Cost–benefit analysis of far-UVC lamps for reducing indoor infection transmission in Switzerland and Germany: Insights from the CERN Airborne Model for Indoor Risk Assessment (CAiMIRA)
Far-UVC light (wavelengths 207–230 nm) can be used directly overhead and has germicidal capabilities to improve indoor air quality. This study evaluates the cost–benefit analysis of implementing far-UVC devices in various settings in Switzerland and Germany. To our knowledge, this is the first study to model the feasibility of direct-acting UVC light in occupied settings, diverging from the consensus on the use of upper-room germicidal UVA and UVB systems. We used the CERN Airborne Model for Indoor Risk Assessment (CAiMIRA) to model infection risk reduction in restaurants, offices, and waiting rooms, considering factors such as room size, occupancy, and ventilation rates. Three scenarios were analysed: a normal winter (22 weeks), a COVID-19-like pandemic (4-week wave), and a severe pandemic (8-week wave). Avoided infections were translated into healthcare, economic, and quality-adjusted life years (QALY) metrics. Costs included purchasing, installing, maintaining, and operating UVC lamps. In Switzerland, cost–benefit ratios ranged 30–290 during a normal winter, 65–430 during a COVID-like pandemic, and 2,300–20,500 during a severe pandemic. In Germany, cost–benefit ratios ranged 10–110 during a normal winter, 30–190 during a COVID-like pandemic, and 1,000–9,000 during a severe pandemic. Far-UVC lamps are a highly cost-effective solution for societies during normal winter and pandemic scenarios. Future studies should focus on implementation in the settings studied; they seem to represent a safe and effective measure for infectious disease control, but need real-world validation.
ACGIH. (2021). TLVs and BEIs: Based on the documentation of the threshold limit values for chemical substances and physical agents & biological exposure indices. Cincinnati: American Conference of Governmental Industrial Hygienists. Available from: https://portal.acgih.org/s/store#/store/browse/detail/a154W00000BOag7QAD [Last accessed on 2026 Feb 23].
Aziz, G., Sarwar, S., Muhammad Wasim Hussan, & Saeed, A. (2023). The importance of extended-STIRPAT in responding to the environmental footprint: Inclusion of environmental technologies and environmental taxation. Energy Strategy Reviews, 50, 101216. https://doi.org/10.1016/j.esr.2023.101216
Banholzer, N., Zurcher, K., Jent, P., Bittel, P., Furrer, L., Egger, M., Hascher, T., & Fenner, L. (2023). SARS-CoV-2 transmission with and without mask wearing or air cleaners in schools in Switzerland: A modeling study of epidemiological, environmental, and molecular data. PLOS Medicine, 20(5), e1004226. https://doi.org/10.1371/journal.pmed.1004226
Blatchley, E. R., III, Brenner, D. J., Claus, H., Cowan, T. E., Linden, K. G., Liu, Y., Mao, T., Park, S. J., Piper, P. J., Simons, R. M., & Sliney, D. H. (2022). Far UV-C radiation: An emerging tool for pandemic control. Critical Reviews in Environmental Science and Technology, 53(6), 733–753. https://doi.org/10.1080/10643389.2022.2084315
Brouwer, A. F., Eisenberg, M. C., Remais, J. V., Collender, P. A., Meza, R., & Eisenberg, J. N. (2017). Modeling biphasic environmental decay of pathogens and implications for risk analysis. Environmental Science & Technology, 51(4), 2186–2196. https://doi.org/10.1021/acs.est.6b04030
Bulfone, T. C., Malekinejad, M., Rutherford, G. W., & Razani, N. (2021). Outdoor transmission of SARS-CoV-2 and other respiratory viruses: A systematic review. The Journal of Infectious Diseases, 223(4), 550–561. https://doi.org/10.1093/infdis/jiaa742
Buonanno, M., Welch, D., Shuryak, I., & Brenner, D. J. (2020). Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses. Scientific Reports, 10(1), 10285. https://doi.org/10.1038/s41598-020-67211-2
Centers for Disease Control and Prevention. (2024). Upperroom ultraviolet germicidal irradiation (UVGI). Available from: https://www.cdc.gov/niosh/ventilation/germicidalultraviolet/index.html [Last accessed on 2026 Feb 23].
