Professional Documents
Culture Documents
Purpose
EtO sterilizing units are used to sterilize medical
and surgical supplies and equipment. EtO (chemical
formula C2H4O), a colorless gas at room temperature
and atmospheric pressure, is flammable at concentra-
tions greater than 3% in air and liquefies at tempera-
tures below 52°F (11°C) and under pressure. It can be
used to sterilize non-heat-sensitive devices, as well as
those sensitive to excessive moisture or heat that would
be damaged by steam or liquid chemical sterilization.
C613UN5A
controlled amounts of moisture or steam to be released Cylinder
by a chamber heating system, thereby raising the Vacuum Pump
relative humidity (RH). Typically, after humidifica-
Figure 1. Schematic of an EtO sterilizer
tion, EtO or an EtO/diluent mixture is injected into the
chamber, starting the exposure (sterilizing) phase. The
chamber concentration of EtO varies from 450 to 1,200 alkylation process that kills the organisms. Extremely
mg/L of the chamber area, depending on the sterilizer. dry organisms may not be destroyed in normal EtO
sterilization; therefore, dehydrated cells may require
In the exposure phase for systems operating at presterilization treatments at 75% to 98% RH, pro-
positive pressure, chamber pressure may drop slightly longed EtO exposure time, and/or complete immersion
as EtO is absorbed by the items. Most sterilizers in water.
detect these pressure drops and provide small
amounts of additional gas (gas makeups) to maintain Because microbes vary in heat and moisture re-
proper pressure and EtO concentration. Typically, if quirements, any materials to be sterilized should be
three of these pressure drops occur, an alarm will prehumidified by washing and surface drying (not in a
sound to alert for potential leaks. hot oven) or by exposure to moderately humid air (30%
In the exhaust phase, the vacuum system vents the RH). The chamber should be maintained at 30% to
gas from the chamber to an exhaust drain and/or 100% RH during the sterilization cycle (Young 1986).
directly to the outside of the building to reduce work-
ers’ exposure to EtO when the door is opened. Most Exposure time depends on the temperature of the
sterilizers then purge the chamber with fresh, filtered chamber: as the temperature decreases, the required
air to prevent gas buildup from items degassing in the exposure time increases. A typical warm sterilization
chamber. The sterilized contents are then aerated to temperature is 120° to 145°F (49° to 63°C), with an
remove EtO residue, in either a separate aerator or an exposure time of one to two hours. Some units allow
in-chamber aerator. If separate aerators are used, they the operator to select a warm or cold cycle, according
should be of the same capacity as the sterilizer or to the items being sterilized. Temperature-sensitive
larger. devices, such as catheters, require lower temperatures
(80° to 131°F, or 27° to 55°C) to avoid damage or
Although the exact process is unknown, EtO is degradation and therefore require longer exposure
thought to attack the RNA and DNA of the microor- times (five to six hours).
ganisms on the surfaces of the items to be sterilized.
It penetrates the sealed pack and sterilizes the goods EtO is available diluted with CO2 or HCFC or in its
within. A number of variables determine whether pure (100%) form. Whatever the form, the gas must be
sterilization is successful, including EtO concentra- handled carefully to protect the operators in the event
tion, exposure time, temperature, and RH. RH is of an accident, but particular care must be taken in
important because moisture enhances EtO penetra- storing, using, and disposing 100% EtO to prevent
tion of microbial cells/spores and aids the chemical explosion.
2 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 3
Healthcare Product Comparison System
“alert” requirement among managers and variable in- In certain situations, normally nonflammable mix-
terpretation of this requirement by OSHA. In the tures may become explosive when mixed with air. For
absence of clarity on this issue, some EtO-monitor example, one case involved an older portable EtO
marketers have interpreted the requirement in favor sterilizer that did not exhaust to the outside. Leaks in
of their own interests, recommending expensive alarm the pressure-relief valve and the gas-inlet piping al-
systems that comply with the OSHA standard. This is lowed gas to enter and accumulate in the cabinet
a situation in which educational intervention could beneath the chamber, resulting in combustion and
improve health and safety and decrease costs to hospi- explosion. The gas mixture apparently reached the
tals to comply with the standard (LaMontagne and combustion point for EtO and air and was ignited
Kelsey 1997). (probably by a spark from a relay or the purging
motor); investigators speculated that the EtO concen-
Exposure to high levels of EtO has resulted from
tration might have changed through selective diffusion
malfunctioning valves, worn door gaskets, and defec-
and loss of some of the nonflammable component.
