When it Comes to Chemicals…Less is Best
Every so often we hear about residue on medical devices including our SteriTite containers. Others report it as well on their containers but say use as is. We know at times white powder can be peroxide seen after sterilization in vaporized hydrogen peroxide sterilizers even on wrapped trays. Sometimes the cause is detergent residue. Other times it’s hard water deposits. Perhaps salt mushing when water softeners are used to “purify” tap water to remove calcium and magnesium from utility water. White powder can be chemical residue, but also a sign of surface corrosion on anodized aluminum containers routinely cleaned with alkaline detergents. White powder can be any of these, or simply an accumulation of all. But there is a simple solution to solving this issue. It is so obvious that we may miss the cause completely. However by identifying the cause, we can solve the problem, reduce steps, conserve energy and reduce the chemical footprint. We are simply using too many chemical agents and not adequately rinsing.
The experiment
Reusable devices provide the best return on investment when compared to limited or single use devices and when properly processed have the most sustainable environmental impact. Last week we replicated something we often hear about from users… white powder residue. We ran some parts on a short cycle in our automated washer and found white powder residue on the parts. There was no residue when the parts went into the washer only when they came out. The amount of detergent used was the same as a full cycle. We ran a short cycle. The rinse time was reduced. Reusable products help sustain the environment for future generations and allow the product to be used to the greatest extent. Even though reusable items need to be washed, they consume fewer resources, when comparable single-use items over their life cycle. We found that using a fast cycle with a brief rinse created a white powdery residue. This is why we need to take a closer look at the current practice.
Water is the Universal Solvent
Years ago, folks in SPD used the three-sink method to clean: wash and rinse medical devices. The process was viewed as sufficient. Often the wash and rinse water would not be changed in the basins until the next shift. Rinsing under the flow of water was not considered even though it provided a more efficient way to remove soil and bioburden. That manual method has been replaced for the most part by automated washers in healthcare facilities. Nonetheless, the automated step starts with pre-treatment with detergent or gel, followed by soaking with an enzymatic cleaner, then manual cleaning at the sink or sonication with a detergent of course, and finally the automated cleaning process where not one but three chemical agents are applied sequentially and a 15- second rinse is programmed into the washer to save time and to save water. On a practical matter we are simply not rinsing enough …
Are We Poisoning Ourselves and Our Water Supply?
Environmental awareness is growing in healthcare to reduce the carbon and chemical footprint and to preserve our natural resources. People depend on safe water for their health and livelihood. Water is a finite resource and is being depleted faster than it is naturally replenished. The volume of chemicals entering rivers, streams, estuaries, and seas is increasing and potentially damaging marine organisms, ecosystems, and us. Throughout the country, concerns are rising about the health effects of harmful chemicals and the excessive use of chemicals in cleaning products. Let’s consider how many chemicals are used in the automatic washer alone and evaluate how much water is needed to dilute each of the several chemical agents. Evaluate whether every cleaning step is needed. While water is the universal solvent, it’s being contaminated with chemical additives, salt for softening, media like sand to remove particulate matter, and chemicals, such as chlorine, lime, activated carbon, sodium hydroxide, and polyphosphates to treat the water when there are safer more sustainable ways. Filtration is best of all because it’s chemical free and sustainable. Consider using less chemicals when you clean and process devices. You may find that an enzymatic pre-treatment, a certified detergent, followed by a pure water rinse may be all that is needed.
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Kindest Regards,
