Sterilization (microbiology)

207: 1237:

hazardous and NIOSH has set the IDLH at 75 ppm, less than one tenth the IDLH for ethylene oxide (800 ppm). Prolonged exposure to lower concentrations can cause permanent lung damage and consequently, OSHA has set the permissible exposure limit to 1.0 ppm, calculated as an eight-hour time-weighted average. Sterilizer manufacturers go to great lengths to make their products safe through careful design and incorporation of many safety features, though there are still workplace exposures of hydrogen peroxide from gas sterilizers documented in the FDA MAUDE database. When using any type of gas sterilizer, prudent work practices should include good ventilation, a continuous gas monitor for hydrogen peroxide and good work practices and training.

1033:

The combination of rapid lethality and easy removal of the gas allows for shorter overall cycle times during the sterilization (or decontamination) process and a lower level of sterilant residuals than are found with other sterilization methods. Eniware, LLC has developed a portable, power-free sterilizer that uses no electricity, heat or water. The 25 liter unit makes sterilization of surgical instruments possible for austere forward surgical teams, in health centers throughout the world with intermittent or no electricity and in disaster relief and humanitarian crisis situations. The four hour cycle uses a single use gas generation ampoule and a disposable scrubber to remove nitrogen dioxide gas.

1605:(PES). The filtration equipment and the filters themselves may be purchased as pre-sterilized disposable units in sealed packaging or must be sterilized by the user, generally by autoclaving at a temperature that does not damage the fragile filter membranes. To ensure proper functioning of the filter, the membrane filters are integrity tested post-use and sometimes before use. The nondestructive integrity test assures the filter is undamaged and is a regulatory requirement. Typically, terminal pharmaceutical sterile filtration is performed inside of a 670: 830:(EO, EtO) gas treatment is one of the common methods used to sterilize, pasteurize, or disinfect items because of its wide range of material compatibility. It is also used to process items that are sensitive to processing with other methods, such as radiation (gamma, electron beam, X-ray), heat (moist or dry), or other chemicals. Ethylene oxide treatment is the most common chemical sterilization method, used for approximately 70% of total sterilizations, and for over 50% of all 815:. In these situations chemicals, either in a gaseous or liquid form, can be used as sterilants. While the use of gas and liquid chemical sterilants avoids the problem of heat damage, users must ensure that the article to be sterilized is chemically compatible with the sterilant being used and that the sterilant is able to reach all surfaces that must be sterilized (typically cannot penetrate packaging). In addition, the use of chemical sterilants poses new challenges for 1393: 1176:) are accepted liquid sterilizing agents, provided that the immersion time is sufficiently long. To kill all spores in a clear liquid can take up to 22 hours with glutaraldehyde and even longer with formaldehyde. The presence of solid particles may lengthen the required period or render the treatment ineffective. Sterilization of blocks of tissue can take much longer, due to the time required for the fixative to penetrate. Glutaraldehyde and formaldehyde are 1618: 38: 546:, sometimes called a converter or steam sterilizer. The article is placed in the autoclave chamber, which is then sealed and heated using pressurized steam to a temperature set point for a defined period of time. Steam sterilization cycles can be categorized as either pre-vacuum or gravity displacement. Gravity displacement cycles rely on the lower density of the injected steam to force cooler, denser air out of the chamber drain. 799: 559:) to steam sterilization, the article's heat tolerance, and the required sterility assurance level. Following the completion of a cycle, liquids in a pressurized autoclave must be cooled slowly to avoid boiling over when the pressure is released. This may be achieved by gradually depressurizing the sterilization chamber and allowing liquids to evaporate under a negative pressure, while cooling the contents. 192: 757:

the previous boiling period to germinate to form the heat-sensitive vegetative (growing) stage, which can be killed by the next boiling step. This is effective because many spores are stimulated to grow by the heat shock. The procedure only works for media that can support bacterial growth, and will not sterilize non-nutritive substrates like water. Tyndallization is also ineffective against prions.

1105: 1219:. In medical sterilization, hydrogen peroxide is used at higher concentrations, ranging from around 35% up to 90%. The biggest advantage of hydrogen peroxide as a sterilant is the short cycle time. Whereas the cycle time for ethylene oxide may be 10 to 15 hours, some modern hydrogen peroxide sterilizers have a cycle time as short as 28 minutes. 1446:

radioisotope under water at all times and lowers the product to be irradiated in the water in hermetically sealed bells; no further shielding is required for such designs. Other uncommonly used designs use dry storage, providing movable shields that reduce radiation levels in areas of the irradiation chamber. An incident in

845:, and it can penetrate through some plastic materials and films. Ethylene oxide kills all known microorganisms, such as bacteria (including spores), viruses, and fungi (including yeasts and moulds), and is compatible with almost all materials even when repeatedly applied. It is flammable, toxic, and 681:

The standard setting for a hot air oven is at least two hours at 160 °C (320 °F). A rapid method heats air to 463.15 K (190.00 °C; 374.00 °F) for 6 minutes for unwrapped objects and 12 minutes for wrapped objects. Dry heat has the advantage that it can be used on powders and

1445:

Use of a radioisotope requires shielding for the safety of the operators while in use and in storage. With most designs, the radioisotope is lowered into a water-filled source storage pool, which absorbs radiation and allows maintenance personnel to enter the radiation shield. One variant keeps the

1032:

at its Baltimore, Maryland (U.S.) facility. This has been demonstrated in Noxilizer's lab in multiple studies and is supported by published reports from other labs. These same properties also allow for quicker removal of the sterilant and residual gases through aeration of the enclosed environment.

756:

that are left by a simple boiling water method. The process involves boiling for a period (typically 20 minutes) at atmospheric pressure, cooling, incubating for a day, and then repeating the process a total of three to four times. The incubation periods are to allow heat-resistant spores surviving

677:

Dry heat was the first method of sterilization and is a longer process than moist heat sterilization. The destruction of microorganisms through the use of dry heat is a gradual phenomenon. With longer exposure to lethal temperatures, the number of killed microorganisms increases. Forced ventilation

1227:

may become brittle. The penetrating ability of hydrogen peroxide is not as good as ethylene oxide and so there are limitations on the length and diameter of the lumen of objects that can be effectively sterilized. Hydrogen peroxide is a primary irritant and the contact of the liquid solution with

1090:

time-weighted average. The sterilant gas manufacturers include many safety features in their products but prudent practice is to provide continuous monitoring of exposure to ozone, in order to provide a rapid warning in the event of a leak. Monitors for determining workplace exposure to ozone are

678:

of hot air can be used to increase the rate at which heat is transferred to an organism and reduce the temperature and amount of time needed to achieve sterility. At higher temperatures, shorter exposure times are required to kill organisms. This can reduce heat-induced damage to food products.

1236:

depending on the concentration and contact time. It is relatively non-toxic when diluted to low concentrations, but is a dangerous oxidizer at high concentrations (> 10% w/w). The vapour is also hazardous, primarily affecting the eyes and respiratory system. Even short term exposures can be

710:

below). However, during the initial heating, infectious material may be sprayed from the wire surface before it is killed, contaminating nearby surfaces and objects. Therefore, special heaters have been developed that surround the inoculating loop with a heated cage, ensuring that such sprayed

765:

Glass bead sterilizers work by heating glass beads to 250 °C (482 °F). Instruments are then quickly doused in these glass beads, which heat the object while physically scraping contaminants off their surface. Glass bead sterilizers were once a common sterilization method employed in

550:

In comparison, pre-vacuum cycles draw a vacuum in the chamber to remove cool dry air prior to injecting saturated steam, resulting in faster heating and shorter cycle times. Typical steam sterilization cycles are between 3 and 30 minutes at 121–134 °C (250–273 °F) at 100 kPa

856:

The traditional process consists of a preconditioning phase (in a separate room or cell), a processing phase (more commonly in a vacuum vessel and sometimes in a pressure rated vessel), and an aeration phase (in a separate room or cell) to remove EO residues and lower by-products such as

291:

Many components of instruments used on spacecraft cannot withstand very high temperatures, so techniques not requiring excessive temperatures are used as tolerated, including heating to at least 120 °C (248 °F), chemical sterilization, oxidization, ultraviolet, and irradiation.

1485:

loads of medical devices. They are sufficiently penetrating to treat multiple pallet loads of low-density packages with very good dose uniformity ratios. X-ray sterilization does not require chemical or radioactive material: high-energy X-rays are generated at high intensity by an

899:

It is important to adhere to patient and healthcare personnel government specified limits of EO residues in and/or on processed products, operator exposure after processing, during storage and handling of EO gas cylinders, and environmental emissions produced when using EO.

895:

are being replaced by systems using 100% EO, because of regulations and the high cost of the blends. In hospitals, most EO sterilizers use single-use cartridges because of the convenience and ease of use compared to the former plumbed gas cylinders of EO blends.

1412:(NRC). The radiation exposure accidents that have occurred in the past are documented by the agency and thoroughly analyzed to determine the cause and improvement potential. Such improvements are then mandated to retrofit existing facilities and future design. 865:(EG). An alternative process, known as all-in-one processing, also exists for some products whereby all three phases are performed in the vacuum or pressure rated vessel. This latter option can facilitate faster overall processing time and residue dissipation. 495:

Theoretically, the likelihood of the survival of an individual microorganism is never zero. To compensate for this, the overkill method is often used. Using the overkill method, sterilization is performed by sterilizing for longer than is required to kill the

711:

material does not further contaminate the area. Another problem is that gas flames may leave carbon or other residues on the object if the object is not heated enough. A variation on flaming is to dip the object in a 70% or more concentrated solution of

1450:, US, where water-soluble caesium-137 leaked into the source storage pool, requiring NRC intervention has led to use of this radioisotope being almost entirely discontinued in favour of the more costly, non-water-soluble cobalt-60. Cobalt-60 gamma 1269:

with each other by using an acid catalyst. Peracetic acid is never sold in unstabilized solutions which is why it is considered to be environmentally friendly. Peracetic acid is a colorless liquid and the molecular formula of peracetic acid is

1070:

that reverts it to oxygen and ensures that the cycle time is relatively short. The disadvantage of using ozone is that the gas is very reactive and very hazardous. The NIOSH's immediately dangerous to life and health limit (IDLH) for ozone is

601:

Most autoclaves have meters and charts that record or display information, particularly temperature and pressure as a function of time. The information is checked to ensure that the conditions required for sterilization have been met.

