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Central Service - Issue 2/2008

Central Service - Issue 2/2008

Central Service - Issue 2/2008

EDITORIAL

Insurance or Elephant Repellent?

NEWS UPDATE

  • What’s New in Standardisation: The Sterilizing Agent
  • Process Control - 9th Forum Medical Devices and Processes
  • Risk Management for Medical Device Decontamination. Continuing Professional Development, 15 March 2008 in Essen
  • Professor Mike Emmerson

MAIN ARTICLES

C. Viard, C. Vadrot, V. Planas, J.C.Darbord::
Validation of Double Cleaning for Invasive Medical Devices - Implications for Management of the Prion Risk
(Zentr Steril 2008; 16 (2): 97-102)

Abstract
Cleaning has been acknowledged as being a fundamental step in the decontamination of reusable medical devices (RMDs), in particular in view of the risk of transmission posed by iatrogenic non-conventional transmissible agents (NCTAs). The importance of this cleaning phase has been emphasised in France in Circular No. 100 of 11 December 1995 setting out the precautions to be taken in the surgical and anatomopathological setting to counter the risk of transmission of Creutzfeldt-Jakob disease. This has been superseded by Circular No. 138 of 14 March 2001 and Circular No. 591 of 17 December 2003 recommending double cleaning of RMDs that do not tolerate a maximum inactivation process for NCTAs.
At present, there is no standardised method for investigating cleaning (detergent activity). The aim of the present study was therefore to evaluate the relevance and actual performance of double cleaning while using 16 different medical device detergent or disinfectant products tested on a neuroprotein soil representative of the biological residues encountered in the surgical setting and posing a risk of prions. A baseline protocol as well as different versions of that protocol tailored to everyday use conditions were employed. The detergent activity was evaluated by measuring residual proteins with a colorimetric method.
The results obtained with the baseline protocol showed that only the alkaline cleaners were endowed with detergent activity. It was possible to enhance greatly this activity by using higher concentrations of the detergent solutions and by interposing a soaking phase before cleaning. Likewise, detergent activity was improved on repeating the "cleaning-rinsing" cycles. The activity of enzymatic or low-alkaline detergents did not appear to be affected essentially by the various versions of the test protocol.
The tests attested to the superior detergent activity of the alkaline cleaners, which could justify their preferential use as advocated initially by Circular No. 100 of 1995. This activity can be improved by increasing the detergent solution concentrations used or by repeating the "cleaning-rinsing" cycles.
Key Words
disinfection. Creuzfeldt-Jakob disease, detergent activity, prion, reusable medical device, soil, cleaning, sterilisation

M. Jung::
Noise Protection in the CSSD - Unclean Side
(Zentr Steril 2008; 16 (2): 108-112)

Abstract
Noise destroys our hearing. An acquired hearing impairment cannot be cured, and even the most modern hearing aids are not an optimal substitute. Since the hearing faculties are often lost gradually, the person concerned notices only too late just how precious these faculties were.
Our ears are our communication receptors. If they do not discharge this function, or do so imperfectly, we can take part in social life only to a certain extent. Our concentration and efficiency decline, something that can lead to problems not only in our working lives. Apart from the damage inflicted on the ears through noise pollution, stress hormones (adrenaline) are released, with their scientifically corroborated consequences: narrowing of blood vessels, high blood pressure and an increased heart rate.
Outside their working hours, everyone is responsible for their own ears. However, in the workplace the employer has a duty of care, as enshrined in several legislative acts and regulations. In areas where noise pollution is likely, structural, technical and organisational measures must be taken to minimise noise. If such structural, technical and organisational endeavours are not sufficient, the employer must provide employees with personal protective equipment (hearing protection).
In our CSSD the employer already complies with his obligations by providing hearing protection. Hence the focus of my project is on the use and acceptance of hearing protection by staff members.
Key Words
CSSD, noise pollution, hearing protection, occupational safety stearothermophilus, Endoscope reprocessing

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