tive door-interlock systems. According to one reported
problem, a malfunctioning solenoid valve allowed EtO can adversely affect some materials after re-
high-pressure EtO gas to enter the chamber, and a peated sterilization. For example, rubber endotracheal
safety relief valve failed to open, causing a pressure tubes soften and kink more easily, which could seri-
explosion. Valve failure can result from the deteriora- ously compromise a patient’s air exchange. Therefore,
tion of valve seal material caused by EtO or by the a strict hospital quality-assurance program should be
buildup of contaminants such as dirt and polymers. instituted to ensure the integrity of all EtO-sterilized
EtO will polymerize if it is left in contact with some items.
materials for extended periods; ECRI has had reports
Chlorofluorocarbons (CFCs) have been mixed with
of valve failures resulting from polymer buildup on
EtO to reduce its flammability; however, CFCs have
valve seals.
been found to deplete the Earth’s ozone layer. The
In another instance, EtO leaked because of an im- international ban on CFCs (under provisions of the
properly adjusted door-interlock system that allowed Clean Air Act of 1995) has encouraged many hospitals
the sterilization cycle to run with the door only par- to replace 12/88 EtO sterilizers with 100% EtO steril-
tially sealed. Regular inspections and newer safety izers, although some larger sterilizers now use EtO-
features can help eliminate these kinds of problems. CO2 or EtO-HCFC gas mixtures. Despite this
replacement, recent studies have questioned the effec-
When changing EtO cylinders, employees should
tiveness of 100% EtO sterilization. There is some indi-
avoid exposure to both the vapor and the liquid forms
cation that a narrower safety margin exists for 100%
of EtO. The installation of a check or shutoff valve near
EtO sterilization than for 12% EtO diluent gas sterili-
the disconnection point minimizes the release of EtO
zation (Alfa et al. 1996).
from the supply line. However, such valves are not
foolproof. ECRI received a report of two hospital em-
ployees being sprayed with EtO from a 63.6 kg (140 lb) Purchase considerations
cylinder after a valve had been turned completely to In general, there are four traditional methods used
the OFF position. Precautions that should be taken to sterilize medical devices: pressurized steam, EtO,
when changing an EtO cylinder or conducting other gas plasma, and liquid germicides. Each method has
sterilizer maintenance include wearing a respirator its limitations. Hospitals need to assess their current
with suitable eye and face protection, wearing suitable sterilization/reprocessing protocols and evaluate cur-
coveralls (preferably disposable) and neoprene gloves rent and future needs before purchasing a sterilizer.
to avoid skin exposure, and having an emergency
Plasma sterilization may be a cost-effective and
evacuation plan.
environmentally sound choice for low-temperature
Dedicated exhaust and ventilation systems should be sterilization. The process involves the generation of
carefully designed to avoid personnel exposure. EtO reactive species that interact with cell membranes,
sterilizers should be placed in isolated, well-ventilated enzymes, or nucleic acids to destroy microorganisms
areas with controlled access. Exhaust lines should be at or below 55°C (131°F). Currently marketed
local and lead directly from the sterilizer door to an plasma sterilizers employ a hydrogen peroxide gas
exhaust drain and/or to the outside. The ventilation plasma in the sterilization process. Although the
system should be nonrecirculating, discharging air from liquid sterilants used in plasma sterilizers are listed
the space to the outdoors. With adequate engineering substances in the OSHA hazard communication
controls and proper work techniques, exposures should standard (29 CFR 1910.1200), safety features have
be well below the permissible exposure limit of 1 ppm. been devised to minimize the chance of exposing
4 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
operatorstotheconcentrated chemicals. The end prod- or more dedicated electric lines. Other considerations
ucts of plasma sterilization are not toxic, reducing include the following:
regulatory and safety concerns. Installation of a • Current or pending changes in local regulations on
plasma sterilizer is straightforward, with a low risk of EtO or EtO diluent emissions
emission-related errors.
• Liability and cost issues associated with protecting
Because gas plasma technology is relatively new, personnel from exposure to toxic sterilants
many medical devices were not developed with the gas • Benefits and limitations of low-temperature sterili-
plasma sterilization method in mind, and many users zation alternatives
will have less experience with the process.