819:, as the properties that make chemicals effective sterilants usually make them harmful to humans. The procedure for removing sterilant residue from the sterilized materials varies depending on the chemical and process that is used. 3740:"Association for Advancement of Medical Instrumentation ANSI/AAMI ST41-Ehylene Oxyde Sterilization in Healthcare facilities: Safety and Effectiveness. Arlington, VA: Association for Advancement of Medical Instrumentation; 2000." 1222:

Drawbacks of hydrogen peroxide include material compatibility, a lower capability for penetration and operator health risks. Products containing cellulose, such as paper, cannot be sterilized using VHP and products containing

806:

Chemicals are also used for sterilization. Heating provides a reliable way to rid objects of all transmissible agents, but it is not always appropriate if it will damage heat-sensitive materials such as biological materials,

1310:, and sodium hydroxide reduce prion levels by more than 4 logs; chlorine (too corrosive to use on certain objects) and sodium hydroxide are the most consistent. Many studies have shown the effectiveness of sodium hydroxide. 2423:

Kanemitsu K, Imasaka T, Ishikawa S, Kunishima H, Harigae H, Ueno K, et al. (May 2005). "A comparative study of ethylene oxide gas, hydrogen peroxide gas plasma, and low-temperature steam formaldehyde sterilization".

1379:

between uses, but is ineffective in shaded areas, including areas under dirt (which may become polymerized after prolonged irradiation, so that it is very difficult to remove). It also damages some plastics, such as

1464:

use an on-off technology and provide a much higher dosing rate than gamma or X-rays. Due to the higher dose rate, less exposure time is needed and thereby any potential degradation to polymers is reduced. Because

470: 2175: 919:

is around 500 ppm, so EO is imperceptible until concentrations are well above the OSHA PEL. Therefore, OSHA recommends that continuous gas monitoring systems be used to protect workers using EO for processing.

1520:

and very high-energy particles can make materials radioactive, but have good penetration, whereas lower energy particles (other than neutrons) cannot make materials radioactive, but have poorer penetration.

1192:, but is much more volatile. Formaldehyde is also used as a gaseous sterilizing agent; in this case, it is prepared on-site by depolymerization of solid paraformaldehyde. Many vaccines, such as the original 612:

can also be used to independently confirm autoclave performance. Simple biological indicator devices are commercially available, based on microbial spores. Most contain spores of the heat-resistant microbe

300:

The aim of sterilization is the reduction of initially present microorganisms or other potential pathogens. The degree of sterilization is commonly expressed by multiples of the decimal reduction time, or

1294:, such as formaldehyde, have actually been shown to increase prion resistance. Hydrogen peroxide (3%) for one hour was shown to be ineffective, providing less than 3 logs (10) reduction in contamination. 574:, which vary in their resistance. For prion elimination, various recommendations state 121–132 °C (250–270 °F) for 60 minutes or 134 °C (273 °F) for at least 18 minutes. The 263K 3449:

Bharati S, Soundrapandian C, Basu D, Datta S (2009). "Studies on a novel bioactive glass and composite coating with hydroxyapatite on titanium based alloys: Effect of γ-sterilization on coating".

730:

is a waste treatment process that involves the combustion of organic substances contained in waste materials. This method also burns any organism to ash. It is used to sterilize medical and other

3526: 606:

is often placed on the packages of products prior to autoclaving, and some packaging incorporates indicators. The indicator changes color when exposed to steam, providing a visual confirmation.

872:, EO has traditionally been delivered by filling a large chamber with a combination of gaseous EO either as pure EO, or with other gases used as diluents; diluents include chlorofluorocarbons ( 1469:

carry a charge, electron beams are less penetrating than both gamma and X-rays. Facilities rely on substantial concrete shields to protect workers and the environment from radiation exposure.

1180:, and toxic by both skin contact and inhalation. Glutaraldehyde has a short shelf-life (<2 weeks), and is expensive. Formaldehyde is less expensive and has a much longer shelf-life if some 1282:

or CH3COOOH. More recently, peracetic acid is being used throughout the world as more people are using fumigation to decontaminate surfaces to reduce the risk of COVID-19 and other diseases.

849:; however, only with a reported potential for some adverse health effects when not used in compliance with published requirements. Ethylene oxide sterilizers and processes require biological 177:, "the absence of microorganisms capable of growing in the food at normal non-refrigerated conditions at which the food is likely to be held during distribution and storage" according to the 1590:). Smaller pore sizes lower the flow rate, so in order to achieve higher total throughput or to avoid premature blockage, pre-filters might be used to protect small pore membrane filters. 150:, who discovered that application of heat over a suitable period slowed the decay of foods and various liquids, preserving them for safe consumption for a longer time than was typical. 630:

For autoclaving, cleaning is critical. Extraneous biological matter or grime may shield organisms from steam penetration. Proper cleaning can be achieved through physical scrubbing,

3206:

Rogez-Kreuz C, Yousfi R, Soufflet C, Quadrio I, Yan ZX, Huyot V, et al. (August 2009). "Inactivation of animal and human prions by hydrogen peroxide gas plasma sterilization".

734:

before it is discarded with non-hazardous waste. Bacteria incinerators are mini furnaces that incinerate and kill off any microorganisms that may be on an inoculating loop or wire.

2625:"NIOSH: Documentation for Immediately Dangerous to Life or Health Concentrations (IDLH) / NIOSH Chemical Listing and Documentation of Revised IDLH Values (as of 3/1/95) - intridl4" 3140: 1897: 912: 623:), which is extremely resistant to steam sterilization. Biological indicators may take the form of glass vials of spores and liquid media, or as spores on strips of paper inside 1261:. Peracetic acid which is also known as peroxyacetic acid is a chemical compound often used in disinfectants such as sanitizers. It is most commonly produced by the reaction of 256:

sterilization. However, since 1950, there has been an increase in medical devices and instruments made of materials (e.g., plastics) that require low-temperature sterilization.

1059:) capable of destroying a wide range of pathogens, including prions, without the need for handling hazardous chemicals since the ozone is generated within the sterilizer from 3690: 935:) gas is a rapid and effective sterilant for use against a wide range of microorganisms, including common bacteria, viruses, and spores. The unique physical properties of NO 3249:

Bauman PA, Lawrence LA, Biesert L, Dichtelmüller H, Fabbrizzi F, Gajardo R, et al. (July 2006). "Critical factors influencing prion inactivation by sodium hydroxide".

2144: 260:

gas has been used since the 1950s for heat- and moisture-sensitive medical devices. Within the past 15 years, a number of new, low-temperature sterilization systems (e.g.,

841:

above 30% and a gas concentration between 200 and 800 mg/L. Typically, the process lasts for several hours. Ethylene oxide is highly effective, as it penetrates all

129:, in that those methods reduce rather than eliminate all forms of life and biological agents present. After sterilization, an object is referred to as being sterile or 360: 3732: 330: 2981: 1126: 904: 400: 380: 939:

gas allow for sterilant dispersion in an enclosed environment at room temperature and atmospheric pressure. The mechanism for lethality is the degradation of

206: 3402:"Potential hazard due to induced radioactivity secondary to radiotherapy: the report of task group 136 of the American Association of Physicists in Medicine" 883:

Ethylene oxide is still widely used by medical device manufacturers. Since EO is explosive at concentrations above 3%, EO was traditionally supplied with an

3670: 706:

until it glows red ensures that any infectious agent is inactivated. This is commonly used for small metal or glass objects, but not for large objects (see

284:

from biological material from Earth. Standards vary depending on both the type of mission and its destination; the more likely a planet is considered to be

3662: 2199: 3023: 1028:

fashion, as is typical of other sterilization processes. Noxilizer, Inc. has commercialized this technology to offer contract sterilization services for

775: 1215:, which allows it to destroy a wide range of pathogens. Hydrogen peroxide is used to sterilize heat- or temperature-sensitive articles, such as rigid 1048:

most organic matter. On the other hand, it is a toxic and unstable gas that must be produced on-site, so it is not practical to use in many settings.

2705: 3073: 2690:

Görsdorf S, Appel KE, Engeholm C, Obe G.; Nitrogen dioxide induces DNA single-strand breaks in cultured Chinese hamster cells: Carcinogenesis. 1990.

1821:

Diep, Benjamin; Moulin, Julie; Bastic-Schmid, Viktoria; Putallaz, Thierry; Gimonet, Johan; Valles, Antonio Deban; Klijn, Adrianne (September 2019).

2176:"When using autoclave we use autoclave tape which changes color to black indicating autoclaving was successful, what is the molecular mechanism?" 3750:“US Department of Labor, Occupational Safety and Health Administration.29 CFR 1910.1020. Access to Employee Medical Records.". October 26, 2007. 987:

occurs on the devices being sterilized. This means that no aeration of the devices is required immediately following the sterilization cycle. NO

507:

For high-risk applications, such as medical devices and injections, a sterility assurance level of at least 10 is required by the United States

1859: 542:

of macromolecules, primarily proteins. This method is a faster process than dry heat sterilization. Steam sterilization is performed using an

3773: 3758: 1805: 1735: 1542:

Subatomic particles may be more or less penetrating and may be generated by a radioisotope or a device, depending upon the type of particle.

