Choosing a low-temperature sterilization technology

Low-temperature sterilization technologies are used instead of steam for sterilizing heat-sensitive or moisture-intolerant surgical equipment and supplies. In this Guidance Article, we describe several common alternatives, but we focus specifically on the two that have generated the most interest in recent years: ethylene oxide (EtO) and gas plasma sterilization. Ethylene oxide has been used as a low-temperature sterilization technology since the 1950s. Although EtO can be used safely, exposure to this gas is known to be a health hazard, and the emissions from certain EtO sterilizers are known to pollute the atmosphere. For these reasons, the use of EtO is regulated--more strictly in some regions than in others--and many healthcare facilities have decided to investigate alternative technologies. Gas plasma sterilization emerged in the 1990s as one promising alternative. This method appears to pose fewer health and environmental risks, and it offers faster turnaround times. However, this technology also has some limitations. We describe the advantages and disadvantages of both methods, along with the factors to consider when selecting from among these alternatives, in this Guidance Article.