Biological evaluation of medical devices - Part 7: Ethylene oxide sterilization residuals

ISO 10993-7:2008 specifies allowable limits for residual ethylene oxide (EO) and ethylene chlorohydrin (ECH) in individual EO-sterilized medical devices, procedures for the measurement of EO and ECH, and methods for determining compliance so that devices may be released. Additional background, including guidance and a flowchart showing how the standard is applied are also included in informative annexes. EO-sterilized devices that have no patient contact (e.g., in vitro diagnostic devices) are not covered by ISO 10993-7:2008.

Évaluation biologique des dispositifs médicaux — Partie 7: Résidus de stérilisation à l'oxyde d'éthylène

L'ISO 10993-7:2007 spécifie les limites admissibles des résidus d'oxyde d'éthylène (OE) et de chlorhydrate d'éthylène (ECH) pour des dispositifs médicaux individuels stérilisés à l'oxyde d'éthylène, les modes opératoires pour le mesurage de l'oxyde d'éthylène et du chlorhydrate d'éthylène et les méthodes de mesure en vue de déterminer leur conformité et de procéder à leur libération. Une documentation supplémentaire, y compris des directives et un diagramme de flux sont également inclus dans les annexes informatives.

General Information

Status
Not Published
Current Stage
5020 - FDIS ballot initiated: 2 months. Proof sent to secretariat
Start Date
21-Nov-2025
Completion Date
21-Nov-2025

Relations

Effective Date
06-Jun-2022
Effective Date
06-Jun-2022
Effective Date
06-Jun-2022

Overview

ISO/FDIS 10993-7:2025 is a critical international standard developed by ISO Technical Committee 194 focusing on the biological evaluation of medical devices, specifically addressing ethylene oxide (EO) sterilization residuals. This standard specifies stringent allowable limits for residual ethylene oxide and ethylene chlorohydrin (ECH) present in individual EO-sterilized medical devices. The document provides comprehensive procedures for measuring these residues and methods for determining compliance. It also offers guidance and flowcharts to assist manufacturers in correctly applying the standard during product development and release.

This third edition supersedes the 2008 version, introducing updated risk assessment approaches and exposure limits ensuring patient safety against harmful EO and ECH residues. By establishing these limits, the standard helps manufacturers validate sterilization processes, optimize materials, and ensure regulatory compliance for safe medical device use.

Key Topics

  • Allowable Limits for Residual EO and ECH
    ISO 10993-7:2025 defines maximum residual amounts per device that are considered safe for patient exposure. These limits are derived using an uncertainty factor approach specific to exposure duration and patient subpopulations.

  • Measurement and Compliance Methods
    The standard details analytical methods such as gas chromatographic determination to quantify EO and ECH residues accurately. It also outlines procedures for consistent product batch release based on these measurements.

  • Risk Assessment Integration
    Manufacturers can employ risk assessments to establish appropriate allowable limits, considering patient populations and intended device usage duration to minimize biological risks related to EO exposure.

  • Product Release and Validation
    Guidelines include the use of residual dissipation curves and minimum aeration times to ensure devices meet safety limits before market release, supporting process validation and quality control.

  • Exclusion Scope
    Devices without direct or indirect patient contact, such as certain in vitro diagnostic devices, are excluded from this standard. Additionally, devices made solely of metals or glass which do not retain EO or ECH residues are out of scope.

  • Informative Annexes
    Annexes provide in-depth background on factors influencing residuals, rationale for limits, calibration standards, and examples of release methods to support practical implementation.

Applications

ISO 10993-7:2025 serves as an essential reference for medical device manufacturers, sterilization service providers, and regulatory bodies. Its applications include:

  • Sterilization Process Development and Control
    Optimizing ethylene oxide sterilization parameters such as gas concentration, exposure duration, and aeration cycles to achieve safe residual levels.

  • Biological Safety Assurance
    Ensuring devices released to market comply with allowable EO and ECH limits to prevent patient risks associated with irritation, mutagenicity, carcinogenicity, and reproductive toxicity.

  • Material Selection and Device Design
    Supporting the evaluation of new materials and sterilization methods during product design to reduce EO residual risk and improve patient safety.

  • Regulatory Compliance and Certification
    Providing a recognized framework for demonstrating conformance with biological safety requirements necessary for device approval and market access internationally.

  • Quality Management Systems
    Integrating residual testing and risk assessment processes within overall device quality control and post-market surveillance programs.

Related Standards

ISO/FDIS 10993-7:2025 works in conjunction with other parts of the ISO 10993 series and related standards, including:

  • ISO 10993-1:2018 – Biological evaluation of medical devices: Evaluation and testing within a risk management process. This foundational document provides a general framework for assessing biological safety, which complements EO residue evaluation.

  • ISO 11135:2014 – Sterilization of health care products – Ethylene oxide – Requirements for development, validation, and routine control of a sterilization process for medical devices. This standard governs the EO sterilization process parameters critical for controlling residues.

  • ISO 10993-23:2021 – Tests for irritation, which addresses potential local effects from residual chemicals like EO or ECH on patient tissues.

These interconnected standards collectively facilitate comprehensive biological safety evaluation and effective sterilization process control of medical devices.


Keywords: ISO 10993-7, ethylene oxide sterilization, EO residuals, ethylene chlorohydrin, medical device safety, sterilization validation, biocompatibility, allowable limits, risk assessment, gas chromatography, product release, medical device standards.

Draft

ISO/FDIS 10993-7 - Biological evaluation of medical devices — Part 7: Ethylene oxide sterilization residuals Released:7. 11. 2025

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REDLINE ISO/FDIS 10993-7 - Biological evaluation of medical devices — Part 7: Ethylene oxide sterilization residuals Released:7. 11. 2025

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ISO/FDIS 10993-7 - Évaluation biologique des dispositifs médicaux — Partie 7: Résidus de stérilisation à l'oxyde d'éthylène Released:18. 12. 2025

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Frequently Asked Questions

ISO/FDIS 10993-7 is a draft published by the International Organization for Standardization (ISO). Its full title is "Biological evaluation of medical devices - Part 7: Ethylene oxide sterilization residuals". This standard covers: ISO 10993-7:2008 specifies allowable limits for residual ethylene oxide (EO) and ethylene chlorohydrin (ECH) in individual EO-sterilized medical devices, procedures for the measurement of EO and ECH, and methods for determining compliance so that devices may be released. Additional background, including guidance and a flowchart showing how the standard is applied are also included in informative annexes. EO-sterilized devices that have no patient contact (e.g., in vitro diagnostic devices) are not covered by ISO 10993-7:2008.

ISO 10993-7:2008 specifies allowable limits for residual ethylene oxide (EO) and ethylene chlorohydrin (ECH) in individual EO-sterilized medical devices, procedures for the measurement of EO and ECH, and methods for determining compliance so that devices may be released. Additional background, including guidance and a flowchart showing how the standard is applied are also included in informative annexes. EO-sterilized devices that have no patient contact (e.g., in vitro diagnostic devices) are not covered by ISO 10993-7:2008.

ISO/FDIS 10993-7 is classified under the following ICS (International Classification for Standards) categories: 11.100.20 - Biological evaluation of medical devices. The ICS classification helps identify the subject area and facilitates finding related standards.

ISO/FDIS 10993-7 has the following relationships with other standards: It is inter standard links to ISO 8858-1:2019, ISO 10993-7:2008/Amd 1:2019, ISO 10993-7:2008. Understanding these relationships helps ensure you are using the most current and applicable version of the standard.

ISO/FDIS 10993-7 is available in PDF format for immediate download after purchase. The document can be added to your cart and obtained through the secure checkout process. Digital delivery ensures instant access to the complete standard document.

Standards Content (Sample)


FINAL DRAFT
International
Standard
ISO/TC 194
Biological evaluation of medical
Secretariat: DIN
devices —
Voting begins on:
2025-11-21
Part 7:
Ethylene oxide sterilization
Voting terminates on:
2026-01-16
residuals
Évaluation biologique des dispositifs médicaux —
Partie 7: Résidus de stérilisation à l'oxyde d'éthylène
RECIPIENTS OF THIS DRAFT ARE INVITED TO SUBMIT,
WITH THEIR COMMENTS, NOTIFICATION OF ANY
RELEVANT PATENT RIGHTS OF WHICH THEY ARE AWARE
AND TO PROVIDE SUPPOR TING DOCUMENTATION.
IN ADDITION TO THEIR EVALUATION AS
BEING ACCEPTABLE FOR INDUSTRIAL, TECHNO-
ISO/CEN PARALLEL PROCESSING LOGICAL, COMMERCIAL AND USER PURPOSES, DRAFT
INTERNATIONAL STANDARDS MAY ON OCCASION HAVE
TO BE CONSIDERED IN THE LIGHT OF THEIR POTENTIAL
TO BECOME STAN DARDS TO WHICH REFERENCE MAY BE
MADE IN NATIONAL REGULATIONS.
Reference number
FINAL DRAFT
International
Standard
ISO/TC 194
Biological evaluation of medical
Secretariat: DIN
devices —
Voting begins on:
Part 7:
Ethylene oxide sterilization
Voting terminates on:
residuals
Évaluation biologique des dispositifs médicaux —
Partie 7: Résidus de stérilisation à l'oxyde d'éthylène
RECIPIENTS OF THIS DRAFT ARE INVITED TO SUBMIT,
WITH THEIR COMMENTS, NOTIFICATION OF ANY
RELEVANT PATENT RIGHTS OF WHICH THEY ARE AWARE
AND TO PROVIDE SUPPOR TING DOCUMENTATION.
© ISO 2025
IN ADDITION TO THEIR EVALUATION AS
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
BEING ACCEPTABLE FOR INDUSTRIAL, TECHNO-
ISO/CEN PARALLEL PROCESSING
LOGICAL, COMMERCIAL AND USER PURPOSES, DRAFT
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting on
INTERNATIONAL STANDARDS MAY ON OCCASION HAVE
the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address below
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Published in Switzerland Reference number
ii
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Requirements . 5
4.1 General .5
4.2 Categorization of devices .6
4.3 Allowable limits .6
4.3.1 General .6
4.3.2 Limited exposure devices .8
4.3.3 Prolonged contact devices .9
4.3.4 Long-term exposure devices .9
4.3.5 Special situations .11
4.3.6 Tolerable contact level . 12
4.4 Determination of EO and ECH residuals . 12
4.4.1 Procedure . 12
4.4.2 Test method validation . 12
4.4.3 Product sampling . 12
4.4.4 Sample/fluid ratios . . 13
4.4.5 Product extraction . 13
4.4.6 Multi-device systems . 13
5 Product release .13
5.1 General . 13
5.2 Batch release of products . .14
5.3 Release of products at specified minimum aeration time .14
5.4 Procedure for product release using residual dissipation curves .14
6 Adoption of products into established aeration family .15
7 Change evaluation .15
Annex A (informative) Guidance for the application of this document for the determination of
EO and ECH residuals in medical devices .16
Annex B (informative) Factors influencing product residuals .26
Annex C (informative) Rationale for the provisions of this document .29
Annex D (informative) Establishment of allowable limits for EO .37
Annex E (informative) Establishment of allowable limits for ECH .55
Annex F (informative) Ethylene glycol .65
Annex G (normative) Evaluation of gas chromatograms .69
Annex H (informative) Gas chromatographic determination for EO and ECH .73
Annex I (informative) Preparation of EO and ECH standards .77
Annex J (informative) Ethylene oxide and ethylene chlorohydrin residual measuring methods .81
Annex K (informative) Examples of product release methods .89
Annex ZA (informative) Relationship between this European Standard the General Safety and
Performance Requirements of Regulation (EU) 2017/745 aimed to be covered .109
Bibliography .113

