Development of the headspace gas chromatography-tandem mass spectrometry method for ethylene oxide and ethylene chlorohydrin residue in medical devices.

RATIONALE: Ethylene oxide (EO) sterilization is commonly employed for the sterilization of medical devices and has a very high market share. However, EO and its metabolite ethylene chlorohydrin (ECH) are toxic to humans. In compliance with the classification and residue limits of medical devices defined by ISO 10993-7, our study established two extraction methods for the testing of EO and ECH. METHODS: The first method involves simulated-use extraction using water as the extraction solvent. While the second, exhaustive extraction, directly extracts sample through headspace sampling analysis. Gas chromatography-tandem mass spectrometry in multiple reaction monitoring mode was utilized, requiring only 16 min. Then, the developed method was applied to assess 10 commercially available medical devices sterilized by EO. RESULTS: In simulated-use extraction, calibration curves were evaluated in the range of 1-100 and 5-500 µg for EO and ECH, respectively (r > 0.999). Inter-day recoveries ranged from 85.0% to 95.2% and from 94.8% to 102.4%. In exhaustive extraction, calibration curves spanned 0.5-50 and 2-200 µg for EO and ECH, respectively (r > 0.999). Inter-day recoveries ranged from 101.6% to 102.1% for EO and from 98.1% to 102.2% for ECH. After analysis of the 10 commercially available medical devices, two cotton swabs were found to have ECH of 35.1 and 28.4 µg per device, and four medical devices were found to have EO with concentration below the limit of quantification. Meanwhile, we found that the EO internal standard (propylene oxide) recommended by ISO 10993-7 had interference problems with other similar substances and was not suitable as an internal standard for EO. CONCLUSIONS: This study offers a sensitive and straightforward analytical approach to EO and ECH residues in a variety of medical devices. In addition, the results show that the EO or ECH content of these types of medical devices in our study falls below the regulatory limits, therefore instilling confidence among consumers regarding their safe use.

Dynamic headspace GC-MS/MS analysis of ethylene oxide and 2-chloroethanol in dry food commodities: a novel approach.

With frequent RASFF notifications from the EU countries, the residue testing of ethylene oxide (EtO) and its metabolite 2-chloroethanol (2-CE) in food commodities has become essential to check their compliance with MRLs. This study, for the first time, aimed at establishing a dynamic headspace-GC-MS/MS method for the simultaneous determination of these two analytes in acetonitrile extracts of cumin, ashwagandha, chilli powder, turmeric powder, guar gum, locust bean gum, and ginger powder. The samples (4 g) were extracted using acetonitrile (10 mL). A dispersive-solid phase extraction cleanup step with primary secondary amine sorbent (50 mg/mL) reduced the interfering signal of (matrix-derived) acetaldehyde by >40% in chilli powder, ginger, turmeric, and guar gum. This cleanup was not required for sesame seeds. With high selectivity and sensitivity, the GC-MS/MS approach identified and quantified both compounds simultaneously. At the spiking levels of 0.01, 0.02, and 0.05 mg/kg, the recoveries and precision were satisfactory (70-120%, RSDs, ≤15%). The headspace method-performance was similar to liquid injections. The method provided reproducible results when evaluated by two different laboratories. The method provided high-precision results for incurred residue analysis. Given its efficiency, the validated method is anticipated to improve the effectiveness of monitoring of EtO residues in food commodities.

Ethylene oxide review: characterization of total exposure via endogenous and exogenous pathways and their implications to risk assessment and risk management.

This review is intended to provide risk assessors and risk managers with a better understanding of issues associated with total exposures of human populations to ethylene oxide from endogenous and exogenous pathways. Biomonitoring of human populations and lab animals exposed to ethylene oxide has relied upon the detection of hemoglobin adducts such as 2-hydroxyethylvaline (HEV), which provides a useful measure of total exposure to ethylene oxide from all pathways. Recent biomonitoring data from CDC provide an excellent characterization of total exposure to ethylene oxide to the general U.S. population by demographic factors such as age, gender, and race as well as smoking habit, which might be comparable to previous measurements reported for humans and lab animals. The biochemical pathways including gastrointestinal (production by bacteria) and systemic (enzymatic production) pathways by which endogenous ethylene is generated and converted to ethylene oxide are described. The relative importance of endogenous pathways and exogenous pathways via ambient air or tobacco smoke was quantified based upon available data to characterize their relative importance to total exposure. Considerable variation was noted for HEV measurements in human populations, and important sources of variation for all pathways are discussed. Issues related to risk assessment and risk management of human populations exposed to ethylene oxide are provided within the context of characterizing total exposure, and data needs for supporting future risk assessment identified.

