1. Controlling HAIs in Healthcare Settings I NNOVATIVE P RODUCTS FOR H EALTHIER L IVING 575 Wentworth Street East, Unit 21, Oshawa, ON L1H 3V8 Telephone #: 905-723-9600/1-866-594-3648 Fax: 905-723-9610 www.marsbiomed.com

2.  Hand hygiene  Respiratory hygiene  Personal protective equipment  Appropriate use of antibiotics  Reprocessing of reusable devices  Sterilization of reusable instruments and devices  High level disinfection of reusable instruments and devices  Environmental cleaning CDC. HAIs: Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care. July 2011. Available at http://www.cdc.gov/HAI/settings/outpatient/checklist/outpatient-care-checklist-observations.html. Reducing Incidence of HAIs

3. How Can M.A.R.S. Help? Reduce the incidence of HAIs Improve infection control score Limit cross-contamination by airborne pathogens Reduce readmission rates, specifically those related to HAIs Reduce costs Reduce treatment time and resources dedicated to HAIs Reduce hospital staff sick leave Improve patient perception of TUHS Improve staff satisfaction with work environment

4. Air Sterilization Unit  Silent  Portable  Powerful  Sustainable  Clinically Proven tm

5. Controlling the airborne transmission of MRSA using UV light Peder Bo Nielsen MD MRCPath MSc DLSHTM DipHIC Consultant Microbiologist Northwick Park Hospital London, UK MEDIXAIR Clinical Trial Proof of Performance

6. Goal: “intervene” in the environmental transmission cycle of MRSA Method Select 2 identical general medical ward rooms o Test room o Control room Both wards o MRSA hot-spots o Identical cleaning regimes At start, patients not colonized or infected with MRSA Swabs taken 3 times per week o From patients: groin, nose, axilla o In rooms : floor, curtains, bedrails, monitor screens, etc Duration: 3 months MEDIXAIR Clinical Trial Proof of Performance Nielsen PB. Northwick Park Hospital clinical study. Presented at the 8 th Congress of the International Federation of Infection Control, Oct 2008

7. Curtain 9% Bed 9% Floor 26% Light 9% UV ROOM W/MEDIXAIR Curtain 22% Bed 61% Floor 74% Light 30% CONTROL ROOM CONTROL ROOM Patient 47% Patient 0% Swab Test for MRSA: % Positive Results MEDIXAIR Clinical Trial Proof of Performance Nielsen PB. Northwick Park Hospital clinical study. Presented at the 8 th Congress of the International Federation of Infection Control, Oct 2008

8. Curtain 22% Bed 61% Floor 74% Light 30% Curtain 9% Bed 9% Floor 26% Light 9% UV ROOM W/MEDIXAIR CONTROL ROOM CONTROL ROOM Patient 47% Patient 0% Statistically significant evidence of environmental decontamination MEDIXAIR Clinical Trial Proof of Performance

9. 1.MRSA and other pathogens are present in the aerobiological environment 2.Pathogens collect in “hot-spots” 3.There is a correlation between these hot-spots of environmental contamination and the colonization of patients 4.For MRSA specifically, there is a correlation between the number of colonized patients and those who develop blood stream infections and ultimate mortality 5.Intervention in this cycle of transmission shows statistically significant and positive results Conclusions from the Northwick Park Hospital trial: MEDIXAIR Clinical Trial Proof of Performance The principles of the trial also apply for all traditional respiratory airborne infections: influenza, mumps, measles, and the common cold Nielsen PB. Northwick Park Hospital clinical study. Presented at the 8 th Congress of the International Federation of Infection Control, Oct 2008

10. 200620072008 Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2 Q3 All Hospital Wards7679844762936438444950 Acute Trauma Ward664081241100 Beginning in July 2007, ten Medixair units were placed in the trauma ward, one in each side room and one in each bay During the study period, the hospital had an active protocol against CDI The protocol for the trauma ward was not distinct from the rest of the hospital except for the installation of the air sterilization units Clostridium difficile Aerobiology and nosocomial transmission Reduction in all wards 33% Reduction in acute trauma ward 80% Nielsen PB. Northwick Park Hospital clinical study. Presented at the 32 nd National Congress of Indian Association of Medical Microbiologist Oct 2008 MEDIXAIR Clinical Trial Proof of Performance

11. Clostridium difficile - surveillance data 2006 - 2008 MEDIXAIR Clinical Trial Proof of Performance Nielsen PB. Northwick Park Hospital clinical study. Presented at the 32 nd National Congress of Indian Association of Medical Microbiologist Oct 2008