iii
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
ISO technical committees. Each member body interested in a subject for which a technical committee
has been established has the right to be represented on that committee. International organizations,
governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely
with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the different types
of ISO document should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
ISO draws attention to the possibility that the implementation of this document may involve the use of (a)
patent(s). ISO takes no position concerning the evidence, validity or applicability of any claimed patent
rights in respect thereof. As of the date of publication of this document, ISO had not received notice of (a)
patent(s) which may be required to implement this document. However, implementers are cautioned that
this may not represent the latest information, which may be obtained from the patent database available at
www.iso.org/patents. ISO shall not be held responsible for identifying any or all such patent rights.
Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.
For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and expressions
related to conformity assessment, as well as information about ISO's adherence to the World Trade
Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www.iso.org/iso/foreword.html.
This document was prepared by Technical Committee ISO/TC 194, Biological and clinical evaluation of medical
devices, in collaboration with the European Committee for Standardization (CEN) Technical Committee CEN/
TC 206, Biological and clinical evaluation of medical devices, in accordance with the Agreement on technical
cooperation between ISO and CEN (Vienna Agreement).
This third edition cancels and replaces the second edition (ISO 10993-7:2008), which has been technically
revised. It also incorporates the Amendment ISO 10993-7:2008/Amd 1:2019 and the Technical Corrigendum
ISO 10993-7:2008/Cor 1:2009.
The main changes are as follows:
— allowable limits and extraction conditions have been derived based on the patient population and the
duration of use;
— the use of a risk assessment to establish allowable limits has been permitted;
— additional guidance on product release has been provided;
— additional guidance on determining residuals and the factors that affect residual has been provided.
A list of all parts in the ISO 10993 series can be found on the ISO website.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.

iv
Introduction
As noted in the introduction to ISO 11135:2014, when determining the suitability of ethylene oxide (EO)
for sterilization of medical devices, it is important to ensure that the levels of residual EO and ethylene
chlorohydrin (ECH) pose a minimal risk to the patient in intended product use. Therefore, it is important
that the use of alternative materials and sterilization processes are considered during product design
and development. EO is known to exhibit a number of biological effects. In the development of this
document, consideration was given to these effects, which include irritation, organ damage, mutagenicity,
carcinogenicity, and reproductive effects in humans and animals. Similar consideration was given to the
harmful effects of ECH and ethylene glycol (EG). ECH can be formed when EO comes into contact with free
chloride ions, whereas EG is a hydrolytic reaction product of EO and water. In practice, for most devices,
exposure to EO and ECH is considerably lower than the maximum allowable limits established according to
this document. No allowable limits are set for EG because risk assessment indicated that when EO residuals
are controlled, it is unlikely that biologically significant residuals of EG would be present.
Requirements herein are in addition to the biological evaluation requirements as indicated in ISO 10993-1.
The biological evaluation, combined with the EO-sterilization process residual limits, form the justification
that an EO-sterilized device is safe for its anticipated contact duration. Maximum allowable residuals for
ECH, when ECH has been found to be present in medical devices sterilized with EO, are also specified. Local
effects (e.g. irritation) have been considered and are incorporated in the TCL as given in 4.3.6.2 and Annex D
for EO, and in 4.3.6.3 and Annex E for ECH.
In this edition of this document (i.e. ISO 10993-7:2025), an uncertainty factor approach is used to derive EO
and ECH exposure duration-specific tolerable intake (TI) values (expressed in µg/kg/d). Furthermore, this
edition of this document (i.e. ISO 10993-7:2025) introduces the conversion of each EO and ECH TI value into
subpopulation-specific cumulative exposure-allowable limit values (expressed in milligrams per device),
which are used to determine the extent that EO and ECH, extracted under clinically relevant conditions and
time-periods, needs to be reduced post-sterilization.
This edition of this document (i.e. ISO 10993-7:2025) applies a different approach as compared to
ISO 10993-17:2023 to establishing allowable limits to make it useful for development, validation, and
routine control of ethylene oxide sterilization in the manufacture of finished medical devices with focus
on the risk assessments associated with three chemical constituents that are potentially left in medical
devices sterilized with ethylene oxide. This document extends this knowledge further by calculating the
largest amount of EO, ECH or EG that can be present in a medical device such that it would always meet
the requirements of ISO 10993-17 when that device has been exposed to the validated sterilization cycle
parameters. This maximum amount or allowable limit is expressed in milligrams per device deemed
acceptable when taken into the body through exposure to that medical device. These allowable limits will
help determine the appropriate sterilization parameters such as sterilant gas concentration and dwell, as
well as aeration temperature and hold time when validating the sterilization process to be used for a product
or group of products. Furthermore, the allowable limits can be used by regulatory bodies, manufacturers,
and processors to optimize processes and aid in the selection and qualification of alternative materials in
order to protect patient health.

v
FINAL DRAFT International Standard ISO/FDIS 10993-7:2025(en)
Biological evaluation of medical devices —
Part 7:
Ethylene oxide sterilization residuals
1 Scope
This document specifies allowable limits (AL) for residual ethylene oxide (EO) and ethylene chlorohydrin
(ECH) in EO-sterilized medical devices, procedures for the measurement of EO and ECH, and methods for
determining conformity so that devices can be released. Additional background, including guidance and a
flowchart showing how this document is applied, are also included in Annexes A, B, C, D, E, F, G, H, I, J and K.
EO-sterilized devices or components that have neither direct nor indirect body or user contact (e.g. in vitro
diagnostic devices) are out of scope of this document. This document does not apply to devices that have
been demonstrated to not absorb or retain EO or its degradation product ECH, such as medical devices made
[228]
exclusively of metal alloys and glass, see Clause C.5 .
NOTE This document does not specify limits for ethylene glycol (EG). No device limits are specified for EG because
the risk assessment in Annex F indicates that calculated allowable levels are higher than those likely to occur in a
medical device.
2 Normative references
The following documents are referred to in the text in such a way that some or all of their content constitutes
requirements of this document. For dated references, only the edition cited applies. For undated references,
the latest edition of the referenced document (including any amendments) applies.
ISO 10993-1:2018, Biological evaluation of medical devices — Part 1: Evaluation and testing within a risk
management process
ISO 10993-23:2021, Biological evaluation of medical devices — Part 23: Tests for irritation
3 Terms and definitions
For the purposes of this document, the terms and definitions given in ISO 10993-1 and the following apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
3.1
aeration
part of the sterilization cycle (3.5) during which the sterilizing agent and/or its reaction products desorb
from the health care product until predetermined levels are reached
Note 1 to entry: Aeration can be performed within the sterilization chamber or in a separate chamber or room.
[SOURCE: ISO 11139:2018, 3.7, modified — Note 1 to entry has been added.]

3.2
allowable limit
AL
amount of residual (3.20) ethylene oxide or ethylene chlorohydrin on a single device that is permitted as a
condition of release for patient use
Note 1 to entry: Allowable limits are expressed in milligrams per device for each applicable exposure period. These
limits represent acceptable biological risks for medical devices under the circumstances of their anticipated contact
duration.
3.3
cumulative exposure
total quantity of ethylene oxide and ethylene chlorohydrin that contacts the body for a specified period of time
Note 1 to entry: Cumulative exposure can apply when consecutive uses of the same device or of new devices of the
same type for same patient or user applies (e.g. when one device is used repeatedly over a specified period of time).
3.4
concomitant exposure factor
CEF
numerical safety (3.21) factor that accounts for patient exposure to the simultaneous use of other ethylene
oxide sterilized medical devices different from the subject medical device
Note 1 to entry: CEF is calculated from the reciprocal of the number of devices (1/device) used during a procedure.
The default value (3.6) of 0,2 assumes five other devices are used during a procedure, see 4.4.5 and Clause D.6 for
further details.
3.5
cycle
set of sterilization process parameters
3.6
default value
value or factor used in the derivation of a tolerable contact level (3.22) or tolerable intake (3.24), in the
absence of specific data [e.g. an uncertainty factor (3.26)]
[SOURCE: ISO 10993-17:2023, 3.5, modified — the "worst-case exposure dose" has been removed from the
definition.]
3.7
dose-response
relationship of dosage to observable harm
Note 1 to entry: In general, there are two types of dose-response relationships. The first type is the change in response
of an individual to a range of doses. The second type is the distribution of the response among individuals to a range
of doses.
[SOURCE: ISO 10993-17:2023, 3.6]
3.8
exhaustive extraction
multi-step extraction conducted until the amount of material extracted in a subsequent extraction step is
less than 10 % of that determined in the initial extraction step
Note 1 to entry: Based upon the boiling point of ethylene oxide (EO) (10,7 °C) and the knowledge that substances,
other than EO and ethylene chlorohydrin, can be extracted from the device under evaluation, gravimetric analysis is
not appropriate for determining the exhaustivity level.
[SOURCE: ISO 10993-18:2020, 3.15, modified — "by gravimetric analysis (or achieved by other means)" has
been removed from the definition and Note 1 to entry has been added.]

