Ethylene oxide (EO) is a true gas and has many properties which make it a highly effective sterilizing agent. Being a true gas, ethylene oxide will completely fill any area it is injected into and has excellent penetration properties. However, the major drawback of using ethylene oxide is its explosivity when even small amounts are in contact with the air. For this reason, ethylene oxide must only be used in vacuum sterilizer applications making large scale-ups such as room decontaminations impossible. Ethylene oxide is also a known animal carcinogen and due to its explosive nature many facilities require expensive explosion-resistant construction in areas where ethylene oxide will be used.
The Principles of Effective Decontamination are the underlying fundamentals which must be achieved in order to ensure a successful decontamination cycle and apply to all decontaminating agents. Each agent's chemical and physical properties will affect the extent to which these principles are met and will influence the overall effectiveness of the decontamination cycle. Environmental factors will influence these properties and will play an important role in the effectiveness of your agent.
In order for any sterilant to be successful, it must reach all surfaces. True gases such as chlorine dioxide gas, formaldehyde, and ethylene oxide offer the best distribution properties. Liquids and vapors, such as hydrogen peroxide, are limited by temperature and environmental factors which negatively affect their distribution properties and effectiveness.
In addition to complete distribution, the sterilant must be able to penetrate into all areas. As explained above, gases have superior penetration abilities as compared to liquid and vapor agents.
Once your sterilizing agent has distributed to and thoroughly penetrated into all areas, it must remain there long enough to provide the desired level of kill. If it is difficult to get distribution and penetration throughout your target areas as it is for liquids and vapors, then it will also be a challenge to achieve the appropriate concentration and contact time required.