Associations between exposure to ethylene oxide, job termination, and cause-specific mortality risk.

BACKGROUND: Previous analyses of mortality were conducted in a large cohort of ethylene oxide (EtO) exposed workers employed at 13 sterilization facilities throughout the U.S. and followed from the start of operation through 1998. Statistically significant elevated mortality was reported from hematopoietic cancer in men and breast cancer in women compared to the general population. Possible healthy worker survivor bias was not addressed. METHODS: To examine survivor bias in this cohort, employment termination was analyzed with statistical models stratified on sex and race that included age, employment duration, and cumulative EtO exposure. To reduce survivor bias employment duration was included in Poisson regression model specifications for estimating standardized mortality ratios for several cancer outcomes. RESULTS: Strong statistically significant effects of unlagged cumulative EtO exposure were observed on rate of employment termination, indicating potential healthy worker survivor effect bias. Adjustment for employment duration in analyses of mortality resulted in statistically significant and stronger associations between cumulative EtO exposure and lung cancer, female breast cancer and hematopoietic cancer. There was a striking reduction in nonmalignant respiratory disease mortality risk with increasing employment duration with a further (nonsignificant) reduction with cumulative EtO, suggesting that EtO itself is driving termination of workers with respiratory morbidity even though the average EtO exposures in this population were generally far below odor and acute irritancy thresholds. CONCLUSIONS: Important survivor bias was present in this EtO cohort and may be present in many occupational settings involving irritant exposures.

[Discussion about the sampling positions of the bag-type infusion sets for single use in the ethylene oxide residues detection].

This paper selects the bag-type infusion sets for single use as samples, which are produced by different manufacturers and based on the ethylene oxide sterilization. The ethylene oxide sterilization residues in different parts of samples are detected by colorimetric analysis. Combined the comparison of the ethylene oxide residues testing results in the different parts of the same sample with the actual situation in clinical use, more reasonable sampling positions are found to detect the ethylene oxide sterilization residues. The result of this experiment will play a guiding role in the detection of the actual samples.

Confirmation of the full conversion of ethylene oxide to 2-chloroethanol in fumigated foodstuffs: possible implications for risk assessment.

This study describes the extension of a gas chromatography mass spectrometry (GC-MS) method, initially devoted to the analysis of ethylene oxide (EO) in ice cream, to a larger range of food items including herbs, spices, vegetables, inorganic salts, food supplements, thickeners, etc. Results are reported as EOTotal according to EC 2015/868 definition (expressed as EO equivalents as the sum of native EO and 2-chloroethanol (2-CE) after acidic hydrolysis) with a limit of quantification at 0.01 mg/kg regardless of the food item. Its ruggedness was demonstrated through fortification experiments on hundreds of samples. Re-analysis of 146 positive food samples without hydrolysis demonstrated that not EO but 2-CE is the predominant analyte detected in the different processed ingredients suspected to have been previously treated with EO. A series of eight contaminated dried herbs and spices were also re-analysed by four ISO 17025 accredited commercial laboratories making use of different analytical strategies for EO determination in foods. Each laboratory reported EOTotal levels within the same concentration range, but the resulting reproducibility ranged from 23% to 41% depending on the sample. Additionally, we show that results of free EO from methods based on conversion to 2-iodoethanol may lead to artefactual detection of native EO (false positive). An official method of analysis applicable for different food matrices would be useful to avoid discrepancies of results. Altogether, these data re-enforce the fact that in absence of native EO in food items, risk assessment of EO in foodstuffs should consider the predominance of 2-CE. A toxicological risk assessment using the food additive xanthan gum as a case study is discussed.

The application of mass spectrometry in molecular dosimetry: ethylene oxide as an example.