12. MEDIXAIR In Vitro Testing Proof of Performance UVc Power Level Antimicrobial performance. Data on file, Medixair

13. MEDIXAIR In Vitro Testing Proof of Performance UVc Power Level Antimicrobial performance. Data on file, Medixair

14. MEDIXAIR In Vitro Testing Proof of Performance UVc Power Level Antimicrobial performance. Data on file, Medixair

15. Traditional Definition of Airborne Infection  Airborne infection: contagious and/or respiratory infections transmitted predominantly by aerosoles from already infected persons o e.g, chicken pox, mumps, measles, the common cold, and influenza New Definition  Pathogens can remain viable in dry dust o e.g, staphylococcus aureus, spores of clostridia, bacilli, and viruses  These pathogens can be easily distributed into the air by staff activities (e.g., bed making) and other vectors of air movement (e.g., air conditioning) Schael KP. J Hosp Infect. 1991;18 Suppl A:451-9. Medical and microbiological problems arising from airborne infection in hospitals. Airborne Infection and HAI

16.  Hard and soft surface disinfection  Hard and soft surface sterilization  Disinfection of reusable instruments and devices  Sterilization of reusable instruments and devices  Air disinfection  Air sterilization Reducing Incidence of HAIs

17. UVc Light: Key Properties UV light does not propagate well through the air Distance from UVc Souce (cm) UVc Power Level Within 5 cm (2 inches) of the source, >70% of the power has dissipated Data on file, Medixair

18. 50 mm / 2 inches 14,400 mW/cm 2 3,750mW/cm 2 UVc Light: Key Properties Power Dissipation Data on file, Medixair

19. Patented Technology

20. 4 x 3,750mW/cm 2 = 15,000mW/cm 2 4 tubes built into an array - each tube reinforces the power from its neighbors Result: produce a power distribution of sufficient intensity to provide the basis for UVGI – Ultra Violet Germicidal Irradiation Overlap UVc Lights Overlapping Power Configuration of MEDIXAIR Units Data on file, Medixair

21. 15,000W cm -2 Minimum Power = 15,000 mW /cm 2 + plus reflectance Aluminium reflector box increases energy generated Power Reflectance Configuration of MEDIXAIR Units Data on file, Medixair

22.  Brandenburg UK Ltd. Power distribution in cross section providing a high level of usable power Cross section through the unit Configuration of MEDIXAIR Units Data on file, Medixair

23. x airspeed = 0.3m /sec fanfan 1.Traditionally air is blown air across the tubes….. 2.This does not allow sufficient exposure time for the bacteria to be killed 3.In Medixair a fan draws the air up the length of the tubes thus maximizing the exposure 4.Medixair has A controlled airspeed 5… a fixed tube length 6.Therefore a residence time inside the unit of 7.Thus when combined with the power of 8.Medixair has minimum energy of L = 450mm t = 1.5seconds = 15,000mW/cm 2 = 15,000mW/cm 2 22,500mW/cm 2 Data on file Medixair

24. tm FAN FOUR 254nm UVc emitters in an array Slow speed fan to create maximum exposure to the UV Enclosed reflective aluminium chamber Design Principles 22,500 µW/cm 2 Kills viruses and bacteria

25. Product Features Mobile or wall mount Ease of use Portable – instant isolation wards Producing 25m 3 of sterile air per hour Ease of service – lamp/filter change Whisper quiet <33dB Safety approved and CE marked tm Sustainable Infection Control

26. Kills 99.999% of all viruses and bacteria No ozone generation No UVC exposure Safe for use in close proximity to patients and healthcare workers Continuous and sustainable infection control Ease of installation, low maintenance Quiet (<33 dB) Highly portable and compact Benefits of MEDIXAIR Units

27. How Can M.A.R.S. Help? Reduce the incidence of HAIs Improve infection control score Limit cross-contamination by airborne pathogens Reduce readmission rates, specifically those related to HAIs Reduce costs Reduce treatment time and resources dedicated to HAIs Reduce hospital staff sick leave Improve patient perception of TUHS Improve staff satisfaction with work environment

28. 575 Wentworth Street East, Unit 21 Oshawa, ON L1H 3V8 1-866-594-3648 info@marsbiomed.com M.A.R.S. I NNOVATIVE P RODUCTS FOR H EALTHIER L IVING