Main Sterilization Technologies

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Main Sterilization Technologies (55%) Surface sterilant Typically 100% Sterilize under vacuum Process variables include Temperature RH Time Pressure EO concentration Preconditioning / Aeration (45%) Penetrative sterilant Gamma Cobalt 60 Alpha particles High penetration Electron Beam Accelerated electrons Beta particles Processing speed dependant on power (Kwatts) Penetration dependant on energy / particle speed (MeV)

Criteria to Consider Validation Initial validation Cross Plant / Cross Line Requalification / Maintenance Product / Materials Material Compatibility Packaging Electronic Components Operations / Logistics Speed to market Processing Cost Turnaround Time Product Release Processing Risks Capacity Management Residuals Health, Safety & Environmental

Initial Validation Set out in ISO11135 Typically takes 8-12 weeks Protocol needs to take into consideration Load configuration Placement of internal BI s EO residuals Product functionality Number of samples Changes to product / load configuration Set out ISO11137 VD max 15 / 25 most common Small # of samples required Methods 1 & 2 Larger # of samples required Detail on Bioburden Typically can be carried out in 3-4 weeks Test of sterility incubation time of 14 days Ebeam needs to factor in scatter

Cross Line / Plant Requirements Within same plant need to evaluate process equivalence and may be able to justify reduced validation activity. Capacity Load Configuration Equipment Capability With different plant, equivalence often difficult to establish and therefore requires full validation. Gamma Gamma Dosimetric Only Gamma Ebeam Dosimetric Microbiological Ebeam Ebeam (Similar Operating Mode) Dosimetric Only Ebeam Ebeam (Different Operating Mode) Dosimetric Microbiological

Maintenance / Requalification Generally re-qualified every 1-2 years Review of Process history Product / packaging changes Equipment changes Quarterly dose audits Control of routine Bioburden Product / packaging changes quicker to qualify Changes in orientation

New Product Speed to Market Long validation lead time Complex validation Extra validation activity to accommodate scale up. Quicker validation Smaller # of samples for validation Product for clinical trials Scalable from product development

Processing Cost By Chamber (e.g. 10 Pallets) Cycle price dictated by cycle length Expensive for small volume loads Extra costs may include Extra aeration BI s Other testing Factor in WIP cost due to longer lead times By pallet / Carrier / tote or box Easier to manage unit costs Optimize batch size to reduce dosimetry Processing cost dictated by density of product Factor in lower WIP due to faster lead times

Processing Time Typically 7-10 days Processing : 20-48 hours BI testing : 2 7 days Aeration : 0-5 days Some products may require post sterilization processing Parametric Release may shorten turnaround time by elimination of BI s Long turnaround times result in increased WIP Typically 2-3 days No BI s to test No Aeration requirements Minimal requirement for post sterilisation processing Can be as quick as < 24 hours Ebeam Tote or box to box so can be even quicker than gamma Quick turnaround time result in less WIP

Product Release Up to 7 days Review of Batch record Cycle parameters within specification BI results Aeration Complete 1-2 days Dosimeters Certificate of Processing Quality review and approval Parametric release an option for quicker release

Processing Risk Batch Process 1-32 pallets Multiple parameters to be controlled and monitored Multiple sterilization capability recommended Only option is to reprocess or scrap Gamma Pallet / Carrier / tote Ebeam, Tote / box to box Product orientation Incremental dose Dose is cumulative Dose augmentation Load presentation Critical for Ebeam

Capacity Management Lengthy process to add capacity Quicker lead time to increase capacity Equipment lead time Commissioning PQ Typically 12 18 months High capital cost Gamma Increase cobalt source Run on extra shifts Ebeam Increase power Speed up conveyor Run extra shifts

Residuals EO & ECH levels on product must meet limits set out in ISO10993-7. Can result in increased processing time to get limits below required limits Influenced by No known residual issues with irradiation of medical devices does not have high enough energy to impart radioactivity Aeration temperature Materials Product design Layers of packaging

Product / Material Compatibility Product design Tortuous pathway Dead legs Coatings Most materials compatible May be issue where product is temperature / RH sensitive EO / ECH residuals Cross linkage Discolouration Reduced with Ebeam Shorter exposure Incremental dose Reduced oxidization effects Additives to reduce impact of irradiation

Packaging Porous to EO May need post sterilization activity of product is RH sensitive Packaging validation needs to take pressure changes into consideration. Ideally need to minimize layers to facilitate EO penetration Can use non-permeable materials Foil pouches No pressure change implications No temperature / RH restrictions Potential for cheaper packaging Reduced need for post processing packaging Most materials suitable for Ebeam Unsuitable materials for Gamma Standard polypropylene Brittle UPVC Discolouration / Brittle

Electrical Components Increased risk of source of ignition Cycle can be designed outside flammable zone May result in longer cycle leading to higher processing costs Devices incorporating passive components may tolerate irradiation Some electronic components susceptible to irradiation Damage is gradual rather than sudden

Health & Safety / Environmental Hazardous Gas Occupational exposure Facility design Atex Fail Safe Emission Control Radiological shielding Occupational exposure Production of small amount of Ozone Transportation & control of Cobalt Ebeam can be quickly shut down Does not impart radioactivity No known residuals

Conclusions offers significant advantages over There are limitations with irradiation, but there are strategies to minimise these. Electron Beam offers the advantages of Gamma but with fewer of the limitations.

Questions to Ask Yourself Am I using the most suitable sterilization method for my product? Was it selected based on availability at the time? Are there other materials that would be irradiation compatible? Has anything changed to make my product capable of using an alternative sterilization method? Can I change to a different sterilization method? Is my product compatible? What are the regulatory requirements? How long will it take? Will it be worth the while Financially and operationally? Am I considering the sterilization method early enough in the product design phase?