Ethylene Oxide Exposures in Hospitals

Abstract

Ethylene oxide (EtO) is used in hospitals as a sterilant of heat-and/or moisture-sensitive hospital supplies and surgical instruments. Comprehensive industrial hygiene surveys were conducted at 12 hospitals to characterize EtO exposure levels for workers in the sterilization areas. Hospitals included in the study were selected to represent a wide range of exposure situations as a result of various engineering controls, administrative controls, and work practices. Sampling results indicated that 8-hour time-weighted average (TWA) personal EtO exposure levels ranged from less than the limit of detection (LOD) of the method to 6.7 ppm, and short-term personal EtO exposures ranged from less than the LOD to 103 ppm. Based upon information regarding the degree of engineering controls and work practices employed, the hospitals were placed in one of four categories. The exposure results for each group of hospitals were compared with the criteria on engineering controls and work practices for that category. As expected, good engineering controls in conjunction with good work practices afforded the best reduction in exposure potential; short-term and long-term EtO exposures were not detectable. While both are effective, good engineering controls were found to be far more influential than good work practices alone in reducing EtO exposure levels. When compared to situations with poor work practices and no engineering controls, good work practices alone were found to effect a sizable reduction in exposure.