Cowling, B. J., & Aiello, A. E. (2020). Public health measures to slow community spread of coronavirus disease 2019. The Journal of Infectious Diseases, 221(11), 1749–1751. https://doi.org/10.1093/infdis/jiaa123
Destatis. (2024). Time use. Weisbaden: Federal Statistic Office of Germany. Available from: https://www.destatis.de/EN/Themes/Society-Environment/Income-Consumption-Living-Conditions/Time-Use/_node.html [Last accessed on 2026 Feb 23].
Dimitroulopoulou, C., & Bartzis, J. (2013). Ventilation rates in European office buildings: A review. Indoor and Built Environment, 23(1), 5–25. https://doi.org/10.1177/1420326x13481786
Dubey, S., Rohra, H., & Taneja, A. (2021). Assessing effectiveness of air purifiers (HEPA) for controlling indoor particulate pollution. Heliyon, 7(9), e07976. https://doi.org/10.1016/j.heliyon.2021.e07976
Eadie, E., Hiwar, W., Fletcher, L., Tidswell, E., O’Mahoney, P., Buonanno, M., Welch, D., Adamson, C. S., Brenner, D. J., Noakes, C., & Wood, K. (2022). Far-UVC (222 nm) efficiently inactivates an airborne pathogen in a room-sized chamber. Scientific Reports, 12(1), 4373. https://doi.org/10.1038/s41598-022-08462-z
Environmental Health & Safety. (n.d.). Ultraviolet (UV) radiationsafety. Available from: https://www.unr.edu/ehs/programareas/radiation-safety/ultraviolet [Last accessed on 2026 Feb 23].
European Commission: Directorate-General for Employment. (2011). Non-binding guide to good practice for implementing Directive 2006/25/EC “Artificial optical radiation.” Luxembourg: Publications Office of the European Union. Available from: https://www.hsa.ie/media/3w5iwrnw/eu-guide_artificial-optical-radiation.pdf [Last accessed on 2026 Feb 23].
European Parliament. (2008). Consolidated text: Directive 2008/50/EC of the European Parliament and of the Council of 21 May 2008 on ambient air quality and cleaner air for Europe. Luxembourg: Publications Office of the European Union. Available from: https://eur-lex.europa.eu/legalcontent/en/ALL/?uri=CELEX%3A32008L0050 [Last accessed on 2026 Feb 23].
Fadlallah, R., El‐Jardali, F., Karroum, L. B., Kalach, N., Hoteit, R., Aoun, A., Al‐Hakim, L., Verdugo‐Paiva, F., Rada, G., Fretheim, A., Lewin, S., Ludolph, R., & Akl, E. A. (2024). The effects of public health and social measures (PHSM) implemented during the COVID-19 pandemic: An overview of systematic reviews. Cochrane Evidence Synthesis Methods, 2(5), e12055. https://doi.org/10.1002/cesm.12055
Far UV Technologies. (2021). ACGIH increases Threshold Limit Values - Far UV Technologies. Available from: https://faruv.com/acgih-increases-threshold-limit-values/ [Last accessed on 2026 Feb 23].
Federal Statistical Office. (2024). Absences. Neuchatel: Federal Statistical Office. Available from: https://www.bfs.admin.ch/bfs/en/home/statistics/work-income/employmentworking-hours/working-hours/absences.html [Last accessed on 2026 Feb 23].
