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Complete List of Links for the P2 for Hospital Sterilizers Topic Hub™ -Total Number of Links: 35
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Article/report Abstract: Article describing connection between different levels of EtO exposure and the probability of resulting tumors and leukemia. (Full text of article requires online subscription.) Fact sheet and information papers about Ethylene Oxide (EtO) Sterilizers. Source: Society for Risk Analysis URL: http://www.blackwell-synergy.com/links/doi/10.1111/j.0272-4332 .2004.00517.x/abs/ APIC State-of-the-Art Report: The role of infection control during construction in health care facilities Abstract: This report reviews issues related to construction and renovation projects in health care facilities that can help prevent transmission of infectious agents to vulnerable patient populations, health care workers, and visitors. Source: Association for Professionals in Infection Control and Epidemiology, Inc. URL: http://www.apic.org/AM/Template.cfm?Section=Home&TEMPLATE=/CM/ ContentDisplay.cfm&CONTENTID=6369 Best Management Practices for Hospital Waste [PDF] Abstract: Report: Comprehensive 392 page document handling all types of hospital waste. Includes section on air quality and sterilizer alternatives and vendors, WA state permitting information and complete list of air toxics found in hospitals. Source: Washington Department of Ecology URL: http://www.ecy.wa.gov/pubs/0504013.pdf Best Practices for Cleaning, Disinfection and Sterilization - In All Health Care Settings [PDF] Abstract: Thorough overview of best practices including a glossary of terms, assistance with selecting SUD resprocessers, a sterilization decision tree etc. Source: Provincial Infectious Diseases Advisory Committee (PIDAC) URL: http://www.health.gov.on.ca/english/providers/program/infectio us/diseases/best_prac/bp_cds_2.pdf Cleaning, Disinfection and Sterilization Procedures [PDF] Abstract: Good article with basic methods elaborated for veteranary facilities, however is relevant to human health care facilities as well. Source: Veteranary Technician URL: http://www.vettechjournal.com/pdf/Caveney-BackBasics-Apr%20VT% 2006.pdf Evaluation of the Carcinogenicity of Ethylene Oxide (External Review Draft) Abstract: This draft assessment document characterizes the potential for a carcinogenic health hazard from human inhalation exposure to EtO. Source: EPA's National Center for Environmental Assessment URL: http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?deid=157664 Final Regulation Order: Ethylene Oxide Airborne Toxic Control Measure (ATCM) Abstract: Final rule promulgated in 1999 by CARB shows an example of a state law regulating EtO sources over 25 lbs/year. Source: California Air Resources Board URL: http://www.arb.ca.gov/toxics/atcm/etoatcm.htm Guidelines for Environmental Infection Control in Health-Care Facilities Abstract: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Source: CDC, HICPAC, American Society for Healthcare Engineering/American Hospital Association, vol. 2004 URL: http://www.apic.org/AM/Template.cfm?Section=Home&TEMPLATE=/CM/ ContentDisplay.cfm&CONTENTID=1174 Mortality among workers exposed to ethylene oxide Abstract: Article describing a study of mortality in 18,254 U.S. workers exposed to ethylene oxide at 14 plants producing sterilized medical supplies and spices and results of research. Source: New England Journal of Medicine URL: http://content.nejm.org/cgi/content/abstract/324/20/1402 Mortality study of ethylene oxide workers in chemical manufacturing: a 10-year update Abstract: Mortality study on men assigned to units at a Union Carbide plant in Connecticut producing ethylene oxide by the chlorohydrin or direct oxidation processes from 1940 to 1988. (Full text of article requires online subscription.) Source: National Center for Biotechnology Information URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db= PubMed&list_uids=8398856&dopt=Citation Recent Developments in Sterilization Technology Abstract: Detailed description