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Sterilization () refers to any process that removes, kills, or deactivates all forms of
life Life, also known as biota, refers to matter that has biological processes, such as Cell signaling, signaling and self-sustaining processes. It is defined descriptively by the capacity for homeostasis, Structure#Biological, organisation, met ...
(particularly
microorganism A microorganism, or microbe, is an organism of microscopic scale, microscopic size, which may exist in its unicellular organism, single-celled form or as a Colony (biology)#Microbial colonies, colony of cells. The possible existence of unseen ...
s such as
fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
,
bacteria Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one Cell (biology), biological cell. They constitute a large domain (biology), domain of Prokaryote, prokaryotic microorganisms. Typically a few micr ...
,
spore In biology, a spore is a unit of sexual reproduction, sexual (in fungi) or asexual reproduction that may be adapted for biological dispersal, dispersal and for survival, often for extended periods of time, in unfavourable conditions. Spores fo ...
s, and
unicellular A unicellular organism, also known as a single-celled organism, is an organism that consists of a single cell, unlike a multicellular organism that consists of multiple cells. Organisms fall into two general categories: prokaryotic organisms and ...
eukaryotic The eukaryotes ( ) constitute the Domain (biology), domain of Eukaryota or Eukarya, organisms whose Cell (biology), cells have a membrane-bound cell nucleus, nucleus. All animals, plants, Fungus, fungi, seaweeds, and many unicellular organisms ...
organisms) and other
biological agent Biological agents, also known as biological weapons or bioweapons, are pathogens used as weapons. In addition to these living or replicating pathogens, toxins and Toxin#Biotoxins, biotoxins are also included among the bio-agents. More than 1,2 ...
s (such as
prion A prion () is a Proteinopathy, misfolded protein that induces misfolding in normal variants of the same protein, leading to cellular death. Prions are responsible for prion diseases, known as transmissible spongiform encephalopathy (TSEs), w ...
s or
virus A virus is a submicroscopic infectious agent that replicates only inside the living Cell (biology), cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are ...
es) present in fluid or on a specific surface or object. Sterilization can be achieved through various means, including
heat In thermodynamics, heat is energy in transfer between a thermodynamic system and its surroundings by such mechanisms as thermal conduction, electromagnetic radiation, and friction, which are microscopic in nature, involving sub-atomic, ato ...
,
chemical A chemical substance is a unique form of matter with constant chemical composition and characteristic properties. Chemical substances may take the form of a single element or chemical compounds. If two or more chemical substances can be combin ...
s,
irradiation Irradiation is the process by which an object is exposed to radiation. An irradiator is a device used to expose an object to radiation, most often gamma radiation, for a variety of purposes. Irradiators may be used for sterilizing medical and p ...
,
high pressure In science and engineering the study of high pressure examines its effects on materials and the design and construction of devices, such as a diamond anvil cell, which can create high pressure. ''High pressure'' usually means pressures of thousan ...
, and
filtration Filtration is a physical separation process that separates solid matter and fluid from a mixture using a ''filter medium'' that has a complex structure through which only the fluid can pass. Solid particles that cannot pass through the filte ...
. Sterilization is distinct from
disinfection A disinfectant is a chemical substance or compound used to inactivate or destroy microorganisms on inert surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than ...
, sanitization, and
pasteurization In food processing, pasteurization (American and British English spelling differences#-ise, -ize (-isation, -ization), also pasteurisation) is a process of food preservation in which packaged foods (e.g., milk and fruit juices) are treated wi ...
, in that those methods reduce rather than eliminate all forms of life and biological agents present. After sterilization, fluid or an object is referred to as being sterile or
aseptic Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deri ...
.


Applications


Foods

One of the first steps toward modernized sterilization was made by
Nicolas Appert Nicolas Appert (17 November 1749 – 1 June 1841) was a French confectioner and inventor who, in the early 19th century, invented airtight food preservation. Appert, known as the " father of food science", described his invention as a way "of c ...
, who discovered that application of heat over a suitable period of time slowed the decay of foods and various liquids, preserving them for safe consumption for a longer time than was typical.
Canning Canning is a method of food preservation in which food is processed and sealed in an airtight container (jars like Mason jars, and steel and tin cans). Canning provides a shelf life that typically ranges from one to five years, although under ...
of foods is an extension of the same principle and has helped to reduce food borne illness ("food poisoning"). Other methods of sterilizing foods include
ultra-high temperature processing Ultra-high temperature processing (UHT), ultra-heat treatment, or ultra-pasteurization is a food processing technology that sterilization (microbiology), sterilizes liquid diet, liquid food by heating it above  – the temperature required ...
(which uses a shorter duration of heating),
food irradiation Food irradiation (sometimes American English: radurization; British English: radurisation) is the process of exposing food and food packaging to ionizing radiation, such as from gamma rays, x-rays, or electron beams. Food irradiation improves ...
, and high pressure (
pascalization Pascalization, bridgmanization, high pressure processing (HPP) or high hydrostatic pressure (HHP) processing is a method of preserving and sterilizing food, in which a product is processed under very high pressure, leading to the inactivation of ...
). In the context of food, sterility typically refers to ''commercial sterility'', defined as "the absence of microorganisms capable of growing in the food at normal non-refrigerated conditions at which the food is likely to be held during distribution and storage" according to the ''
Codex Alimentarius The is a collection of internationally recognized standards, codes of practice, guidelines, and other recommendations published by the Food and Agriculture Organization (FAO) and World Health Organization (WHO) of the United Nations relating to f ...
''.


Medicine and surgery

In general, surgical instruments and medications that enter an already
aseptic Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deri ...
part of the body (such as the bloodstream, or penetrating the skin) must be sterile. Examples of such instruments include
scalpel A scalpel or bistoury is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, podiatry and various handicrafts. A lancet is a double-edged scalpel. Scalpel blades are usually made of hardened and tempered ...
s,
hypodermic needle A hypodermic needle (from Greek Language, Greek ὑπο- (''hypo-'' = under), and δέρμα (''derma'' = skin)) is a very thin, hollow tube with one sharp tip. As one of the most important intravenous inventions in the field of drug admini ...
s, and
artificial pacemaker A pacemaker, also known as an artificial cardiac pacemaker, is an Implant (medicine), implanted medical device that generates Pulse (signal processing), electrical pulses delivered by electrodes to one or more of the Heart chamber, chambers of ...
s. This is also essential in the manufacture of
parenteral In pharmacology and toxicology, a route of administration is the way by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. ...
pharmaceuticals. Preparation of injectable medications and intravenous
solution Solution may refer to: * Solution (chemistry), a mixture where one substance is dissolved in another * Solution (equation), in mathematics ** Numerical solution, in numerical analysis, approximate solutions within specified error bounds * Solu ...
s for
fluid replacement Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced with oral rehydration therapy (drinking), intravenous ...
therapy requires not only sterility but also well-designed containers to prevent entry of adventitious agents after initial product sterilization. Most medical and surgical devices used in healthcare facilities are made of materials that are able to undergo
steam Steam is water vapor, often mixed with air or an aerosol of liquid water droplets. This may occur due to evaporation or due to boiling, where heat is applied until water reaches the enthalpy of vaporization. Saturated or superheated steam is inv ...
sterilization. However, since 1950, there has been an increase in medical devices and instruments made of materials (e.g., plastics) that require low-temperature sterilization.
Ethylene oxide Ethylene oxide is an organic compound with the chemical formula, formula . It is a cyclic ether and the simplest epoxide: a three-membered ring (chemistry), ring consisting of one oxygen atom and two carbon atoms. Ethylene oxide is a colorless ...
gas has been used since the 1950s for heat- and moisture-sensitive medical devices. Within the past 15 years, a number of new, low-temperature sterilization systems (e.g., vaporized hydrogen peroxide,
peracetic acid Peracetic acid (also known as peroxyacetic acid, or Percidine) is an organic compound with the formula CH3CO3H. This peroxy acid is a colorless liquid with a characteristic acrid odor reminiscent of acetic acid. It can be highly corrosive. Perac ...
immersion,
ozone Ozone () (or trioxygen) is an Inorganic compound, inorganic molecule with the chemical formula . It is a pale blue gas with a distinctively pungent smell. It is an allotrope of oxygen that is much less stable than the diatomic allotrope , break ...
) have been developed and are being used to sterilize medical devices.