Graeffe, F., Luo, Y., Guo, Y., & Ehn, M. (2023). Unwanted indoor air quality effects from using ultraviolet C lamps for disinfection. Environmental Science & Technology Letters, 10(2), 172–178. https://doi.org/10.1021/acs.estlett.2c00807
Henriques, A., Mounet, N., Aleixo, L., Elson, P., Devine, J., Azzopardi, G., Andreini, M., Rognlien, M., Tarocco, N., & Tang, J. (2022). Modelling airborne transmission of SARS-CoV-2 using CARA: Risk assessment for enclosed spaces. Interface Focus, 12(2). https://doi.org/10.1098/rsfs.2021.0076
Hessling, M., Haag, R., Sieber, N., & Vatter, P. (2021). The impact of far-UVC radiation (200-230 nm) on pathogens, cells, skin, and eyes - A collection and analysis of a hundred years of data. GMS Hygiene and Infection Control, 16, Doc07. https://doi.org/10.3205/dgkh000378
International Commission on Non-Ionizing Radiation Protection (ICNIRP). (2004). Guidelines on limits of exposure to ultraviolet radiation of wavelengths between 180 nm and 400 nm (incoherent optical radiation). Health Physics, 87(2), 171–186. https://doi.org/10.1097/00004032-200408000-00006
Jefferson, T., Del Mar, C. B., Dooley, L., et al. (2020). Physical interventions to interrupt or reduce the spread of respiratory viruses. The Cochrane Database of Systematic Reviews, 2020(11). https://doi.org/10.1002/14651858.CD006207.pub5
Kaltenhauser, B. (2025). Factors influencing the acceptance of the measures for the containment of COVID-19. Journal of Public Health, 33(4), 757–767. https://doi.org/10.1007/s10389-023-02047-4
Kinner, S. A., Young, J. T., Snow, K., Southalan, L., Lopez-Acuna, D., Ferreira-Borges, C., & O’Moore, E. (2020). Prisons and custodial settings are part of a comprehensive response to COVID-19. The Lancet Public Health, 5(4), e188–e189. https://doi.org/10.1016/S2468-2667(20)30058-X
Li, Y., Leung, G. M., Tang, J. W., Yang, X., Chao, C. Y. H., Lin, J. Z., Lu, J. W., Nielsen, P. V., Niu, J., Qian, H., Sleigh, A. C., Su, H.-J. J., Sundell, J., Wong, T. W., & Yuen, P. L. (2007). Role of ventilation in airborne transmission of infectious agents in the built environment - A multidisciplinary systematic review. Indoor Air, 17(1), 2–18. https://doi.org/10.1111/j.1600-0668.2006.00445.x
Link, M. F., Shore, A., Hamadani, B. H., & Poppendieck, D. (2023). Ozone generation from a germicidal ultraviolet lamp with peak emission at 222 nm. Environmental Science & Technology Letters, 10(8), 675–679. https://doi.org/10.1021/acs.estlett.3c00318
Ma, B., Linden, Y. S., Gundy, P. M., Gerba, C. P., Sobsey, M. D., & Linden, K. G. (2021). Inactivation of coronaviruses and phage Phi6 from irradiation across UVC wavelengths. Environmental Science & Technology Letters, 8(5), 425–430. https://doi.org/10.1021/acs.estlett.1c00178
Mahon, M. B., Sack, A., Aleuy, O. A., et al. (2024). A meta-analysis on global change drivers and the risk of infectious disease. Nature, 629(8013), 830–836. https://doi.org/10.1038/s41586-024-07380-6
Maverakis, E., Miyamura, Y., Bowen, M. P., Correa, G., Ono, Y., & Goodarzi, H. (2010). Light, including ultraviolet. Journal of Autoimmunity, 34(3), J247–J257. https://doi.org/10.1016/j.jaut.2009.11.011
Mossong, J., Hens, N., Jit, M., Beutels, P., Auranen, K., Mikolajczyk, R., Massari, M., Salmaso, S., Tomba, G. S., Wallinga, J., Heijne, J., Sadkowska-Todys, M., Rosinska, M., & Edmunds, W. J. (2008). Social contacts and mixing patterns relevant to the spread of infectious diseases. PLOS Medicine, 5(3), e74. https://doi.org/10.1371/journal.pmed.0050074
