TRISTEN PREGER – DIRECTOR OF OEM SALES AND BUSINESS DEVELOPMENT, ATI UK OPERATIONAL STANDARDS
Reviewofperaceticacid monitoring standards
Peracetic acid decontamination procedures are essential for the disinfection of healthcare facilities and equipment to help infection prevention and control. However, concerns over background levels of this sterilant used to disinfect is on the increase. This high-strength oxidant is dangerous to all living cells, so how can it be proven that no toxic gases remain, eliminating serious health risks of keyworkers and patients?
The international outbreak of Mycobacterium chimera among LivaNova 3T heater-coolers in 2015 saw a spotlight shine upon medical device disinfection and perfusion, with the implementation of peracetic acid (PAA) for disinfection of the devices subsequently introduced. However, since then, little regard has
been given to the practical implementation of PAA in hospital settings. Advice on safe handling, ventilation and PPE is scarce, leaving questions about the health and safety of the staff disinfecting these devices, along with the long term, adverse health effects, becoming a cause for concern. PAA was introduced into
decontamination due to its efficacy in preventing the growth of mycobacterium species, while also being environmentally friendly. Its high reactivity, however, puts employees immediately exposed to it at risk, due to its corrosive properties, can cause severe chemical burns. Its vapours can lead to irritation of the eyes and mucous membranes of the respiratory tract, along with lacrimation and a pungent odour causing discomfort. Exposure to lethal concentrations of
PAA results in haemorrhage, oedema and consolidation of the lungs. However, despite all of this, there are currently no guidelines issued by providers of PAA for safe exposure limits to the vapours in
ATi UK joined forces with a well-known children’s hospital to create a decontamination chamber, helping in the fight against COVID-19.
the UK, or guidance for best practice for use and storage. Some cases have been outlined in the
literature of PAA causing hypersensitisation, occupational asthma and irritant vocal cord dysfunction. One case brought to the attention of the Health and Safety Executive (HSE) was a 48-year old male that was diagnosed with occupational asthma, after exposure to unknown concentrations of PAA vapours during the cleaning of endoscopes within a ventilated room. Protective clothing, gloves, goggles and a mask (not fitted with a vapour filter) were used. After five months he presented
Tristen Preger
Tristen Preger is director of OEM sales and business development at ATi UK, which specialises in analysers and detectors for gas, air, and water monitoring. Tristen has 17 years of water and gas sensing experience. Working for one of only a handful of electro-chemical sensor manufacturers in the world, he has
been central to many innovating, successful projects that have allowed ATi UK to grow and diversify. Tristen’s passion and
enthusiasm to help customers become more efficient has seen him work closely with universities and hospitals to create innovative solutions.
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with rhinorrhoea, continuous cough and breathlessness with recovery of symptoms upon cessation of exposure. Newcastle’s Freeman Hospital (NFH)
has since written a white paper, following the completion of their study carried out within their medical facilities, monitoring PAA levels every ten seconds with a portable leak detector, donated free of charge for the trial. The trial investigated the obvious
background levels of PAA while cleaning the heater-cooler system and storage of the sterilant. but proved that without the ability to monitor it, there could be no conclusion as to its safety or efficacy, just hypothesis.
White paper Earlier this year, as part of ATi UK’s research into the use of PAA as a sterilant and the dangers of not knowing what levels were present at any time, their director of business development Tristen Preger met with the HSE. This highlighted a general lack of knowledge within the medical industry surrounding the measurement of such a strong disinfectant in the gaseous stage. Although there are no known regulatory
IFHE DIGEST 2021
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