Mass spectrometry plays an increasingly important role in the search for and quantification of novel chemically specific biomarkers. The revolutionary advances in mass spectrometry instrumentation and technology empower scientists to specifically analyze DNA and protein adducts, considered as molecular dosimeters, derived from reactions of a carcinogen or its active metabolites with DNA or protein. Analysis of the adducted DNA bases and proteins can elucidate the chemically reactive species of carcinogens in humans and can serve as risk-associated biomarkers for early prediction of cancer risk. In this article, we review and compare the specificity, sensitivity, resolution, and ease-of-use of mass spectrometry methods developed to analyze ethylene oxide (EO)-induced DNA and protein adducts, particularly N7-(2-hydroxyethyl)guanine (N7-HEG) and N-(2-hydroxyethyl)valine (HEV), in human samples and in animal tissues. GC/ECNCI-MS analysis after HPLC cleanup is the most sensitive method for quantification of N7-HEG, but limited by the tedious sample preparation procedures. Excellent sensitivity and specificity in analysis of N7-HEG can be achieved by LC/MS/MS analysis if the mobile phase, the inlet (split or splitless), and the collision energy are properly optimized. GC/ECNCI-HRMS and GC/ECNCI-MS/MS analysis of HEV achieves the best performance as compared with GC/ECNCI-MS and GC/EI-MS. In conclusion, future improvements in high-throughput capabilities, detection sensitivity, and resolution of mass spectrometry will attract more scientists to identify and/or quantify novel molecular dosimeters or profiles of these biomarkers in toxicological and/or epidemiological studies.

Production of chemoenzymatic catalyzed monoepoxide biolubricant: optimization and physicochemical characteristics.

Linoleic acid (LA) is converted to per-carboxylic acid catalyzed by an immobilized lipase from Candida antarctica (Novozym 435). This per-carboxylic acid is only intermediate and epoxidized itself in good yields and almost without consecutive reactions. Monoepoxide linoleic acid 9(12)-10(13)-monoepoxy 12(9)-octadecanoic acid (MEOA) was optimized using D-optimal design. At optimum conditions, higher yield% (82.14) and medium oxirane oxygen content (OOC) (4.91%) of MEOA were predicted at 15 µL of H(2)O(2), 120 mg of Novozym 435, and 7 h of reaction time. In order to develop better-quality biolubricants, pour point (PP), flash point (FP), viscosity index (VI), and oxidative stability (OT) were determined for LA and MEOA. The results showed that MEOA exhibited good low-temperature behavior with PP of -41(°)C. FP of MEOA increased to 128(°)C comparing with 115(°)C of LA. In a similar fashion, VI for LA was 224 generally several hundred centistokes (cSt) more viscous than MEOA 130.8. The ability of a substance to resist oxidative degradation is another important property for biolubricants. Therefore, LA and MEOA were screened to measure their OT which was observed at 189 and 168(°)C, respectively.

[Development of the method for determining substances--markers of the hazardous production of advanced oil processing (ethylene oxide, 1,3-butadiene) in the air at the level of reference concentrations].

The results of experimental studies on the development of gas chromatographic method for the determination of 1,3-butadiene and ethylene oxide in ambient air at the level of reference concentration with the use of sorption of the compounds studied from ambient air on the adsorbent TenaxTA in conjunction with optimum conditions of thermal desorption and the use of capillary gas chromatography are presented. The parameters of adsorption, thermal desorption and gas chromatographic determination of 1,3-butadiene and ethylene oxide in ambient air have been justified. A high sensitivity of gas chromatographic determination in the range of concentrations (in mg/m3) of 1,3-butadiene, 0,002 - 5, 0, ethylene oxide 0.005 - 1, 0 with 25% uncertainty in the determination has been reached .

Mass spectrometry of the soot left after ethylene oxide explosion answers some questions on the crash of Polish Air Force Flight 101.

