(2011) "Association for Professionals in Infection Prevention (APIC), the Society for Healthcare Epidemiology of America (SHEA) and the Association for the Healthcare Environment (AHE) formerly ASHES, we welcome the opportunity to comment on the topic of fogging applications for disinfectants" "Other chemicals such as chlorine dioxide and ozone also have many documented safety issues that would preclude their use in healthcare facilities."

**** "ClO2 struggled to be accepted initially as a fumigant because of fears over its potential corrosiveness and toxicity. It is ***not considered a substance of concern by the ECHA, so is exempt from BPR PT2***. ClO2 fumigations are actually not corrosive, but a controlled study by the US EPA showed it can be corrosive inside functioning computers due to the heat from the CPU" "study gives this system the thumbs up in terms of its efficacy and reliability in comparison with formaldehyde against a range of tough-to-kill pathogens and spores. It is also excellent at inactivating beta-lactams" [Note: Fogging of chlorine dioxide liquid solution likely results in greater concentrations in some areas of room for at least some of the time. How much might variations in humidity throughout a room result in variations in chlorine dioxide concentrations in different areas when chlorine dioxide gas is emitted separately from any liquid?): "The other main advantages of this [hydrogen peroxide/ peracetic acid] system are that the room humidity does not need to be raised pre-fumigation, so there is little chance of the chemical pooling in cooler areas."

", solutions of ClO2 do not fog well and are prone to foaming, so gas generation is more effective and practical" " Gaseous ClO2 systems are available for fumigating laboratory rooms or suites of rooms up to 800 m3... Humidifiers and fans are used within the treated area to maintain relative humidity, typically in the 65% to 75% RH range, and to encourage uniform mixing of gas and moisture in the treated area." "All lights must be turned off in the room during decontamination as ClO2 broken down by UV light. With some commercial systems, to avoid corrosion damage, the decontamination device is placed outside the treated room and the gas piped in via a one-way valve."