3.9
harm to health
adverse reaction, such as altered morphology, physiology, growth, development, reproduction or lifespan that
a) impairs function of an organ or system, organism or (sub)population,
b) reduces capacity to tolerate an impaired function, or
c) increases susceptibility to other influences that impair function
Note 1 to entry: Examples of (sub)population include, but are not limited to: male, female, preterm neonates, adults.
[SOURCE: ISO 10993-17:2023, 3.8]
3.10
load
sterilization batch
sterilization load
product, equipment or materials to be processed together within an operating cycle (3.5)
[SOURCE: ISO 11139:2018, 3.155, modified — the admitted terms "sterilization batch" and "sterilization
load" have been added.]
3.11
implant
medical device which is intended to be totally introduced into the human body or to replace an epithelial
surface or the surface of the eye by means of clinical intervention and which is intended to remain in place
after the procedure
[SOURCE: ISO 10993-1:2018, 3.10]
3.12
irritation
localized non-specific inflammatory response to single, repeated or continuous application of a substance/
material
Note 1 to entry: Skin irritation is a reversible reaction and is mainly characterized by local erythema (redness) and
swelling (oedema) of the skin.
[SOURCE: ISO 10993-23:2021, 3.7]
3.13
lowest observed adverse effect level
LOAEL
lowest concentration or amount of an identified constituent found by experiment or observation which
causes detectable harm to health (3.9) to the target organism under defined conditions of exposure
[SOURCE: ISO 10993-17:2023, 3.13, modified — Note 1 to entry has been deleted.]
3.14
minimally irritating level
MIL
lowest amount per surface area of an identified constituent that is irritating to the tissue at the contact site
as determined by valid experimental or observational evidence
Note 1 to entry: The minimally irritating level is expressed in microgram per centimetre squared (μg/cm ).
[SOURCE: ISO 10993-17:2023, 3.15]

3.15
modifying factor
MF
mathematical product of uncertainty factors (3.26)
[SOURCE: ISO 10993-17:2023, 3.16]
3.16
non-irritating level
NIL
greatest amount per surface area of an identified constituent that does not elicit irritation (3.12) to the tissue
at the contact site as determined by valid experimental or observational evidence
Note 1 to entry: The non-irritating level is usually expressed as milligram or microgram per centimetre squared (mg/
2 2
cm or μg/cm ).
[SOURCE: ISO 10993-17:2023, 3.17, modified — Note 1 to add ‘usually’, ‘milligram or’ and ‘mg/cm ’. ]
3.17
no observed adverse effect level
NOAEL
greatest concentration or amount of an identified constituent found by experiment or observation which
causes no detectable harm to health (3.9) to the target organism under defined conditions of exposure
Note 1 to entry: No observed adverse effect level is expressed in microgram per kilogram of body mass per day (μg/kg/d).
[SOURCE: ISO 10993-17:2023, 3.18]
3.18
physiologically based pharmacokinetic modelling
PBPK modelling
system of modelling biological effects taking into account metabolic and pharmacokinetic differences among
species of animals
Note 1 to entry: Such data should be utilized whenever available and applicable to medical device anticipated contact
duration.
3.19
residual
quantity of ethylene oxide, ethylene chlorohydrin or ethylene glycol that remains in or on the product after
ethylene oxide sterilization
3.20
safety
freedom from unacceptable risk
[SOURCE: ISO 14971:2019, 3.26]
3.21
simulated-use extraction
extraction using a method that simulates clinical use
Note 1 to entry: A simulated-use extraction is performed to estimate the type and amount of substances that are
expected to be released from a medical device during its clinical use. A simulated-use extraction is designed to
produce an extractables profile that represents the worst-case leachables profile, meaning that all leachables are also
extractables and the levels of all individual extractables are at least equal to the level of all individual leachables.
[SOURCE: ISO 10993-18:2020, 3.35]

3.22
tolerable contact level
TCL
estimate of the surface-contact exposure to an identified constituent that is without appreciable irritation (3.12)
Note 1 to entry: Tolerable contact level is expressed in microgram per centimetre squared (μg/cm ) of tissue at the
contact site.
[SOURCE: ISO 10993-17:2023, 3.25]
3.23
tolerable exposure
TE
product of the tolerable intake (3.24), the body mass and the concomitant exposure factor (3.4)
Note 1 to entry: Tolerable exposure is normally expressed in milligrams per day to the patient.
3.24
tolerable intake
TI
estimate of the daily exposure of an identified constituent over a specified time period (e.g. acute, subacute,
sub-chronic or chronic), on the basis of body mass, that is considered to be without appreciable harm to
health (3.9)
Note 1 to entry: Tolerable intake is normally expressed in microgram per kilogram of body mass per day (μg/kg/d). It
is derived to establish an allowable limit (3.2) for a medical device constituent.
[SOURCE: ISO 10993-17:2023, 3.26, modified — ‘normally’ has been added and ‘toxicological exposure limit’
has been replaced with ‘an allowable limit (3.2)’ in Note 1 to entry.]
3.25
toxicological risk assessment
determination of whether an exposure dose to a constituent can or cannot elicit appreciable harm to health (3.10)
[SOURCE: ISO 10993-17:2023, 3.29]
3.26
uncertainty factor
UF
numerical value that accounts for uncertainties when extrapolating a point of departure to individuals who
can be exposed to a constituent of toxicological concern
EXAMPLE Extrapolation types include, but are not limited to: intraspecies, interspecies, dose route and study
duration.
[SOURCE: ISO 10993-17:2023, 3.31]
4 Requirements
4.1 General
This clause specifies maximum ALs for residuals of ethylene oxide (EO) and ethylene chlorohydrin (ECH) for
each individual medical device sterilized with EO. Local (acute) effects (e.g. irritation) have been considered
and are incorporated in the TCL.
The requirements in this document shall be applied in addition to the requirements set out in ISO 10993-1.
All applicable requirements of ISO 10993-1 shall take into account the EO residual level at the time of release
for each individually designed medical device. The results of the biological assessment of the device may
lead to other limits than those specified in 4.3, which are designed to protect against local irritation and
systemic effects.
Medical devices already on the market and tested to the previous edition of this document (i.e.
ISO 10993-7:2008) do not have to undergo the testing of this edition of this document (i.e. ISO 10993-7:2025).
A review and confirmation that none of the issues identified in ISO 10993-1:2018, 4.9 have occurred shall
be carried out. If there are any changes, then a new biological risk assessment shall be carried out to
demonstrate conformity to allowable limits. This may include re-testing to this edition of this document (i.e.
ISO 10993-7:2025). The previous editions of this document reported a limit of 4 mg for EO and 9 mg for ECH
for adults with limited exposure [with the concomitant exposure factor (CEF) equal to 0,2] for 70 kg adult
population and a uncertainty factor 1 (UF1) of 10 for intra-species variability. From a toxicological point of
view, these values are not significantly different from the values calculated in this edition of this document
(i.e. ISO 10993-7:2025) and thus, these changes in ALs do not warrant re-evaluating a product that met the
limits of the previous edition of this document (i.e. ISO 10993-7:2008).
A flowchart providing guidance for the application of this document to the determination of EO residuals in
medical devices is given in Annex A.
NOTE 1 Information on the derivation of the limits in this document as well as other background information and
guidance relevant to the use of this document is contained in Annexes C, D and E.
NOTE 2 Throughout this document, numbers calculated from formulae were rounded following the rules provided
[250]
in NIST Special Publication 811, Guide for the Use of the International System of Units (SI). Thereby, the number
of (typically two) significant digits from the source literature were retained, and only increased (to typically three
significant digits), where the calculated result was evaluated to provide the adequate amount of relevant information
[250]
only with an increased number of digits. This evaluation is in line with NIST Special Publication 811, section B.7.2.
4.2 Categorization of devices
In establishing the maximum daily doses of EO and ECH that a medical device is allowed to deliver to patients,
the medical device shall be categorized in accordance with the duration of body contact in accordance with
ISO 10993-1:2018:
a) limited exposure;
b) prolonged exposure;
c) long-term exposure.
If a device can be placed in more than one duration category, the more rigorous testing or evaluation
considerations shall apply. If a device is intended for repeated or multiple usages, the decision into which
exposure category a device is placed shall take into account the potential cumulative effect, bearing in mind
the period of time over which the cumulative exposure occurs. For example, a dialyzer cartridge is used for
less than 24 h per treatment, but repeated usages of the same or a replacement cartridge for more than 30 d
would categorize the cartridge as long-term contact.
For medical devices that have very brief contact with the body, typically for less than one minute (e.g. lancets,
hypodermic needles, capillary tubes), it can be possible to prepare a written justification that there is no
potential for biological harm. For products with repeated use, the total exposure period shall be considered.
However, for medical devices that can leave materials in contact with tissues after the medical device is
removed (e.g. coatings, lubricants), a more detailed biological evaluation is required (see ISO 10993-1 for
further guidance).
4.3 Allowable limits
4.3.1 General
For each medical device, the maximum exposure of EO and ECH to patients shall not exceed the AL using
Formulae (1) and (2) based on the defaults in Table 1 for any of the applicable exposure categories (see 4.2).
Alternative limits may be calculated based on risk assessment that accounts for device usage and patient
population. The procedure that was used to establish the tolerable intake (TI) is described in Annex D for EO
and in Annex E for ECH.
Prolonged contact devices carry additional limits for the first 24 h exposure period and, in the case of the
long-term exposure devices, for the first 24 h period and the first 30 d period. These constraints set limits
on the amount of EO and ECH that can be delivered to the patient during these early time periods.
The CEF uses a default value of 0,2 based on five devices used simultaneously. If data are available on
the number of devices used at one time, for example, in multi-device systems, convenience kits, long-
term exposure devices, then the default CEF of 0,2 may be modified (see 4.4.5, A.3.3 and D.6.1 for further
justification).
The tolerable exposure (TE) shall be calculated based on the TI multiplied by body mass (m ) and CEF.
b
TE=×TI mC× EF (1)
b
where
TE is the tolerable exposure;
TI is the tolerable intake;
m is the body mass;
b
CEF is the concomitant exposure factor.
The AL shall be determined based on tolerable exposure multiplied by the days in the category unless
an alternative limit can be justified. The lowest patient population mass, based on the anticipated
exposure duration for the device, shall be used, see Clause C.4. The application of higher body masses
associated for these sub population age groups, or lower body masses associated with younger sub
population age groups, shall be justified and documented. See example in K.8.1.
D
 
