Chest
Volume 107, Issue 4, April 1995, Pages 1032-1034
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Clinical Investigations: Infection
Sterilization of Talc for Pleurodesis: Available Techniques, Efficacy, and Cost Analysis

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Although talc has been used as a pleurodesis agent since 1935, a sterilization protocol has not been established. We obtained USP asbestos-free talc from six different suppliers and sterilized each using dry heat, gamma irradiation, and ethylene oxide gas. Aerobic, anaerobic, and fungal cultures were obtained prior to sterilization, and 1,30, and 90 days after sterilization. Bacillus species were cultured from all six unsterilized specimens and coagulase-negative Staphylococcus grew from two unsterilized specimens. No growth of organisms was found following any method of sterilization. The cost of sterilization per 5-g packet of talc was $4.74, $7.85, and $16.25 for heat, ethylene oxide, and gamma irradiation, respectively. In conclusion, untreated talc is not sterile. Sterilization by prolonged dry heat exposure, ethylene oxide gas, and gamma irradiation are all effective, with dry heat being the least expensive.

Section snippets

Materials and Methods

Six suppliers of USP talc were identified from standard chemical supply catalogues: (1) Humco, Texarkana, Tex; (2) Spectrum Chemical Manufacturing Corporation, Gardenia, Calif; (3) J.T. Baker, Phillipsburg, NJ; (4) City Chemical Corporation, New York; (5) Integra Chemical Company, Renton, Wash; and (6) Mallinckrodt Specialty Chemical Company, Chesterfield, Mo. One pound of talc was purchased from each supplier. The talc from each supplier was weighed into 5-g portions and placed into self-seal

Results

Unsterile specimens from each supplier cultured Bacillus species immediately and at 30 and 90 days after packaging (Table 1). Specimens from suppliers 1 and 4 that were submitted immediately after packaging cultured coagulase-negative Staphylococcus. None of the sterilized specimens had any growth of bacteria or fungal organisms at any testing time.

The actual cost of talc varies widely between distributors, with prices ranging from $5 to $25.10/lb. The average price of $8.86/lb was used in the

Discussion

Talc used for pleurodesis is USP asbestos free and must meet minimal criteria with regard to loss on ignition, acid-soluble substances, water-soluble substances, arsenic, lead, and heavy metals.2 Additional product specifications vary among manufacturers. Although talc is not packaged sterilely by the manufacturer, limitation on the number of microorganisms is a part of USP specifications and total bacteria count cannot exceed 500/g. Several protocols for sterilization have been described

Acknowledgment

We would like to thank Gloria Infinger for her assistance with sterile processing.

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revision accepted August 17.

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