EtO indicator labels are the key to efficacy, efficiency, and safety

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Ethylene oxide (EtO) gas sterilization is a widely used method for sterilizing medical devices and other heat-sensitive materials. This sterilization process is highly effective but requires meticulous monitoring to ensure its efficacy and safety. One of the critical components in this monitoring process is the use of EtO indicator labels whose ink changes color when exposed to EtO. These labels provide a visual confirmation that the sterilization process has occurred, helping to maintain high standards of quality control and regulatory compliance.

What is EtO gas sterilization?

EtO gas sterilization works by exposing products to ethylene oxide gas under controlled conditions of temperature, humidity, and time. The gas penetrates the materials, effectively killing bacteria, viruses, and fungi, making the products safe for use in medical and other critical applications. However, the process must be carefully monitored to ensure all parameters are met and the sterilization is effective.

Challenges in EtO gas sterilization

EtO has a lot of advantages and is an effective way to ensure sterilization. It does, however, have some unique challenges.

Precise control of parameters

The efficacy of EtO sterilization depends on maintaining precise control over a number of parameters, including gas concentration, temperature, humidity, and exposure time.

Safety concerns

Ethylene oxide is a toxic and flammable gas, making safety a top priority. Proper handling and monitoring are essential to protect workers and ensure environmental safety.

Regulatory compliance

Strict regulations govern the use of EtO for sterilization, necessitating thorough documentation and validation of the sterilization process.

The role of EtO indicator labels

Like many sterility indicating labels, EtO indicator labels are designed to change color when exposed to ethylene oxide gas. These labels serve as a visual confirmation that the sterilization process has taken place. Here’s how they contribute to effective monitoring:

Visual confirmation

The primary function of EtO indicator labels is to provide a clear visual indication that the sterilization process has been completed. The color change is an immediate and easily recognizable sign that the items have been exposed to EtO gas.

Quality assurance

By providing a straightforward method to verify sterilization, these labels enhance quality assurance processes. They help ensure that every item in a batch has been exposed to the sterilization process, reducing the risk of non-sterile items reaching the end user.

Regulatory compliance

Using indicator labels helps meet regulatory requirements for documentation and validation of the sterilization process. The labels can be included in records, providing evidence that the sterilization parameters were achieved.

Ease of use

EtO indicator labels are simple to use and can be easily integrated into existing sterilization workflows. They do not require any special equipment or training, making them appropriate for a wide range of applications.

Chemical mechanism of EtO indicator labels

EtO indicator labels use specialized inks that undergo a distinct chemical reaction upon exposure to ethylene oxide gas. These inks typically contain specific dye compounds that change their molecular structure when they react with EtO, resulting in a visible color change. For instance, a dye used in EtO indicator labels  might transition from purple to green upon sufficient exposure to EtO gas. This reaction is both time and concentration dependent, meaning the color change indicates not only the presence of EtO but also that it has been present in adequate quantities and for a sufficient duration to ensure sterilization.

Illustration of EtO indicator label before exposureIllustration of EtO indicator label after exposure

Types of EtO indicator labels  and sensitivity

EtO indicator labels are classified into different categories, according to ISO 11140 standards, based on their sensitivity and the information they provide. 

Class 1 EtO indicators: These provide a basic pass/fail result, indicating whether the item has been exposed to EtO gas.

Class 2 and higher EtO indicators: These can offer more detailed information, such as exposure to specific sterilization conditions like temperature and humidity.

The sensitivity of these indicators is critical, as they must respond accurately to the presence of EtO gas. Most indicators are designed to react within a specific range of EtO concentration, typically between 200 to 600 mg/L, at controlled temperature and humidity levels, ensuring reliable performance across various sterilization cycles.

Integration with existing labeling systems

One significant advantage of EtO indicator ink is its versatility. This ink can be incorporated into labels that are already in use for asset identification and tracking. This integration allows for a seamless addition of sterilization verification without the need for separate labels, simplifying the process and reducing costs. 

By using custom-engineered labels that combine asset identification and sterilization indicators in a single label, organizations can enhance their efficiency and ensure comprehensive monitoring and tracking throughout the sterilization process.

Best practices for using EtO indicator labels

To maximize the effectiveness of EtO indicator labels, it’s important to follow a few best practices:

Placement

Place the EtOindicator labels in locations where they will be directly exposed to the EtO gas. Ensure that labels are attached to all items or packages that need to be sterilized.

Storage and handling

Store EtO indicator labels in a cool, dry place to maintain their sensitivity and reliability. Handle them with care to avoid any pre-exposure to conditions that might affect their performance.

Interpretation

Train personnel on the correct interpretation of the color change. Ensure that everyone involved in the sterilization process understands what a positive color change looks like and the implications for items that do not show the expected change.

Documentation

Include the use of EtO indicator labels in your sterilization process documentation. Record the presence and condition of labels as part of your routine quality checks.

Ensure safety and efficacy with EtO indicator labels

Effective monitoring of EtO gas sterilization is essential for ensuring the safety and efficacy of sterilized products. EtO indicator labels play a crucial role in this process by providing a clear, visual confirmation that sterilization has occurred. By incorporating these labels into your sterilization workflow, and potentially integrating them with existing asset identification and tracking labels, you can enhance quality assurance, ensure regulatory compliance, and improve the overall safety of your products.

For more information on how to optimize your labels for EtO gas sterilization, schedule a consultation with one of our label engineers.

Author

David Baker