AL=×TE (2)
 
N 
where
AL is the allowable limit;
D is the number of days of the medical device contact duration;
N is the number of devices used during this duration.
When the number of medical devices does not apply (e.g. the largest surface area of device which can be in
contact with the body is not the same as the surface area of the device which is tested, or powder or liquid
device), the “number of devices used during this duration” in Formula (2) shall be replaced by “the quantity
of devices used during this duration”. The quantity should be expressed in cm , g or ml as appropriate
considering the form of the device and the AL shall be expressed in mg/cm , mg/g or mg/ml respectively.
The definition of AL shall be modified accordingly.
NOTE The number of devices (N) considered in Formula (2) is not related to the CEF, but number subject devices
during the exposure duration used for a treatment or therapy, which can be 1 or more.
The intended population shall be documented.

Table 1 — TE and AL default values for Formulae (1) and (2)
TI for EO TI for ECH CEF Anticipated contact duration
Contact category
mg/kg/d mg/kg/d default d
Limited 0,3 0,64 ≤ 1
Prolonged 0,3 0,27 ≤ 30
≤ 25 000 d for adults (>16 y)
0,2
OR
Long-term 0,02 0,029 ≤ 5 840 d for paediatric (0 to 16 y)
AND
≤ 19 160 d for adult (> 16 y)
For medical devices used in a pediatric sub population age group, the factors to consider in the selection of fewer days (i.e. <
5 840 d) are described in Clause C.4 and D.6.8.
4.3.2 Limited exposure devices
The AL for limited exposure devices are based on the TI value of 0,3 mg/kg/d for EO, 0,64 mg/kg/d for
ECH, with CEF = 0,2 (default) as established in Clause D.4 and Clause E.5 respectively. The total EO and
ECH cumulative exposure estimate obtained by simulated-use or exhaustive extraction shall be compared
to the limited exposure AL, unless otherwise justified. Alternatively, an assessment targeted to evaluate
toxicological risk associated with exposure to EO or ECH from the actual anticipated exposure duration
of a specific device as well as more clinically relevant details for the device and indication can be used to
determine appropriate allowable limits using Formulae (3) to (5).
D
 
AL=×TI mC××EF (3)
b  
N 
EXAMPLE
D
 
AL =×03,,m ××02 (4)
 
EO b
N 
where
0,3 is the limited contact tolerable intake value in mg/kg/d;
m is the body mass of anticipated patient population in kg;
b
0,2 is the default concomitant exposure factor;
D is the anticipated contact duration up to 1 d;
N is the number of devices used during this duration.
D
 
AL =×06,,40m ××2 (5)
 
ECHb
N
 
where
0,64 is the limited contact tolerable intake value in mg/kg/d;
m is the body mass of anticipated patient population in kg;
b
0,2 is the default concomitant exposure factor;
D is the anticipated contact duration up to 1 d;
N is the number of devices used during this duration.

Examples of AL calculations can be found in Annex K.
4.3.3 Prolonged contact devices
The AL for prolonged contact devices are based on TI value of 0,3 mg/kg/d for EO, 0,27 mg/kg/d for ECH,
body mass m , and with CEF equal to 0,2 (default) as established in Clause D.4 and Clause E.5. The cumulative
b
exposure estimate obtained by simulated use extraction or exhaustive extraction shall be compared to the
applicable prolonged duration limit for up to 30 d, unless otherwise justified. Alternatively, an assessment
targeted to evaluate toxicological risk associated with exposure to EO or ECH from the actual anticipated
exposure duration of a specific device as well as more clinically relevant details for the device and indication
can be used to determine appropriate allowable limits using Formulae (6) and (7).
D
 
AL =×03,,m ××02 (6)
EO b  
N 
where
0,3 is the limited contact tolerable intake value in mg/kg/d;
m is the body mass of anticipated patient population in kg;
b
0,2 is the default concomitant exposure factor;
D is the anticipated contact duration up to 30 d;
N is the number of devices used during this duration.
D
 
AL =×02,,70m ××2 (7)
ECHb  
N
 
where
0,27 is the prolonged contact tolerable intake value in mg/kg/d;
m is the body mass of anticipated patient population in kg;
b
0,2 is the default concomitant exposure factor;
D is the anticipated contact duration up to 30 d;
N is the number of devices used during this duration.
Prolonged-contact devices shall meet limited exposure AL in 4.3.2 during the first 24 h period. Examples of
these calculations can be found in Annex K.
4.3.4 Long-term exposure devices
4.3.4.1 Ethylene oxide
For EO, the tolerable exposure for long-term use devices is based on TI value of 0,02 mg/kg/d. The
AL is determined by multiplying the TE with the number of days of anticipated contact from a single or
repeated use of a device for general populations (adults). Alternatively, an assessment targeted to evaluate
toxicological risk associated with exposure to EO or ECH from the actual anticipated exposure duration
of a specific device as well as more clinically relevant details for the device and indication can be used to
determine appropriate allowable limits using Formulae (8) and (9).
TE =×TI mC×=EF 00,,26××00 20= ,24mg/d (8)
AdultEOb
D
 
AL =×02, 4 (9)
 
AdultEO
N
 
where
0,02 is the long-term contact tolerable intake value in mg/kg/d;
m is the body mass of anticipated patient population in kg;
b
0,2 is the default concomitant exposure factor;
D is the anticipated contact duration up to 19 160 d;
N is the number of devices used during this duration.
For devices to be used for paediatric patients during a specific time frame (age), the TE value can be
calculated based upon the values given in Table D.9. For a device intended to be used throughout paediatric
time frame (age 0 to 16 y) and through adulthood, the TE value is 0,11 mg/d, see D.6.7. The cumulative
exposure estimate shall be compared to the applicable AL, unless otherwise justified.
TE =×TI mC× EF (10)
PaediatricEO b
D
 
AL =×TE (11)
 
Paediatric EO
N
 
Long-term exposure devices shall also meet limited and prolonged AL in 4.3.2 and 4.3.3 during the first 24 h
period and the first 30 d, respectively. Examples of AL calculations can be found in Annex K.
4.3.4.2 Ethylene chlorohydrin
For ECH, the tolerable exposure for long-term use devices is based on TI value of 0,029 mg/kg/d. The AL is
determined by multiplying the TE with the number of days of anticipated contact from a single or repeated
use of a device for general populations (adults) based on the anticipated contact duration. Alternatively, an
assessment targeted to evaluate toxicological risk associated with exposure to EO or ECH from the actual
anticipated exposure duration of a specific device as well as more clinically relevant details for the device
and indication can be used to determine appropriate allowable limits using Formulae (12) and (13).
TE = 0,029 × 60 × 0,2 = 0,35 mg/d (12)
Adult ECH
where
0,029 is the long-term contact tolerable intake value in mg/kg/d;
m is the body mass of anticipated patient population in kg;
b
0,2 is the default concomitant exposure factor;
D is the anticipated contact duration up to 19 160 d;
N is the number of devices used during this duration.
D
 
AL =×TE (13)
 
AdultE CH
N 
For devices to be used for paediatric patients during a specific time frame, the TE value can be calculated
based upon the values given in Table E.5. For a device intended to be used for throughout the paediatric time

frame (age 0 to 16 y) and through adulthood the TE value is 0,16 mg/d, see E.5.2.3. The cumulative exposure
estimate shall be compared to the applicable AL, unless otherwise justified.
TE = TI × m × CEF (14)
Paediatric ECH b
D
 
AL =×TE (15)
Paediatric ECH  
N
 
Long-term exposure devices shall also meet limited and prolonged AL in 4.3.2 and 4.3.3 during the first 24 h
period and the first 30 d, respectively.
4.3.5 Special situations
4.3.5.1 General
For certain medical devices, the default AL for EO and ECH are not
...