Hospitals can purchase service contracts or service
Although EtO units have larger chambers than gas on a time-and-materials basis from the supplier. Ser-
plasma sterilizers and thus can process more items at vice may also be available from a third-party organi-
once, EtO sterilization requires a longer cycle time and zation. The decision to purchase a service contract
10 to 16 hours of aeration time after processing to should be carefully considered. Purchasing a service
eliminate toxic residues from the sterilized items. contract can ensure that preventive maintenance will
These requirements can result in the removal of ster- be performed at regular intervals, thereby eliminating
ilized items from use for up to 24 hours and may the possibility of unexpected maintenance costs. Also,
require the purchase of additional inventory to meet many suppliers do not extend system performance and
the demands of the hospital. The cost of maintaining uptime guarantees beyond the length of the warranty
such an inventory is compounded by the costs associ- unless the system is covered by a service contract.
ated with meeting federal regulations for emissions
and personnel safety. ECRI recommends that, to maximize bargaining
leverage, hospitals negotiate pricing for service con-
Because of the potentially detrimental effects that tracts before the system is purchased. As a guideline,
EtO can have on the environment, a number of regions full-service contracts typically cost approximately 8%
have enacted regulations to limit emissions from EtO to 12% of the sterilizer’s purchase price. Additional
sterilizers. For healthcare facilities that are affected service contract discounts may be negotiable for mul-
by these regulations, the use of an EtO-emission- tiple-year agreements or for service contracts that are
abatement system may be the most desirable alterna- bundled with contracts on other sterilizing equipment
tive. Currently available systems can effectively in the department or hospital.
reduce emissions by up to 99.9%, allowing healthcare
facilities that wish to continue using EtO sterilizers to Stage of development
comply with even the most stringent environmental The earliest EtO sterilizers were produced in the
regulations. In some emission-abatement systems, early 1950s. Newer EtO sterilizers have such features
EtO is broken down into CO2 and water through a as built-in safety devices, the ability to be modified
process called catalytic oxidation. Other emission- with additional safety components (e.g., door-interlock
abatement systems use a scrubbing method. Purchase systems, audible alarms), and microprocessor-control-
prices for EtO-emission-abatement systems vary de- led sterilization cycles. In-chamber aeration is now
pending on the size and amount of EtO removed, with available with many sterilizers.
systems typically costing between $15,000 and
$100,000. Reportedly, scrubbing costs less than cata- Since the manufacture of 12/88 EtO sterilizing
lytic oxidation (MacNeal and Glaser 1997). units has ceased under provisions of the Clean Air Act
of 1995, alternative technologies to EtO with CFCs
Cost containment have become available. Aside from 100% EtO, EtO
with different stabilizing gases, such as CO2 or HCFC,
Installation costs for EtO sterilizers vary greatly. can be used in large-capacity, tank-supplied steriliz-
Most suppliers assume the hospital will provide ers. The EtO-CO2 mixture consists of 8.5% EtO and
plumbing, electricity, and ventilation before unit 91.5% CO2. This is less expensive than EtO-HCFC but
installation; a hospital should be aware of the sup- requires pressure vessels that are rated for steam
plier’s specific requirements. In addition, if an older sterilization because higher pressures (28 psi gauge)
unit is being removed, it is important to remove and are required. HCFCs are approximately 50-fold less
properly dispose of any asbestos insulation used in damaging to the Earth’s ozone layer than CFCs (Ru-
the unit and its interconnections. EtO sterilizers tala and Weber 1998). In the United States, HCFC
typically require a steam line, a cold-water line, a manufacturers will be subject to incremental produc-
drain, a duct to the outside of the building, and one tion restrictions starting in the year 2004. The U.S.
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 5
Healthcare Product Comparison System
Environmental Protection Agency will begin regula- MacNeal JR, Glaser ZR. Comparison of health care-
tion of HCFCs in the year 2015 and will ultimately based sterilization technologies: safety, efficacy,
terminate their production in the year 2030. EtO- and economics. J Healthc Saf Compliance Infect
HCFC mixtures are sold as drop-in replacements for Control 1997 Dec:91-107.
CFC-12 and are available in ratios of 8.6% EtO/91.4%
HCFC and 10% EtO/90% HCFC. Meridian Research Inc. Ethylene oxide: a case study in
hazard identification, OSHA regulation, and mar-
Alternative methods to EtO sterilization include ket response: final report. Silver Springs (MD): Me-
vapor-phase hydrogen peroxide and gas plasma ster- ridian Research Inc.; 1992. Contract No.
ilization (see the Product Comparison titled STERILIZ- J-9-F-1-0019.
ING UNITS, PLASMA); sterilization with ozone may be
available in the future. Pokrop F. Lessons from EtO vessel operations. Med
Device Diagn Ind 1989 Dec:36-42.
For facilities located in areas that have EtO emis-
sion-limiting regulations, emission abatement sys- Rutala WA. Weber DJ. Clinical effectiveness of low-
tems are now available that can effectively reduce temperature sterilization technologies. Infect Con-
emissions by up to 99.9%. However, the purchase and trol Hosp Epidemiol 1998 Oct;19(10):798-804.
operation of these systems can cost nearly as much as
a new EtO sterilizer. Rutala WA, Weber DJ. Low-temperature sterilization
technologies: do we need to redefine “sterilization”?
