The Myths of Sterilant Gas Safety Exposed

Sterilization is of vital importance in healthcare and while steam and heat provide reliable service for the majority of medical supplies, chemical sterilants and especially gas sterilants are the main methods used for those medical devices and supplies which are heat and moisture-sensitive. Below are some commonly perceived myths that you and your Sterilization Department should be aware of.

Myth 1: Hydrogen peroxide and ozone are much safer than EtO.
Sterilant chemicals are designed to kill all life, whether within or without the sterilizer and therefore chemicals that are used in a sterilizer will cause harm to humans who are exposed to them.

Myth 2: There are no OSHA regulations for hydrogen peroxide or ozone.
Many people believe incorrectly that there are no regulations for hydrogen peroxide or ozone.  In 1970 Congress passed the Occupational Health and Safety Act which, among other things, created OSHA, authorized it to promulgate workplace safety regulations, and imposed a legal duty on employers to provide a safe workplace.

Myth 3: Sterilizers never leak.
While everyone may wish this myth were true, unfortunately the evidence suggests it is not. Again, the simplest approach is to consider the overall risk as comprising the harm caused by failure and the risk of the failure.

Myth 4: Hydrogen peroxide is as safe as mouthwash.
Many people have small brown bottles of 3 percent hydrogen peroxide in their bathrooms and some brave souls even use it for mouthwash. While the hydrogen peroxide in the brown bottles is chemically the same as is used in sterilization, the key difference is concentration. Concentration is the most critical factor in toxicology.  For comparison, the stock solutions for the Sterrad hydrogen peroxide gas plasma 100S sterilizers is nominally 59 percent and the Sterrad NX internally concentrates the solution to around 90 percent to increase its sterilization efficacy. If three percent hydrogen peroxide were used instead, it would not be effective. The hydrogen peroxide used in a medical sterilizer is not mouthwash.

Myth 5: If a sterilant is good for the environment, it must be safe for me.
This high reactivity means that hydrogen peroxide and ozone do not last long in the environment and so they are generally not considered to be environmentally harmful. Therefore the aggressiveness of ozone and hydrogen peroxide make them efficient sterilants, and severe irritants to anyone exposed, but they are both very environmentally friendly materials. Environmental safety is not the same as personal safety.

Myth 6: Small ozone leaks are OK because ozone freshens the air.
Ozone is as strong oxidant and will destroy many odor causing chemicals and serves as a commercial disinfectant in for example water supplies, but these applications only use ozone under conditions where personal exposure is avoided. The same strongly oxidizing properties of ozone that make it useful as a bleaching agent and sterilant, make ozone hazardous to human health.

Myth 7: I don’t need a sterilant gas monitor because I will smell the gas if it leaks.
Odor cannot be used to detect the presence of ethylene oxide leaks unless they far exceed the OSHA PEL. For hydrogen peroxide, there is no published odor threshold, and even 100 percent hydrogen peroxide is reported to have almost no odor.

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