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ISO/TC 194/ WG 11
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Secretariat: DIN
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Date: 2025-11-06
Biological evaluation of medical devices — —
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Part 7:
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Ethylene oxide sterilization residuals
Formatted
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Third edition
Date: 2024-11-17
ISO #####-#:####(X)
Évaluation biologique des dispositifs médicaux —
Partie 7: Résidus de stérilisation à l'oxyde d'éthylène
FDIS stage
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ii
Contents
Foreword . iv
Introduction . v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Requirements. 6
4.1 General . 6
4.2 Categorization of devices . 7
4.3 Allowable limits . 7
4.4 Determination of EO and ECH residuals . 13
5 Product release. 14
5.1 General . 14
5.2 Batch release of products . 15
5.3 Release of products at specified minimum aeration time . 15
5.4 Procedure for product release using residual dissipation curves . 15
6 Adoption of products into established aeration family . 16
7 Change evaluation . 16
Annex A (informative) Guidance for the application of this document for the determination of
EO and ECH residuals in medical devices . 17
Annex B (informative) Factors influencing product residuals . 30
Annex C (informative) Rationale for the provisions of this document . 33
Annex D (informative) Establishment of allowable limits for EO . 41
Annex E (informative) Establishment of allowable limits for ECH . 61
Annex F (informative) Ethylene glycol . 72
Annex G (normative) Evaluation of gas chromatograms . 77
Annex H (informative) Gas chromatographic determination for EO and ECH . 83
Annex I (informative) Preparation of EO and ECH standards . 87
Annex J (informative) Ethylene oxide and ethylene chlorohydrin residual measuring methods 92
Annex K (informative) Examples of product release methods . 102
Annex ZA (informative) Relationship between this European Standard the General Safety and
Performance Requirements of Regulation (EU) 2017/745 aimed to be covered . 126
Bibliography . 130