Serious health risks to hospital personnel due to Infect Control Hosp Epidemiol 1996 Feb;17(2):87-91.
EtO exposure have been addressed much more seri-
ously since the classification of EtO as a known car- Weaver VM. Chemical hazards in health care workers.
cinogen; consequently, EtO sterilizers are becoming Occup Med 1997 Oct-Dec;12(4):655-67.
less favorable as a means of sterilization. However, due
Young JH. Comparison of in-hospital and industrial
to the difficulty of sterilizing heat- and moisture-sen-
sterilization of medical devices. J Healthc Mater
sitive instruments, and due to the ready availability of
Manage 1986 Mar-Apr;4:30-4.
EtO sterilizing units, EtO sterilizers are still consid-
ered to be highly effective and will probably not be
phased out of the market for a few more decades. Standards and guidelines
Note: Although every effort is made to ensure that the
Bibliography following list is comprehensive, please note that other
applicable standards may exist.
Alfa MJ, DeGagne P, Olson N, et al. Comparison of ion
American National Standards Institute. Residuals
plasma, vaporized hydrogen peroxide, and 100%
and redesignation of biological evaluation of medi-
ethylene oxide sterilizers to the 12/88 ethylene oxide
cal devices — part 7: ethylene oxide sterilization
gas sterilizer. Infect Control Hosp Epidemiol 1996
[standard]. ANSI/AAMI/ISO 10993-7-1995. 1996.
Feb;17(2):92-100.
American National Standards Institute/Association
American Society for Hospital Central Service Person- for the Advancement of Medical Instrumentation.
nel. Ethylene oxide use in hospitals: a manual for Safe current limits for electromedical apparatus
health care personnel. Chicago: American Hospital [standard]. 3rd ed. ANSI/AAMI ES1-1993. 1985 (re-
Association; 1982. vised 1993).
Booth AF. Sterilization validation & routine operation American Society for Healthcare Central Service Pro-
handbook: ethylene oxide. Lancaster: Technomic fessionals. Recommended practice for central serv-
Publishing Company; 2000. ice section six: sterilization. Committee for
Recommended Practices. C-013833. 1989 (revised
Henke C, ed. Alternative sterilization technologies 1999).
come of age. Med Device Diagn Ind 1992 Association for the Advancement of Medical Instru-
Dec;14(12):41-5. mentation. AAMI standards and recommended
LaMontagne AD, Kelsey KT. Evaluating OSHA’s eth- practices: Sterilization, Part 1. Volume 1.1: Sterili-
ylene oxide standard: employer exposure-monitor- zation in health care facilities. STBK5-1. 2001.
ing activities in Massachusetts hospitals from 1985 AAMI standards and recommended practices:
through 1993. Am J Public Health 1997 sterilization — Volume 1.2: Sterilization, Part 2.
Jul;87(7):1119-25. Sterilization equipment. STBK5-2. 2001.
6 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
In-hospital ethylene oxide sterilization [technology European Committee for Standardization. Biological
assessment report]. TAR8-152-EC. 1984. systems for testing sterilizers — part 2: systems for
use in ethylene oxide sterilizers [draft standard].
Association for the Advancement of Medical Instru- prEN 866-2:1993. 1995.
mentation/American National Standards Institute.
Automatic, general-purpose ethylene oxide steriliz- Biological systems for testing sterilizers — part 8:
ers and sterilant sources intended for use in health particular requirements for self-contained biologi-
care facilities [standard]. ST24-152-EC. 1992 (re- cal indicator systems for use in ethylene oxide ster-
vised 2000). ilizers [draft standard]. prEN 866-8:1995. 1995.
Sterilizers for medical purposes — ethylene oxide
Biological indicators for ethylene oxide sterilization
sterilizers — specification [draft standard]. prEN
processes in health care facilities [standard]. ST21-
1422:1994. 1994.
152-EC. 1986 (reaffirmed 1994).
Health Industry Manufacturers Association. Funda-
Good hospital practice: ethylene oxide gas — venti-
mentals of medical device sterilization. 97-2. 1997.
lation recommendations and safe use [recom-
mended practice]. 3rd ed. ST43-152-EC. 1993. International Electrotechnical Commission. Medical
electrical equipment — part 1: general requirements
Good hospital practice: ethylene oxide sterilization
for safety [standard]. IEC 60601-1 (1988-12). 1988.
and sterility assurance [recommended practice].
2nd ed. ST41-152-EC. 1992. Medical electrical equipment — part 1: general re-
quirements for safety. Amendment 1 [standard].
