Time is quickly running out for hospitals to notify the EPA of compliance with their latest ruling concerning EtO sterilizers. The May 2009 deadline applies to units installed or rebuilt before November 2006. Users of newer equipment were already required to comply by the end of 2007. This means that all U.S. hospitals should now be using these updated procedures to reduce EtO emissions. Fortunately, this switch does not mean all current users of this technology must purchase new sterilizers. Instead, the regulations set standards for appropriate use of existing equipment.

Running a full load rather than a partial one is required except when there is a medically necessary reason to do otherwise. This common sense approach is the same one most people have for running the dishwasher at home and should already be standard hospital policy. It reduces operating costs and pollution. Of course, batches must be made up of medical equipment that requires the same cycle time. On some occasions waiting to sterilize instruments until a sufficient quantity have accumulated will not be feasible. Under these circumstances it is up to hospital personnel to make the call and run the cycle anyway. Each time the sterilizer is used, a record must be created indicating the date, time, and whether or not the unit was full. This report has to be signed by a staff member noting that running a partial load was necessary. All of these files must be kept available in case the EPA wants to review them.

How To Avoid Excess Paperwork

If all this paperwork seems like a hassle, there is an alternative. An air pollution control device (APCD) can be used to reduce emissions to acceptable levels. As long as this APCD is used every time a cycle is run, the additional record keeping is not considered necessary. These pollution control devices effectively “scrub” EtO emissions that may be created by the sterilizer. This process uses a combination of absorption and hydrolysis to transform potentially harmful chemicals into virtually harmless glycols. The end product can be collected and hauled away after a sufficient quantity has accumulated. EtO scrubbing towers can be bulky. One manufacturer of large capacity units uses a design that is over 8’ tall. The purchase and installation costs can be daunting. However, these APCDs boast a removal rate of over 99% of harmful gases making them an attractive option for locations with strict safety regulations.

The EPA rule applies only to locations that focus mainly on inpatient care. Smaller clinics that treat most clients on an outpatient basis are exempt from this regulation for the time being. It is still a good idea to run as much equipment as possible in each load to save energy costs and reduce possible exposure to fumes. Although sterilizer leaks are rare, they can occur due to poor maintenance, defects, and improper use. Comprehensive operator training is one way to reduce these risks. Sterilization units should also be regularly inspected. If you find that your current equipment is in need of replacement, you can use our free report to help you locate the right machine for your facility.

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