iii
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
ISO technical committees. Each member body interested in a subject for which a technical committee has been
established has the right to be represented on that committee. International organizations, governmental and
non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the
International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the different types of
ISO document should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
ISO draws attention to the possibility that the implementation of this document may involve the use of (a)
patent(s). ISO takes no position concerning the evidence, validity or applicability of any claimed patent rights
in respect thereof. As of the date of publication of this document, ISO had not received notice of (a) patent(s)
which may be required to implement this document. However, implementers are cautioned that this may not
represent the latest information, which may be obtained from the patent database available at
www.iso.org/patents. ISO shall not be held responsible for identifying any or all such patent rights.
Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.
For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and expressions
related to conformity assessment, as well as information about ISO's adherence to the World Trade
Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www.iso.org/iso/foreword.html.
This document was prepared by Technical Committee ISO/TC 194, Biological and clinical evaluation of medical
devices, in collaboration with the European Committee for Standardization (CEN) Technical Committee
CEN/TC 206, Biological and clinical evaluation of medical devices, in accordance with the Agreement on
technical cooperation between ISO and CEN (Vienna Agreement).
This third edition cancels and replaces the second edition (ISO 10993-7:2008, ISO 10993-7:2008/Cor 1:2009
and ISO 10993-7:2008/Amd 1:2019), which has been technically revised. It also incorporates the Amendment
ISO 10993-7:2008/Amd 1:2019 and the Technical Corrigendum ISO 10993-7:2008/Cor 1:2009.
The main changes are as follows:
— — manufacturer to specify allowable limits and extraction conditions, have been derived based on the
patient population and the duration of use;
— — allow for the use of a risk assessment to establish allowable limits has been permitted;
— — provide additional guidance on product release has been provided;
— — provide additional guidance on determining residuals and the factors that affect residual has been
provided.
A list of all parts in the ISO 10993 series can be found on the ISO website.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.
iv
Introduction
As noted in the introduction to ISO 11135:2014, when determining the suitability of ethylene oxide (EO) for
sterilization of medical devices, it is important to ensure that the levels of residual EO and ethylene
chlorohydrin (ECH) pose a minimal risk to the patient in intended product use. Therefore, it is important that
the use of alternative materials and sterilization processes are considered during product design and
development. EO is known to exhibit a number of biological effects. In the development of this document,
consideration was given to these effects, which include irritation, organ damage, mutagenicity,
carcinogenicity, and reproductive effects in humans and animals. Similar consideration was given to the
harmful effects of ECH and ethylene glycol (EG). ECH can be formed when EO comes into contact with free
chloride ions, whereas EG is a hydrolytic reaction product of EO and water. In practice, for most devices,
exposure to EO and ECH is considerably lower than the maximum allowable limits established according to
this document. No allowable limits are set for EG because risk assessment indicated that when EO residuals
are controlled, it is unlikely that biologically significant residuals of EG would be present.
Requirements herein are in addition to the biological evaluation requirements as indicated in ISO 10993-1.
The biological evaluation, combined with the EO-sterilization process residual limits, form the justification
that an EO-sterilized device is safe for its anticipated contact duration. Maximum allowable residuals for ECH,
when ECH has been found to be present in medical devices sterilized with EO, are also specified. Local effects
(e.g. irritation) have been considered and are incorporated in the TCL as given in 4.3.6.24.3.6.2 and
Annex DAnnex D for EO, and in 4.3.6.34.3.6.3 and Annex EAnnex E for ECH.
In this edition of this document (i.e. ISO 10993-7:2025), an uncertainty factor approach is used to derive EO
and ECH exposure duration-specific tolerable intake (TI) values (expressed in µg/kg/d). Unique
inFurthermore, this versionedition of this document (i.e. ISO 10993-7 is:2025) introduces the conversion of
each EO and ECH TI value into subpopulation-specific cumulative exposure-allowable limit values (expressed
in mg/milligrams per device), which are used to determine the extent that EO and ECH, extracted under
clinically relevant conditions and time-periods, needs to be reduced post-sterilization.
This edition of this document (i.e. ISO 10993-7:2025) applies a different approach as compared to ISO 10993-
17:2023 to establishing allowable limits to make it useful for development, validation, and routine control of
ethylene oxide sterilization in the manufacture of finished medical devices with focus on the risk assessments
associated with 3three chemical constituents that are potentially left in medical devices sterilized with
ethylene oxide. ISO 10993-7This document extends this knowledge further by calculating the largest amount
of EO, ECH or EG that can be present in a medical device such that it would always meet the requirements of
ISO 10993-17 when that device has been exposed to the validated sterilization cycle parameters. This
maximum amount or allowable limit is expressed in mg/milligrams per device deemed acceptable when taken
into the body through exposure to that medical device. These allowable limits will help determine the
appropriate sterilization parameters such as sterilant gas concentration and dwell, as well as aeration
temperature and hold time when validating the sterilization process to be used for a product or group of
products. FurtherFurthermore, the allowable limits can be used by regulatory bodies, manufacturers, and
processors to optimize processes and aid in the selection and qualification of alternative materials in order to
protect patient health.
v
Biological evaluation of medical devices — —
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Part 7:
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Ethylene oxide sterilization residuals
between Asian text and numbers
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1 Scope
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This document specifies allowable limits (AL) for residual ethylene oxide (EO) and ethylene chlorohydrin
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(ECH) in EO-sterilized medical devices, procedures for the measurement of EO and ECH, and methods for
stops: Not at 0.7 cm + 1.4 cm + 1.59 cm + 2.1 cm +
determining complianceconformity so that devices can be released. Additional background, including
2.8 cm + 3.5 cm + 4.2 cm + 4.9 cm + 5.6 cm + 6.3
guidance and a flowchart showing how this document is applied, are also included in Annex A, 0, Annex C,
cm + 7 cm
Annex D, Annex E, Annex F, Annex G, Annex H, Annex I, Annex J and Annex Kthe informative annexes.
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EO-sterilized devices or components that have neither direct nor indirect body or user contact (e.g. in vitro
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diagnostic devices) are out of scope of this document. This document does not apply to devices that have been
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demonstrated to not absorb or retain EO or its degradation product ECH, such as medical devices made
[ [228] ] Formatted: Adjust space between Latin and Asian text,
exclusively of metal alloys and glass, see C.5 Error! Reference source not found.Clause C.5 . .
Adjust space between Asian text and numbers, Tab
stops: Not at 0.7 cm + 1.4 cm + 2.1 cm + 2.8 cm +
NOTE This document does not specify limits for ethylene glycol (EG). No device limits are specified for EG because
3.5 cm + 4.2 cm + 4.9 cm + 5.6 cm + 6.3 cm + 7 cm
the risk assessment in Annex FAnnex F indicates that calculated allowable levels are higher than those likely to occur in
a medical device.
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2 Normative references
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The following documents are referred to in the text in such a way that some or all of their content constitutes
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requirements of this document. For dated references, only the edition cited applies. For undated references,
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the latest edition of the referenced document (including any amendments) applies.
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ISO 10993--1:2018, Biological evaluation of medical devices — Part 1: Evaluation and testing within a risk
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management process
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ISO 10993--23:2021, Biological evaluation of medical devices — Part 23: Tests for irritation
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3 Terms and definitions
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For the purposes of this document, the terms and definitions given in ISO 10993-1 and the following apply.
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ISO and IEC maintain terminology databases for use in standardization at the following addresses:
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— — ISO Online browsing platform: available at https://www.iso.org/obp
stops: Not at 0.7 cm + 1.4 cm + 2.1 cm + 2.8 cm +
3.5 cm + 4.2 cm + 4.9 cm + 5.6 cm + 6.3 cm + 7 cm
— — IEC Electropedia: available at https://www.electropedia.org/
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and Asian text, Adjust space between Asian text and
3.1 3.1
numbers
aeration
part of the sterilization cycle (Error! Reference source not found.(3.5)) during which the sterilizing agent Formatted: Adjust space between Latin and Asian text,
and/or its reaction products desorb from the health care product until predetermined levels are reached Adjust space between Asian text and numbers
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Note 1 to entry: This Aeration can be performed within the sterilization chamber or in a separate chamber or room.
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[SOURCE: ISO 11139:2018, 3.7, modified by adding— Note 1 to entry] has been added.]
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3.2 3.2
allowable limit
AL
amount of residual (Error! Reference source not found.(3.20) EO) ethylene oxide or ECHethylene
chlorohydrin on a single device that is permitted as a condition of release for patient use
Note 1 to entry: Allowable limits are expressed in mg/milligrams per device for each applicable exposure period. These
limits represent acceptable biological risks for medical devices under the circumstances of their anticipated contact
duration.
3.3 3.3
cumulative exposure
total quantity of EOethylene oxide and ECHethylene chlorohydrin that contacts the body for a specified period
of time
Note 1 to entry: Cumulative exposure can apply when consecutive uses of the same device or of new devices of the same
type for same patient or user applies. For example, (e.g. when one device is used repeatedly over a specified period of
time.).
3.4 3.4
concomitant exposure factor
CEF
numerical safety (Error! Reference source not found.(3.21)) factor that accounts for patient exposure to the
simultaneous use of other EOethylene oxide sterilized medical devices different from the subject medical
device
Note 1 to entry: CEF is calculated from the reciprocal of the number of devices (1/device) used during a procedure. The
default value (Error! Reference source not found.(3.6)) of 0,2 assumes five other devices are used during a procedure,
see 4.4.54.4.5 and D.6D.6 for further details.
3.5 3.5
cycle
set of sterilization process parameters
3.6 3.6
default value
value or factor used in the derivation of a tolerable contact level (Error! Reference source not found.(3.24))
or tolerable intake (Error! Reference source not found.(3.26),), in the absence of specific data [e.g. an
uncertainty factor (Error! Reference source not found.(3.28)])]
[SOURCE: ISO 10993-17:2023, 3.5, modified to remove — the "worst-case exposure dose and replace with
tolerable contact level]" has been removed from the definition.]
3.7 3.7
dose-response
relationship of dosage to observable harm
Note 1 to entry: In general, there are two types of dose-response relationships. The first type is the change in response
forof an individual to a range of doses. The second type is the distribution of athe response among individuals to a range
of doses.
[SOURCE: ISO 10993-17:2023, 3.6]
3.8 3.8
exhaustive extraction
multi-step extraction conducted until the amount of material extracted in a subsequent extraction step is less
than 10 % of that determined in the initial extraction step
Note 1 to entry: Based upon the boiling point of ethylene oxide (EO) (10,7 °C) and the knowledge that substances, other
than EO and ECHethylene chlorohydrin, can be extracted from the device under evaluation, gravimetric analysis is not
appropriate for determining the exhaustivity level.
[SOURCE: ISO 10993-18:2020, 3.15, modified – removal of ‘— "by gravimetric analysis (or achieved by other
means))" has been removed from the definition and addition of Note 1 to entry has been added.]
3.9 3.9
harm to health
adverse reaction, such as altered morphology, physiology, growth, development, reproduction or lifespan that
a) a) impairs function of an organ or system, organism, or (sub)population,
b) b) reduces capacity to tolerate an impaired function, or
c) c) increases susceptibility to other influences that impair function
Note 1 to entry: Examples of (sub)population include, but are not limited to: male, female, preterm neonates, adults.
[SOURCE: ISO 10993-17:2023, 3.8]
3.10 3.10
load
sterilization batch
sterilization load
product, equipment, or materials to be processed together within an operating cycle (Error! Reference
source not found.(3.5))
Note 1 to entry: Frequently referred to as a sterilization batch or sterilization load.
[SOURCE: ISO 11139:2018, 3.155, modified – addition of Note 1 to entry]— the admitted terms "sterilization
batch" and "sterilization load" have been added.]
3.11 3.11
implant
medical device which is intended to be totally introduced into the human body or to replace an epithelial
surface or the surface of the eye by means of clinical intervention and which is intended to remain in place
after the procedure
Note 1 to entry: Skin irritation is a reversible reaction and is mainly characterized by local erythema (redness) and
swelling (oedema) of the skin.
[SOURCE: ISO 10993-23:20211:2018, 3.7] 10]
3.12 3.12
irritation
localized non-specific inflammatory response to single, repeated, or continuous application of a
substance/material
Note 1 to entry: Skin irritation is a reversible reaction and is mainly characterized by local erythema (redness) and
swelling (oedema) of the skin.
[SOURCE: ISO 10993-23:2021, 3.7]
3.13 3.13
lowest observed adverse effect level
LOAEL
lowest concentration or amount of an identified constituent found by experiment or observation which causes
detectable harm to health (Error! Reference source not found.(3.10)) to the target organism under defined
conditions of exposure
[SOURCE: ISO 10993-17:2023, 3.13, modified –— Note 1 to entry has been deleted.]
3.14 3.14
minimally irritating level
MIL
lowest amount per surface area of an identified constituent that is irritating to the tissue at the contact site as
determined by valid experimental or observational evidence
Note 1 to entry: Minimally The minimally irritating level is expressed asin microgram per centimetre squared (μg/cm ).
[SOURCE: ISO 10993-17:2023, 3.15]
3.15 3.15
modifying factor
MF
mathematical product of uncertainty factors (Error! Reference source not found.(3.26))
[SOURCE: ISO 10993-17:2023, 3.16]
3.16 3.16
non-irritating level
NIL
greatest amount per surface area of an identified constituent that does not elicit irritation (Error! Reference
source not found.(3.12)) to the tissue at the contact site as determined by valid experimental or
observational evidence
Note 1 to entry: Non The non-irritating level is usually expressed as milligram or microgram per centimetre squared
2 2
(mg/cm or μg/cm ).
[SOURCE: ISO 10993-17:2023, 3.17 – Modified, modified — Note 1 to add ‘usually’, ‘milligram or’ and
‘mg/cm2’. ]
3.17 3.17
no observed adverse effect level
NOAEL
greatest concentration or amount of an identified constituent found by experiment or observation which
causes no detectable harm to health (Error! Reference source not found.(3.9)) to the target organism under
defined conditions of exposure
Note 1 to entry: No observed adverse effect level is expressed asin microgram per kilogram of body weightmass per day
(μg/kg/d).
[SOURCE: ISO 10993-17:2023, 3.18]
3.18 3.18
physiologically based pharmacokinetic modelling
PBPK modelling
system of modelling biological effects taking into account metabolic and pharmacokinetic differences among
species of animals
Note 1 to entry: Such data should be utilized whenever available and applicable to medical device anticipated contact
duration.
3.19 3.19
residual
quantity of EO, ECH,ethylene oxide, ethylene chlorohydrin or EGethylene glycol that remains in or on the
product after EOethylene oxide sterilization
3.20 3.20
safety
freedom from unacceptable risk
[SOURCE: ISO 14971:2019, 3.26]
3.21 3.21
simulated-use extraction
extraction using a method that simulates clinical use
Note 1 to entry: A simulated-use extraction is performed to estimate the type and amount of substances that are expected
to be released from a medical device during its clinical use. A simulated-use extraction is designed to produce an
extractables profile that represents the worst-case leachables profile, meaning that all leachables are also extractables
and the levels of all individual extractables are at least equal to the level of all individual leachables.
[SOURCE: ISO 10993-18:2020, 3.35]
3.22 3.22
tolerable contact level
TCL
estimate of the surface-contact exposure to an identified constituent that is without appreciable irritation
(Error! Reference source not found.(3.12))
Note 1 to entry: Tolerable contact level is expressed asin microgram per centimetre squared (μg/cm ) of tissue at the
contact site.
[SOURCE: ISO 10993-17:2023, 3.25]
3.23 3.23
tolerable exposure
TE
product of the tolerable intake (Error! Reference source not found.(3.24),), the body weight,mass and the
concomitant exposure factor (Error! Reference source not found.(3.4))
Note 1 to entry: It Tolerable exposure is normally expressed in milligrams per day to the patient.
3.24 3.24
tolerable intake
TI
estimate of the daily exposure of an identified constituent over a specified time period (e.g. acute, subacute,
sub-chronic, or chronic), on the basis of body weightmass, that is considered to be without appreciable harm
to health (Error! Reference source not found.(3.9))
Note 1 to entry: Tolerable intake is normally expressed asin microgram per kilogram of body weightmass per day
(μg/kg/d). It is derived to establish an allowable limit (Error! Reference source not found.) for a medical device
constituent.
[SOURCE: ISO 10993-17:2023, 3.26, Modified Note 1 to addmodified — ‘normally’ has been added and change
‘toxicological exposure limit’ tohas been replaced with ‘an ALallowable limit (3.2)’ in Note 1 to entry.]
3.25 3.25
toxicological risk assessment
determination of whether an exposure dose to a constituent can or cannot elicit appreciable harm to health
(Error! Reference source not found.(3.10))
[SOURCE: ISO 10993-17:2023, 3.29]
3.26 3.26
uncertainty factor
UF
numerical value that accounts for uncertainties when extrapolating a point of departure to individuals who
can be exposed to a constituent of toxicological concern
EXAMPLE Extrapolation types include, but are not limited to: intraspecies, interspecies, dose route and study
duration.
[SOURCE: ISO 10993-17:2023, 3.31]
4 Requirements
4.1 General
This clause specifies maximum ALs for residuals of ethylene oxide (EO) and ethylene chlorohydrin (ECH) for
each individual medical device sterilized with EO. Local (acute) effects (e.g. irritation) have been considered
and are incorporated in the TCL.
The requirements in this document areshall be applied in addition to the requirements set out in ISO 10993-
1. All applicable requirements of ISO 10993-1 shall take into account the EO residual level at the time of release
for each individually designed medical device. ResultsThe results of the biological assessment of the device
may lead to other limits than those specified in 4.34.3,, which are designed to protect against local irritation
and systemic effects.
Medical devices already on the market and tested to the previous revisionedition of this standard
maydocument (i.e. ISO 10993-7:2008) do not require additionalhave to undergo the testing toof this new
revision.edition of this document (i.e. ISO 10993-7:2025). A review and confirmation that none of the issues
identified in ISO 10993-1:2018, 4.9 have occurred shall be carried out. If there are any changes, then a new
biological risk assessment shall be carried out to demonstrate complianceconformity to allowable limits. This
may include re-testing to this new version of the standard.edition of this document (i.e. ISO 10993-7:2025).
The previous versionseditions of this standarddocument reported a limit of 4 mg for EO and 9 mg for ECH for
adults with limited exposure ([with the concomitant exposure factor, (CEF) equal to 0,2)] for 70 kg adult
population and a uncertainty factor 1 (UF1) of 10 for intra-species variability. From a toxicological point of
view, these values are not significantly different from the values calculated in the currentthis edition of this
document (i.e. ISO 10993-7:2025) and thus, these changes in ALs do not warrant re-evaluating a product that
met the limits of the previous edition of this document. (i.e. ISO 10993-7:2008).
A flowchart providing guidance for the application of this document to the determination of EO residuals in
medical devices is presentedgiven in Annex AAnnex A.
NOTE 1 Information on the derivation of the limits in this document as well as other background information and
guidance relevant to the use of this document is contained in Annex C, Annex D and Annex Ethe informative annexes.
NOTE 2 Throughout this document, numbers calculated from equationsformulae were rounded following the rules
[
provided in NIST Special Publication 811, Guide for the Use of the International System of Units (SI). Error! Reference
]
source not found.) [250]. Thereby, the number of (typically two) significant digits from the source literature were
retained, and only increased (to typically three significant digits), where the calculated result was evaluated to provide
the adequate amount of relevant information only with an increased number of digits. This evaluation is in line with NIST
[ ]
Special Publication 811, section B.7.2. Error! Reference source not found.
4.2 Categorization of devices
In establishing the maximum daily doses of EO and ECH that a medical device is allowed to deliver to patients,
the medical device shall be categorized according to in accordance with the duration of body contact in
accordance with ISO 10993-1:2018:
a) a) Limitedlimited exposure;
b) b) Prolongedprolonged exposure;
c) c) Longlong-term exposure.
If a device can be placed in more than one duration category, the more rigorous testing or evaluation
considerations shall apply. If a device is intended for repeated or multiple usages, the decision into which
exposure category a device is placed shall take into account the potential cumulative effect, bearing in mind
the period of time over which the cumulative exposure occurs. For example, a dialyzer cartridge is used for
less than 24 h per treatment, but repeated usages of the same or a replacement cartridge for more than 30 d
would categorize the cartridge as long-term contact.
For medical devices that have very brief contact with the body, typically for less than one minute (e.g.,. lancets,
hypodermic needles, capillary tubes), it can be possible for the manufacturer to prepare a written justification
that there is no potential for biological harm. For products with repeatrepeated use, the total exposure period
shouldshall be considered. However, for medical devices that couldcan leave materials in contact with tissues
after the medical device is removed (e.g.,. coatings, lubricants)), a more detailed biological evaluation is
required (see ISO 10993-1 for further guidance).
4.3 Allowable limits
4.3.1 General
For each medical device, the maximum exposure of EO and ECH to patients shall not exceed the AL using 0the
formulae (1) and 0(2) based on the defaults in 0Table 1 for any of the applicable exposure categories (see
04.2).). Alternative limits may be calculated based on risk assessment that accounts for device usage and
patient population. The procedure that was used to establish the tolerable intake (TI) is described in 0Annex D
for EO, and in 0Annex E for ECH.
Prolonged contact devices carry additional limits for the first 24 h exposure period and, in the case of the long-
term exposure devices, for the first 24 h period and the first 30 d period. These constraints set limits on the
amount of EO and ECH that can be delivered to the patient during these early time periods.
The CEF uses a default value of 0,2 based on 5five devices used simultaneously. If data are available on the
number of devices used at one time, e.g.for example, in multi-device systems, convenience kits, long-term
exposure devices, then the default CEF of 0,2 may be modified (see 04.4.5, A.3.3, 0 and 0D.6.1 for further
justification).
Formatted
...
Formatted Table
The tolerable exposure (TE) shall be calculated based on the tolerable intake (TI) multiplied by body
...
weightmass (m ) and CEF.
b
Formatted
...
Formatted
...
TE = TI × 𝑚 × CEF (1)
b
Formatted
...
where
Formatted
...
Formatted
...
TE is the tolerable exposure;
Formatted
...
TI is the tolerable intake;
Formatted
...
m is the body weightmass;
b
Formatted
...
CEF is the concomitant exposure factor.
Formatted
...
Formatted
The AL shall be determined based on tolerable exposure multiplied by the days in the category unless an .
alternative limit can be justified. The lowest patient population weightmass, based on the anticipated exposure
Formatted
...
duration for the device, shouldshall be used, see 0Clause C.4. Application. The application of higher body
Formatted
...
weightsmasses associated for these sub population age groups, or lower body weightsmasses associated
Formatted
with younger sub population age groups, shall be justified and documented. See example in K.8.1. .
Formatted Table
...
𝐷 𝐷
AL = TE × ( ) 𝐴𝐿 = 𝑇𝐸 × ( )
N 𝑁 Formatted
...
(2)
Formatted
...
where Formatted
...
Formatted
...
AL is the Allowable Limitallowable limit;
Formatted
...
D is the number of days of the medical device contact duration;
Formatted
...
N is the number of devicedevices used during this duration.
Formatted
...
Formatted
...
When the number of medical devices does not apply (e.g. the largest surface area of device which can be in
Formatted
...
contact with the body is not the same as the surface area of the device which is tested, or powder or liquid
device), the “number of devices used during this duration” in 0Formula (2) shall be replaced by “the quantity
Formatted
...
of devices used during this duration”. The quantity should be expressed in cm²,cm , g, or ml as appropriate
Formatted
...
considering the form of the device and the AL shall be expressed in mg/cm²,cm , mg/g or mg/mLml
Formatted
respectively.” Definition. The definition of AL shall be modified accordingly. .
Formatted
...
NOTE The number of devices (N) considered in 0Formula (2) is not related to the CEF, but number subject devices
Formatted
during the exposure duration used for a treatment or therapy, which maycan be 1 or more. .
Formatted
...
The intended population shall be documented.
Formatted
...
Table 1 — TE and AL Defaultdefault values for 0Formulae (1) and 0(2) Formatted Table
...
Formatted
...
TI for EO TI for ECH CEF Anticipated contact duration
Contact category
Formatted
...
mg/kg/d mg/kg/d default d
Formatted
...
Limited 0,3 0,64 ≤ 1
Formatted
...
Prolonged 0,3 0,27 ≤ 30
Formatted Table
...
≤ 25 000 d for adults (>16 y)
0,2
Formatted
...
OR
Long-term 0,02 0,029
Formatted
...
≤ 5 840 d for paediatric (0 to 16 y)
Formatted
AND
...
Formatted
...
TI for EO TI for ECH CEF Anticipated contact duration
Formatted: Font: Not Bold, English (United Kingdom)
Contact category
mg/kg/d mg/kg/d default d
Formatted: Font: Not Bold
≤ 19 160 d for adult (> 16 y)
Formatted: Font: Not Bold
For medical devices used in a pediatric sub population age group, whatthe factors to consider in the selection of fewer days (i.e.,.
Formatted: Font: Not Bold
< 5 840 d) are described in C.4C.4 and D.6.8D.6.8.
Formatted: Adjust space between Latin and Asian text,
Adjust space between Asian text and numbers
4.3.2 Limited exposure devices
Formatted Table
The AL for limited exposure devices are based on the tolerable intake (TI) value of 0,3 mg/kg/d for EO,
Formatted: Font: Not Bold
0,64 mg/kg/d for ECH, with CEF = 0,2 (default) as established in 0clause D.4 and 0clause E.5 respectively. The
Formatted: Adjust space between Latin and Asian text,
total EO and ECH cumulative exposure estimate obtained by simulated-use or exhaustive extraction shall be
Adjust space between Asian text and numbers
compared to the limited exposure AL, unless otherwise justified. Alternatively, an assessment targeted to
Formatted: English (United Kingdom)
evaluate toxicological risk associated with exposure to EO or ECH from the actual anticipated exposure
duration of a specific device as well as a more clinically relevant details for the device and indication can be
Formatted: Font: 9 pt
used to determine appropriate allowable limits using 0 to 0the formulas below.
Formatted: Table footer, Adjust space between Latin
and Asian text, Adjust space between Asian text and
𝐷 𝐷
AL = TI ×  𝑚 × CEF × ( ) 𝐴𝐿 = 𝑇𝐼 ×  𝑚 × 𝐶𝐸𝐹 × ( ) (3)
numbers
𝑏 b
N 𝑁
Formatted: Font: 9 pt
AL =EXAMPLE
EO
Formatted: Font: 9 pt
mg
Formatted: Font: 9 pt
kg 1 𝐷
𝐴𝐿 = 0,3  × 𝑚   × 𝑚 × 0,2 × ( ) × ( ) (4)
EO 𝑏 b
𝑑 N 𝑁
Formatted: Font: 9 pt
whereAL = Formatted: Font: 9 pt
ECH
Formatted: Heading 3, Space Before: 12 pt
0,3 is the limited contact tolerable intake value in mg/kg/d;
Formatted: Adjust space between Latin and Asian text,
m is the body mass of anticipated patient population in kg; Adjust space between Asian text and numbers
b
Formatted
0,2 is the default concomitant exposure factor; .
Formatted: English (United Kingdom)
D is the anticipated contact duration up to 1 d;
Formatted: label, English (United Kingdom)
N is the number of devices used during this duration.
Formatted: English (United Kingdom)
mg
1 𝐷 Formatted
kg .
AL = 0,64  × 𝑚 × 0,2  × ( )   × 𝑚 × 0,2  × ( ) (5)
ECH 𝑏 b
𝑑 N 𝑁
Formatted
...
where Formatted
...
Formatted: English (United Kingdom)
0,64 is the limited contact tolerable intake value in mg/kg/d;
Formatted: label, English (United Kingdom)
m is the body mass of anticipated patient population in kg;
b
Formatted: English (United Kingdom)
0,2 is the default concomitant exposure factor;
Formatted
...
D is the anticipated contact duration up to 1 d;
Formatted
...
N is the number of devices used during this duration.
Formatted: English (United Kingdom)
Formatted: label, English (United Kingdom)
Examples of AL calculations can be found in Annex KAnnex K. .
Formatted: English (United Kingdom)
4.3.3 Prolonged contact devices
Formatted
...
Formatted
...
The AL for prolonged contact devices are based on TI value of 0,3 mg/kg/d for EO, 0,27 mg/kg/d for ECH,
Formatted: Heading 3
body weightmass m , and with CEF =equal to 0,2 (default) as established in 0clause D.4 and 0clause E.5. The
b
cumulative exposure estimate obtained by simulated use extraction or exhaustive extraction shall be
Formatted
...
compared to the applicable prolonged duration limit for up to 30 d, unless otherwise justified. Alternatively,
an assessment targeted to evaluate toxicological risk associated with exposure to EO or ECH from the actual
anticipated exposure duration of a specific device as well as a more clinically relevant details for the device
and indication can be used to determine appropriate allowable limits using 0 and 0the formulas below.
mg
𝐷 𝐷
kg
AL = 𝐴𝐿 = 0,3  × 𝑚 × 𝑚 × 0,2 × ( ) × ( ) (6)
EO
EO 𝑏 b
𝑑 N 𝑁
Formatted: Adjust space between Latin and Asian text,
where D can be up to 30 d.
Adjust space between Asian text and numbers, Tab
stops: Not at 0.7 cm + 1.4 cm + 2.1 cm + 2.8 cm +
AL =
ECH
3.5 cm + 4.2 cm + 4.9 cm + 5.6 cm + 6.3 cm + 7 cm
+ 16.95 cm
0,3 is the limited contact tolerable intake value in mg/kg/d;
Formatted: Font: (Intl) Cambria Math, English (United
m is the body mass of anticipated patient population in kg;
b
Kingdom)
0,2 is the default concomitant exposure factor;
Formatted: English (United Kingdom)
D is the anticipated contact duration up to 30 d;
Formatted: label, English (United Kingdom)
N is the number of devices used during this duration. Formatted: English (United Kingdom)
Formatted: Space Before: 12 pt, Adjust space between