Guidelines for the selection and use of reusable rigid
IEC 60601-1-am1 (1991-11). 1991.
sterilization container systems for ethylene oxide
sterilization and steam [recommended practice]. Medical electrical equipment — part 1: general re-
ST33-152-EC. 1996. quirements for safety. Amendment 2 [standard].
IEC 60601-1-am2 (1995-03). 1995.
Association for the Advancement of Medical Instru-
Medical electrical equipment — part 1: general re-
mentation/American National Standards Insti-
quirements for safety. Section 1. Collateral standard:
tute/International Organization for
safety requirements for medical electrical systems.
Standardization. Medical devices — requirements
IEC 60601-1-1 (1992-06). 1992.
for validation and routine control of ethylene oxide
sterilization [standard]. ST1135-005-MM. 1994. Medical electrical equipment — part 1: general re-
quirements for safety. Section 1. Collateral standard:
Association of Operating Room Nurses. Sterilization safety requirements for medical electrical systems.
in the practice setting [recommended practice]. Amendment 1 [standard]. IEC 60601-1-1-am1 (1995-
1980 (revised 1999). 11). 1995.
British Standards Institution. Sterilizers for medical Medical electrical equipment — part 1: general re-
purposes — ethylene oxide sterilizers — require- quirements for safety. Section 2. Collateral standard:
ments and test methods [standard]. BS EN electromagnetic compatibility — requirements and
1422:1998. 1998. tests. IEC 60601-1-2 (2001-09). 2001.
International Organization for Standardization. Bio-
Canadian Standards Association. Effective steriliza-
logical evaluation of medical devices — part 7: eth-
tion in hospitals by the ethylene oxide process
ylene oxide sterilization residuals [standard]. 1st
[standard]. CAN/CSA-Z314.2-M91. 1984 (reaf-
ed. ISO 10993-7. 1995.
firmed 1991).
Sterilization of health care products — biological
Ethylene oxide sterilizers for hospitals [standard]. indicators — part 2: biological indicators for ethyl-
CAN/CSA-Z314.1-M91. 1991. ene oxide sterilization [standard]. 1st ed. ISO
Installation and ventilation of ethylene oxide steril- 11138-2:1994. 1994.
izers in health care facilities [standard]. CAN/CSA- National Institute for Occupational Safety and Health.
Z341.9-M89. 1989. CIB-35-ethylene oxide. Evidence of carcinogenicity.
81-130.
Center for Healthcare Environmental Management.
Ethylene oxide [recommendation]. Healthc Environ Ethylene oxide sterilizers in health care facilities
Manage Syst 1994 Sep;(1.2). [guideline]. 1989 Jul 13.
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 7
Healthcare Product Comparison System
Special occupational hazard review with control Hospitals weigh options and costs in EtO sterilization.
recommendations — use of ethylene oxide as a ster- 1995 Feb;7(2):5-6.
ilant in medical facilities. NTIS No. PB-274-795.
8 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
ARS Fedegari
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 9
Healthcare Product Comparison System
EtO exposure, hr: The time (recommended by the MDD — Medical Devices Directive
manufacturer) that devices are exposed to EtO.
OSHA — U.S. Occupational Safety and Health
Times may be programmable, depending on the
Administration
sterilizer and the devices to be sterilized.
In-chamber aeration: Times shown are those recom- PC — Personal computer
mended by the manufacturer. However, times may psig — Pounds per square inch gauge
be programmable, depending on the device to be
sterilized. TUV — Technischer Ueberwachungs Verein
10 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
About ECRI . . .
ECRI is a nonprofit health services research agency and a Collaborating Center of the World Health
Organization, providing information and technical assistance to the healthcare community to support
safe and cost-effective patient care for more than 25 years. The results of ECRI’s research and
experience are available through its publications, information systems, databases, technical assis-
tance program, laboratory services, seminars, and fellowships.
Our full-time staff includes a wide range of specialists in healthcare technology, hospital admini-
stration, financial analysis, risk management, and information and computer science, as well as
hospital planners, attorneys, physicists; biomedical, electrical, electronic, chemical, mechanical, and
registered engineers; physicians; basic medical scientists; epidemiologists and biostatisticians; and
writers, editors, and communications specialists.
Underlying ECRI’s knowledge base in healthcare technology are its integrity and objectivity. ECRI
accepts no financial support from medical product manufacturers, and no employee may own stock
in or consult for a medical equipment or pharmaceutical company.
The scope of ECRI’s resources extends far beyond technology. ECRI keeps healthcare professionals,
manufacturers, legal professionals, information specialists, and others aware of the changing trends
in healthcare, healthcare standards and regulations, and the best ways to handle environmental and
occupational health and safety issues. ECRI also advises on management issues related to healthcare
cost containment, accreditation, risk management, human resources, quality of care, and other
complex topics.