Spacecraft

There are strict international rules to protect the contamination of Solar System bodies from biological material from Earth. Standards vary depending on both the type of mission and its destination; the more likely a planet is considered to be habitable, the stricter the requirements are. Many components of instruments used on spacecraft cannot withstand very high temperatures, so techniques not requiring excessive temperatures are used as tolerated, including heating to at least , chemical sterilization, oxidization, ultraviolet, and irradiation.


Quantification

The aim of sterilization is the reduction of initially present microorganisms or other potential pathogens. The degree of sterilization is commonly expressed by multiples of the decimal reduction time, or D-value, denoting the time needed to reduce the initial number N_0 to one tenth (10^) of its original value. Then the number of microorganisms N after sterilization time t is given by: :\frac= 10^. The D-value is a function of sterilization conditions and varies with the type of microorganism,
temperature Temperature is a physical quantity that quantitatively expresses the attribute of hotness or coldness. Temperature is measurement, measured with a thermometer. It reflects the average kinetic energy of the vibrating and colliding atoms making ...
,
water activity In food science, water activity (''aw'') of a food is the ratio of its vapor pressure to the vapor pressure of water at the same temperature, both taken at equilibrium. Pure water has a water activity of one. Put another way, ''aw'' is the equi ...
, pH, etc.. For steam sterilization (see below), typically the temperature, in degrees
Celsius The degree Celsius is the unit of temperature on the Celsius temperature scale "Celsius temperature scale, also called centigrade temperature scale, scale based on 0 ° for the melting point of water and 100 ° for the boiling point ...
, is given as an index. Theoretically, the likelihood of the survival of an individual microorganism is never zero. To compensate for this, the overkill method is often used. Using the overkill method, sterilization is performed by sterilizing for longer than is required to kill the bioburden present on or in the item being sterilized. This provides a sterility assurance level (SAL) equal to the probability of a non-sterile unit. For high-risk applications, such as medical devices and injections, a sterility assurance level of at least 10−6 is required by the United States of America
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...
(FDA).


Heat


Steam

Steam sterilization, also known as moist heat sterilization, uses heated
saturated steam Steam is water vapor, often mixed with air or an aerosol of liquid water droplets. This may occur due to evaporation or due to boiling, where heat is applied until water reaches the enthalpy of vaporization. Saturated or superheated steam is ...
under
pressure Pressure (symbol: ''p'' or ''P'') is the force applied perpendicular to the surface of an object per unit area over which that force is distributed. Gauge pressure (also spelled ''gage'' pressure)The preferred spelling varies by country and eve ...
to inactivate or kill microorganisms via denaturation of macromolecules, primarily proteins. This method is a faster process than dry heat sterilization. Steam sterilization is performed using an
autoclave An autoclave is a machine used to carry out industrial and scientific processes requiring elevated temperature and pressure in relation to ambient pressure and/or temperature. Autoclaves are used before surgical procedures to perform steriliza ...
, sometimes called a converter or steam sterilizer. The object or liquid is placed in the autoclave chamber, which is then sealed and heated using pressurized steam to a temperature set point for a defined period of time. Steam sterilization cycles can be categorized as either pre-vacuum or gravity displacement. Gravity displacement cycles rely on the lower density of the injected steam to force cooler, denser air out of the chamber drain
Steam Sterilization , Disinfection & Sterilization Guidelines , Guidelines Library , Infection Control , CDC
In comparison, pre-vacuum cycles create a vacuum in the chamber to remove cool dry air prior to injecting saturated steam, resulting in faster heating and shorter cycle times. Typical steam sterilization cycles are between 3 and 30 minutes at at , but adjustments may be made depending on the bioburden of the article being sterilized, its resistance ( D-value) to steam sterilization, the article's heat tolerance, and the required sterility assurance level. Following the completion of a cycle, liquids in a pressurized autoclave must be cooled slowly to avoid boiling over when the pressure is released. This may be achieved by gradually depressurizing the sterilization chamber and allowing liquids to evaporate under a negative pressure, while cooling the contents. Proper autoclave treatment will inactivate all resistant bacterial
spore In biology, a spore is a unit of sexual reproduction, sexual (in fungi) or asexual reproduction that may be adapted for biological dispersal, dispersal and for survival, often for extended periods of time, in unfavourable conditions. Spores fo ...
s in addition to
fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
, bacteria, and viruses, but is not expected to eliminate all
prion A prion () is a Proteinopathy, misfolded protein that induces misfolding in normal variants of the same protein, leading to cellular death. Prions are responsible for prion diseases, known as transmissible spongiform encephalopathy (TSEs), w ...
s, which vary in their heat resistance. For prion elimination, various recommendations state for 60 minutes or for at least 18 minutes. The 263K scrapie prion is inactivated relatively quickly by such sterilization procedures; however, other strains of scrapie and strains of Creutzfeldt-Jakob disease (CKD) and
bovine spongiform encephalopathy Bovine spongiform encephalopathy (BSE), commonly known as mad cow disease, is an incurable and always fatal neurodegenerative disease of cattle. Symptoms include abnormal behavior, trouble walking, and weight loss. Later in the course of th ...
(BSE) are more resistant. Using
mice A mouse (: mice) is a small rodent. Characteristically, mice are known to have a pointed snout, small rounded ears, a body-length scaly tail, and a high breeding rate. The best known mouse species is the common house mouse (''Mus musculus' ...
as test animals, one experiment showed that heating BSE positive
brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...
tissue at for 18 minutes resulted in only a 2.5 log decrease in prion infectivity. Most autoclaves have meters and charts that record or display information, particularly temperature and pressure as a function of time. The information is checked to ensure that the conditions required for sterilization have been met. Indicator tape is often placed on the packages of products prior to autoclaving, and some packaging incorporates indicators. The indicator changes color when exposed to steam, providing a visual confirmation. Biological indicators can also be used to independently confirm autoclave performance. Simple biological indicator devices are commercially available, based on microbial spores. Most contain spores of the heat-resistant microbe '' Geobacillus stearothermophilus'' (formerly ''Bacillus stearothermophilus''), which is extremely resistant to steam sterilization. Biological indicators may take the form of glass vials of spores and liquid media, or as spores on strips of paper inside glassine envelopes. These indicators are placed in locations where it is difficult for steam to reach to verify that steam is penetrating that area. For autoclaving, cleaning is critical. Extraneous biological matter or grime may shield organisms from steam penetration. Proper cleaning can be achieved through physical scrubbing,
sonication image:Sonicator.jpg, A sonicator at the Weizmann Institute of Science during sonicationSonication is the act of applying sound energy to agitate particles in a sample, for various purposes such as the extraction of multiple compounds from plants, ...
,
ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...
, or pulsed air.
Pressure cooking A pressure cooker is a sealed vessel for cooking food with the use of high pressure steam and water or a water-based liquid, a process called pressure cooking. The high pressure limits boiling and creates higher temperatures not possible at low ...
and
canning Canning is a method of food preservation in which food is processed and sealed in an airtight container (jars like Mason jars, and steel and tin cans). Canning provides a shelf life that typically ranges from one to five years, although under ...
is analogous to autoclaving, and when performed correctly renders food sterile. To sterilize waste materials that are chiefly composed of liquid, a purpose-built effluent decontamination system can be utilized. These devices can function using a variety of sterilants, although using heat via steam is most common.


