homebound aged over the long term. Twenty‐seven years later, we have made 42,866 home visits to 2264 persons in lower Manhattan, an area of New York City housing a high concentration of older people. Our purpose is to help our patients remain in their own homes and community at the maximum possible level of personal control and to maintain the best attainable health. Additionally, the program is a valuable component of the Hospital's Primary Care Adult Medicine residency program. It also serves as a laboratory for the study of health problems faced by the homebound aged and the solutions to these problems. The program, a medical‐social model, has required modest philanthropic investments, dedicated service by physicians, nurses, and social workers, and the support of a hospital with a strong charitable mission. The CVP experience has encouraged the creation of other long‐term home healthcare programs across the country, including the Medicaid‐supported Nursing Home Without Walls program that spans New York State. Thus, the CVP can be viewed as a model rather than an idiosyncratic non‐replicable phenomenon. As such, the program has established that multidisciplinary healthcare teams, in collaboration with a teaching hospital, can provide long‐term home health care to homebound older people in the local community. Moreover such a practice is mutually beneficial. J Am Geriatr Soc 48:1002–1011, 2000.

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SYNOPSISBioterrorism is an area of increasing public health concern. The intent of this article is to review the air cleansing technologies available to protect building occupants from the intentional release of bioterror agents into congregate spaces (such as offices, schools, auditoriums, and transportation centers), as well as through outside air intakes and by way of recirculation air ducts. Current available technologies include increased ventilation, filtration, and ultraviolet germicidal irradiation (UVGI)UVGI is a common tool in laboratories and health care facilities, but is not familiar to the public, or to some heating, ventilation, and air conditioning engineers. Interest in UVGI is increasing as concern about a possible malicious release of bioterror agents mounts. Recent applications of UVGI have focused on control of tuberculosis transmission, but a wide range of airborne respiratory pathogens are susceptible to deactivation by UVGI. In this article, the authors provide an overview of air disinfection technologies, and an in-depth analysis of UVGI-its history, applications, and effectiveness.

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Health care is generally unavailable for the homeless. This heterogeneous group of men and women, including long-term street dwellers, residents of shelters, the chronically mentally ill, the economically debased, and alienated youth, are subject to a broad range of acute and chronic diseases, intensified by unsuitable living conditions, stress, and sociopathic behavior. Trauma, pulmonary tuberculosis, infestations, and peripheral vascular disease are common problems among the homeless; incomplete and fragmentary medical care permits exacerbation of chronic disorders. Outreach programs imaginatively constructed by teams of physicians, nurses, and social workers can effectively reestablish and maintain health services for these disenfranchised persons.

We conducted a retrospective study to examine trends in latent tuberculosis infection (LTBI) and TB disease rates among homeless persons in shelters in New York, NY, 1992–2006. Although TB case rates fell from 1,502/100,000 population to 0, a 31% LTBI rate in 2006 shows the value of identifying and treating TB in the homeless.