ECRI has more than 35 publications, databases, software, and services to fulfill the growing need
for healthcare information and decision support. They focus on three primary areas: healthcare
technology, healthcare risk and quality management, and healthcare environmental management.
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 11
Healthcare Product Comparison System
CHAMBER
Size, m3 (ft3) 0.17 (6) : 0.28 (10) 0.11-0.85 1.1-1.98 1.1 (38.8) and up
: 0.92 (32.5) (3.9-30) (38.8-69.9)
Jacket material Stainless steel 316 stainless steel 316 stainless steel 316 stainless steel
or steel with
nickel-clad interior
TYPE OF GAS 100% EtO single-use 12/88 12/88 100% EtO or 12/88
cartridges
STANDARD CYCLE
Chamber pressure,
psig NA * 40 40 15-40
Warm temp, °C (F) 50 (122) 57 (134.6) 57 (134.6) 57 (134.6)
Cold temp, °C (F) 50 (122) 38 (100.4) 38 (100.4) 38 (100.4)
Full cycle time, hr 16, sterilization 3 warm, 8.5 cold 3 warm, 8.5 cold 3 warm, 8.5 cold
and aeration
EtO exposure, hr 16, sterilization 2.5 warm, 8 cold 2.5 warm, 8 cold 2.5 warm, 8.5 cold
and aeration
DOOR(S)
Configuration Single Single or double Single or double Single or double
Operation Manual, self-locking Manual Power Manual or power
(side sliding)
Hinge
1 door Front right side Left or right Left or right Customized
2 doors Back left side Left or right (both) Left or right (both) Customized
LOADING EQUIPMENT Wire rack shelves Car, transfer Floor cart Cart or pallets
carriage, trays
12 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
Water, avg psig NA 60-80, cold water 60-80, cold water 60-80, cold water
H x W x D, cm (in) 73.6 x 72.4 x 65.5 40.6 x 40.6 x 66 157.5 x 66 x 106.7 Customized
(29 x 28.5 x 25.8) : (16 x 16 x 26), (62 x 26 x 42),
99 x 62.2 x 65.5 50.8 x 50.8 x 96.5 157.5 x 66 x 193
(39 x 24.5 x 25.8) : (20 x 20 x 38), (62 x 26 x 76)
203.2 x 86.4 x 65.5 61 x 91.4 x [91.4,
(80 x 34 x 25.8) 121.9, 152.4] (24 x
36 x [36, 48, 60])
PURCHASE INFORMATION
Price From $15,000 Not specified Not specified Not specified
Warranty 1 year, parts and 2 years, parts and 2 years, parts and 2 years, parts and
labor labor; 15 years, labor; 15 years, labor; 15 years,
vessel vessel vessel
Service contract Not specified Not specified Not specified Not specified
Delivery time, ARO 4 weeks 90-120 days 120-150 days 150-180 days
Year first sold 1996 Not specified Not specified Not specified
Number installed
USA Not specified Not specified Not specified Not specified
Worldwide Not specified Not specified Not specified Not specified
Fiscal year January to December November to October November to October November to October
OTHER SPECIFICATIONS Gas diffusion Liquid and gas Liquid and gas Custom cycles and
process matches dose separator tank separator tank control options;
size to load volume; (requires a vent (requires a vent zero-discharge
password entry; only); dual- only); dual- vacuum pump;
automatic load loading system; loading system; optional catalytic
tracking; zero-discharge zero-discharge converter with
diagnostic display; vacuum pump; vacuum pump; immediate system
custom chamber sizes optional catalytic optional catalytic connection;
on request; exhaust- converter with converter with backdraft safety
gas-abatement equip- immediate system immediate system assay.
ment available. connection. connection. Meets requirements
Meets requirements Meets requirements Meets requirements of ASME and CLA.
of CSA and OSHA; EPA of ASME and CLA. of ASME and CLA.
registered.