Dry

Dry heat was the first method of sterilization and is a longer process than moist heat sterilization. The destruction of microorganisms through the use of dry heat is a gradual phenomenon. With longer exposure to lethal temperatures, the number of killed microorganisms increases. Forced ventilation of hot air can be used to increase the rate at which heat is transferred to an organism and reduce the temperature and amount of time needed to achieve sterility. At higher temperatures, shorter exposure times are required to kill organisms. This can reduce heat-induced damage to food products. The standard setting for a hot air oven is at least two hours at . A rapid method heats air to for 6 minutes for unwrapped objects and 12 minutes for wrapped objects. Dry heat has the advantage that it can be used on powders and other heat-stable items that are adversely affected by steam (e.g., it does not cause rusting of steel objects).


Flaming

Flaming is done to inoculation loops and straight-wires in microbiology labs for
streaking Streaking is the act of running naked through a public area for publicity, for fun, as a prank, a dare, a form of protest, or to participate in a fad. Streaking is often associated with sporting events, but can occur in more secluded areas. Str ...
. Leaving the loop in the flame of a
Bunsen burner A Bunsen burner, named after Robert Bunsen, is a kind of ambient air gas burner used as laboratory equipment; it produces a single open gas flame, and is used for heating, sterilization, and combustion. The gas can be natural gas (which is main ...
or alcohol burner until it glows red ensures that any infectious agent is inactivated or killed. This is commonly used for small metal or glass objects, but not for large objects (see
Incineration Incineration is a waste treatment process that involves the combustion of substances contained in waste materials. Industrial plants for waste incineration are commonly referred to as waste-to-energy facilities. Incineration and other high ...
below). However, during the initial heating, infectious material may be sprayed from the wire surface before it is killed, contaminating nearby surfaces and objects. Therefore, special heaters have been developed that surround the inoculating loop with a heated cage, ensuring that such sprayed material does not further contaminate the area. Another problem is that gas flames may leave carbon or other residues on the object if the object is not heated enough. A variation on flaming is to dip the object in a 70% or more concentrated solution of
ethanol Ethanol (also called ethyl alcohol, grain alcohol, drinking alcohol, or simply alcohol) is an organic compound with the chemical formula . It is an Alcohol (chemistry), alcohol, with its formula also written as , or EtOH, where Et is the ps ...
, then briefly leave the object in the flame of a
Bunsen burner A Bunsen burner, named after Robert Bunsen, is a kind of ambient air gas burner used as laboratory equipment; it produces a single open gas flame, and is used for heating, sterilization, and combustion. The gas can be natural gas (which is main ...
. The ethanol will ignite and burn off rapidly, leaving less residue than a gas flame


Incineration

Incineration Incineration is a waste treatment process that involves the combustion of substances contained in waste materials. Industrial plants for waste incineration are commonly referred to as waste-to-energy facilities. Incineration and other high ...
is a waste treatment process that involves the combustion of organic substances contained in waste materials. This method also burns any organism to ash. It is used to sterilize medical and other biohazardous waste before it is discarded with non-hazardous waste. Bacteria incinerators are mini furnaces that incinerate and kill off any microorganisms that may be on an inoculating loop or wire.


Tyndallization

Named after
John Tyndall John Tyndall (; 2 August 1820 – 4 December 1893) was an Irish physicist. His scientific fame arose in the 1850s from his study of diamagnetism. Later he made discoveries in the realms of infrared radiation and the physical properties of air ...
, tyndallization is an obsolete and lengthy process designed to reduce the level of activity of sporulating microbes that are left by a simple boiling water method. The process involves boiling for a period of time (typically 20 minutes) at atmospheric pressure, cooling, incubating for a day, and then repeating the process a total of three to four times. The incubation allow heat-resistant spores surviving the previous boiling period to germinate and form the heat-sensitive vegetative (growing) stage, which can be killed by the next boiling step. This is effective because many spores are stimulated to grow by the heat shock. The procedure only works for media that can support bacterial growth, and will not sterilize non-nutritive substrates like water. Tyndallization is also ineffective against prions.


Glass bead sterilizers

Glass bead sterilizers work by heating glass beads to . Instruments are then quickly doused in these glass beads, which heat the object while physically scraping contaminants off their surface. Glass bead sterilizers were once a common sterilization method employed in dental offices as well as biological laboratories, but are not approved by the U.S. Food and Drug Administration (FDA) and
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency under the United S ...
(CDC) to be used as a sterilizers since 1997. They are still popular in
Europe Europe is a continent located entirely in the Northern Hemisphere and mostly in the Eastern Hemisphere. It is bordered by the Arctic Ocean to the north, the Atlantic Ocean to the west, the Mediterranean Sea to the south, and Asia to the east ...
an and
Israel Israel, officially the State of Israel, is a country in West Asia. It Borders of Israel, shares borders with Lebanon to the north, Syria to the north-east, Jordan to the east, Egypt to the south-west, and the Mediterranean Sea to the west. Isr ...
i dental practices, although there are no current
evidence-based Evidence-based practice is the idea that occupational practices ought to be based on scientific evidence. The movement towards evidence-based practices attempts to encourage and, in some instances, require professionals and other decision-makers ...
guidelines for using this sterilizer.


Chemical sterilization

Chemicals are also used for sterilization. Heating provides a reliable way to rid objects of all transmissible agents, but it is not always appropriate if it will damage heat-sensitive materials such as biological materials,
fiber optic An optical fiber, or optical fibre, is a flexible glass or plastic fiber that can transmit light from one end to the other. Such fibers find wide usage in fiber-optic communications, where they permit transmission over longer distances and at ...
s, electronics, and many
plastic Plastics are a wide range of synthetic polymers, synthetic or Semisynthesis, semisynthetic materials composed primarily of Polymer, polymers. Their defining characteristic, Plasticity (physics), plasticity, allows them to be Injection moulding ...
s. In these situations, chemicals either in a gaseous or liquid form, can be used as sterilants. While the use of gas and liquid chemical sterilants avoids the problem of heat damage, users must ensure that the article to be sterilized is chemically compatible with the sterilant being used and that the sterilant is able to reach all surfaces that must be sterilized (typically cannot penetrate packaging). In addition, the use of chemical sterilants poses new challenges for workplace safety, as the properties that make chemicals effective sterilants usually make them harmful to humans. The procedure for removing sterilant residue from the sterilized materials varies depending on the chemical and process that is used.


