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Medivators Technical White Paper
Advances in Disinfection Technologies
RAPICIDE OPA/28 used as a high level disinfectant with endoscopes
RAPICIDE® OPA/28 Unique Properties as a High-Level Disinfectant (HLD)
INTRODUCTION
RAPICIDE OPA/28 contains a dual surfactant
package that is patent pending. This addition to
the high-level disinfectant gives RAPICIDE
OPA/28 unique properties which result in many
benefits for the user, patient and purchaser. One
must understand what a surfactant is first to
realize how this can be such an enormous
advantage to the cleaning/disinfection process.
Surfactants are compounds that lower the
surface tension, or interfacial tension, between
two liquids or between a liquid and a solid.
Surfactants may act as detergents, wetting
agents, emulsifiers, foaming agents and
dispersants. Surfactants will diffuse in water and
adsorb at interfaces between air and water or at
the interface between oil and water. This
reduces the adhesion of organic material and
debris (dirt) from the surface it is attached and
allows for a faster manual disinfection time.
TERMINOLOGY
Aldehyde: organic chemical compound formed
by the oxidation of alcohols, contains a –CHO
group
Anaphylaxis: a severe, potentially life
threatening, allergic reaction
Cleaning Agent: An agent for the removal from
facility and equipment surfaces of product
residues that may inactivate sanitizing agents or
harbor microorganisms
Decontamination: The removal of
microorganisms by disinfection or sterilization.
Dermatitis: general term meaning inflammation
of the skin, may present in multiple forms
Dyspnea: difficult or labored breathing
High-Level Disinfectant: a chemical or physical
agent that destroys all microorganisms, including
Mycobacterium tuberculosis, with the exception
of high numbers of bacterial spores
Residuals: any substance remaining on an
endoscope after high-level disinfection and
rinsing
Respiratory sensitization: hypersensitivity of
the airways induced by inhalation of a substance
Adv Disinfect Tech 2015: 50098-751/A
Surfactant: a compound that reduces surface
tension between two liquids or between a liquid
and a solid; often used as a cleaning agent or
detergent; surface active agent
Type-1 hypersensitivity response: an allergic
reaction that causes the body to produce
antibodies
DISCUSSION
Prolonged exposure to ortho-phthalaldehyde
(OPA) vapors can cause respiratory
sensitization, as shown by studies conducted on
mice that exhibited a type-1 hypersensitivity
immune response after repeated exposure to
OPA.1 After eight months of exposure to OPA
vapors while cleaning endoscopes, a nurse at a
Japanese hospital experienced dyspnea and a
dry-cough along with dermatitis.2 RAPICIDE
OPA/28 requires only a ten-minute manual
disinfection period whereas other available OPA
disinfectants require 12 minutes exposure for
manual disinfection. Reduction in manual
cleaning time means a reduction in worker
exposure to potentially harmful OPA fumes.
Surfactants are effective cleaning agents3
because of their ability to reduce surface tension
in water, which causes the water to wet items or
surfaces more uniformly. Also, surfactants have a
hydrophobic (water-fearing) end and a
hydrophilic (water-loving) end. The hydrophobic
end of the molecule is attracted to
oil and dirt while the hydrophilic end is attracted
to water. Because of this unique property,
surfactant molecules help water molecules to
grab dirt and oils and remove them from
surfaces. With the addition of two surfactants to
RAPICIDE OPA/28, this product is especially
successful at removing soil from endoscopes.
These same properties are also thought to
remove any debris barriers between the active
agent in the disinfectant (OPA) and the microbial
targets; this makes RAPICIDE OPA/28 among
the fastest and most efficacious high-level
disinfectants on the market. Also, due to the
2015 Medivators Inc. All rights reserved.
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nature of the surfactants in RAPICIDE OPA/28, it
is easily removed from endoscopes with a
requirement of only two water rinses after
disinfection. Other OPA products on the market
require three water rinses. Previous cases show
residual OPA found on cystoscopes caused
anaphylaxis in four patients after a urology
practice starting using OPA for endoscope
disinfection.4 Using RAPICIDE OPA/28 can
lower the risk of residuals to the patient because
surfactants decrease adhesion to the scope.
With twice the reuse life offered by competing
OPAs, RAPICIDE OPA/28 minimizes the
frequency in which healthcare workers need to
change the solution. Frequent high-level
disinfectant changes could lead to staff injury due
to ergonomic issues, chemical spills or increased
respiratory stress. By offering an up to 28 day
use life RAPICIDE OPA/28 minimizes this type of
exposure. Also, RAPICIDE OPA/28 achieves 84
cycles during reuse life, which benefits the
purchaser when analyzing cost per cycle.
Also, RAPICIDE OPA/28 has been tested to
archive around 84 cycles during reuse life, per
EPA Reuse Test Protocol Specifications.
Purchasers will see this benefit when analyzing
cost per cycle.
CONCLUSION
RAPICIDE OPA/28 has multiple benefits over
traditional OPA products. RAPICIDE OPA has a
dual surfactant package that removes soil from
endoscopes more readily. RAPICIDE OPA only
needs a 10 minute disinfection, as opposed to a
12 minute disinfection with other OPA products.
This decreases the amount of exposure for
health workers. RAPICIDE OPA also only needs
two water rinses as opposed to three because of
the surfactants present, therefore decreasing the
risk of patient exposure. With a 28 day reuse life
and high cycle counts, the purchaser realizes a
lower cost per cycle. These breakthrough
properties of RAPICIDE OPA/28 make it stand
apart from other OPA High-Level Disinfectant
(HLD)s on the market.
REFERENCES
1.
Johnson, V. J., Reynolds, J. S., Wang, W., Fluharty, K., &
Yucesoy, B. (2011). Inhalation of Ortho-Phthalaldehyde Vapor
Causes Respiratory Sensitization in Mice. Journal of Allergy,
2011, 751052. doi:10.1155/2011/751052
2.
Fujita, H., Ogawa, M., & Endo, Y. (2006). A Case of
Occupational Bronchial Asthma and Contact Dermatitis
Caused by ortho-Phthalaldehyde Exposure in a Medical
Worker. Journal of Occupational Health, 48(6), 413-416.
3.
Hashiguchi, M., Nishi, Y., Kanie, T., Ban, S., & Nagaoka, E.
(2009). Bactericidal efficacy of glycine-type amphoteric
surfactant as a denture cleaner and its influence on properties
of denture base resins. Dental Materials Journal, 28(3), 307314.
Comparison of the leading brands of OPA
and RAPICIDE OPA/28 Reuse Life
90
Number of AER Cycles
80
84
74
4.
Sokol, W. (2004). Nine episodes of anaphylaxis following
cystoscopy caused by Cidex OPA (ortho-phthalaldehyde) highlevel disinfectant in 4 patients after cytoscopy. Journal of
Allergy and Clinical Immunology, 114(2), 392-397.
Sensitization in Mice. Journal of Allergy, 2011, 751052.
doi:10.1155/2011/7510
70
60
50
42
40
30
20
10
0
Leading Brand 1 Leading Brand 2 Rapicide OPA/28
Figure 1: Comparison of the reuse life of the leading OPA brands
versus RAPICIDE OPA/28. RAPICIDE OPA/28 can be reused up
to ten more cycles than the leading brand of OPA.
Adv Disinfect Tech 2015: 50098-751/A
®
RAPICIDE is a registered trademark of Medivators Inc.
2015 Medivators Inc. All rights reserved.
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