408: 627:

envelopes. These indicators are placed in locations where it is difficult for steam to reach to verify that steam is penetrating there.

1044:

is used in industrial settings to sterilize water and air, as well as a disinfectant for surfaces. It has the benefit of being able to

3550: 3386: 2055: 1401: 1362: 2569: 3745: 3711: 1152: 771: 159: 2350: 2151: 1051:

Ozone offers many advantages as a sterilant gas; ozone is a very efficient sterilant because of its strong oxidizing properties (

583: 3723: 3527:"Employing Ionizing Radiation to Enhance Food Safety – a Review The Purpose of Food Irradiation In recent decades, food irradia" 1629:

Instruments that have undergone sterilization can be maintained in such condition by containment in sealed packaging until use.

1502:

conversion. These systems are energy-inefficient, requiring much more electrical energy than other systems for the same result.

2101:

Rutala WA, Weber DJ (February 2010). "Guideline for disinfection and sterilization of prion-contaminated medical instruments".

652: 195: 114: 2230:"Characterization of Bacillus subtilis spore inactivation in low-pressure, low-temperature gas plasma sterilization processes" 911:(PEL) at 1 ppm – calculated as an eight-hour time-weighted average (TWA) – and 5 ppm as a 15-minute excursion limit (EL). The 1130: 1004: 615: 31: 578:

prion is inactivated relatively quickly by such sterilization procedures; however, other strains of scrapie, and strains of

2076: 1409: 218:

part of the body (such as the bloodstream, or penetrating the skin) must be sterile. Examples of such instruments include

3361: 2977: 2559:

Mendes GCC, Brandão TRS, Silva CLM. 2007. Ethylene oxide sterilization of medical devices: A review. Am J Infect Control.

1550:

Fluids that would be damaged by heat, irradiation or chemical sterilization, such as drug solution, can be sterilized by

655:

can be utilized. These devices can function using a variety of sterilants, although using heat via steam is most common.

3646: 3077: 3074:"Cleared Sterilants and High Level Disinfectants with General Claims for Processing Reusable Medical and Dental Devices" 2062: 2041: 1528: 1418:

is very penetrating, and is commonly used for sterilization of disposable medical equipment, such as syringes, needles,

707: 547: 508: 101:) present in or on a specific surface, object, or fluid. Sterilization can be achieved through various means, including 3048: 2645: 2963: 1490:

that does not require shielding when not in use. X-rays are generated by bombarding a dense material (target) such as

1240: 1208: 1056: 816: 539: 261: 850: 3551:"Guidance for Industry, Sterile Drug Products Produced by Aseptic Processing — Current Good Manufacturing Practice" 1574:

species have, however, been shown to be flexible enough to pass through 0.22 μm filters. In the processing of

908: 983:). Additionally, the low levels of concentration required, coupled with the high vapour pressure, assures that no 887:

carrier gas, such as a CFC or HCFC. The use of CFCs or HCFCs as the carrier gas was banned because of concerns of

3676: 1376: 1319: 1177: 579: 501: 682:

other heat-stable items that are adversely affected by steam (e.g. it does not cause rusting of steel objects).

548:

Steam Sterilization | Disinfection & Sterilization Guidelines | Guidelines Library | Infection Control | CDC

252:

Most medical and surgical devices used in healthcare facilities are made of materials that are able to go under

2741: 2207: 1686: 1681: 1575: 1457: 1115: 695: 525: 53: 3027: 2521:"Effectiveness of pressurised carbon dioxide for inactivation of Escherichia coli isolated from sewage sludge" 2467: 2296: 1371:) is useful for sterilization of surfaces and some transparent objects. Many objects that are transparent to 1307: 1134: 1119: 955:

has a boiling point of 21 °C (70 °F) at sea level, which results in a relatively highly saturated

892: 787: 3675:(6th ed.). International Association of Healthcare Central Service Materiel Management. Archived from 1953:"Disinfection & Sterilization Guidelines | Guidelines Library | Infection Control | CDC" 3783: 2716: 1952: 1350: 664: 556: 302: 285: 1243:(VHP) is used to sterilize large enclosed and sealed areas, such as entire rooms and aircraft interiors. 179: 3793: 3561: 1891: 1656: 1591: 1513: 1008:, which is the same MRO for both steam and hydrogen peroxide sterilization processes. The spore form of 858: 3002: 2935: 2015: 1594:(TFF) and alternating tangential flow (ATF) systems also reduce particulate accumulation and blockage. 2956: 837:

Ethylene oxide treatment is generally carried out between 30 and 60 °C (86 and 140 °F) with

669: 3590:"Filterability of staphylococcal species through membrane filters following application of stressors" 3379: 3317: 2861: 2802: 1760: 1661: 1454:

have about twice the energy, and hence greater penetrating range, of caesium-137-produced radiation.

1173: 1013: 972: 609: 281: 238: 227: 3737:

Pharmaceutical Filtration - The Management of Organism Removal, Meltzer TH, Jornitz MW, PDA/DHI 1998

3091: 2772:"Sterilization Trumps Disposable: Pre-packaged instruments place 'huge burden' on remote facilities" 2077:"Difference Between Moist Heat and Dry Heat Sterilization (with Comparison Chart) - Bio Differences" 2037: 3451: 992: 753: 635: 3721:

Innovative Technologies for the Biofunctionalisation and Terminal Sterilisation of Medical Devices

3639: 1396:

Efficiency illustration of the different radiation technologies (electron beam, X-ray, gamma rays)

1298:, formaldehyde, glutaraldehyde, and peracetic acid also fail this test (one hour treatment). Only 3431: 3274: 3231: 3141:"Peracetic acid fumigation as powerful and cost-effective disinfectant of SARS-CoV-2 on surfaces" 2449: 2259: 2126: 1997: 1651: 1641: 1472: 1346: 1345:. Electromagnetic or particulate radiation can be energetic enough to ionize atoms or molecules ( 1338: 1193: 869: 476:

The D-value is a function of sterilization conditions and varies with the type of microorganism,

155: 2670: 1392: 1066:. The high reactivity of ozone means that waste ozone can be destroyed by passing over a simple 752:, tyndallization is an obsolete and lengthy process designed to reduce the level of activity of 2849: 2410: 1617: 3778: 3754: 3741: 3707: 3621: 3508: 3423: 3343: 3266: 3223: 3188: 2885: 2877: 2830: 2542: 2441: 2393: 2320: 2251: 2118: 1989: 1934: 1801: 1776: 1731: 1671: 1266: 1204: 968: 838: 242: 223: 37: 3477:

Pirker L, Krajnc AP, Malec J, Radulović V, Gradišek A, Jelen A, et al. (February 2021).

1597:

Membrane filters used in production processes are commonly made from materials such as mixed

335: 3788: 3733:

Sterilization of liquids, solids, waste in disposal bags and hazardous biological substances

3611: 3601: 3498: 3490: 3459: 3413: 3333: 3325: 3258: 3215: 3178: 2869: 2820: 2810: 2532: 2433: 2241: 2110: 1979: 1924: 1871: 1834: 1768: 1602: 1536: 1532: 1447: 1189: 1052: 1025: 928: 842: 731: 691: 641: 587: 163: 90: 17: 3400:

Thomadsen B, Nath R, Bateman FB, Farr J, Glisson C, Islam MK, et al. (November 2014).

2577: 1257:(0.2%) is a recognized sterilant by the FDA for use in sterilizing medical devices such as 719:

flame. The ethanol will ignite and burn off rapidly, leaving less residue than a gas flame

308: 3727: 3574: 3291: 2598: 1598: 1555: 1551: 1512:, because the energy used is too low. Generally an energy of at least 10 MeV is needed to 1487: 1415: 1368: 1029: 888: 862: 531: 245:

therapy requires not only sterility but also well-designed containers to prevent entry of

3479:"Sterilization of polypropylene membranes of facepiece respirators by ionizing radiation" 3362:"NRC: Information Notice No. 89-82: Recent Safety-Related Incidents at Large Irradiators" 995:

than other sterilant gases, and is compatible with most medical materials and adhesives.

3321: 2865: 2806: 1913:"Disinfection and sterilization in health care facilities: what clinicians need to know" 1764: 1706: 915:'s (NIOSH) immediately dangerous to life and health limit (IDLH) for EO is 800 ppm. The 3616: 3589: 3503: 3478: 3463: 3338: 3305: 2825: 2790: 2357: 1666: 1583: 1571: 1567: 1477: 1405: 1254: 1229: 1185: 1165: 956: 916: 877: 827: 743: 703: 603: 481: 385: 365: 265: 257: 147: 126: 1772: 3767: 3720: 3698: 3262: 2246: 2229: 2001: 1562:

solutions in medicinal drug processing. A microfilter with pore size of usually 0.22

1524:

Sterilization by irradiation with gamma rays may however affect material properties.

1372: 1342: 1060: 716: 699: 167: 67: 3435: 3235: 2453: 2263: 2130: 798: 3278: 2337: 1839: 1822: 1423: 1169: 984: 749: 727: 191: 122: 2791:"Nitrogen Dioxide Sterilization in Low-Resource Environments: A Feasibility Study" 651:

To sterilize waste materials that are chiefly composed of liquid, a purpose-built

594:

tissue at 134–138 °C (273–280 °F) for 18 minutes resulted in only a 2.5

3494: 3116: 2815: 1795: 1725: 3663:

WHO - Infection Control Guidelines for Transmissible Spongiform Encephalopathies

3418: 3401: 2771: 1676: 1509: 1505: 1461: 1431: 1381: 1323: 1262: 1104: 868:

The most common EO processing method is the gas chamber method. To benefit from

808: 648:

is analogous to autoclaving, and when performed correctly renders food sterile.