of sterilation technologies including their uses and advantages and disadvantages. Source: Medical Device Link URL: http://www.devicelink.com/mpb/archive/98/09/002.html Replacing Ethylene Oxide and Glutaraldehyde [PDF] Abstract: Gives an overview of where EtO and glutaraldehyde are used in hospitals, the reasons to find alternatives and a case study that shows a cost benefit analysis of switching to alternate sterilization/disinfection methods and products. Source: EPA URL: http://www.ciwmb.ca.gov/wpie/Healthcare/EPAEtOGlut.pdf Rule and Implementation Information for Commercial Sterilizers Abstract: Website with list of documents regarding the history and status of the EPA rules for commercial sterilizers. Includes Rule Information, Technical Information and Implementation Information. Source: EPA URL: http://www.epa.gov/ttn/uatw/eo/eopg.html What Are Antimicrobial Pesticides? Abstract: Fact sheet describing the categorization of ethylene oxide as a sterilizer in the antimicrobial pesticide group. Links to other resources such as chemical composition and laws affecting the use of these chemicals. Source: EPA URL: http://www.epa.gov/oppad001/ad_info.htm 
Fact sheet/checklist Abstract: A quick and easy checklist of pollution prevention measures for health care facilities. Source: New York State Department of Environmental Conservation Pollution Prevention Unit URL: http://www.dec.ny.gov/docs/permits_ej_operations_pdf/esahcf.pd f Ethylene Oxide (EtO) Fact Sheet Abstract: Fact sheet gives resources to find out if you are working with EtO, how EtO enters and affects your body, tests for exposure and how to reduce exposure. Also lists additional resources. Source: California Department of Health Services URL: http://www.dhs.ca.gov/ohb/HESIS/eto.htm Ethylene Oxide (EtO) Sterilizers Abstract: Fact Sheet: Background of regulations concerned EtO. Presents alternatives that can be used. *Note that hospital exemption is no longer valid.* Source: Hazardous and Medical Waste Programs, Aberdeen Proving Ground, MD URL: http://chppm-www.apgea.army.mil/hmwp/Factsheets/EtOSterilizers .pdf#search=%22hospital %20sterilizers%22 Ethylene Oxide Fact Sheet [PDF] Abstract: Fact sheet written to give employers the information they need in order to manage staff exposure to EtO. Source: OSHA URL: http://www.osha.gov/OshDoc/data_General_Facts/ethylene-oxide-f actsheet.pdf Fact sheet and information papers about Ethylene Oxide (EtO) Sterilizers Abstract: Fact Sheet: Background of regulations concerning EtO. Presents alternatives that can be used. *Note that hospital exemption is no longer valid.* Source: Hazardous and Medical Waste Programs, Aberdeen Proving Ground, MD URL: http://chppm-www.apgea.army.mil/hmwp/Factsheets/EtOSterilizers .pdf#search=%22hospital %20sterilizers%22 Frequently-Asked-Questions about the Reprocessing and Reuse of Single-Use Devices by Third-Party and Hospital Reprocessors [PDF] Abstract: If a hospital is reprocessing or having a provider reprocess single use devices as an alternative to using EtO to sterilize reusable devices, this document provides guidance on selecting and evaluating a provider. Source: Food and Drug Administration (FDA) URL: http://www.fda.gov/cdrh/ohip/guidance/1333.pdf
List Abstract: Lists alternative sterilization and disinfecting products and resources. Source: Sustainable Hospitals URL: http://www.sustainablehospitals.org/cgi-bin/DB_Report.cgi?px=W &rpt=Cat&id=28 Infectious Diseases in Healthcare Settings Abstract: Lists infectious diseases that may be transmitted and/or acquired in healthcare settings and links with suggestions about how to minimize risk for each disease. Source: Center for Disease Control and Prevention (CDC) URL: http://www.cdc.gov/ncidod/dhqp/id.html