Latin and Asian text, Adjust space between Asian text
and numbers
mg
kg 𝐷 𝐷
Formatted: Heading 3
𝐴𝐿 = 0,27  × 𝑚 × 0,2 × ( ) × 𝑚 × 0,2 × ( )
ECH 𝑏 b
𝑑 N 𝑁
Formatted: Adjust space between Latin and Asian text,
(7)
Adjust space between Asian text and numbers, Tab
where D can be up to 30 d. stops: Not at 0.71 cm + 0.99 cm + 1.27 cm + 1.55 cm
+ 1.9 cm
0,27 is the prolonged contact tolerable intake value in mg/kg/d; Formatted: Adjust space between Latin and Asian text,
Adjust space between Asian text and numbers
m is the body mass of anticipated patient population in kg;
b
Formatted: Adjust space between Latin and Asian text,
0,2 is the default concomitant exposure factor;
Adjust space between Asian text and numbers, Tab
stops: Not at 0.7 cm + 1.4 cm + 2.1 cm + 2.8 cm +
D is the anticipated contact duration up to 30 d;
3.5 cm + 4.2 cm + 4.9 cm + 5.6 cm + 6.3 cm + 7 cm
N is the number of devices used during this duration.
+ 16.95 cm
Formatted: Font: (Intl) Cambria Math, English (United
Prolonged-contact devices shall meet Limitedlimited exposure AL in 4.3.24.3.2 during the first 24 h period.
Kingdom)
Examples of these calculations can be found in Annex KAnnex K.
Formatted: Font: (Intl) Cambria Math, English (United
Kingdom)
4.3.4 Long-term exposure devices
Formatted: Font: (Intl) Cambria Math, English (United
4.3.4.1 Ethylene oxide
Kingdom)
Formatted: Font: (Intl) Cambria Math, English (United
For EO, the tolerable exposure for long-term use devices is based on TI value of 0,02 mg/kg/d. The AL is
Kingdom)
determined by multiplying the TE with the number of days of anticipated contact from a single or repeated
Formatted: Eng
...