The Polish TU 154M plane, Polish Air Force Flight 101, had crashed near Smolensk on 10th of April 2010. The crash was investigated by The Interstate Aviation Committee, whose conclusions were questioned by a number of Polish scientists. The cause of the crash still appears to be incompletely documented and requires additional evidence. In this paper, investigations of a solid material eluted from a piece of cloth of one of the victims of the crash are described. High resolution mass spectrometry was applied to analyze the soot left after controlled ethylene oxide (EO) explosions, performed under different conditions. These included electric ignition of EO vapors in a large volume steel container, and explosions of glass tubes filled with liquid EO, stimulated by thermally initiated explosions of pentaerythritol tetranitrate (PETN). One of these explosions was conducted in the vessel used for the electric ignition of EO and the other in a hermetically locked, small volume container. It was shown that the soot comprises a set of C2 H4 O homopolymers and copolymers whose characteristic MS patterns are condition-dependent. The MS spectrum of the postcrash sample referred to above reveals a number of polymers that are also present in the soot obtained in PETN-initiated ethylene oxide explosions. It can be concluded that the piece of cloth was subjected to an EO explosion initiated by an explosion of energetic material, possibly PETN. Similar control experiments with ethylene glycol (EG) showed that the polymers identified in the investigated postcrash sample could not originate from exploding EG.

Monitored and Modeled Ambient Air Concentrations of Ethylene Oxide: Contextualizing Health Risk for Potentially Exposed Populations in Georgia.

Recent studies have monitored and modeled long-term ambient air concentrations of ethylene oxide (EO) around emitting facilities in Georgia with the intent of informing risk management of potentially exposed nearby residential populations. Providing health context for these data is challenging because the U.S. Environmental Protection Agency's risk-specific concentrations lack practical utility in distinguishing a health significant increase in exposure. This study analyzes EO data for eight emitting facilities, using a previously published alternative exposure metric, the total equivalent concentration, which is based on U.S. Centers for Disease Control biomarker data for the non-smoking U.S. POPULATION: Mean concentrations for monitoring sites were compared to mean background concentrations to assess whether emissions contribute significantly to environmental concentrations. To assess the health significance of potential exposure at nearby residential locations, the 50th percentile concentration was added to the 50th percentile endogenous equivalent concentration and compared to the total equivalent concentration distribution for the non-smoking U.S. POPULATION: The findings demonstrate that impacts from nearby emission sources are small compared to mean background concentrations at nearby locations, and the total equivalent concentrations for exposed populations are generally indistinguishable from that of the 50th percentile for the non-smoking U.S.

Trace-level quantification of ethylene oxide and 2-chloroethanol in low-viscosity hydroxypropyl methylcellulose with solid phase microextraction and GC-MS.

Ethylene oxide (EtO) is naturally present in numerous food products but recently EtO and its degradation product of 2-chloroethanol (2-CE) have been reported in amounts exceeding the maximum residue limit in Europe. The reports include hard capsules for dietary supplements made from low viscous hydroxypropyl methylcellulose (HPMC). The European council (EC) has proposed a generalized method for spices, seeds, and capsules utilizing QuEChERS, solid phase extraction (SPE), and GC-MS/MS to accommodate the need for analyte specificity, trace-level analysis, and higher throughput. HPMC has unique solvation properties and, without care, can potentially be transferred to the instrument. The current work presents the development of two methods specific for EtO and 2-CE in low viscous HPMC using solid phase microextraction (SPME) and GC-MS. Method optimization for solvation, SPME settings, and GC-MS settings are presented along with validation based on standard addition. Both methods present a high degree of specificity and limits of detection (EtO 6.7 µg/kg and 2-CE 12 µg/kg), comparable to those obtained with the EC method. Apart from sampling, the methods were fully automated and rely on low cost GC-MS instrumentation, widely available. Analyzed samples did not contain EtO or 2-CE, and method development was done with spiked samples. Contamination from plastic containers and analytical carry-over are shown as possible sources of EtO and 2-CE.

Ethylene Oxide Exposure in U.S. Populations Residing Near Sterilization and Other Industrial Facilities: Context Based on Endogenous and Total Equivalent Concentration Exposures.

