Sterilizing and High-level Disinfecting with Germicides

Chemical sterilants can cause tissue irritation (e.g., skin, eye, and respiratory tract) and reactive airway disease. To reduce toxicity, special precautions include the use of closed containers to limit vapor release; chemically resistant gloves and aprons, goggles, and face shields; and special ventilation (10 air exchanges per hour). The use of heat-sensitive critical and semi-critical items, when heat-tolerant or disposable alternatives are available, is generally discouraged.

Following sterilization or high-level disinfection, patient-care items must be (1) rinsed with sterile water after immersion to remove toxic or irritating residues; (2) handled using sterile gloves and dried with sterile towels; (3) delivered to the point of use in an aseptic manner; and (4) must be used immediately (the items processed cannot be stored). Finally, the efficacy of the sterilization or high-level disinfection process using germicides cannot be verified.

Federal law requires that label instructions on FDA and EPA-registered products be followed (e.g., use-dilution, shelf life, storage, material compatibility, safe use, and disposal). If the user selects exposure conditions that differ from those on an FDA or EPA-registered product’s label, the user assumes liability for any injuries resulting from off-label use and is potentially subject to enforcement action under Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA).2,3,5,9