Ethylene oxide

Ethylene oxide Ethylene oxide is an organic compound with the chemical formula, formula . It is a cyclic ether and the simplest epoxide: a three-membered ring (chemistry), ring consisting of one oxygen atom and two carbon atoms. Ethylene oxide is a colorless ...
(EO, EtO) gas treatment is one of the common methods used to sterilize, pasteurize, or disinfect items because of its wide range of material compatibility. It is also used to process items that are sensitive to processing with other methods, such as radiation (gamma, electron beam, X-ray), heat (moist or dry), or other chemicals. Ethylene oxide treatment is the most common chemical sterilization method, used for approximately 70% of total sterilizations, and for over 50% of all
disposable A disposable (also called disposable product) is a product designed for a single use after which it is recycled or is disposed as solid waste. The term is also sometimes used for products that may last several months (e.g. disposable air filt ...
medical devices. Ethylene oxide treatment is generally carried out between with
relative humidity Humidity is the concentration of water vapor present in the air. Water vapor, the gaseous state of water, is generally invisible to the human eye. Humidity indicates the likelihood for precipitation (meteorology), precipitation, dew, or fog t ...
above 30% and a gas concentration between 200 and 800 mg/L. Typically, the process lasts for several hours. Ethylene oxide is highly effective, as it penetrates all
porous materials In materials science, a porous medium or a porous material is a material containing pores (voids). The skeletal portion of the material is often called the "matrix" or "frame". The pores are typically filled with a fluid (liquid or gas). The sk ...
, and it can penetrate through some plastic materials and films. Ethylene oxide kills all known microorganisms, such as bacteria (including spores), viruses, and fungi (including yeasts and moulds), and is compatible with almost all materials even when used repeatedly. It is flammable, toxic, and
carcinogen A carcinogen () is any agent that promotes the development of cancer. Carcinogens can include synthetic chemicals, naturally occurring substances, physical agents such as ionizing and non-ionizing radiation, and biologic agents such as viruse ...
ic; however, only with a reported potential for some adverse health effects when not used in compliance with published requirements. Ethylene oxide sterilizers and processes require biological validation after sterilizer installation, significant repairs, or process changes. The traditional process consists of a preconditioning phase (in a separate room or cell), a processing phase (more commonly in a vacuum vessel and sometimes in a pressure rated vessel), and an aeration phase (in a separate room or cell) to remove EO residues and lower by-products such as ethylene chlorohydrin (EC or ECH) and, of lesser importance,
ethylene glycol Ethylene glycol ( IUPAC name: ethane-1,2-diol) is an organic compound (a vicinal diol) with the formula . It is mainly used for two purposes: as a raw material in the manufacture of polyester fibers and for antifreeze formulations. It is an odo ...
(EG). An alternative process, known as all-in-one processing, also exists for some products whereby all three phases are performed in the vacuum or pressure rated vessel. This latter option can facilitate faster overall processing time and residue dissipation. The most common EO processing method is the gas chamber. To benefit from
economies of scale In microeconomics, economies of scale are the cost advantages that enterprises obtain due to their scale of operation, and are typically measured by the amount of Productivity, output produced per unit of cost (production cost). A decrease in ...
, EO has traditionally been delivered by filling a large chamber with a combination of gaseous EO, either as pure EO, or with other gases used as diluents; diluents include chlorofluorocarbons ( CFCs), hydrochlorofluorocarbons (HCFCs), and
carbon dioxide Carbon dioxide is a chemical compound with the chemical formula . It is made up of molecules that each have one carbon atom covalent bond, covalently double bonded to two oxygen atoms. It is found in a gas state at room temperature and at norma ...
. Ethylene oxide is still widely used by medical device manufacturers. Since EO is explosive at concentrations above 3%, EO was traditionally supplied with an inert carrier gas, such as a CFC or HCFC. The use of CFCs or HCFCs as the carrier gas was banned because of concerns of
ozone depletion Ozone depletion consists of two related events observed since the late 1970s: a lowered total amount of ozone in Earth, Earth's upper atmosphere, and a much larger springtime decrease in stratospheric ozone (the ozone layer) around Earth's polar ...
. These
halogenated hydrocarbon The haloalkanes (also known as halogenoalkanes or alkyl halides) are alkanes containing one or more halogen substituents of hydrogen atom. They are a subset of the general class of halocarbons, although the distinction is not often made. Haloalka ...
s are being replaced by systems using 100% EO, because of regulations and the high cost of the blends. In hospitals, most EO sterilizers use single-use cartridges because of the convenience and ease of use compared to the former plumbed gas cylinders of EO blends. It is important to adhere to patient and healthcare personnel government specified limits of EO residues in and/or on processed products, operator exposure after processing, during storage and handling of EO gas cylinders, and environmental emissions produced when using EO. The U.S.
Occupational Safety and Health Administration The Occupational Safety and Health Administration (OSHA; ) is a regulatory agency of the United States Department of Labor that originally had federal visitorial powers to inspect and examine workplaces. The United States Congress established ...
(OSHA) has set the
permissible exposure limit The permissible exposure limit (PEL or OSHA PEL) is a legal limit in the United States for exposure of an employee to a chemical substance or physical agents such as high level noise. Permissible exposure limits were established by the Occupational ...
(PEL) at 1 ppm – calculated as an 8-hour time-weighted average (TWA) – and 5 ppm as a 15-minute excursion limit (EL). The
National Institute for Occupational Safety and Health The National Institute for Occupational Safety and Health (NIOSH, ) is the List of United States federal agencies, United States federal agency responsible for conducting research and making recommendations for the prevention of work-related occ ...
's (NIOSH) immediately dangerous to life and health limit (IDLH) for EO is 800 ppm. The odor threshold is around 500 ppm, so EO is imperceptible until concentrations are well above the OSHA PEL. Therefore, OSHA recommends that continuous gas monitoring systems be used to protect workers using EO for processing.