Given ubiquitous human exposure to ethylene oxide (EO), regardless of occupation or geography, the current risk-specific concentrations (RSCs: 0.0001-0.01 ppb) from the U.S. Environmental Protection Agency (EPA) cancer risk assessment for EO are not useful metrics for managing EO exposures to the general U.S. population. The magnitude of the RSCs for EO are so low, relative to typical endogenous equivalent metabolic concentrations (1.1-5.5 ppb) that contribute ~93% of total exposure, that the RSCs provide little utility in identifying excess environmental exposures that might increase cancer risk. EO monitoring data collected in the vicinity of eight EO-emitting facilities and corresponding background locations were used to characterize potential excess exogenous concentrations. Both 50th and 90th percentile exogenous exposure concentrations were combined with the 50th percentile endogenous exposure concentration for the nonsmoking population, and then compared to percentiles of total equivalent concentration for this population. No potential total exposure concentration for these local populations exceeded the normal total equivalent concentration 95th percentile, indicating that excess facility-related exposures are unlikely to require additional management to protect public health.

Analysis of ethylene oxide in ice creams manufactured with contaminated carob bean gum (E410).

Residues of ethylene oxide (EO), a banned fumigant in the EU, were found at amounts above the maximum residue limit (MRL) in carob (locust) bean gum (additive E410). The pesticide entered the food chain via stabiliser blends that are used as minor ingredients in the manufacture of ice cream. Consequently, all products that contained the non-compliant ingredient were withdrawn or recalled in several countries across the EU, in most cases irrespective of whether the pesticide residue was detectable or not in the final product. This is the first report of a reliable method to determine EO and its metabolite/marker compound 2-chloroethanol (2-CE), either together or independently in ice cream, with a limit of quantification at 0.01 mg EO/kg and recovery in the range of 87-104% across the levels investigated (0.01, 0.02 and 0.06 mg EO/kg). The method applies QuEChERS extraction and isotope dilution gas chromatography coupled with tandem mass spectrometry (GC-MS/MS). High resolution mass spectrometry (HRMS) confirmed the specificity of low mass ions. Data on the stability of EO and 2-CE under thermal conditions revealed that 2-CE is relatively stable in an ice cream matrix (ca. 80% recovery of spiked material). Importantly, this study also demonstrates that not EO, but 2-CE is the predominant analyte detected in the contaminated samples, which is new information of significance in terms of the overall risk assessment of EO in foodstuffs.

Elution of substances from a silorane-based dental composite.

Previous studies have shown that residual monomers, initiators, and additives are eluted from methacrylate-based dental composite materials. Recently, a composite material (Filtek Silorane), based on a new resin chemistry, was introduced. The purpose of this study was to investigate substances eluted from Filtek Silorane in water and ethanol. Polymerized specimen discs of the material were immersed in either distilled water or 75 vol% ethanol at 37 degrees C, and the solutions were analyzed using liquid chromatography-mass spectrometry after 1, 4, 24, and 72 h eluting time. No substances were found to leach from Filtek Silorane in water, whereas silorane monomers and an initiator component were eluted from the material into the ethanol solution.

Optimization of a novel headspace-solid-phase microextraction-gas chromatographic method by means of a Doehlert uniform shell design for the analysis of trace level ethylene oxide residuals in sterilized medical devices.

Medical devices sterilized by ethylene oxide (EtO) retain trace quantities of EtO residuals, which may irritate patients' tissue. Reliably quantifying trace level EtO residuals in small medical devices requires an extremely sensitive analytical method. In this research, a Doehlert uniform shell design was utilized in obtaining a response surface to optimize a novel headspace-solid-phase microextraction-gas chromatographic (HS-SPME-GC) method developed for analyzing trace levels of EtO residuals in sterilized medical devices, by evaluating sterilized, polymer-coated, drug-eluting cardiovascular stents. The effects of four independent experimental variables (HS-SPME desorption time, extraction temperature, GC inlet temperature and extraction time) on GC peak area response of EtO were investigated simultaneously and the most influential experimental variables determined were extraction temperature and GC inlet temperature, with the fitted model showing no evidence of lack-of-fit. The optimized HS-SPME-GC method demonstrated overall good linearity/linear range, accuracy, repeatability, reproducibility, absolute recovery and high sensitivity. This novel method was successfully applied to analysis of trace levels of EtO residuals in sterilized/aerated cardiovascular stents of various lengths and internal diameter, where, upon heating, trace EtO residuals fully volatilized into HS for extraction, thereby nullifying matrix effects. As an alternative, this novel HS-SPME-GC method can offer higher sensitivity compared with conventional headspace analyzer-based sampling.