Other resources Abstract: APPENDIX 112H of the Clean Air Act that governs EtO for large sources. Source: EPA URL: http://www.p2pays.org/ref/22/21430/112H.pdf#search=%22hospital %20sterilizers %22 Detox Sterilization and Disinfection [PDF] Abstract: PowerPoint about balance between sporicidal, viricidal, and bactericidal effectiveness, human and environmental health, compatibility with delicate devices and repair costs. Design tips to promote success and assure patient and health care worker safety. Source: Hospitals for a Healthy Environment: Sharing Successes URL: http://www.h2e-online.org/docs/266.pdf Ethylene Oxide Emissions 1999 [PDF] Abstract: This chart shows the sources of EtO emissions in 1999. Source: EPA URL: http://www.epa.gov/ttn/atw/nata1999/99pdfs/ethoxide.pdf Infection Control Guidelines Abstract: This collection of guidelines pertains to keeping patients and healthcare workers in healthcare settings protected from infectious diseases. Source: Center for Disease Control and Prevention (CDC) URL: http://www.cdc.gov/ncidod/dhqp/index.html#
Software/electronic tool Abstract: Virtual tour of hospital hazards. Covers the health effects of ethylene oxide gas exposure and options for reducing use. Source: OSHA URL: http://www.osha.gov/SLTC/etools/hospital/central/central.html# ExposuretoEthyleneOxideGas
Web site Abstract: Website: APIC's mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. Resources include practical guidelines and publications. Source: Association for Professionals in Infection Control and Epidemiology (APIC) URL: http://www.apic.org/AM/Template.cfm?Section=About_APIC FDA-Cleared Sterilants and High Level Disinfectants with General Claims for Processing Reusable Medical and Dental Devices Abstract: Alternative Disinfectants: A roster of FDA cleared steriliants and high-level disinfectants (HLDs) and conditions for their use. Source: Food and Drug Administratio (FDA) URL: http://www.fda.gov/cdrh/ode/germlab.html Guidance for Industry and FDA Staff: for Reprocessed Single-Use Medical Abstract: Website with information regarding regulations for the reprocessing of single-use medical devices (as an alternative to in-house sterilization of durable devices using EtO). Source: FDA URL: http://www.fda.gov/cdrh/ode/guidance/1216.html NIOSH Alert: Preventing Worker Injuries and Deaths from Explosions in Industrial Ethylene Oxide Sterilization Facilities Abstract: Website about Ethylene Oxide including; background, industrial sterilization process, safety, current standards, case reports, conclusions, recommendations, abbreviations a glossary and information about occupational illnesses, injuries, and deaths. Source: National Institute for Occupational and Safety and Health (NIOSH) URL: http://www.cdc.gov/niosh/docs/2007-164/ Nurses' Health and Workplace Exposures Abstract: Caring for patients during a typical workday, nurses handle dozens of chemicals, drugs, and other agents that are designed to prevent, diagnose, control, or cure diseases and other health conditions. These therapeutic agents can heal, but have side effects as well. For most patients, the benefits of tightly controlled doses usually outweigh the risks. But the same may not be true for nurses. Source: Environmental Working Group URL: www.ewg.org/sites/nurse_survey/analysis/summary.php Practice Guidance Abstract: Website with links to a wide variety of infection control guidelines from specific to a single disease to general. Source: Association for Professionals in Infection Control and Epidemiology (APIC) URL: http://www.apic.org/AM/Template.cfm?Section=Guidelines&Templat e=/TaggedPage/TaggedPageDisplay.cfm&TPLID=6&ContentID=519 Sterilants and Disinfectants in Healthcare Facilities Abstract: Website dedicated to those who want to go beyond mere compliance. Describes properties of sterilants and disinfectants, risks, compliance requirements, alternatives and disposal methods as well as listing additional resources. Source: Hospitals for a Healthy Environment: Sharing Successes URL: http://cms.h2e-online.org/ee/hazmat/hazmatconcern/steril/ Waste Reduction in Hospital and Medical Core Reference Documents Abstract: Website with a wide variety of P2 resources including handbooks, fact sheets and case studies from hospitals across the U.S. Source: Waste Reduction Resource Center URL: http://wrrc.p2pays.org/industry/indsectinfo.asp?INDSECT=15
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