This is the next article in our ‘Light and health’ series, where we look at how light affects our physical and mental health in sometimes surprising ways. Read other articles in the series.

You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals.

You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging.

Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease.

1. On-the-spot tests

Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis.

The “flashlight” your GP uses to view the inside of your eye (known as an ophthalmoscope) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be causing your headaches.

The invention of lasers and LEDs has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab.

Pulse oximetry is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by measuring the different responses of oxygenated and de-oxygenated blood to different colours of light.

Pulse oximetry is used at hospitals (and sometimes at home) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting heart defects in babies.

2. Looking at molecules

Now, back to that blood test. Analysing a small amount of your blood can diagnose many different diseases.

A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a snapshot of your overall health.

For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present.

These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a spectrometer can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels.

3. Medical imaging

Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging.

A common example is an endoscope, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts.

Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during laparoscopic surgery (also known as keyhole surgery) to diagnose and treat disease.

How about the future?

Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include:

• nanomaterials (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests
• wearable optical biosensors the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time
• AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a comprehensive database of scatter patterns to detect any cancer
• a type of non-invasive imaging called optical coherence tomography for more detailed imaging of the eye, heart and skin
• fibre optic technology to deliver a tiny microscope into the body on the tip of a needle.

So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.

Matthew Griffith, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Have you ever wondered why most disinfectants indicate they kill 99.9% or 99.99% of germs, but never promise to wipe out all of them? Perhaps the thought has crossed your mind mid-way through cleaning your kitchen or bathroom.

Surely, in a world where science is able to do all sorts of amazing things, someone would have invented a disinfectant that is 100% effective?

The answer to this conundrum requires understanding a bit of microbiology and a bit of mathematics.

What is a disinfectant?

A disinfectant is a substance used to kill or inactivate bacteria, viruses and other microbes on inanimate objects.

There are literally millions of microbes on surfaces and objects in our domestic environment. While most microbes are not harmful (and some are even good for us) a small proportion can make us sick.

Although disinfection can include physical interventions such as heat treatment or the use of UV light, typically when we think of disinfectants we are referring to the use of chemicals to kill microbes on surfaces or objects.

Chemical disinfectants often contain active ingredients such as alcohols, chlorine compounds and hydrogen peroxide which can target vital components of different microbes to kill them.

The maths of microbial elimination

In the past few years we’ve all become familiar with the concept of exponential growth in the context of the spread of COVID cases.

This is where numbers grow at an ever-accelerating rate, which can lead to an explosion in the size of something very quickly. For example, if a colony of 100 bacteria doubles every hour, in 24 hours’ time the population of bacteria would be more than 1.5 billion.

Conversely, the killing or inactivating of microbes follows a logarithmic decay pattern, which is essentially the opposite of exponential growth. Here, while the number of microbes decreases over time, the rate of death becomes slower as the number of microbes becomes smaller.

For example, if a particular disinfectant kills 90% of bacteria every minute, after one minute, only 10% of the original bacteria will remain. After the next minute, 10% of that remaining 10% (or 1% of the original amount) will remain, and so on.

Because of this logarithmic decay pattern, it’s not possible to ever claim you can kill 100% of any microbial population. You can only ever scientifically say that you are able to reduce the microbial load by a proportion of the initial population. This is why most disinfectants sold for domestic use indicate they kill 99.9% of germs.

Other products such as hand sanitisers and disinfectant wipes, which also often purport to kill 99.9% of germs, follow the same principle.

Real-world implications

As with a lot of science, things get a bit more complicated in the real world than they are in the laboratory. There are a number of other factors to consider when assessing how well a disinfectant is likely to remove microbes from a surface.

One of these factors is the size of the initial microbial population that you’re trying to get rid of. That is, the more contaminated a surface is, the harder the disinfectant needs to work to eliminate the microbes.

If for example you were to start off with only 100 microbes on a surface or object, and you removed 99.9% of these using a disinfectant, you could have a lot of confidence that you have effectively removed all the microbes from that surface or object (called sterilisation).

In contrast, if you have a large initial microbial population of hundreds of millions or billions of microbes contaminating a surface, even reducing the microbial load by 99.9% may still mean there are potentially millions of microbes remaining on the surface.

Time is is a key factor that determines how effectively microbes are killed. So exposing a highly contaminated surface to disinfectant for a longer period is one way to ensure you kill more of the microbial population.

This is why if you look closely at the labels of many common household disinfectants, they will often suggest that to disinfect you should apply the product then wait a specified time before wiping clean. So always consult the label on the product you’re using.

Other factors such as temperature, humidity and the type of surface also influence how well a disinfectant works outside the lab.

Similarly, microbes in the real world may be either more or less sensitive to disinfection than those used for testing in the lab.

Disinfectants are one part infection control

The sensible use of disinfectants plays an important role in our daily lives in reducing our exposure to pathogens (microbes that cause illness). They can therefore reduce our chances of getting sick.

The fact disinfectants can’t be shown to be 100% effective from a scientific perspective in no way detracts from their importance in infection control. But their use should always be complemented by other infection control practices, such as hand washing, to reduce the risk of infection.

Hassan Vally, Associate Professor, Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.