Nitrogen dioxide

Nitrogen dioxide Nitrogen dioxide is a chemical compound with the formula . One of several nitrogen oxides, nitrogen dioxide is a reddish-brown gas. It is a paramagnetic, bent molecule with C2v point group symmetry. Industrially, is an intermediate in the s ...
(NO2) gas is a rapid and effective sterilant for use against a wide range of microorganisms, including common bacteria, viruses, and spores. The unique physical properties of NO2 gas allow for sterilant dispersion in an enclosed environment at room temperature and atmospheric pressure. The mechanism for lethality is the degradation of
DNA Deoxyribonucleic acid (; DNA) is a polymer composed of two polynucleotide chains that coil around each other to form a double helix. The polymer carries genetic instructions for the development, functioning, growth and reproduction of al ...
in the spore's core through
nitration In organic chemistry, nitration is a general class of chemical processes for the introduction of a nitro group () into an organic compound. The term also is applied incorrectly to the different process of forming nitrate esters () between Alcohol ...
of the phosphate backbone, which kills the exposed organism as it absorbs NO2. This degradations occurs at even very low concentrations of the gas. NO2 has a boiling point of at sea level, which results in a relatively high saturated
vapour pressure Vapor pressure or equilibrium vapor pressure is the pressure exerted by a vapor in thermodynamic equilibrium with its condensed phases (solid or liquid) at a given temperature in a closed system. The equilibrium vapor pressure is an indicat ...
at ambient temperature. Because of this, liquid NO2 may be used as a convenient source for the sterilant gas. Liquid NO2 is often referred to by the name of its dimer,
dinitrogen tetroxide Dinitrogen tetroxide, commonly referred to as nitrogen tetroxide (NTO), and occasionally (usually among ex-USSR/Russian rocket engineers) as amyl, is the chemical compound N2O4. It is a useful reagent in chemical synthesis. It forms an equilibrium ...
(N2O4). Additionally, the low levels of concentration required, coupled with the high vapour pressure, assures that no
condensation Condensation is the change of the state of matter from the gas phase into the liquid phase, and is the reverse of vaporization. The word most often refers to the water cycle. It can also be defined as the change in the state of water vapor ...
occurs on the devices being sterilized. This means that no aeration of the devices is required immediately following the sterilization cycle. NO2 is also less
corrosive Corrosion is a natural process that converts a refined metal into a more chemically stable oxide. It is the gradual deterioration of materials (usually a metal) by chemical or electrochemical reaction with their environment. Corrosion engine ...
than other sterilant gases, and is compatible with most medical materials and adhesives. The most-resistant organism (MRO) to sterilization with NO2 gas is the spore of '' Geobacillus stearothermophilus'', which is the same MRO for both steam and hydrogen peroxide sterilization processes. The spore form of ''G. stearothermophilus'' has been well characterized over the years as a biological indicator in sterilization applications. Microbial inactivation of ''G. stearothermophilus'' with NO2 gas proceeds rapidly in a log-linear fashion, as is typical of other sterilization processes. Noxilizer, Inc. has commercialized this technology to offer contract sterilization services for
medical devices A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...
at its Baltimore, Maryland (USA) facility. This has been demonstrated in Noxilizer's lab in multiple studies and is supported by published reports from other labs. These same properties also allow for quicker removal of the sterilant and residual gases through aeration of the enclosed environment. The combination of rapid lethality and easy removal of the gas allows for shorter overall cycle times during the sterilization (or decontamination) process and a lower level of sterilant residuals than are found with other sterilization methods. Eniware, LLC has developed a portable, power-free sterilizer that uses no electricity, heat, or water. The 25 liter unit makes sterilization of surgical instruments possible for austere forward surgical teams, in health centers throughout the world with intermittent or no electricity and in disaster relief and humanitarian crisis situations. The 4-hour cycle uses a single use gas generation ampoule and a disposable scrubber to remove NO2 gas.


Ozone

Ozone Ozone () (or trioxygen) is an Inorganic compound, inorganic molecule with the chemical formula . It is a pale blue gas with a distinctively pungent smell. It is an allotrope of oxygen that is much less stable than the diatomic allotrope , break ...
is used in industrial settings to sterilize water and air, as well as a disinfectant for surfaces. It has the benefit of being able to
oxidize Redox ( , , reduction–oxidation or oxidation–reduction) is a type of chemical reaction in which the oxidation states of the reactants change. Oxidation is the loss of electrons or an increase in the oxidation state, while reduction is ...
most organic matter. On the other hand, it is a toxic and unstable gas that must be produced on-site, so it is not practical to use in many settings. Ozone offers many advantages as a sterilant gas; ozone is a very efficient sterilant because of its strong oxidizing properties ( E=2.076 vs SHE) capable of destroying a wide range of pathogens, including prions, without the need for handling hazardous chemicals since the ozone is generated within the sterilizer from medical-grade
oxygen Oxygen is a chemical element; it has chemical symbol, symbol O and atomic number 8. It is a member of the chalcogen group (periodic table), group in the periodic table, a highly reactivity (chemistry), reactive nonmetal (chemistry), non ...
. The high reactivity of ozone means that waste ozone can be destroyed by passing over a simple
catalyst Catalysis () is the increase in rate of a chemical reaction due to an added substance known as a catalyst (). Catalysts are not consumed by the reaction and remain unchanged after it. If the reaction is rapid and the catalyst recycles quick ...
that reverts it to oxygen and ensures that the cycle time is relatively short. The disadvantage of using ozone is that the gas is very reactive and very hazardous. The NIOSH's IDLH for ozone is smaller than the IDLH for ethylene oxide. NIOSH and OSHA have set the PEL for ozone at , calculated as an 8-hour time-weighted average. The sterilant gas manufacturers include many safety features in their products but prudent practice is to provide continuous monitoring of exposure to ozone, in order to provide a rapid warning in the event of a leak. Monitors for determining workplace exposure to ozone are commercially available.


Glutaraldehyde and formaldehyde

Glutaraldehyde Glutaraldehyde is an organic compound with the formula . The molecule consists of a five carbon chain doubly terminated with formyl (CHO) groups. It is usually used as a solution in water, and such solutions exists as a collection of hydrates, ...
and
formaldehyde Formaldehyde ( , ) (systematic name methanal) is an organic compound with the chemical formula and structure , more precisely . The compound is a pungent, colourless gas that polymerises spontaneously into paraformaldehyde. It is stored as ...
solutions (also used as fixatives) are accepted liquid sterilizing agents, provided that the immersion time is sufficiently long. To kill all spores in a clear liquid can take up to 22 hours with glutaraldehyde and even longer with formaldehyde. The presence of solid particles may lengthen the required period or render the treatment ineffective. Sterilization of blocks of tissue can take much longer, due to the time required for the fixative to penetrate. Glutaraldehyde and formaldehyde are volatile, and toxic by both skin contact and inhalation. Glutaraldehyde has a short shelf-life (<2 weeks), and is expensive. Formaldehyde is less expensive and has a much longer shelf-life if some
methanol Methanol (also called methyl alcohol and wood spirit, amongst other names) is an organic chemical compound and the simplest aliphatic Alcohol (chemistry), alcohol, with the chemical formula (a methyl group linked to a hydroxyl group, often ab ...
is added to inhibit
polymerization In polymer chemistry, polymerization (American English), or polymerisation (British English), is a process of reacting monomer molecules together in a chemical reaction to form polymer chains or three-dimensional networks. There are many fo ...
of the chemical to
paraformaldehyde Paraformaldehyde (PFA) is the smallest polyoxymethylene, the polymerization product of formaldehyde with a typical degree of polymerization of 8–100 units. Paraformaldehyde commonly has a slight odor of formaldehyde due to decomposition. Par ...
, but is much more volatile. Formaldehyde is also used as a gaseous sterilizing agent; in this case, it is prepared on-site by depolymerization of solid paraformaldehyde. Many vaccines, such as the original
Salk polio vaccine Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated vaccine, inactivated poliovirus given by injection (IPV) and a attenuated vaccine, weakened poliovirus given by mouth (OPV). The World Healt ...
, are sterilized with formaldehyde.


