Survey of Low Temperature Gas/Vapor Sterilant Use in Healthcare

ChemDAQ was pleased to see many new and familiar faces at the recent IAHCSMM show. This show is almost exclusively attended by people who are responsible for or who work in sterile processing departments. As part of the show we asked attendees to complete a short information card in exchange for being entered into a competition to win some prizes. This survey is not a scientific random sample, but it probably shows a reasonable snap shot of low temperature chemical sterilization in the US today.

The survey asked which chemicals were used for high level disinfection and sterilization and which manufacturers equipment was used, but the survey did not ask about specific models. We had about 175 respondents and eliminated entries that did not list the chemicals and equipment, and multiple people from the same institution. There were not enough responses from outside the US to be able to draw any conclusions and so non-US facilities were also excluded.

Some of the numbers may not add up exactly because of rounding errors and because a few entrants said that they used a particular without specifying the manufacturer. These responses were included in the totals for each sterilant gas/vapor but were excluded from the statistics by manufacturer. In the end we had responses from 117 institutions. There are 5,724 hospitals in the US and so our sample represents about 2% of US hospitals.

All of the institutions in our survey did some kind of gas/vapor sterilization. Of the 117 institutions, 109 (93%) used hydrogen peroxide and 43 (37%) used ethylene oxide and 35 (30%) that used both EtO and H2O2.

Of the hydrogen peroxide users, 100 (86%) had a Sterrad (Advanced Sterilization Products (ASP)) and 32 (27%) used a Steris sterilizer. The market dominance of ASP was expected, but we were surprised at how many Steris hydrogen peroxide vapor sterilizers were in use (presumably the Steris V-Pros). The vast majority of the Steris hydrogen peroxide sterilizers (26/32 = 81%) were used along side Sterrad sterilizers; perhaps a reflection of the more recent entry of the Steris V-Pro sterilizers to the US market.

People have been claiming the demise of ethylene oxide (EtO) for several years now, in part because of the confusion between ethylene oxide and the CFC/HCFC carrier gases that were phased out under the Montreal Protocol. This survey indicates that EtO sterilization is still widely used. Out of the survey, 43 (37%) facilities are using EtO, and of these 23 (53%) and 18 (41%) use 3M and Steris sterilizers respectively. Most (39 out of 43, 91%) of the facilities that use EtO also use hydrogen peroxide, presumably because of the faster cycle times available with hydrogen peroxide sterilizers.

We hope you found the results of this survey interesting and would like to thank everyone who completed their survey cards at the IAHCSMM show. The next entry in this blog will summarize the findings for liquid sterilants and high level disinfectants.