Risks of Ozone Therapy
Ozone therapy is not recommended for medical use due to significant respiratory toxicity and other health risks, with limited evidence supporting its therapeutic benefits.
Health Risks of Ozone Exposure
Ozone is a toxic gas that can cause serious adverse effects when inhaled or exposed to human tissue. The risks include:
Respiratory System Effects
- At 0.1 ppm: Stimulation of upper respiratory tract and urinary tract 1
- At 1.0-2.0 ppm: Rhinitis, cough, nausea, retching, and asthma 1
- At 2-5 ppm: Breathing difficulties, bronchospasm, and retrosternal pain after 10-20 minutes of exposure 1
- At 10 ppm: Potentially fatal after 4 hours of exposure 1
- At 50 ppm: Death within minutes 1
Regulatory Safety Limits
Multiple regulatory agencies have established strict exposure limits:
- U.S. Environmental Protection Agency: 0.08 ppm for 8 hours
- Occupational Safety and Health Administration: 0.10 ppm for 8 hours
- Food and Drug Administration: 0.05 ppm for 8 hours 1
Material Damage
Ozone is highly reactive and can damage various materials:
- Rubber products: Destroys molecular chain network structure and cross-linking points, reducing tensile strength and causing aging and deformation 1
- Plastics: Causes irreversible chemical reactions with unsaturated bonds and reducing groups 1
- Medical equipment: Can potentially damage equipment and supplies through oxidation 1
Lack of Clinical Evidence
The International Working Group on the Diabetic Foot (IWGDF) strongly recommends against using ozone therapy for wound healing:
- Strong recommendation against use: "Do not use other gases (e.g. cold atmospheric plasma, ozone, nitric oxide, and CO2) in comparison to standard of care for wound healing in people with diabetes-related foot ulcers" 1
- Evidence quality: The evidence supporting ozone therapy is poor, with no studies assessed to be at low risk of bias 1
- Efficacy assessment: Both desirable and undesirable effects were rated as trivial, with the balance of effects unlikely to favor ozone over standard care 1
Practical Concerns
- Monitoring challenges: Maintaining safe ozone levels in treatment environments is difficult, especially in places with continuous air exchange 1
- Fire risk: Oxygen-enriched environments (which may be present with ozone generators) increase fire risk, as documented in cases of home oxygen therapy 1
- Regulatory status: Ozone is not included as an approved virucidal agent by either the Spanish Health Ministry or the US Environmental Protection Agency 1
Potential Applications Under Research
While not recommended for medical use in patients, ozone has been studied for specific non-medical applications:
- Surface disinfection: May be effective for disinfecting surfaces and equipment when humans are not present 1
- PPE decontamination: Some research suggests potential for disinfecting personal protective equipment, though more studies are needed 1
Key Precautions
If ozone is used for non-medical disinfection purposes:
- Ensure no humans are present during application
- Allow sufficient time for ozone levels to decrease below safety thresholds before reoccupying spaces
- Use ozone decomposition devices containing catalysts to eliminate residual ozone
- Ensure proper ventilation after use 1
Conclusion
The evidence strongly suggests that ozone therapy poses significant health risks while offering minimal proven benefits. Medical guidelines explicitly recommend against its use for therapeutic purposes, and regulatory agencies have established strict exposure limits due to its toxicity.