488:

etc.. For steam sterilization (see below) typically the temperature, in degrees

477: 231: 110: 83: 3306:"Molecular indications of protein damage in adenoviruses after UV disinfection" 2917: 2624: 1984: 1967: 2873: 1563: 1334: 1233: 846: 831: 631: 199: 118: 86: 3640:"Guidance for Industry: Sterile Drug Products Produced by Aseptic Processing" 3052: 2881: 2649: 2056:"Guidance for Industry: Sterile Drug Products Produced by Aseptic Processing" 1780: 3606: 1606: 1587: 1427: 1258: 1216: 1211:(VHP), is another chemical sterilizing agent. Hydrogen peroxide is a strong 1067: 947:

of the phosphate backbone, which kills the exposed organism as it absorbs NO

944: 884: 767: 595: 552: 543: 497: 246: 3625: 3512: 3427: 3347: 3270: 3227: 3192: 2834: 2546: 2445: 2397: 2255: 2122: 1993: 1938: 1875: 2889: 2278: 1375:

absorb UV. UV irradiation is routinely used to sterilize the interiors of

3329: 2537: 2520: 1632:

Aseptic technique is the act of maintaining sterility during procedures.

1495: 1491: 1466: 1299: 1291: 1181: 951:. This degradations occurs at even very low concentrations of the gas. NO 624: 535: 530:

Steam sterilization, also known as moist heat sterilization, uses heated

106: 75: 62:) refers to any process that removes, kills, or deactivates all forms of 27:

Process that eliminates all biological agents on an object or in a volume

778:(CDC) to be used as a sterilizers since 1997. They are still popular in 770:

offices as well as biological laboratories, but are not approved by the

154:

of foods is an extension of the same principle and has helped to reduce

1646: 1622: 1559: 1517: 1419: 1303: 1212: 1045: 853:

after sterilizer installation, significant repairs or process changes.

812: 712: 645: 575: 489: 272:) have been developed and are being used to sterilize medical devices. 219: 215: 214:

In general, surgical instruments and medications that enter an already

151: 130: 2789:

Shomali, Majdi; Opie, David; Avasthi, Trisha; Trilling, Ariel (2015).

1290:

Prions are highly resistant to chemical sterilization. Treatment with

1482: 1451: 1435: 1330: 1295: 1246:

Although toxic, VHP breaks down in a short time to water and oxygen.

1082:

IDLH for ethylene oxide. NIOSH and OSHA has set the PEL for ozone at

1063: 783: 779: 3380:"2019 Midwest Medical Device Sterilization Workshop: Summary Report" 2749: 1751:

Diehl JR (March 2002). "Food irradiation—past, present and future".

465:{\displaystyle {\frac {N}{N_{0}}}=10^{\left(-{\frac {t}{D}}\right)}} 3219: 3183: 3166: 2495: 2437: 2114: 1968:"Planetary protection: an international concern and responsibility" 1929: 1912: 1558:. This method is commonly used for heat labile pharmaceuticals and 963:

may be used as a convenient source for the sterilant gas. Liquid NO

562:

Proper autoclave treatment will inactivate all resistant bacterial

146:

One of the first steps toward modernized sterilization was made by

1616: 1579: 1391: 1326: 1224: 1041: 797: 668: 591: 571: 567: 563: 269: 253: 205: 98: 94: 79: 71: 36: 1845:(see also 21 CFR 113, a definition focused on thermal processing) 590:

as test animals, one experiment showed that heating BSE positive

3024:"Occupational Safety and Health Guideline for Hydrogen Peroxide" 2700: 2698: 2696: 873: 102: 63: 42: 158:("food poisoning"). Other methods of sterilizing foods include 3753:

Perioperative Standards and Recommended Practices, AORN 2013,

2570:"ATSDR - Medical Management Guidelines (MMGs): Ethylene Oxide" 1823:"Validation protocol for commercial sterility testing methods" 1508:

with X-rays, gamma rays, or electrons does not make materials

1439: 1098: 940: 570:, bacteria, and viruses, but is not expected to eliminate all 2918:"CDC - Index of Chemicals - NIOSH Publications and Products" 2411:

https://www.cdc.gov/OralHealth/InfectionControl/faq/bead.htm

551:(15 psi), but adjustments may be made depending on the 500:

present on or in the item being sterilized. This provides a

2599:"Substitute Sterilants under SNAP as of September 28, 2006" 485: 362:) of its original value. Then the number of microorganisms 3003:"MAUDE - Manufacturer and User Facility Device Experience" 998:

The most-resistant organism (MRO) to sterilization with NO

3292:

Trends in Radiation Sterilization of Health Care Products

1400:

The safety of irradiation facilities is regulated by the

1016:

in sterilization applications. Microbial inactivation of

305:, denoting the time needed to reduce the initial number 2850:"Ozone: An overview of its toxicity in man and animals" 210:

Apparatus to sterilize surgical instruments (1914–1918)

504:(SAL) equal to the probability of a non-sterile unit. 237:

Preparation of injectable medications and intravenous

173:

In the context of food, sterility typically refers to

3556:. U.S. Department of Health and Human Services. 2004. 1582:

must be removed or inactivated, requiring the use of

913:

National Institute for Occupational Safety and Health

411: 388: 368: 338: 311: 1535:

