Sterilisation
What the law says
Anyone conducting a business which involves piercing human skin is subject to the Local Authorities Act 1991 and the Health and Safety at Work Act 1974. Local byelaws require people and businesses to be registered with the council, under the adopted Local Government (Miscellaneous Provisions) Act 1982.
A copy of the rules of management for places offering special treatments document is available to help you.
The use of instruments
• instruments used to pierce skin, or objects in contact with broken skin, should be considered to be contaminated and should not be used again unless they have been sterilised
• regarding the Hepatitis B Virus, instruments must be sterilised as disinfection is not adequate
Sterilisation
Sterilisation is the complete destruction of all microbes or germs. The most efficient and reliable form of sterilisation is heat. Moist heat - steam - is far more effective than dry heat. Moist heat sterilisation is carried out in an autoclave - a pressurised, steam-heated vessel used for sterilisation. The recommended temperature and times being 134°C for three minutes.
It is recommended that all articles which come into direct or indirect contact with the skin or body fluids, or may otherwise become contaminated by skin or body fluids, must be sterilised by an acceptable steam method. Other articles will require suitable dry heat or chemical treatment. You may need to discuss alternative methods with the environmental health officer.
Dry heat ovens take considerably longer to sterilise - a temperature of 160°C requires a holding time of 45 minutes, for example - and are considered to be unsatisfactory due to temperature variations in the oven.
| Method
|
Temperature (°C) | Holding time* (minutes) |
|---|---|---|
| autoclave (moist heat) | 121 | 15 |
|
|
126 |
10 |
|
|
134 |
3 |
Disinfectants are corrosive to skin, especially in the concentrated form as supplied.
Disinfection
Disinfection is the reduction in number of microbes to a level where microbiological infection will not occur.
Disinfectants do not sterilise; they only reduce the number of some microbes. Although there are many clinical products on sale as sterilants, most are nothing of the kind. All chemicals should be treated as disinfectants.
Hypochlorite solutions (e.g. Chloros, Domestos) of the correct strength, or aldehyde disinfectants (eg Cidex [Glutaraldehyde] used undiluted after addition of the powder activator) are likely to be the most useful disinfectants for skin piercing. Hypochlorite at the effective strength may corrode metals.
Spirit alcohol (70%) or a clear solution of Hypochlorite and clear Phenolics must be freshly made up each day, and of Glutaraldehyde each week. The manufacturers instructions regarding the correct concentrations should be strictly followed. Any organic matter or dust adhering to objects that are to be disinfected will seriously affect the potency of the disinfectant, so all instruments must be physically clean.
As with heat sterilisation, time is an important factor to take into account when using disinfectants. For most disinfectants at least half-an-hours soaking is required.
As with all hazards in the workplace, those posed by chemicals must be assessed and controlled. Ask your supplier for hazard data sheets as these will greatly help you comply with the legislation.
* The holding time is the time the entire load is held at the recommended temperature.