The 2023 report from UCS (Union of Concerned Scientists) sheds light on the concerning proximity of ethylene oxide (EtO) emitting facilities to residential areas and schools, highlighting the potential health risks associated with long-term exposure to this toxic gas. The delayed action from regulatory agencies like the EPA (US Environmental Protection Agency) and FDA raises significant concerns about public health.

EPA's overdue regulations for commercial sterilizers are a critical step in addressing the health risks posed by EtO emissions. However, the efforts of the medical device and sterilization industries to weaken these standards undermine public safety. It's crucial for regulatory agencies to prioritize public health over industry interests and ensure that emissions are effectively controlled without disrupting essential medical supply chains.

Additionally, the FDA's role in identifying and promoting safer sterilization alternatives is pivotal in reducing EtO use and mitigating associated health risks. Collaborative efforts between EPA and FDA are essential to protect not only patients but also workers and communities affected by sterilization facilities.

Overall, urgent and comprehensive action from regulatory agencies is needed to address the risks posed by EtO emissions and protect public health1

The FDA's designation of vaporized hydrogen peroxide (VHP) as an Established Category A sterilization method for medical devices is a significant development in the field of medical device sterilization. This move reflects the FDA's commitment to diversifying sterilization practices and reducing reliance on ethylene oxide (EtO), a traditional sterilization method. The FDA's decision is based on VHP's extensive history of safety and effectiveness2.


Key Points and Implications

1. Reducing Reliance on Ethylene Oxide (EtO):

Ethylene oxide has been a widely used sterilization method for medical devices in the United States. However, due to environmental and health concerns associated with EtO, the FDA has been actively encouraging the exploration of alternative methods since 2019. The inclusion of VHP as an Established Category A method aims to reduce dependence on EtO and promote safer sterilization practices.

2. Resilience in the Medical Device Supply Chain:

The FDA's recognition of VHP is part of a broader effort to enhance the resilience of the medical device supply chain. By diversifying sterilization methods, the industry becomes less vulnerable to potential shortages and disruptions. This is particularly crucial for ensuring a stable supply of sterile medical devices, which are essential for patient care.

3. Promoting Innovation and Sustainability:

The FDA's decision is expected to encourage wider acceptance and implementation of VHP in the medical device manufacturing landscape. VHP's addition to the Established Category A methods aligns with the agency's goal of promoting innovation and sustainability in sterilization technologies. This move signals a commitment to advancing solutions that prioritize both public health and environmental considerations.


4. ISO Standard Recognition:

The inclusion of VHP in the Established Category A methods is further reinforced by the FDA's recognition of the ISO standard 22441:2022. This recognition provides a standardized framework for the use of VHP in medical device sterilization, contributing to the credibility and acceptance of this method in the industry.


5. Environmental and Public Health Considerations:

The FDA emphasizes its commitment to reducing adverse impacts on the environment and public health. VHP, as an alternative sterilization method, is recognized for posing fewer risks to the environment and local communities compared to traditional methods. This aligns with a broader trend in the healthcare industry towards more sustainable practices.


Overall, the FDA's decision regarding VHP represents a positive step towards safer, more sustainable, and innovative medical device sterilization methods. It reflects a broader commitment to addressing environmental concerns, ensuring public health, and building a resilient medical device supply chain2.

Recent evidences highlight that ethylene oxide (EtO), used for sterilizing medical devices, has been linked to cancer, even upon inhalation. 
This connection has led to stricter regulations on EtO emissions, increasing pressure on the industry to find safer alternatives. The toxicity and cancer risk associated with EtO are the main motivations behind the search for alternative sterilization methods3.


If you're thinking about moving away from EtO, contact us!




The content of this website is aimed exclusively at healthcare professionals (HCPs) and not at the general public. Please confirm by clicking below that you are a healthcare professional, duly authorized to practice in your field. ASP EMEA declines all responsibility in case of unauthorized consultation.