area. Some foods (e.g. spices and ground meats) are

3697: 1498:with high-energy electrons, in a process known as 959:at ambient temperature. Because of this, liquid NO 464: 394: 374: 354: 324: 2228:Roth S, Feichtinger J, Hertel C (February 2010). 1896:: CS1 maint: DOI inactive as of September 2024 ( 555:of the article being sterilized, its resistance ( 2351:"Sterilization of Broth Media by Tyndallization" 1864:Global Journal of Biochemistry and Biotechnology 1012:has been well characterized over the years as a 786:dental practices, although there are no current 282:protect the contamination of Solar System bodies 3588:Onyango LA, Dunstan RH, Roberts TK (May 2010). 1384:foam if exposed for prolonged periods of time. 230:. This is also essential in the manufacture of 2854:Journal of Toxicology and Environmental Health 2038:"Guidance for Industry: Biological Indicators" 1797:Understanding Food: Principles and Preparation 1286:Potential for chemical sterilization of prions 2982:Occupational Safety and Health Administration 2475:Occupational Safety and Health Administration 1800:(3 ed.). Cengage Learning. p. 546. 1727:Food irradiation: principles and applications 905:Occupational Safety and Health Administration 8: 2500:North American Sterilization & Packaging 1860:"Sterilization methods and its applications" 694:and straight-wires in microbiology labs for 162:(which uses a shorter duration of heating), 3208:Infection Control and Hospital Epidemiology 3051:. Atsdr.cdc.gov. 2007-09-24. Archived from 2742:"Noxilizer Contract Sterilization Services" 2648:. Atsdr.cdc.gov. 2007-09-24. Archived from 2426:Infection Control and Hospital Epidemiology 2356:. Science in the Real World. Archived from 2103:Infection Control and Hospital Epidemiology 1133:. Unsourced material may be challenged and 2619: 2617: 2519:Mushtaq M, Banks CJ, Heaven S (May 2012). 1481:) allow irradiation of large packages and 1422:and IV sets, and food. It is emitted by a 1367:Ultraviolet light irradiation (UV, from a 776:Centers for Disease Control and Prevention 3615: 3605: 3502: 3417: 3337: 3182: 2824: 2814: 2536: 2245: 2016:"No bugs please, this is a clean planet!" 1983: 1928: 1838: 1460:is also commonly used for sterilization. 1153:Learn how and when to remove this message 876:), hydrochlorofluorocarbons (HCFCs), and 538:to inactivate or kill microorganisms via 445: 436: 421: 412: 410: 387: 367: 343: 337: 316: 310: 3706:. Weinheim: Wiley-VCH. pp. 157–84. 3704:Biotechnology, 2E, Vol. 3, Bioprocessing 3304:Eischeid AC, Linden KG (February 2011). 3167:"The challenge of prion decontamination" 1408:and monitored by the different national 967:is often referred to by the name of its 280:There are strict international rules to 190: 2671:"Hospital eTool: Central Supply Module" 1697: 861:(EC or ECH) and, of lesser importance, 3570: 3559: 3310:Applied and Environmental Microbiology 1911:Rutala WA, Weber DJ (September 2004). 1889: 1853: 1851: 790:guidelines for using this sterilizer. 2904:CRC Handbook of Chemistry and Physics 2379: 2377: 2018:. European Space Agency. 30 July 2002 715:, then briefly touch the object to a 698:. Leaving the loop in the flame of a 288:, the stricter the requirements are. 249:after initial product sterilization. 7: 2384:Zadik Y, Peretz A (April 2008). "". 1357:Non-ionizing radiation sterilization 1318:Sterilization can be achieved using 1196:, are sterilized with formaldehyde. 1131:adding citations to reliable sources 2200:"Decontamination and Sterilization" 3464:10.1016/j.jeurceramsoc.2009.02.013 2848:Menzel, Daniel B. (January 1984). 1858:Lamerhofer, Michael (2 May 2022). 1402:International Atomic Energy Agency 1363:Ultraviolet germicidal irradiation 25: 3165:McDonnell G, Burke P (May 2003). 3092:"Peracetic Acid Uses and Hazards" 1966:Athena, Coustenis (30 May 2023). 772:U.S. Food and Drug Administration 160:ultra-high temperature processing 121:. Sterilization is distinct from 3672:Central Service Technical Manual 3294:, IAEA, Vienna,24 September 2008 3263:10.1111/j.1423-0410.2006.00790.x 3049:"ATSDR - MMG: Hydrogen Peroxide" 2748:. Noxilizer, Inc. Archived from 2715:. Noxilizer, Inc. Archived from 2247:10.1111/j.1365-2672.2009.04453.x 1586:with a smaller pore size (20–50 1388:Ionizing radiation sterilization 1103: 586:(BSE) are more resistant. Using 584:bovine spongiform encephalopathy 2706:"Mechanism Overview, June 2012" 2297:"– Alberta Health and Wellness" 2234:Journal of Applied Microbiology 1972:Life Sciences in Space Research 1753:Radiation Physics and Chemistry 1438:energies of up to 1.3 and 0.66 1095:Glutaraldehyde and formaldehyde 653:effluent decontamination system 598:decrease in prion infectivity. 2321:"Chemical Vapor Sterilization" 1840:10.1016/j.foodcont.2019.03.029 1410:Nuclear Regulatory Commissions 1005:Geobacillus stearothermophilus 616:Geobacillus stearothermophilus 32:Sterilization (disambiguation) 1: 3702:. In Stephanopoulos G (ed.). 3699:"Media and air sterilization" 3531:scholar.googleusercontent.com 2957:"Guidelines for Disinfection" 2646:"ATSDR - MMG: Ethylene Oxide" 1773:10.1016/s0969-806x(01)00622-3 41:Microorganisms growing on an 3774:Sterilization (microbiology) 3647:Food and Drug Administration 3495:10.1016/j.memsci.2020.118756 3171:Clinical Infectious Diseases 3078:Food and Drug Administration 2978:"29 CFR 1910.1000 Table Z-1" 2816:10.1371/journal.pone.0130043 2525:Water Science and Technology 2386:Refu'at Ha-Peh Veha-Shinayim 2279:"FOOD STERILIZATION BY HEAT" 2063:Food and Drug Administration 2042:Food and Drug Administration 1917:Clinical Infectious Diseases 1529:United States Postal Service 509:Food and Drug Administration 57: 18:Sterilisation (microbiology) 3696:Raju GK, Cooney CL (1993). 3483:Journal of Membrane Science 3419:10.1097/HP.0000000000000139 2964:Centers for Disease Control 1527:Irradiation is used by the 1241:Vaporized hydrogen peroxide 1209:vaporized hydrogen peroxide 621:Bacillus stearothermophilus 262:vaporized hydrogen peroxide 3810: 3026:. Osha.gov. Archived from 1985:10.1016/j.lssr.2023.02.001 1730:. Wiley-IEEE. p. 23. 1609:to prevent contamination. 1592:Tangential flow filtration 1377:biological safety cabinets 1360: 1024:gas proceeds rapidly in a 943:in the spore core through 909:permissible exposure limit 741: 662: 523: 29: 2874:10.1080/15287398409530493 1613:Preservation of sterility 1537:sterilized by irradiation 1531:to sterilize mail in the 1320:electromagnetic radiation 580:Creutzfeldt-Jakob disease 502:sterility assurance level 382:after sterilization time 3665:. Retrieved Jul 10, 2010 3121:pubchem.ncbi.nlm.nih.gov 2283:Liberty Knowledge Reason 1687:Sterilant gas monitoring 1682:Spaulding classification 1566:will effectively remove 1458:Electron beam processing 1207:, in both liquid and as 1172:solutions (also used as 1091:commercially available. 893:halogenated hydrocarbons 811:, electronics, and many 526:Moist heat sterilization 492:, is given as an index. 3607:10.1186/1756-0500-3-152 2349:Thiel, Theresa (1999). 1314:Radiation sterilization 1308:guanidinium thiocyanate 355:{\displaystyle 10^{-1}} 3569:Cite journal requires 2906:(76th ed.). 1995. 2496:"Sterilization | NASP" 1876:10.15651/GJBB.22.10.37 1626: 1397: 1351:non-ionizing radiation 1349:), or less energetic ( 803: 794:Chemical sterilization 761:Glass bead sterilizers 674: 665:Dry heat sterilization 466: 396: 376: 356: 326: 211: 203: 46: 1878:(inactive 2024-09-12) 1657:Contamination control 1625:in sterile packaging. 