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 13
Healthcare Product Comparison System
CHAMBER
Size, m3 (ft3) 0.10 (3.5) 0.25 (8.8), 0.36 0.51 (18) : 0.02 (0.7) : 0.02
(12.7), 0.5 (17.7), 0.68 (24) : (0.7) : 0.1 (3.5)
0.7 (24.7), 0.9 0.85 (30)
(31.8)
Jacket material 316 stainless steel 316 stainless steel Nickel-clad or Stainless steel
stainless steel
TYPE OF GAS 100% EtO 100% EtO, EtO/CO2, 10/90 EtO/HCFC cartridges,
EtO/HCFC EtO/CO2
STANDARD CYCLE
Chamber pressure,
psig -24 -10 to 45 4-10 29 : 26.1 : 65.3
Warm temp, °C (F) 59 (138.2) 54 (129.2) 54 (129.2) 54±8(129.2±14.4)
Cold temp, °C (F) 38 (100.4) 38 (100.4) Adjustable Not specified
Full cycle time, hr 8 8 2.5 to 6 5 : 5 : 16
DOOR(S)
Configuration Single Single or double Single or double Single
Operation Manual, self-locking Automatic, Manual or power Manual
self-locking
Hinge
1 door Vertical sliding Vertical sliding Customized Right
IN-CHAMBER AERATION Up to 16 hr Up to 16 hr Up to 99 hr No : No : Up to 11
hr
RECORDER Optional printer Printer Graphic and No : No :
alphanumeric Alphanumeric printer
recorder or chart
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Sterilizing Units, Ethylene Oxide
WEIGHT, kg (lb) 200 (441) 600 (1,320) Not specified 57 (125) : 63 (139)
: 270 (594)
PURCHASE INFORMATION
Price Not specified Not specified Not specified Not specified
Service contract Not specified Not specified Not specified Not specified
Delivery time, ARO Not specified Not specified Not specified 6 weeks
Year first sold Not specified Not specified Not specified 1974 : 1977 : 1980
Number installed
USA NA NA Not specified NA
Worldwide Not specified Not specified Not specified 3,450 : 1,050 : 45
Fiscal year Not specified Not specified October to September January to December
OTHER SPECIFICATIONS None specified. Microprocessor Microprocessor- Pneumatic or elec-
controlled; optional controlled or tric door lock; door
continuous air wash, electromechanically lock block system;
emissions control, controlled systems parameter-controlled
and gas/water available. system.
separator. Meets requirements
of ASME.
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 15
Healthcare Product Comparison System
CHAMBER
Size, m3 (ft3) 0.02 (0.7) : 0.02 0.1-10 (3.5-353.1) 0.45 (15.9) to 0.16 (5.6), 0.22
(0.7) : 0.1 (3.5) 30 (1,062.3) (7.8), 0.43 (15.2),
0.59 (20.8), 0.79
(27.9)
Jacket material Stainless steel Stainless steel AISI 304 Hot rolled steel
LOADING EQUIPMENT Manual, shelves Baskets, pallets Manual, shelves, Shelves, plates,
racks, baskets, loading car with
automatic pallets shelves
16 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
Water, avg psig Not specified 3 bar, minimum 20, minimum 14-43
H x W x D, cm (in) 38 x 45 x 65 195 x 325 x 86 66 x 66 x 100 50 x 50 x [65, 90]
(15 x 17.7 x 25.6) : (76.8 x 128 x 33.9) (26 x 26 x 39.4) : (19.7 x 19.7 x
38 x 45 x 108 minimum 80 x 80 x 125 [25.6, 35.4]),
(15 x 17.7 x 42.5) : (31.5 x 31.5 x 49.2) 100 x 66 x [65, 90,
157 x 110 x 58.5 : 100 x 80 x 125 120] (39.4 x 26 x
(61.2 x 43.3 x 23) (39.4 x 31.5 x 49.2) [25.6, 35.4, 47.2])
: 130 x 90 x 150
(51.2 x 35.4 x 59.1)
: 115 x 106 x 200
(45.3 x 41.7 x 78.7) ***
WEIGHT, kg (lb) 57 (125) : 63 (139) 1,500 (3,307) Depends on size 600 (1,320), 660
: 270 (594) minimum (1,452), 830
(1,826), 1,030
(2,266), 1,230
(2,706)
PURCHASE INFORMATION
Price Not specified DM 300,000 From $110,000 Not specified
(US$134,374)
Service contract Not specified Depends on volume Not specified Not specified
Delivery time, ARO 6 weeks 7 months 24 weeks Not specified
Year first sold 1997 : 1997 : 1998 1955 1978 Not specified
Number installed
USA NA NA None NA
Worldwide 2 : 5 : Not 1,150 20 Not specified
specified
Fiscal year January to December January to December January to December Not specified
OTHER SPECIFICATIONS Pneumatic or elec- None specified. None specified. Computer controlled;
tric door lock; door reserve timer;
lock block system; vacuum; results
parameter-controlled recorded up to 10
system; vacuum pump; times; leak-test
vacuum test. device; 3 steriliza-
tion programs.
Complies w/Japanese
Ministry of Labor's
Boiler Pressure-
Vessel Code and the
Japan Pharmaceutical
Affairs Law.