Hydrogen peroxide

Hydrogen peroxide Hydrogen peroxide is a chemical compound with the formula . In its pure form, it is a very pale blue liquid that is slightly more viscosity, viscous than Properties of water, water. It is used as an oxidizer, bleaching agent, and antiseptic, usua ...
, in both liquid and as vaporized hydrogen peroxide (VHP), is another chemical sterilizing agent. Hydrogen peroxide is a strong
oxidant An oxidizing agent (also known as an oxidant, oxidizer, electron recipient, or electron acceptor) is a substance in a redox chemical reaction that gains or "Electron acceptor, accepts"/"receives" an electron from a (called the , , or ''electr ...
, which allows it to destroy a wide range of pathogens. Hydrogen peroxide is used to sterilize heat- or temperature-sensitive articles, such as rigid
endoscope An endoscope is an inspection instrument composed of image sensor, optical lens, light source and mechanical device, which is used to look deep into the body by way of openings such as the mouth or anus. A typical endoscope applies several modern ...
s. In medical sterilization, hydrogen peroxide is used at higher concentrations, ranging from around 35% up to 90%. The biggest advantage of hydrogen peroxide as a sterilant is the short cycle time. Whereas the cycle time for ethylene oxide may be 10 to 15 hours, some modern hydrogen peroxide sterilizers have a cycle time as short as 28 minutes. Drawbacks of hydrogen peroxide include material compatibility, a lower capability for penetration and operator health risks. Products containing cellulose, such as paper, cannot be sterilized using VHP and products containing
nylon Nylon is a family of synthetic polymers characterised by amide linkages, typically connecting aliphatic or Polyamide#Classification, semi-aromatic groups. Nylons are generally brownish in color and can possess a soft texture, with some varieti ...
may become brittle. The penetrating ability of hydrogen peroxide is not as good as ethylene oxide and so there are limitations on the length and diameter of the lumen of objects that can be effectively sterilized. Hydrogen peroxide is a primary irritant and the contact of the liquid solution with skin will cause
bleaching Bleach is the generic name for any chemical product that is used industrially or domestically to remove color from (i.e. to whiten) fabric or fiber (in a process called bleaching) or to disinfect after cleaning. It often refers specifically t ...
or
ulceration An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected Organ (biology), organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caus ...
depending on the concentration and contact time. It is relatively non-toxic when diluted to low concentrations, but is a dangerous oxidizer at high concentrations (> 10% w/w). The vapour is also hazardous, primarily affecting the eyes and respiratory system. Even short-term exposures can be hazardous and NIOSH has set the IDLH at 75 ppm, less than 1/10 the IDLH for ethylene oxide (800 ppm). Prolonged exposure to lower concentrations can cause permanent lung damage and consequently, OSHA has set the permissible exposure limit to 1.0 ppm, calculated as an 8-hour time-weighted average. Sterilizer manufacturers go to great lengths to make their products safe through careful design and incorporation of many safety features, though there are still workplace exposures of hydrogen peroxide from gas sterilizers documented in the FDA Manufacturer and User Facility Device Experience (MAUDE) database. When using any type of gas sterilizer, prudent work practices should include good ventilation, a continuous gas monitor for hydrogen peroxide, and good work practices and training. Vaporized hydrogen peroxide (VHP) is used to sterilize large enclosed and sealed areas, such as entire rooms and aircraft interiors. Although toxic, VHP breaks down in a short time to water and oxygen.


Peracetic acid

Peracetic acid Peracetic acid (also known as peroxyacetic acid, or Percidine) is an organic compound with the formula CH3CO3H. This peroxy acid is a colorless liquid with a characteristic acrid odor reminiscent of acetic acid. It can be highly corrosive. Perac ...
(0.2%) is a recognized sterilant by the FDA for use in sterilizing medical devices such as
endoscope An endoscope is an inspection instrument composed of image sensor, optical lens, light source and mechanical device, which is used to look deep into the body by way of openings such as the mouth or anus. A typical endoscope applies several modern ...
s. Peracetic acid which is also known as peroxyacetic acid is a chemical compound often used in disinfectants such as sanitizers. It is most commonly produced by the reaction of
acetic acid Acetic acid , systematically named ethanoic acid , is an acidic, colourless liquid and organic compound with the chemical formula (also written as , , or ). Vinegar is at least 4% acetic acid by volume, making acetic acid the main compone ...
with
hydrogen peroxide Hydrogen peroxide is a chemical compound with the formula . In its pure form, it is a very pale blue liquid that is slightly more viscosity, viscous than Properties of water, water. It is used as an oxidizer, bleaching agent, and antiseptic, usua ...
by using an acid catalyst. Peracetic acid is never sold in un-stabilized solutions which is why it is considered to be environmentally friendly. Peracetic acid is a colorless liquid and the molecular formula of peracetic acid is C2H4O3 or CH3COOOH. More recently, peracetic acid is being used throughout the world as more people are using fumigation to decontaminate surfaces to reduce the risk of COVID-19 and other diseases.


Potential for chemical sterilization of prions

Prions are highly resistant to chemical sterilization. Treatment with
aldehyde In organic chemistry, an aldehyde () (lat. ''al''cohol ''dehyd''rogenatum, dehydrogenated alcohol) is an organic compound containing a functional group with the structure . The functional group itself (without the "R" side chain) can be referred ...
s, such as formaldehyde, have actually been shown to increase prion resistance. Hydrogen peroxide (3%) used for 1 hour was shown to be ineffective, providing less than 3 logs (10−3) reduction in contamination.
Iodine Iodine is a chemical element; it has symbol I and atomic number 53. The heaviest of the stable halogens, it exists at standard conditions as a semi-lustrous, non-metallic solid that melts to form a deep violet liquid at , and boils to a vi ...
, formaldehyde, glutaraldehyde, and peracetic acid also fail this test (1 hour treatment). Only
chlorine Chlorine is a chemical element; it has Symbol (chemistry), symbol Cl and atomic number 17. The second-lightest of the halogens, it appears between fluorine and bromine in the periodic table and its properties are mostly intermediate between ...
, phenolic compounds, guanidinium thiocyanate, and sodium hydroxide reduce prion levels by more than 4 logs; chlorine (too corrosive to use on certain objects) and sodium hydroxide are the most consistent. Many studies have shown the effectiveness of sodium hydroxide.