1620: 1395: 1361:Further information: 1018:G. stearothermophilus 1010:G. stearothermophilus 859:ethylene chlorohydrin 801: 672: 610:Biological indicators 467: 397: 377: 357: 327: 325:{\displaystyle N_{0}} 228:artificial pacemakers 209: 194: 89:organisms) and other 40: 3387:Department of Energy 3330:10.1128/aem.00403-10 3005:. Accessdata.fda.gov 2538:10.2166/wst.2012.064 1662:Electron irradiation 1514:induce radioactivity 1337:, or irradiation by 1184:is added to inhibit 1127:improve this section 1014:biological indicator 1002:gas is the spore of 973:dinitrogen tetroxide 754:sporulating microbes 409: 386: 366: 336: 309: 187:Medicine and surgery 175:commercial sterility 125:, sanitization, and 30:For other uses, see 3691:Control of microbes 3452:J. Eur. Ceram. Soc. 3322:2011ApEnM..77.1145E 3055:on October 11, 2003 2866:1984JTEH...13..181M 2807:2015PLoSO..1030043S 1765:2002RaPC...63..211D 1339:subatomic particles 1086:, calculated as an 907:(OSHA) has set the 690:Flaming is done to 673:Dry heat sterilizer 247:adventitious agents 180:Codex Allimentarius 166:and high pressure ( 3726:2015-11-20 at the 3594:BMC Research Notes 2302:. Health.gov.ab.ca 1724:Molins RA (2001). 1652:Aseptic processing 1642:Antibacterial soap 1627: 1546:Sterile filtration 1473:High-energy X-rays 1398: 1347:ionizing radiation 1304:phenolic compounds 1194:Salk polio vaccine 870:economies of scale 804: 732:biohazardous waste 675: 462: 392: 372: 352: 322: 224:hypodermic needles 212: 204: 200:antiseptic surgery 156:food borne illness 47: 3759:978-1-888460-77-3 3649:. September 2004. 2652:on August 2, 2003 2574:www.atsdr.cdc.gov 2065:. September 2004. 2044:. 4 October 2007. 1807:978-0-495-10745-3 1794:Brown AC (2007). 1737:978-0-471-35634-9 1672:Food preservation 1434:(Cs), which have 1267:hydrogen peroxide 1205:Hydrogen peroxide 1200:Hydrogen peroxide 1163: 1162: 1155: 1078:smaller than the 839:relative humidity 834:medical devices. 692:inoculation loops 638:, or pulsed air. 453: 427: 395:{\displaystyle t} 375:{\displaystyle N} 243:fluid replacement 234:pharmaceuticals. 91:biological agents 16:(Redirected from 3801: 3717: 3701: 3687: 3685: 3684: 3651: 3650: 3645:. United States 3644: 3636: 3630: 3629: 3619: 3609: 3585: 3579: 3578: 3572: 3567: 3565: 3557: 3555: 3547: 3541: 3540: 3538: 3537: 3523: 3517: 3516: 3506: 3474: 3468: 3467: 3446: 3440: 3439: 3421: 3397: 3391: 3390: 3389:. November 2019. 3385:. United States 3384: 3376: 3370: 3369: 3358: 3352: 3351: 3341: 3301: 3295: 3289: 3283: 3282: 3246: 3240: 3239: 3203: 3197: 3196: 3186: 3162: 3156: 3155: 3153: 3152: 3145:News-Medical.net 3137: 3131: 3130: 3128: 3127: 3117:"Peracetic acid" 3112: 3106: 3105: 3103: 3102: 3088: 3082: 3081: 3076:. United States 3070: 3064: 3063: 3061: 3060: 3045: 3039: 3038: 3036: 3035: 3020: 3014: 3013: 3011: 3010: 2999: 2993: 2992: 2990: 2988: 2974: 2968: 2967: 2961: 2953: 2947: 2946: 2944: 2942: 2932: 2926: 2925: 2914: 2908: 2907: 2900: 2894: 2893: 2860:(2–3): 181–204. 2845: 2839: 2838: 2828: 2818: 2786: 2780: 2779: 2768: 2762: 2761: 2759: 2757: 2738: 2732: 2731: 2729: 2727: 2722:on 12 April 2016 2721: 2710: 2702: 2691: 2688: 2682: 2681: 2679: 2678: 2667: 2661: 2660: 2658: 2657: 2642: 2636: 2635: 2633: 2632: 2621: 2612: 2611: 2609: 2608: 2603: 2595: 2589: 2588: 2586: 2585: 2576:. Archived from 2566: 2560: 2557: 2551: 2550: 2540: 2516: 2510: 2509: 2507: 2506: 2492: 2486: 2485: 2483: 2482: 2472: 2468:"Ethylene oxide" 2464: 2458: 2457: 2420: 2414: 2408: 2402: 2401: 2381: 2372: 2371: 2369: 2368: 2362: 2355: 2346: 2340: 2335: 2329: 2328: 2317: 2311: 2310: 2308: 2307: 2301: 2293: 2287: 2286: 2274: 2268: 2267: 2249: 2225: 2219: 2218: 2216: 2215: 2206:. Archived from 2196: 2190: 2189: 2187: 2186: 2172: 2166: 2165: 2163: 2162: 2156: 2150:. Archived from 2149: 2141: 2135: 2134: 2098: 2092: 2091: 2089: 2088: 2073: 2067: 2066: 2061:. United States 2060: 2052: 2046: 2045: 2040:. United States 2034: 2028: 2027: 2025: 2023: 2012: 2006: 2005: 1987: 1963: 1957: 1956: 1949: 1943: 1942: 1932: 1908: 1902: 1901: 1895: 1887: 1885: 1883: 1855: 1846: 1844: 1842: 1818: 1812: 1811: 1791: 1785: 1784: 1759:(3–6): 211–215. 1748: 1742: 1741: 1721: 1715: 1714: 1702: 1603:polyethersulfone 1556:membrane filters 1533:Washington, D.C. 1448:Decatur, Georgia 1442:, respectively. 1228:skin will cause 1190:paraformaldehyde 1158: 1151: 1147: 1144: 1138: 1107: 1099: 1089: 1085: 1081: 1077: 1074: 929:Nitrogen dioxide 924:Nitrogen dioxide 843:porous materials 817:workplace safety 642:Pressure cooking 471: 469: 468: 463: 461: 460: 459: 455: 454: 446: 428: 426: 425: 413: 401: 399: 398: 393: 381: 379: 378: 373: 361: 359: 358: 353: 351: 350: 331: 329: 328: 323: 321: 320: 164:food irradiation 61: 21: 3809: 3808: 3804: 3803: 3802: 3800: 3799: 3798: 3764: 3763: 3728:Wayback Machine 3714: 3695: 3682: 3680: 3668: 3659: 3654: 3642: 3638: 3637: 3633: 3587: 3586: 3582: 3568: 3558: 3553: 3549: 3548: 3544: 3535: 3533: 3525: 3524: 3520: 3476: 3475: 3471: 3458:(12): 2527–35. 3448: 3447: 3443: 3399: 3398: 3394: 3382: 3378: 3377: 3373: 3360: 3359: 3355: 3303: 3302: 3298: 3290: 3286: 3248: 3247: 3243: 3205: 3204: 3200: 3164: 3163: 3159: 3150: 3148: 3139: 3138: 3134: 3125: 3123: 3114: 3113: 3109: 3100: 3098: 3090: 3089: 3085: 3072: 3071: 3067: 3058: 3056: 3047: 3046: 3042: 3033: 3031: 3022: 3021: 3017: 3008: 3006: 3001: 3000: 2996: 2986: 2984: 2976: 2975: 2971: 2959: 2955: 2954: 2950: 2940: 2938: 2934: 2933: 2929: 2916: 2915: 2911: 2902: 2901: 2897: 2847: 2846: 2842: 2801:(6): e0130043. 2788: 2787: 2783: 2770: 2769: 2765: 2755: 2753: 2740: 2739: 2735: 2725: 2723: 2719: 2708: 2704: 2703: 2694: 2689: 2685: 2676: 2674: 2669: 2668: 2664: 2655: 2653: 2644: 2643: 2639: 2630: 2628: 2623: 2622: 2615: 2606: 2604: 2601: 2597: 2596: 2592: 2583: 2581: 2580:on May 28, 2010 2568: 2567: 2563: 2558: 2554: 2531:(10): 1759–64. 2518: 2517: 2513: 2504: 2502: 2494: 2493: 2489: 2480: 2478: 2470: 2466: 2465: 2461: 2422: 2421: 2417: 2409: 2405: 2392:(2): 36–9, 75. 2383: 2382: 2375: 2366: 2364: 2360: 2353: 2348: 2347: 2343: 2336: 2332: 2319: 2318: 2314: 2305: 2303: 2299: 2295: 2294: 2290: 2276: 2275: 2271: 2227: 2226: 2222: 2213: 2211: 2198: 2197: 2193: 2184: 2182: 2174: 2173: 2169: 2160: 2158: 2154: 2147: 2143: 2142: 2138: 2100: 2099: 2095: 2086: 2084: 2081:Bio Differences 2075: 2074: 2070: 2058: 2054: 2053: 2049: 2036: 2035: 2031: 2021: 2019: 2014: 2013: 2009: 1965: 1964: 1960: 1951: 1950: 1946: 1910: 1909: 1905: 1888: 1881: 1879: 1857: 1856: 1849: 1820: 1819: 1815: 1808: 1793: 1792: 1788: 1750: 1749: 1745: 1738: 1723: 1722: 1718: 1711:www.ph.ucla.edu 1704: 1703: 1699: 1695: 1638: 1615: 1599:cellulose ester 1552:microfiltration 1548: 1516:in a material. 1488:X-ray generator 1416:Gamma radiation 1390: 1369:germicidal lamp 1365: 1359: 1316: 1288: 1281: 1277: 1273: 1252: 1202: 1159: 1148: 1142: 1139: 1124: 1108: 1097: 1087: 1083: 1079: 1075: 1072: 1039: 1030:medical devices 1023: 1001: 990: 982: 978: 966: 962: 957:vapour pressure 954: 950: 938: 934: 926: 889:ozone depletion 863:ethylene glycol 825: 796: 763: 746: 740: 725: 688: 667: 661: 566:in addition to 532:saturated steam 528: 522: 517: 441: 437: 432: 417: 407: 406: 384: 383: 364: 363: 339: 334: 333: 312: 307: 306: 298: 278: 198:, a pioneer of 189: 144: 139: 54:British English 35: 28: 23: 22: 15: 12: 11: 5: 3807: 3805: 3797: 3796: 3791: 3786: 3781: 3776: 3766: 3765: 3762: 3761: 3751: 3748: 3738: 3735: 3730: 3718: 3712: 3693: 3688: 3666: 3658: 3655: 3653: 3652: 3631: 3580: 3571:|journal= 3542: 3518: 3469: 3441: 3406:Health Physics 3392: 3371: 3353: 3296: 3284: 3241: 3220:10.1086/598342 3198: 3184:10.1086/374668 3157: 3132: 3107: 3083: 3065: 3040: 3015: 2994: 2969: 2948: 2927: 2909: 2895: 2840: 2781: 2763: 2752:on 29 May 2018 2733: 2692: 2683: 2662: 2637: 2613: 2590: 2561: 2552: 2511: 2487: 2459: 2438:10.1086/502572 2415: 2403: 2373: 2341: 2330: 2312: 2288: 2269: 2220: 2191: 2167: 2136: 2115:10.1086/650197 2093: 2068: 2047: 2029: 2007: 1958: 1955:. 