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 17
Healthcare Product Comparison System
CHAMBER
Size, m3 (ft3) 0.14 (4.9) 0.68 (24) : 0.11 (3.9) : 0.22 (7.8)
0.85 (30) 0.14 (4.9)
Jacket material Anodized aluminum Steel with nickel- Anodized aluminum Anodized aluminum
clad interior
TYPE OF GAS 100% EtO single-use HCFC blend 100% EtO single-use 100% EtO single-use
cartridges cartridges cartridges
STANDARD CYCLE
Chamber pressure,
psig NA * Up to 12 NA * NA *
Warm temp, °C (F) 54 (129.2) 54 (129.2) 55 (131) 55 (131)
Cold temp, °C (F) 38 (100.4) 38 (100.4) 37 (98.6) 37 (98.6)
Full cycle time, hr 2.5 warm, 6 cold 3 warm, 7.7 cold 2.5 warm, 5.5 cold : 3.75 warm, 5.5 cold **
2.75 warm, 4.75 cold **
EtO exposure, hr 1 warm, 4.5 cold 2.2 warm, 6.7 cold 1 warm, 4 cold 1 warm, 4 cold
DOOR(S)
Configuration Single or double Single or double Single *** Single, opt double
Operation Manual, self-locking Manual or power Manual, self-locking Manual, self-locking
Hinge
1 door Right side Left or right Front right side Front right side
2 doors Left side Left or right (both) NA : Back left side Back left side
LOADING EQUIPMENT 2 baskets, height- Shelves, racks, 2 baskets, optional 3 baskets, optional
adjustable loading cars, carriages, transfer cart transfer cart
car trays
18 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
Water, avg psig See footnote * 20-50, cold water See footnote * See footnote *
H x W x D, cm (in) 73.7 x 83.8 x 94 91.4 x 61 x 121.9 70 x 80 x 72 179 x 94 x 109
(29 x 33 x 37) (36 x 24 x 48) : (27.5 x 31.5 x 28.3) (70.5 x 37 x 42.9)
91.4 x 61 x 152.4 : 79 x 76 x 89
(36 x 24 x 60) (31.1 x 29.9 x 35)
with hood,
58.5 x 76 x 89
(23 x 29.9 x 35)
without hood
WEIGHT, kg (lb) 136.1 (299) Not specified 94 (207) : 127 (279) 340 (750)
PURCHASE INFORMATION
Price $32,500-34,500 $116,000-162,000 $29,975-31,995 $47,750
Warranty 1 year, parts; 90 1 year, parts; 90 6 months, parts and 6 months, parts and
days, labor days, labor; 15 labor ** labor **
years, vessel agreement
Service contract Not specified Not specified Not specified Not specified
Delivery time, ARO Not specified Not specified Not specified Not specified
Number installed
USA Not specified Not specified Not specified Not specified
Worldwide Not specified Not specified Not specified Not specified
Fiscal year January to December January to December Not specified Not specified
OTHER SPECIFICATIONS Built-in Envirogard Built-in Envirogard Localized vent Localized vent
exhaust hood; exhaust hood; system; error codes; system; error codes;
battery backup; battery backup; power interruption power interruption
supervisor access supervisor access restart; vacuum- restart; user codes;
code; aerate-pause code; aerate-pause operated cartridge vacuum-operated
capability; optional capability; optional puncture; all- cartridge puncture;
kit for seismic kit for seismic negative pressure all-negative
installations. installations. cycle; optional pressure cycle;
relative humidity optional relative
monitor; custom humidity control;
cycles upon request. custom cycles upon
Meets requirements request. Meets
of CSA, TUV, and UL. requirements of CE
and CUL.
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 19
Healthcare Product Comparison System
EOS360 : EOS600 :
EOS1000
WHERE MARKETED Not specified
CHAMBER
Size, m3 (ft3) 0.36 (12.7) :
0.6 (21.2) :
1.0 (35.3)
STANDARD CYCLE
Chamber pressure,
psig 22
Warm temp, °C (F) 54 (129.2)
Cold temp, °C (F) 38 (100.4)
Full cycle time, hr 3.5 warm, 8 cold
DOOR(S)
Configuration Single or double
Operation Manual or power
Hinge
1 door Customized
2 doors Customized
20 ©2002 ECRI. Duplication of this page by any means for any purpose is prohibited.
Sterilizing Units, Ethylene Oxide
EOS360 : EOS600 :
EOS1000
UTILITY REQUIREMENTS
VAC, phase 220, 1-phase;
380, 3-phase
Power, kW 16 : 16.5 : 20
PURCHASE INFORMATION
Price Not specified
Warranty 1 year
Number installed
USA Not specified
Worldwide 80 : 100 : 120
©2002 ECRI. Duplication of this page by any means for any purpose is prohibited. 21