Reevaluation of Historical Exposures to Ethylene Oxide Among U.S. Sterilization Workers in the National Institute of Occupational Safety and Health (NIOSH) Study Cohort.

The 2016 U.S. Environmental Protection Agency (EPA) Integrated Risk Information System (IRIS) assessment for ethylene oxide (EO) estimated a 10-6 increased inhalation cancer risk of 0.1 parts per trillion, based on National Institute of Occupational Safety and Health (NIOSH) epidemiology studies of sterilization facility workers exposed to EO between 1938 and 1986. The worker exposure estimates were based on a NIOSH statistical regression (NSR) model "validated" with EO levels measured after 1978. Between 1938 and 1978, when EO data was unavailable, the NSR model predicts exposures lowest in 1938 increasing to peak levels in 1978. That increasing EO concentration trend arose, in part, because engineering/industrial-hygiene (E/IH) factors associated with evolving EO-sterilization equipment and operations before 1978 were not properly considered in the NSR model. To test the NSR model trend prediction, a new E/IH-based model was developed using historical data on EO kill concentrations, EO residue levels in sterilized materials, post-wash EO concentrations in a sterilization chamber, and information on facility characteristics and sterilizer operator practices from operators familiar with pre-1978 industry conditions. The E/IH 90th percentile of 8 h time-weighted average EO exposures (C90) for highly exposed sterilizer operators was calibrated to match 1978 C90 values from the NSR model. E/IH model C90 exposures were estimated to decrease over time from levels 16 and were four-fold greater than NSR-estimated exposures for workers during 1938-1954 and 1955-1964. This E/IH modeled trend is opposite to that of NSR model predictions of exposures before 1978, suggesting that EPA's exclusive reliance on the NIOSH cohort to estimate EO cancer risk should be re-examined.

Ethylene Oxide Exposure Attribution and Emissions Quantification Based on Ambient Air Measurements near a Sterilization Facility.

Ethylene oxide (EtO) is a known carcinogen and mutagen associated with increased incidence of breast and blood cancers. The largest medical sterilization facility in Michigan had been assessed by the U.S. Environmental Protection Agency as imposing an additional cancer risk greater than one in one thousand in nearby neighborhoods. This prompted the Michigan Department of Environmental Quality (now referred to as the Department of Environment, Great Lakes, and Energy) to conduct an air quality modeling study of the ambient EtO impacts of the sterilization facility, followed by 24 h Summa canister sampling and TO-15 analysis in two phases. Inverse modeling of the measured 24 h EtO concentrations during the second phase yielded estimates of 594 lbs/year for the facility's total emissions of EtO and 0.247 µg/m3 for the urban background concentration. The inverse-modeled emissions are similar to reported emissions by the facility operator based on indoor air measurements and simple mass balance assumptions, while the inferred background concentration agrees with estimates from other field investigations. The estimated peak 24 h exposure to EtO caused by the sterilization facility in nearby neighborhoods was 1.83 µg/m3 above the background level, corresponding to an additional cancer risk of approximately one in one hundred, if assumed to represent annual mean exposure.

[Calculation of flammability limits of gas phases with ethylene oxide in sterilisers]. / Berechnung von Explosionsgrenzen ethylenoxidhaltiger Gasphasen in Sterilisatoren.

A calculation method for flammability limits of gas phases with ethylene oxide in sterilisers was developed. Using the Software GasEq and the newly developed Makro "SterEx" for MS-Excel, flammability limits of mixtures with ethylene oxide, air and inert gases at temperatures between 20 degrees C and 100 degrees C and pressures between 0.4 bar and 1.0 bar can be calculated. This method can be used to easily determine safe operating conditions. The used semi-empirical model is based upon the assumption of constant flame temperature profiles at the flammability limits subject to the EO-concentration for different mixtures. To collect model parameters and to validate the model, several experiments with mixtures of ethylene oxide, nitrogen, carbon dioxide, water vapour and air were carried out to determine flammability limits. To simulate the structural conditions of sterilisers, the experiments were conducted in accordance to DIN EN 1839-B in a closed autoclave with temperatures and pressures relevant for sterilisation processes. The calculation of flammability limits of process gas mixtures with "SterEx" provides good agreement with flammability limits that were determined in experiments.