24 May 2019. 1944: 1930:10.1086/423182 1903: 1847: 1813: 1806: 1786: 1743: 1736: 1716: 1696: 1694: 1691: 1690: 1689: 1684: 1679: 1674: 1669: 1667:Food packaging 1664: 1659: 1654: 1649: 1644: 1637: 1634: 1614: 1611: 1572:staphylococcal 1568:microorganisms 1547: 1544: 1500:bremsstrahlung 1478:bremsstrahlung 1462:Electron beams 1406:United Nations 1389: 1386: 1358: 1355: 1343:electron beams 1315: 1312: 1287: 1284: 1279: 1275: 1271: 1255:Peracetic acid 1251: 1250:Peracetic acid 1248: 1201: 1198: 1186:polymerization 1166:Glutaraldehyde 1161: 1160: 1111: 1109: 1102: 1096: 1093: 1038: 1035: 1021: 999: 988: 980: 976: 964: 960: 952: 948: 936: 932: 925: 922: 917:odor threshold 878:carbon dioxide 828:Ethylene oxide 824: 823:Ethylene oxide 821: 795: 792: 788:evidence-based 762: 759: 744:Tyndallization 742:Main article: 739: 738:Tyndallization 736: 724: 721: 704:alcohol burner 687: 684: 660: 657: 604:Indicator tape 521: 518: 516: 513: 482:water activity 474: 473: 458: 452: 449: 444: 440: 435: 431: 424: 420: 416: 391: 371: 349: 346: 342: 332:to one tenth ( 319: 315: 297: 296:Quantification 294: 277: 274: 266:peracetic acid 258:Ethylene oxide 188: 185: 148:Nicolas Appert 143: 140: 138: 135: 127:pasteurization 68:microorganisms 66:(particularly 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 3806: 3795: 3792: 3790: 3787: 3785: 3784:Electron beam 3782: 3780: 3777: 3775: 3772: 3771: 3769: 3760: 3756: 3752: 3749: 3747: 3746:1-57020-420-9 3743: 3739: 3736: 3734: 3731: 3729: 3725: 3722: 3719: 3715: 3713:3-527-28313-7 3709: 3705: 3700: 3694: 3692: 3689: 3679:on 2020-08-07 3678: 3674: 3673: 3669:Ninemeier J. 3667: 3664: 3661: 3660: 3656: 3648: 3641: 3635: 3632: 3627: 3623: 3618: 3613: 3608: 3603: 3599: 3595: 3591: 3584: 3581: 3576: 3563: 3552: 3546: 3543: 3532: 3528: 3522: 3519: 3514: 3510: 3505: 3500: 3496: 3492: 3488: 3484: 3480: 3473: 3470: 3465: 3461: 3457: 3454: 3453: 3445: 3442: 3437: 3433: 3429: 3425: 3420: 3415: 3412:(5): 442–60. 3411: 3407: 3403: 3396: 3393: 3388: 3381: 3375: 3372: 3367: 3363: 3357: 3354: 3349: 3345: 3340: 3335: 3331: 3327: 3323: 3319: 3316:(3): 1145–7. 3315: 3311: 3307: 3300: 3297: 3293: 3288: 3285: 3280: 3276: 3272: 3268: 3264: 3260: 3256: 3252: 3251:Vox Sanguinis 3245: 3242: 3237: 3233: 3229: 3225: 3221: 3217: 3214:(8): 769–77. 3213: 3209: 3202: 3199: 3194: 3190: 3185: 3180: 3177:(9): 1152–4. 3176: 3172: 3168: 3161: 3158: 3146: 3142: 3136: 3133: 3122: 3118: 3111: 3108: 3097: 3096:The Synergist 3093: 3087: 3084: 3080:. March 2015. 3079: 3075: 3069: 3066: 3054: 3050: 3044: 3041: 3030:on 2011-06-12 3029: 3025: 3019: 3016: 3004: 2998: 2995: 2983: 2979: 2973: 2970: 2965: 2958: 2952: 2949: 2937: 2931: 2928: 2924:. 2019-10-08. 2923: 2919: 2913: 2910: 2905: 2899: 2896: 2891: 2887: 2883: 2879: 2875: 2871: 2867: 2863: 2859: 2855: 2851: 2844: 2841: 2836: 2832: 2827: 2822: 2817: 2812: 2808: 2804: 2800: 2796: 2792: 2785: 2782: 2777: 2773: 2767: 2764: 2751: 2747: 2746:noxilizer.com 2743: 2737: 2734: 2718: 2714: 2713:noxilizer.com 2707: 2701: 2699: 2697: 2693: 2687: 2684: 2672: 2666: 2663: 2651: 2647: 2641: 2638: 2626: 2620: 2618: 2614: 2600: 2594: 2591: 2579: 2575: 2571: 2565: 2562: 2556: 2553: 2548: 2544: 2539: 2534: 2530: 2526: 2522: 2515: 2512: 2501: 2497: 2491: 2488: 2476: 2469: 2463: 2460: 2455: 2451: 2447: 2443: 2439: 2435: 2431: 2427: 2419: 2416: 2412: 2407: 2404: 2399: 2395: 2391: 2387: 2380: 2378: 2374: 2363:on 2006-09-02 2359: 2352: 2345: 2342: 2339: 2334: 2331: 2326: 2322: 2316: 2313: 2298: 2292: 2289: 2284: 2280: 2273: 2270: 2265: 2261: 2257: 2253: 2248: 2243: 2240:(2): 521–31. 2239: 2235: 2231: 2224: 2221: 2210:on 2016-06-30 2209: 2205: 2201: 2195: 2192: 2181: 2177: 2171: 2168: 2157:on 2016-10-24 2153: 2146: 2140: 2137: 2132: 2128: 2124: 2120: 2116: 2112: 2109:(2): 107–17. 2108: 2104: 2097: 2094: 2082: 2078: 2072: 2069: 2064: 2057: 2051: 2048: 2043: 2039: 2033: 2030: 2017: 2011: 2008: 2003: 1999: 1995: 1991: 1986: 1981: 1977: 1973: 1969: 1962: 1959: 1954: 1948: 1945: 1940: 1936: 1931: 1926: 1922: 1918: 1914: 1907: 1904: 1899: 1893: 1877: 1873: 1869: 1865: 1861: 1854: 1852: 1848: 1841: 1836: 1832: 1828: 1824: 1817: 1814: 1809: 1803: 1799: 1798: 1790: 1787: 1782: 1778: 1774: 1770: 1766: 1762: 1758: 1754: 1747: 1744: 1739: 1733: 1729: 1728: 1720: 1717: 1712: 1708: 1707:"Definitions" 1705:Frerichs RR. 1701: 1698: 1692: 1688: 1685: 1683: 1680: 1678: 1675: 1673: 1670: 1668: 1665: 1663: 1660: 1658: 1655: 1653: 1650: 1648: 1645: 1643: 1640: 1639: 1635: 1633: 1630: 1624: 1619: 1612: 1610: 1608: 1604: 1600: 1595: 1593: 1589: 1585: 1581: 1577: 1573: 1569: 1565: 1561: 1557: 1553: 1545: 1543: 1540: 1538: 1534: 1530: 1525: 1522: 1519: 1515: 1511: 1507: 1503: 1501: 1497: 1493: 1489: 1484: 1480: 1479: 1475:(produced by 1474: 1470: 1468: 1463: 1459: 1455: 1453: 1449: 1443: 1441: 1437: 1433: 1429: 1425: 1421: 1417: 1413: 1411: 1407: 1403: 1394: 1387: 1385: 1383: 1378: 1374: 1373:visible light 1370: 1364: 1356: 1354: 1352: 1348: 1344: 1340: 1336: 1332: 1328: 1325: 1321: 1313: 1311: 1309: 1305: 1301: 1297: 1293: 1285: 1283: 1268: 1264: 1260: 1256: 1249: 1247: 1244: 1242: 1238: 1235: 1231: 1226: 1220: 1218: 1214: 1210: 1206: 1199: 1197: 1195: 1191: 1187: 1183: 1179: 1175: 1171: 1167: 1157: 1154: 1146: 1136: 1132: 1128: 1122: 1121: 1117: 1112:This section 1110: 1106: 1101: 1100: 1094: 1092: 1069: 1065: 1062: 1061:medical-grade 1058: 1054: 1049: 1047: 1043: 1036: 1034: 1031: 1027: 1019: 1015: 1011: 1007: 1006: 996: 994: 991:is also less 986: 974: 970: 958: 946: 942: 930: 923: 921: 918: 914: 910: 906: 901: 897: 894: 890: 886: 881: 879: 875: 871: 866: 864: 860: 854: 852: 848: 844: 840: 835: 833: 829: 822: 820: 818: 814: 810: 800: 793: 791: 789: 785: 781: 777: 773: 769: 760: 758: 755: 751: 745: 737: 735: 733: 729: 722: 720: 718: 717:Bunsen burner 714: 709: 705: 701: 700:Bunsen burner 697: 693: 685: 683: 679: 671: 666: 658: 656: 654: 649: 647: 643: 639: 637: 633: 628: 626: 622: 618: 617: 611: 607: 605: 599: 597: 593: 589: 585: 581: 577: 573: 569: 565: 560: 558: 554: 549: 545: 541: 537: 533: 527: 519: 514: 512: 510: 505: 503: 499: 493: 491: 487: 483: 479: 456: 450: 447: 442: 438: 433: 429: 422: 418: 414: 405: 404: 403: 402:is given by: 389: 369: 347: 344: 340: 317: 313: 304: 295: 293: 289: 287: 283: 275: 273: 271: 267: 263: 259: 255: 250: 248: 244: 240: 235: 233: 229: 225: 221: 217: 208: 201: 197: 196:Joseph Lister 193: 186: 184: 182: 181: 176: 171: 169: 168:pascalization 165: 161: 157: 153: 149: 141: 136: 134: 132: 128: 124: 120: 116: 115:high pressure 112: 108: 104: 100: 96: 92: 88: 85: 81: 77: 73: 69: 65: 60: 59:sterilisation 55: 51: 50:Sterilization 44: 39: 33: 19: 3794:Microbiology 3703: 3681:. Retrieved 3677:the original 3671: 3634: 3597: 3593: 3583: 3562:cite journal 3545: 3534:. Retrieved 3530: 3521: 3486: 3482: 3472: 3455: 3450: 3444: 3409: 3405: 3395: 3374: 3365: 3356: 3313: 3309: 3299: 3287: 3257:(1): 34–40. 3254: 3250: 3244: 3211: 3207: 3201: 3174: 3170: 3160: 3149:. Retrieved 3147:. 2020-12-08 3144: 3135: 3124:. Retrieved 3120: 3110: 3099:. Retrieved 3095: 3086: 3068: 3057:. Retrieved 3053:the original 3043: 3032:. Retrieved 3028:the original 3018: 3007:. Retrieved 2997: 2985:. Retrieved 2972: 2951: 2939:. Retrieved 2936:"Sterrad NX" 2930: 2921: 2912: 2903: 2898: 2857: 2853: 2843: 2798: 2794: 2784: 2775: 2766: 2754:. Retrieved 2750:the original 2745: 2736: 2724:. Retrieved 2717:the original 2712: 2686: 2675:. Retrieved 2665: 2654:. Retrieved 2650:the original 2640: 2629:. Retrieved 2605:. Retrieved 2593: 2582:. Retrieved 2578:the original 2573: 2564: 2555: 2528: 2524: 2514: 2503:. Retrieved 2499: 2490: 2479:. Retrieved 2474: 2462: 2432:(5): 486–9. 