Radiation sterilization

Sterilization can be achieved using
electromagnetic radiation In physics, electromagnetic radiation (EMR) is a self-propagating wave of the electromagnetic field that carries momentum and radiant energy through space. It encompasses a broad spectrum, classified by frequency or its inverse, wavelength ...
, such as
ultraviolet Ultraviolet radiation, also known as simply UV, is electromagnetic radiation of wavelengths of 10–400 nanometers, shorter than that of visible light, but longer than X-rays. UV radiation is present in sunlight and constitutes about 10% of ...
light Light, visible light, or visible radiation is electromagnetic radiation that can be visual perception, perceived by the human eye. Visible light spans the visible spectrum and is usually defined as having wavelengths in the range of 400– ...
(UV),
X-rays An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
, and
gamma rays A gamma ray, also known as gamma radiation (symbol ), is a penetrating form of electromagnetic radiation arising from high energy interactions like the radioactive decay of atomic nuclei or astronomical events like solar flares. It consists o ...
, or irradiation by
subatomic particle In physics, a subatomic particle is a particle smaller than an atom. According to the Standard Model of particle physics, a subatomic particle can be either a composite particle, which is composed of other particles (for example, a baryon, lik ...
s such as
electron beam Since the mid-20th century, electron-beam technology has provided the basis for a variety of novel and specialized applications in semiconductor manufacturing, microelectromechanical systems, nanoelectromechanical systems, and microscopy. Mechani ...
s. Electromagnetic or particulate radiation can be energetic enough to ionize atoms or molecules (
ionizing radiation Ionizing (ionising) radiation, including Radioactive decay, nuclear radiation, consists of subatomic particles or electromagnetic waves that have enough energy per individual photon or particle to ionization, ionize atoms or molecules by detaching ...
), or less energetic atoms or molecules (
non-ionizing radiation Non-ionizing (or non-ionising) radiation refers to any type of electromagnetic radiation that does not carry enough energy per quantum ( photon energy) to ionize atoms or molecules—that is, to completely remove an electron from an atom or mol ...
).


Non-ionizing radiation sterilization

UV irradiation (from a germicidal lamp) is useful for sterilization of surfaces and some transparent objects. Many objects that are transparent to
visible light Light, visible light, or visible radiation is electromagnetic radiation that can be perceived by the human eye. Visible light spans the visible spectrum and is usually defined as having wavelengths in the range of 400–700 nanometres (nm ...
absorb UV. UV irradiation is routinely used to sterilize the interiors of biological safety cabinets between uses, but is ineffective in shaded areas, including areas under dirt (which may become polymerized after prolonged irradiation, so that it is very difficult to remove). It also damages some plastics, such as
polystyrene Polystyrene (PS) is a synthetic polymer made from monomers of the aromatic hydrocarbon styrene. Polystyrene can be solid or foamed. General-purpose polystyrene is clear, hard, and brittle. It is an inexpensive resin per unit weight. It i ...
foam if exposed for prolonged periods of time.


Ionizing radiation sterilization

The safety of irradiation facilities is regulated by the
International Atomic Energy Agency The International Atomic Energy Agency (IAEA) is an intergovernmental organization that seeks to promote the peaceful use of nuclear technology, nuclear energy and to inhibit its use for any military purpose, including nuclear weapons. It was ...
of the
United Nations The United Nations (UN) is the Earth, global intergovernmental organization established by the signing of the Charter of the United Nations, UN Charter on 26 June 1945 with the stated purpose of maintaining international peace and internationa ...
and monitored by the different national
Nuclear Regulatory Commission The United States Nuclear Regulatory Commission (NRC) is an independent agency of the United States government tasked with protecting public health and safety related to nuclear energy. Established by the Energy Reorganization Act of 1974, the ...
s (NRC). The radiation exposure accidents that have occurred in the past are documented by the agency and thoroughly analyzed to determine the cause and improvement potential. Such improvements are then mandated to retrofit existing facilities and future design.
Gamma radiation A gamma ray, also known as gamma radiation (symbol ), is a penetrating form of electromagnetic radiation arising from high energy interactions like the radioactive decay of atomic nuclei or astronomical events like solar flares. It consists o ...
is very penetrating, and is commonly used for sterilization of disposable medical equipment, such as syringes, needles,
cannula A cannula (; Latin meaning 'little reed'; : cannulae or cannulas) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or out ...
s and IV sets, and food. It is emitted by a
radioisotope A radionuclide (radioactive nuclide, radioisotope or radioactive isotope) is a nuclide that has excess numbers of either neutrons or protons, giving it excess nuclear energy, and making it unstable. This excess energy can be used in one of three ...
, usually
cobalt-60 Cobalt-60 (Co) is a synthetic radioactive isotope of cobalt with a half-life of 5.2714 years. It is produced artificially in nuclear reactors. Deliberate industrial production depends on neutron activation of bulk samples of the monoisotop ...
(60Co) or
caesium-137 Caesium-137 (), cesium-137 (US), or radiocaesium, is a radioactive isotope of caesium that is formed as one of the more common fission products by the nuclear fission of uranium-235 and other fissionable isotopes in nuclear reactors and nucle ...
(137Cs), which have
photon A photon () is an elementary particle that is a quantum of the electromagnetic field, including electromagnetic radiation such as light and radio waves, and the force carrier for the electromagnetic force. Photons are massless particles that can ...
energies of up to 1.3 and 0.66 MeV, respectively. Use of a radioisotope requires shielding for the safety of the operators while in use and in storage. With most designs, the radioisotope is lowered into a water-filled source storage pool, which absorbs radiation and allows maintenance personnel to enter the radiation shield. One variant keeps the radioisotope under water at all times and lowers the product to be irradiated in the water in hermetically sealed bells; no further shielding is required for such designs. Other uncommonly used designs are dry storage, providing movable shields that reduce radiation levels in areas of the irradiation chamber, etc. An incident in
Decatur, Georgia Decatur () is a city and the county seat of DeKalb County, Georgia, DeKalb County, Georgia (U.S. state), Georgia, United States, part of the Atlanta metropolitan area. With a population of 24,928 in the 2020 United States census, 2020 census, th ...
, USA, where water-soluble caesium-137 leaked into the source storage pool, required Nuclear Regulatory Commission (NRC) intervention and led to the use of this radioisotope being almost entirely discontinued in favor of the more costly, non-water-soluble cobalt-60. Cobalt-60 gamma
photon A photon () is an elementary particle that is a quantum of the electromagnetic field, including electromagnetic radiation such as light and radio waves, and the force carrier for the electromagnetic force. Photons are massless particles that can ...
s have about twice the energy, and hence greater penetrating range, of caesium-137-produced radiation. Electron beam processing is also commonly used for sterilization.
Electron beams Cathode rays are streams of electrons observed in discharge tubes. If an evacuated glass tube is equipped with two electrodes and a voltage is applied, glass behind the positive electrode is observed to glow, due to electrons emitted from the ca ...
use an on-off technology and provide a much higher dosing rate than gamma or X-rays. Due to the higher dose rate, less exposure time is needed and thereby any potential degradation to polymers is reduced. Because
electron The electron (, or in nuclear reactions) is a subatomic particle with a negative one elementary charge, elementary electric charge. It is a fundamental particle that comprises the ordinary matter that makes up the universe, along with up qua ...
s carry a charge, electron beams are less penetrating than both gamma and X-rays. Facilities rely on substantial concrete shields to protect workers and the environment from radiation exposure. High-energy X-rays (produced by ''
bremsstrahlung In particle physics, bremsstrahlung (; ; ) is electromagnetic radiation produced by the deceleration of a charged particle when deflected by another charged particle, typically an electron by an atomic nucleus. The moving particle loses kinetic ...
'') allow irradiation of large packages and
pallet A pallet (also called a skid) is a flat transport structure, which supports goods in a stable fashion while being lifted by a forklift, a pallet jack, a Loader (equipment), front loader, a Jack (mechanical), jacking device, or an erect cra ...
loads of medical devices. They are sufficiently penetrating to treat multiple pallet loads of low-density packages with very good dose uniformity ratios. X-ray sterilization does not require chemical or radioactive material: high-energy X-rays are generated at high intensity by an
X-ray generator An X-ray machine is a device that uses X-rays for a variety of applications including medicine, X-ray fluorescence, electronic assembly inspection, and measurement of material thickness in manufacturing operations. In medical applications, X-ra ...
that does not require shielding when not in use. X-rays are generated by bombarding a dense material (target) such as
tantalum Tantalum is a chemical element; it has Symbol (chemistry), symbol Ta and atomic number 73. It is named after Tantalus, a figure in Greek mythology. Tantalum is a very hard, ductility, ductile, lustre (mineralogy), lustrous, blue-gray transition ...
or
tungsten Tungsten (also called wolfram) is a chemical element; it has symbol W and atomic number 74. It is a metal found naturally on Earth almost exclusively in compounds with other elements. It was identified as a distinct element in 1781 and first ...
with high-energy electrons, in a process known as ''bremsstrahlung'' conversion. These systems are energy-inefficient, requiring much more electrical energy than other systems for the same result.
Irradiation Irradiation is the process by which an object is exposed to radiation. An irradiator is a device used to expose an object to radiation, most often gamma radiation, for a variety of purposes. Irradiators may be used for sterilizing medical and p ...
with X-rays, gamma rays, or electrons does not make materials
radioactive Radioactive decay (also known as nuclear decay, radioactivity, radioactive disintegration, or nuclear disintegration) is the process by which an unstable atomic nucleus loses energy by radiation. A material containing unstable nuclei is conside ...
, because the energy used is too low. Generally an energy of at least 10 MeV is needed to induce radioactivity in a material.
Neutron The neutron is a subatomic particle, symbol or , that has no electric charge, and a mass slightly greater than that of a proton. The Discovery of the neutron, neutron was discovered by James Chadwick in 1932, leading to the discovery of nucle ...
s and very high-energy particles can make materials radioactive, but have good penetration, whereas lower energy particles (other than neutrons) cannot make materials radioactive, but have poorer penetration. Sterilization by irradiation with gamma rays may however affect material properties. Irradiation is used by the
United States Postal Service The United States Postal Service (USPS), also known as the Post Office, U.S. Mail, or simply the Postal Service, is an independent agencies of the United States government, independent agency of the executive branch of the federal governmen ...
to sterilize mail in the
Washington, D.C. Washington, D.C., formally the District of Columbia and commonly known as Washington or D.C., is the capital city and federal district of the United States. The city is on the Potomac River, across from Virginia, and shares land borders with ...
area. Some foods (e.g., spices and ground meats) are sterilized by irradiation. Subatomic particles may be more or less penetrating and may be generated by a radioisotope or a device, depending upon the type of particle.