Naito, K., Sawadaishi, K., & Kawasaki, M. (2022). Photo-biochemical mechanisms of biomolecules relevant to germicidal ultraviolet irradiation at 222 and 254 nm. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-22969-5
Panje, C. M., Lupatsch, J. E., Barbier, M., Pardo, E., Lorez, M., Dedes, K. J., Aebersold, D. M., Plasswilm, L., Gautschi, O., & Schwenkglenks, M. (2020). A cost-effectiveness analysis of consolidation immunotherapy with durvalumab in stage III NSCLC responding to definitive radio-chemotherapy in Switzerland. Annals of Oncology, 31(4), 501–506. https://doi.org/10.1016/j.annonc.2020.01.007
Park, S., & Rim, D. (2024). Human exposure to air contaminants under the far-UVC system operation in an office: Effects of lamp position and ventilation condition. Scientific Reports, 14(1). https://doi.org/10.1038/s41598-024-75245-z
Park, S., Mistrick, R., & Rim, D. (2022). Performance of upper-room ultraviolet germicidal irradiation (UVGI) system in learning environments: Effects of ventilation rate, UV fluence rate, and UV radiating volume. Sustainable Cities and Society, 85, 104048. https://doi.org/10.1016/j.scs.2022.104048
Patra, V., Gallais Serezal, I., & Wolf, P. (2020). Potential of skin microbiome, pro- and/or pre-biotics to affect local cutaneous responses to UV exposure. Nutrients, 12(6), 1795. https://doi.org/10.3390/nu12061795
Pavic, M., Pfeil, A. M., & Szucs, T. D. (2014). Estimating the potential annual welfare impact of innovative drugs in use in Switzerland. Frontiers in Public Health, 2, 48. https://doi.org/10.3389/fpubh.2014.00048
Pearce, L. A., Vaisey, A., Keen, C., Calais-Ferreira, L., Foulds, J. A., Young, J. T., Southalan, L., Borschmann, R., Gray, R., Sturup-Toft, S., & Kinner, S. A. (2021). A rapid review of early guidance to prevent and control COVID-19 in custodial settings. Health & Justice, 9(1), 27. https://doi.org/10.1186/s40352-021-00150-w
Peng, Z., Day, D. A., Symonds, G. A., Jenks, O. J., Stark, H., Handschy, A. V., de Gouw, J. A., & Jimenez, J. L. (2023). Significant production of ozone from germicidal UV lights at 222 nm. Environmental Science & Technology Letters, 10(8), 668–674. https://doi.org/10.1021/acs.estlett.3c00314
Piret, J., & Boivin, G. (2021). Pandemics throughout history. Frontiers in Microbiology, 11, 631736. https://doi.org/10.3389/fmicb.2020.631736
Reed, N. G. (2010). The history of ultraviolet germicidal irradiation for air disinfection. Public Health Reports, 125(1), 15–27. https://doi.org/10.1177/003335491012500105
Robert Koch Institute. (2021). Daily situation report of the Robert Koch Institute, week 26, 2021. Berlin: Robert Koch Institut. Available from: https://www.rki.de/DE/Themen/Infektionskrankheiten/Infektionskrankheiten-A-Z/C/ COVID-19-Pandemie/Situationsberichte/Jul_2021/2021-07-01-en.pdf?__blob=publicationFile&v=1 [Last accessed on 2026 Mar 28].
Robert Koch Institute. (2023a). COVID-19 cases by reporting week and gender as well as proportions with symptoms relevant to COVID-19, proportions of hospitalized/deceased and mean/median age. Berlin: Robert Koch Institut. Available from: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Daten/Klinische_Aspekte.html [Last accessed on 2026 Mar 28].
Robert Koch Institute. (2023b). RKI - GrippeWeb. Berlin: Robert Koch Institut. Available from: https://www.rki.de/DE/Themen/Forschung-und-Forschungsdaten/Sentinels-Surveillance-Panel/GrippeWeb/grippeweb-node.html [Last accessed on 2026 Mar 28].