2429: 2425: 2418: 2406: 2389: 2385: 2365:. Retrieved 2358:the original 2344: 2338:Incineration 2333: 2325:www.tpub.com 2324: 2315: 2304:. Retrieved 2291: 2282: 2277:Casolari A. 2272: 2237: 2233: 2223: 2212:. Retrieved 2208:the original 2203: 2194: 2183:. Retrieved 2180:ResearchGate 2179: 2170: 2159:. Retrieved 2152:the original 2139: 2106: 2102: 2096: 2085:. Retrieved 2083:. 2018-02-22 2080: 2071: 2050: 2032: 2020:. Retrieved 2010: 1975: 1971: 1961: 1947: 1923:(5): 702–9. 1920: 1916: 1906: 1892:cite journal 1880:. Retrieved 1867: 1863: 1830: 1827:Food Control 1826: 1816: 1796: 1789: 1756: 1752: 1746: 1726: 1719: 1710: 1700: 1631: 1628: 1596: 1549: 1541: 1526: 1523: 1504: 1499: 1476: 1471: 1456: 1444: 1424:radioisotope 1414: 1399: 1366: 1317: 1289: 1253: 1245: 1239: 1221: 1203: 1170:formaldehyde 1164: 1149: 1140: 1125:Please help 1113: 1050: 1040: 1017: 1009: 1003: 997: 985:condensation 927: 902: 898: 882: 867: 855: 847:carcinogenic 836: 826: 809:fiber optics 805: 764: 750:John Tyndall 748:Named after 747: 728:Incineration 726: 723:Incineration 708:Incineration 689: 680: 676: 650: 640: 629: 620: 614: 608: 600: 561: 540:denaturation 529: 506: 494: 475: 299: 290: 279: 251: 236: 213: 178: 174: 172: 145: 137:Applications 123:disinfection 58: 49: 48: 3366:www.nrc.gov 2922:www.cdc.gov 2776:NextBillion 1677:Food safety 1584:nanofilters 1510:radioactive 1506:Irradiation 1432:caesium-137 1382:polystyrene 1341:such as by 1324:ultraviolet 1263:acetic acid 1143:August 2017 478:temperature 268:immersion, 111:irradiation 84:unicellular 3768:Categories 3683:2018-04-22 3536:2017-10-11 3489:: 118756. 3151:2020-12-12 3126:2020-12-11 3101:2020-12-11 3059:2010-06-25 3034:2010-06-25 3009:2010-06-25 2677:2010-06-25 2673:. Osha.gov 2656:2010-06-25 2631:2010-06-25 2607:2010-06-25 2584:2016-05-17 2505:2016-05-17 2481:2016-05-17 2413:2008-09-11 2367:2007-03-06 2306:2010-06-25 2214:2015-05-13 2185:2018-09-09 2161:2016-10-24 2087:2018-09-09 1693:References 1426:, usually 1335:gamma rays 1322:, such as 1259:endoscopes 1234:ulceration 1217:endoscopes 1088:eight-hour 1055:=2.076 vs 1026:log-linear 851:validation 832:disposable 774:(FDA) and 663:See also: 636:ultrasound 632:sonication 619:(formerly 582:(CKD) and 524:See also: 276:Spacecraft 232:parenteral 119:filtration 87:eukaryotic 3115:PubChem. 2882:0098-4108 2627:. Cdc.gov 2145:"Asepsis" 2002:256609067 1978:: 18–24. 1781:0969-806X 1607:cleanroom 1576:biologics 1467:electrons 1428:cobalt-60 1292:aldehydes 1230:bleaching 1174:fixatives 1114:does not 1076:160 times 993:corrosive 945:nitration 903:The U.S. 802:Chemiclav 696:streaking 553:bioburden 544:autoclave 498:bioburden 443:− 345:− 286:habitable 239:solutions 107:chemicals 93:(such as 3779:Biocides 3724:Archived 3626:20509961 3513:33024349 3436:26289104 3428:25271934 3348:21131511 3271:16756599 3236:26848322 3228:19563265 3193:12715310 2987:25 March 2835:26098905 2795:PLOS ONE 2547:22546789 2454:19446196 2446:15954488 2398:18780544 2264:25835705 2256:19659696 2131:36473735 2123:20055640 2022:7 August 1994:37087175 1939:15356786 1636:See also 1518:Neutrons 1496:tungsten 1492:tantalum 1430:(Co) or 1420:cannulas 1300:chlorine 1182:methanol 1178:volatile 1068:catalyst 891:. These 813:plastics 780:European 625:glassine 536:pressure 220:scalpels 76:bacteria 70:such as 3789:Hygiene 3657:Sources 3617:2896367 3600:: 152. 3504:7528844 3339:3028702 3318:Bibcode 3279:1267167 2966:. 2008. 2890:6376815 2862:Bibcode 2826:4476675 2803:Bibcode 1833:: 1–8. 1761:Bibcode 1647:Asepsis 1623:curette 1580:viruses 1570:. Some 1560:protein 1452:photons 1404:of the 1213:oxidant 1135:removed 1120:sources 1084:0.1 ppm 1080:800 ppm 1046:oxidize 1020:with NO 784:Israeli 713:ethanol 686:Flaming 646:canning 576:scrapie 557:D-value 511:(FDA). 490:Celsius 303:D-value 216:aseptic 152:Canning 131:aseptic 99:viruses 3757: 3744: 3710: 3624: 3614: 3511: 3501: 3434: 3426: 3346: 3336: 3277: 3269: 3234: 3226: 3191: 2941:14 Sep 2888: 2880: 2833: 2823: 2756:2 July 2726:2 July 2545: 2477:. OSHA 2452: 2444: 2396: 2262: 2254: 2129: 2121: 2000: 1992: 1937: 1882:2 June 1804: 1779: 1734: 1554:using 1483:pallet 1436:photon 1331:X-rays 1296:Iodine 1073:5 ppm, 1064:oxygen 768:dental 572:prions 564:spores 534:under 226:, and 117:, and 95:prions 82:, and 80:spores 3643:(PDF) 3554:(PDF) 3432:S2CID 3383:(PDF) 3275:S2CID 3232:S2CID 2960:(PDF) 2720:(PDF) 2709:(PDF) 2602:(PDF) 2471:(PDF) 2450:S2CID 2361:(PDF) 2354:(PDF) 2300:(PDF) 2260:S2CID 2155:(PDF) 2148:(PDF) 2127:S2CID 2059:(PDF) 1998:S2CID 1870:(1). 1327:light 1225:nylon 1042:Ozone 1037:Ozone 969:dimer 885:inert 592:brain 568:fungi 520:Steam 270:ozone 254:steam 142:Foods 72:fungi 45:plate 3755:ISBN 3742:ISBN 3708:ISBN 3622:PMID 3575:help 3509:PMID 3424:PMID 3344:PMID 3267:PMID 3224:PMID 3189:PMID 2989:2015 2943:2023 2886:PMID 2878:ISSN 2831:PMID 2758:2013 2728:2013 2543:PMID 2442:PMID 2394:PMID 2252:PMID 2119:PMID 2024:2014 1990:PMID 1935:PMID 1898:link 1884:2023 1802:ISBN 1777:ISSN 1732:ISBN 1333:and 1265:and 1168:and 1118:any 1116:cite 874:CFCs 782:and 644:and 588:mice 515:Heat 241:for 103:heat 64:life 43:agar 3612:PMC 3602:doi 3499:PMC 3491:doi 3487:619 3460:doi 3414:doi 3410:107 3334:PMC 3326:doi 3259:doi 3216:doi 3179:doi 2870:doi 2821:PMC 2811:doi 2533:doi 2434:doi 2242:doi 2238:108 2204:NIH 2111:doi 1980:doi 1925:doi 1872:doi 1835:doi 1831:103 1769:doi 1601:or 1494:or 1440:MeV 1353:). 1232:or 1188:to 1129:by 1057:SHE 941:DNA 931:(NO 702:or 659:Dry 596:log 170:). 97:or 3770:: 3620:. 3610:. 3596:. 3592:. 3566:: 3564:}} 3560:{{ 3529:. 3507:. 3497:. 3485:. 3481:. 3456:29 3430:. 3422:. 3408:. 3404:. 3364:. 3342:. 3332:. 3324:. 3314:77 3312:. 3308:. 3273:. 3265:. 3255:91 3253:. 3230:. 3222:. 3212:30 3210:. 3187:. 3175:36 3173:. 3169:. 3143:. 3119:. 3094:. 2980:. 2962:. 2920:. 2884:. 2876:. 2868:. 2858:13 2856:. 2852:. 2829:. 2819:. 2809:. 2799:10 2797:. 2793:. 2774:. 2744:. 2711:. 2695:^ 2616:^ 2572:. 2541:. 2529:65 2527:. 2523:. 2498:. 2473:. 2448:. 2440:. 2430:26 2428:. 2390:25 2388:. 2376:^ 2323:. 2281:. 2258:. 2250:. 2236:. 2232:. 2202:. 2178:. 2125:. 2117:. 2107:31 2105:. 2079:. 1996:. 1988:. 1976:10 1974:. 1970:. 1933:. 1921:39 1919:. 1915:. 1894:}} 1890:{{ 1868:10 1866:. 1862:. 1850:^ 1829:. 1825:. 1775:. 1767:. 1757:63 1755:. 1709:. 1621:A 1588:nm 1578:, 1564:μm 1539:. 1329:, 1306:, 1302:, 975:(N 971:, 880:. 634:, 486:pH 484:, 480:, 434:10 341:10 264:, 222:, 183:. 133:. 113:, 109:, 105:, 78:, 74:, 56:: 3716:. 3686:. 3628:. 3604:: 3598:3 3577:) 3573:( 3539:. 3515:. 3493:: 3466:. 3462:: 3438:. 3416:: 3368:. 3350:. 3328:: 3320:: 3281:. 3261:: 3238:. 3218:: 3195:. 3181:: 3154:. 3129:. 3104:. 3062:. 3037:. 3012:. 2991:. 2945:. 2892:. 2872:: 2864:: 2837:. 2813:: 2805:: 2778:. 2760:. 2730:. 2680:. 2659:. 2634:. 2610:. 2587:. 2549:. 2535:: 2508:. 2484:. 2456:. 2436:: 2400:. 2370:. 2327:. 2309:. 2285:. 2266:. 2244:: 2217:. 2188:. 2164:. 2133:. 2113:: 2090:. 2026:. 2004:. 1982:: 1941:. 1927:: 1900:) 1886:. 1874:: 1843:. 1837:: 1810:. 1783:. 1771:: 1763:: 1740:. 1713:. 1280:3 1278:O 1276:4 1274:H 1272:2 1270:C 1156:) 1150:( 1145:) 1141:( 1137:. 1123:. 1053:E 1022:2 1000:2 989:2 981:4 979:O 977:2 965:2 961:2 953:2 949:2 937:2 933:2 472:. 457:) 451:D 448:t 439:( 430:= 423:0 419:N 415:N 390:t 370:N 348:1 318:0 314:N 202:. 52:( 34:. 20:)

Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.