Sterile filtration

Fluids that would be damaged by heat, irradiation, or chemical sterilization, such as drug solution, can be sterilized by
microfiltration Microfiltration is a type of physical filtration process where a contaminated fluid is passed through a special porosity, pore-sized membrane filter to separate microorganisms and suspended particles from process fluid, liquid. It is commonly used ...
using
membrane filter Membrane technology encompasses the scientific processes used in the construction and application of membranes. Membranes are used to facilitate the transport or rejection of substances between mediums, and the mechanical separation of gas and liq ...
s. This method is commonly used for heat labile pharmaceuticals and
protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...
solutions in medicinal drug processing. A microfilter with pore size of usually 0.22 μm will effectively remove
microorganisms A microorganism, or microbe, is an organism of microscopic size, which may exist in its single-celled form or as a colony of cells. The possible existence of unseen microbial life was suspected from antiquity, with an early attestation in ...
. Some Staphylococcal species have, however, been shown to be flexible enough to pass through 0.22 μm filters. In the processing of biologics,
virus A virus is a submicroscopic infectious agent that replicates only inside the living Cell (biology), cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are ...
es must be removed or inactivated, requiring the use of nanofilters with a smaller pore size (20–50 nm). Smaller pore sizes lower the flow rate, so in order to achieve higher total throughput or to avoid premature blockage, pre-filters might be used to protect small pore membrane filters. Tangential flow filtration (TFF) and alternating tangential flow (ATF) systems also reduce particulate accumulation and blockage. Membrane filters used in production processes are commonly made from materials such as mixed cellulose ester or polyethersulfone (PES). The filtration equipment and the filters themselves may be purchased as pre-sterilized disposable units in sealed packaging or must be sterilized by the user, generally by autoclaving at a temperature that does not damage the fragile filter membranes. To ensure proper functioning of the filter, the membrane filters are integrity tested post-use and sometimes before use. The nondestructive integrity test assures that the filter is undamaged and is a regulatory requirement. Typically, terminal pharmaceutical sterile filtration is performed inside of a
cleanroom A cleanroom or clean room is an engineered space that maintains a very low concentration of airborne particulates. It is well-isolated, well-controlled from contamination, and actively cleansed. Such rooms are commonly needed for scientifi ...
to prevent contamination.


Preservation of sterility

Instruments that have undergone sterilization can be maintained in such condition by containment in sealed packaging until use. Aseptic technique is the act of maintaining sterility during procedures.


See also

*
Antibacterial soap Antibacterial soap is a soap which contains chemical ingredients that purportedly assist in killing bacteria. The majority of antibacterial soaps contain triclosan, though other chemical additives are also common. The effectiveness of products b ...
*
Asepsis Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deri ...
*
Aseptic processing Aseptic processing is a processing technique wherein commercially thermally sterilized liquid products (typically food or pharmaceutical) are packaged into previously sterilized containers under sterile conditions to produce shelf-stable products ...
* Contamination control * Electron irradiation *
Food packaging Food packaging is a packaging system specifically designed for food and represents one of the most important aspects among the processes involved in the food industry, as it provides protection from chemical, biological and physical alterations ...
*
Food preservation Food preservation includes processes that make food more resistant to microorganism growth and slow the redox, oxidation of fats. This slows down the decomposition and rancidification process. Food preservation may also include processes that in ...
*
Food safety Food safety (or food hygiene) is used as a scientific method/discipline describing handling, food processing, preparation, and food storage, storage of food in ways that prevent foodborne illness. The occurrence of two or more cases of a simi ...
* Spaulding classification * Sterilant gas monitoring


References


Sources


WHO - Infection Control Guidelines for Transmissible Spongiform Encephalopathies
Retrieved Jul 10, 2010 *
Control of microbes
*
Innovative Technologies for the Biofunctionalisation and Terminal Sterilisation of Medical Devices

Sterilization of liquids, solids, waste in disposal bags and hazardous biological substances
* Pharmaceutical Filtration - The Management of Organism Removal, Meltzer TH, Jornitz MW, PDA/DHI 1998 * "Association for Advancement of Medical Instrumentation ANSI/AAMI ST41-Ehylene Oxyde Sterilization in Healthcare facilities: Safety and Effectiveness. Arlington, VA: Association for Advancement of Medical Instrumentation; 2000." * “US Department of Labor, Occupational Safety and Health Administration.29 CFR 1910.1020. Access to Employee Medical Records.". October 26, 2007. * Perioperative Standards and Recommended Practices, AORN 2013, {{DEFAULTSORT:Sterilization (Microbiology) Microbiology techniques Biocides Hygiene