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WINTER 2009  

Go EtO-Free—and Go Green—with Hydrogen Peroxide Gas Plasma Sterilization

For more than 50 years, ethylene oxide (EtO) gas has been an effective sterilization technology for heat- and moisture-sensitive medical devices and surgical instruments. While EtO is less harsh on instruments than dry heat, steam, or peracetic acid, there are, however significant disadvantages associated with its use in terms of patient and staff safety and the environment.

In particular, because EtO has been linked to cancer, its use raises concerns about employee health and safety as a result of exposure to the gas during the sterilization process, necessitating the use of personal protective equipment and exposure monitoring. In addition, long aeration times are required before instruments are safe for use on patients. As a result, since December 2008, hospitals installing new EtO sterilizers must comply with federal regulations that strictly limit the use of EtO and burden users with onerous record keeping and records storage requirements.1 In addition, EtO sterilization is associated with high levels of electricity and water usage, negatively impacting the environment and increasing costs.

STERRAD® System Solution
For hospitals considering eliminating EtO sterilization, a proven low-temperature sterilization alternative is available—the STERRAD® System from ASP. Introduced in the United States in 1993, the STERRAD System represents the largest worldwide installed base of low-temperature sterilization systems in sterile processing, with thousands of satisfied users.

The system utilizes proprietary low-temperature hydrogen peroxide gas plasma for terminal sterilization of medical devices, and has been proven to be gentler on instruments than peracetic acid and steam.2, 3 It requires only a simple plug in for electricity (it does not require any water source, plumbing, or EtO tanks and aeration systems) and produces only ordinary oxygen and water vapor as byproducts. And, because its process results in no odors, toxic residue, or hazardous emissions, it safely and effectively protects users, patients, medical instruments, and the environment.  

Conserve Resources & Save Money
Hydrogen peroxide gas plasma sterilization saves precious resources and lowers costs by reducing the amount of electricity and water used by hospitals compared with EtO systems. Typically, exhaust fans are used during the hours-long aeration process to remove heat from the aeration chamber and vent EtO gasses that emanate from the sterilized materials to an emission control system (which requires electricity) or the outside environment. Alarms and air monitors also are required and use additional electricity. As a result, switching to the hydrogen peroxide gas plasma system decreases the amount of electricity consumed.

For example, the U.S. Navy, Marines, Army, and Air Force switched from EtO to hydrogen peroxide gas plasma sterilization in order to comply with a 1999 Executive Order to “green” the environment and decrease the amount of electricity used during the sterilization process. According to a Department of Defense handbook, the annual operating cost for the hydrogen peroxide gas plasma system was half that of an EtO sterilizer, largely due to lower energy usage.4

The STERRAD® System also has been shown to reduce water use. A study by the Veterans Affairs Hospital in Portland, Ore., found that an EtO system could utilize 3.9 million gallons of water per year for cooling—more than 6 percent of the hospital’s total annual water usage. By eliminating EtO, the VA Hospital was predicted to save $9,000 annually due to reduced water usage and achieve a return on the investment in a little more than three years.5

Conclusion
Sterilization of heat- and moisture-sensitive instruments remains a fundamental imperative for healthcare providers. EtO sterilization has been a mainstay, but hospitals no longer wishing to deal with and manage the challenges associated with its use—including employee and patient safety, environmental concerns, and increased costs—increasingly turn to the STERRAD® System for fast, effective, and economic low-temperature sterilization. The environmentally friendly hydrogen peroxide gas plasma process also is a logical choice for facilities pursuing “green” purchasing policies or initiatives, or considering new construction projects, with the aim of protecting natural resources and making a measurable impact on the future of the environment. (Click here to download a report containing more information about Going Green with hydrogen peroxide gas plasma sterilization.)

Stay tuned for Go Green case studies in the Spring 2010 issue of Frontiers.

References:
1.U.S. Environmental Protection Agency.  National Emission Standards for Hospital Ethylene Oxide Sterilizers.  Vol 72; December 28, 2007.
2. Heller J. New sterilization system cuts repair costs for rigid scopes. Materials Management in Health Care. September 1996;5.
3. Jacobs P. Advances in low-temperature gas plasma sterilization technology. Infection Control and Sterilization Technology. April 1999:17–20.
4. Joint Service Pollution Prevention Opportunity Handbook.  Low-Temperature Oxidative Sterilization Methods for Sterilizing Medical Devices.  Revision Date: April 2004.
5. U.S. Department of Energy, Federal Energy Management Program. Water Efficiency Case Study—Veterans Affairs Hospital, January 3, 2007.

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