Robert Koch Institute. (2026). Epidemiological profile of SARS-CoV-2 and COVID-19. Berlin: Robert Koch Institut. Available from: https://www.rki.de/DE/Themen/Infektionskrankheiten/Infektionskrankheiten-A-Z/C/COVID-19/covid-19-node.html [Last accessed on 2026 Feb 23].
Sachs, J. D., Karim, S. S. A., Aknin, L., et al. (2022). The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet, 400(10359), 1224–1280. https://doi.org/10.1016/S0140-6736(22)01585-9
Saravanan, N. P. (2004). Indoor air pollution. Resonance, 9(1), 6–11. https://doi.org/10.1007/bf02902524
Simoni, M., Jaakkola, M. S., Carrozzi, L., Baldacci, S., Di Pede, F., & Viegi, G. (2003). Indoor air pollution and respiratory health in the elderly. European Respiratory Journal, 21(40), 15s–20s. https://doi.org/10.1183/09031936.03.00403603
Sliney, D. H., & Stuck, B. E. (2021). A need to revise human exposure limits for ultraviolet UV-C radiation. Photochemistry and Photobiology, 97(3), 485–492. https://doi.org/10.1111/php.13402
Swiss National Covid-19 Science Taskforce. (2021). Why far-reaching health policy measures are sensible from a macroeconomic perspective in the current situation. Available from: https://sciencetaskforce.ch/policy-brief/warum-aus-gesamtwirtschaftlicher-sichtweitgehende-gesundheitspolitische-massnahmen-in-deraktuellen-lage-sinnvoll-sind/ [Last accessed on 2026 Feb 23].
Truong, C. S., Muthukutty, P., Jang, H. K., Kim, Y. H., Lee, D. H., & Yoo, S. Y. (2023). Filter-free, harmless, and single-wavelength far UV-C germicidal light for reducing airborne pathogenic viral infection. Viruses, 15(7), 1463. https://doi.org/10.3390/v15071463
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2009). Environmental control for tuberculosis: Basic upper-room ultraviolet germicidal irradiation guidelines for healthcare settings. https://doi.org/10.26616/nioshpub2009105
Vijayan, V. K., Paramesh, H., Salvi, S. S., & Dalal, A. A. (2015). Enhancing indoor air quality - The air filter advantage. Lung India, 32(5), 473–479. https://doi.org/10.4103/0970-2113.164174
Welch, D., Aquino de Muro, M., Buonanno, M., & Brenner, D. J. (2022). Wavelength-dependent DNA photodamage in a 3-D human skin model over the far-UVC and germicidal UVC wavelength ranges from 215 to 255 nm. Photochemistry and Photobiology, 98(5), 1167–1171. https://doi.org/10.1111/php.13602
Welch, D., Buonanno, M., Grilj, V., et al. (2018). Far-UVC light: A new tool to control the spread of airborne-mediated microbial diseases. Scientific Reports, 8(1). https://doi.org/10.1038/s41598-018-21058-w
Wigginton, K. R., Pecson, B. M., Sigstam, T., Bosshard, F., & Kohn, T. (2012). Virus inactivation mechanisms: Impact of disinfectants on virus function and structural integrity. Environmental Science & Technology, 46(21), 12069–12078. https://doi.org/10.1021/es3029473
World Health Organization. (2024). Indoor airborne risk assessment in the context of SARS-CoV-2: Description of airborne transmission mechanism and method to develop a new standardized model for risk assessment. WHO. Available from: https://www.who.int/publications/b/73437 [Last accessed on 2026 Apr 01].
Yamano, N., Kunisada, M., Kaidzu, S., Sugihara, K., Nishiaki‐Sawada, A., Ohashi, H., Yoshioka, A., Igarashi, T., Ohira, A., Tanito, M., & Nishigori, C. (2020). Long-term effects of 222-nm ultraviolet radiation C sterilizing lamps on mice susceptible to ultraviolet radiation. Photochemistry and Photobiology, 96(4), 853–862. https://doi.org/10.1111/php.13269
