Sustainable Hospitals
Products and Resources for Category:
Disinfection and Sterilization

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Disinfection and Sterilization
High Level Disinfectants & Sterilants

Sterilization - the complete elimination or destruction of all forms of microbial life.
High-level disinfection - destroys all microorganisms, with the exception of high numbers of bacterial spores.
Intermediate-level disinfection - inactivates Mycobacterium tubercuosis, vegetative bacteria, most viruses, and most fungi, but it does not necessarily kill bacterial spores.
Low-level disinfection - kills most bacteria, some viruses, and some fungi, but it cannot be relied on to kill resistant microorganisms such as tubercle bacilli or bacterial spores.

Ref: APIC guideline for selection and use of disinfectants, Rutala (1996)
Product & Manufacturer Comments
Cidex(R) OPA
Advanced Sterilization Products
  • 0.55% ortho-phthalaldehyde
  • High level disinfection in 12 minutes at 20 degrees Celsius for manual processing, and 5 minutes at 25 degrees Celsius for Automated Endoscope Reprocessor (AER) with FDA-cleared capability to maintain solution temperature of 25 C.
Product & Manufacturer Comments
Metrex Compliance(TM) High Level Disinfectant/Sterilant
Metrex Research Corporation
  • 7.35% Hydrogen Peroxide and 0.23% Peracetic acid
  • High level disinfection in 15 minutes at 20 degrees Celsius (room temperature)
  • Sterilization in 3 hours at 20 degrees Celsius (room temperature)
  • Ready to use, full 14-day reuse
Product & Manufacturer Comments
Sultan Chemists
  • 7.5% hydrogen peroxide
  • High level disinfection in 30 minutes at 20 degrees Celsius
Product & Manufacturer Comments
Sterilox Liquid
Sterilox Technologies Inc.
  • Sterilox system has FDA (510k) clearance for high level disinfection in 10 minutes at 25 degrees Celsius.
  • The solution is a dilute mixture of mild oxidants principally hypochlorous acid (HOCl) at a nearly neutral pH. It is a non-aldehyde solution.
Product & Manufacturer Comments
Steris 20(TM) Sterilant
Steris Corporation
  • 0.2% peracetic acid (diluted from 35%)
  • Designed for sterilization. Sterilizes in 12 minutes at 50-55 degrees Celsius
  • Sterilant solution is cleared for use ONLY with the the STERIS System 1(TM) Processor
  • Instruments "patient ready" in <30 minutes
Product & Manufacturer Comments
Sterrad 50 and Sterrad 100S
Advanced Sterilization Products
  • Enclosed system generates hydrogen peroxide gas plasma (from 58% hydrogen peroxide)
  • Effective for sterilization
  • Sterrad 50 sterilizes during a 45 minute cycle
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Disinfection and Sterilization
Intermediate Level Disinfectants
Product & Manufacturer Comments
EnviroSystems EcoTru®
EnviroSystems, Inc.
  • EcoTru is an intermediate-level disinfectant with tuberculocidal and virucidal efficacy
  • Non-toxic disinfectant cleaner for use in healthcare and other commercial markets
  • Hard surface environmentally-friendly disinfectant based on PCMX
  • EPA-registered toxicity category IV (toxicity rating IV indicates that no precautionary statement is required)


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Resource type
APIC Guideline for Selection and Use of Disinfectants by WA Rutala (1996)
APIC Guideline for Selection and Use of Disinfectants. American Journal of Infection Control 24:313-42

This Guideline is to assist health care professionals in their decisions involving the judicious selction and proper use of specific disinfectants. The Guideline can be accessed via the following web address.
British Society of Gastroenterology (BSG) Endoscope Committee (1998)
Cleaning and Disinfection of Eequipment for Gastrointestinal Endoscopy: Report of a Working Party of the British Society of Gastroenterology Endoscopy Committee. Gut 42:585-593
Endoscope Disinfection by Orth-phthalaldehyde in a Clinical Setting: An Evaluation of Reprocessing Time and Costs Compared with Glutaraldehyde
This article by Sandra M. Hession summarizes the experience of using Ortho-phthalaldehyde for high-level disinfection at Massachusetts General Hospital.

Sandra M. Hession, BSN, RN, CGRN, Gastroenterology Nursing, Volume 26(3), May/June 2003, pp110-114
Gastroenterology Nursing
Endoscope Disinfection by Ortho-phthalaldehyde in a Clinical Setting: An Evaluation of Reprocessing Time and Costs Compared With Glutaraldehyde
Sandra Hession, BSN, RN, CGRN; Gastroenterology Nursing, Volume 26(3), May/June 2003, pp 110-114
This article describes a study to determine whether a hospital endoscopy unit could use Ortho-phthalaldehyde as a replacement for Glutaraldehyde and cost-effectively increase endoscope throughput and decrease delayed procedures while maintaining biocidal efficacy.

Royal College of Nursing (2000)
Is There an Alternative to Glutaraldehyde? A Review of Agents Used in Cold Sterilisation. Royal College of Nursing Working Well Initiative. November, 2000
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Resource type
Web site
Replacing Ethylene Oxide and Glutaraldehyde
This fact sheet is from the EPA series of environmental best practices for hospitals. It provides a concise summary of alternatives to EtO and Glutaraldehyde.
Center for Devices and Radiological Health (2000)
Sterilants and High Level Disinfectants Cleared by FDA in a 510(k) as of January 28, 2000 with General Claims for Processing Reusable Medical and Dental Devices. Center for Devices and Radiological Health Office of Device Evlauation , Division of Dental, Infection Control and General Hospital Devices.
NIOSH Publication; Glutaraldehyde: Occupational Hazards in Hospitals
This brochure is published by NIOSH. It provides useful information on adverse health effects of glutaraldehyde, how you can be exposed to glutaraldehyde, and suggests control methods and work practices to prevent or reduce your exposure to glutaraldehyde.
Note: Information has been provided by the named vendors. The Sustainable Hospitals Project does not endorse any products or take responsibility for the accuracy of the information or for product performance. Contact vendors directly to purchase a product or to obtain more information. This table is a work-in-progress, and feedback may be sent by email to or by phone to 978-934-3386.

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