PROJET FINAL
Norme
internationale
ISO/TC 194
Évaluation biologique des
Secrétariat: DIN
dispositifs médicaux —
Début de vote:
2025-11-21
Partie 7:
Résidus de stérilisation à l'oxyde
Vote clos le:
2026-01-16
d'éthylène
Biological evaluation of medical devices —
Part 7: Ethylene oxide sterilization residuals
LES DESTINATAIRES DU PRÉSENT PROJET SONT
INVITÉS À PRÉSENTER, AVEC LEURS OBSERVATIONS,
NOTIFICATION DES DROITS DE PROPRIÉTÉ DONT ILS
AURAIENT ÉVENTUELLEMENT CONNAISSANCE ET À
FOURNIR UNE DOCUMENTATION EXPLICATIVE.
OUTRE LE FAIT D’ÊTRE EXAMINÉS POUR
ÉTABLIR S’ILS SONT ACCEPTABLES À DES FINS
INDUSTRIELLES, TECHNOLOGIQUES ET COM-MERCIALES,
AINSI QUE DU POINT DE VUE DES UTILISATEURS, LES
PROJETS DE NORMES
TRAITEMENT PARALLÈLE ISO/CEN
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Numéro de référence
PROJET FINAL
Norme
internationale
ISO/TC 194
Évaluation biologique des
Secrétariat: DIN
dispositifs médicaux —
Début de vote:
Partie 7: 2025-11-21
Résidus de stérilisation à l'oxyde
Vote clos le:
2026-01-16
d'éthylène
Biological evaluation of medical devices —
Part 7: Ethylene oxide sterilization residuals
LES DESTINATAIRES DU PRÉSENT PROJET SONT
INVITÉS À PRÉSENTER, AVEC LEURS OBSERVATIONS,
NOTIFICATION DES DROITS DE PROPRIÉTÉ DONT ILS
AURAIENT ÉVENTUELLEMENT CONNAISSANCE ET À
FOURNIR UNE DOCUMENTATION EXPLICATIVE.
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Publié en Suisse Numéro de référence
ii
Sommaire Page
Avant-propos .v
Introduction .vi
1 Domaine d'application . 1
2 Références normatives . 1
3 Termes et définitions . 1
4 Exigences . 6
4.1 Généralités .6
4.2 Classification des dispositifs .6
4.3 Limites admissibles .7
4.3.1 Généralités .7
4.3.2 Dispositifs à exposition limitée .8
4.3.3 Dispositifs à contact prolongé .9
4.3.4 Dispositifs à exposition long terme .10
4.3.5 Situations particulières .11
4.3.6 Niveau de contact tolérable [Tolerable contact level]. 12
4.4 Détermination des résidus d'oxyde d'éthylène et de chlorhydrate d'éthylène . 13
4.4.1 Mode opératoire . . 13
4.4.2 Validation de la méthode d'essai . 13
4.4.3 Échantillon de produit . 13
4.4.4 Rapports échantillon/liquide . 13
4.4.5 Extraction du dispositif .14
4.4.6 Systèmes à plusieurs dispositifs.14
5 Libération du produit. 14
5.1 Généralités .14
5.2 Libération des produits par lots . 15
5.3 Libération des produits après un temps d'aération minimal spécifié . 15
5.4 Mode opératoire pour la libération des produits en présence de courbes de dissipation
des résidus . 15
6 Adoption de produits dans une famille d'aération établie .16
7 Évaluation des modifications . 16
Annexe A (informative) Recommandations pour l'application du présent document pour la
détermination des taux résiduels d'oxyde d'éthylène et de chlorhydrate d'éthylène dans
les dispositifs médicaux . 17
Annexe B (informative) Facteurs influençant les résidus sur le produit .28
Annexe C (informative) Justification des dispositions du présent document .31
Annexe D (informative) Établissement de limites admissibles d'oxyde d'éthylène .39
Annexe E (informative) Établissement de limites admissibles de chlorhydrate d'éthylène .59
Annexe F (informative) Éthylène glycol .69
Annexe G (normative) Évaluation des chromatogrammes en phase gazeuse . 74
Annexe H (informative) Détermination des taux d'oxyde d'éthylène et de chlorhydrate
d'éthylène par chromatographie en phase gazeuse .78
Annexe I (informative) Préparation d'étalons d'oxyde d'éthylène et de chlorhydrate d'éthylène .82
Annexe J (informative) Méthodes de mesure des résidus d'oxyde d'éthylène et de chlorhydrate
d'éthylène .87
Annexe K (informative) Exemples de méthodes de libération des produits .96

iii
Annexe ZA (informative) Relation entre la présente Norme européenne et les exigences générales
en matière de sécurité et de performances concernées du Règlement (UE) 2017/745 .118
Bibliographie .123

iv
Avant-propos
L'ISO (Organisation internationale de normalisation) est une fédération mondiale d'organismes nationaux
de normalisation (comités membres de l'ISO). L'élaboration des Normes internationales est en général
confiée aux comités techniques de l'ISO. Chaque comité membre intéressé par une étude a le droit de faire
partie du comité technique créé à cet effet. Les organisations internationales, gouvernementales et non
gouvernementales, en liaison avec l'ISO participent également aux travaux. L'ISO collabore étroitement avec
la Commission électrotechnique internationale (IEC) en ce qui concerne la normalisation électrotechnique.
Les procédures utilisées pour élaborer le présent document et celles destinées à sa mise à jour sont
décrites dans les Directives ISO/IEC, Partie 1. Il convient, en particulier, de prendre note des différents
critères d'approbation requis pour les différents types de documents ISO. Le présent document
a été rédigé conformément aux règles de rédaction données dans les Directives ISO/IEC, Partie 2
(voir www.iso.org/directives).
L'ISO attire l'attention sur le fait que la mise en application du présent document peut entraîner l'utilisation
d'un ou de plusieurs brevets. L'ISO ne prend pas position quant à la preuve, à la validité et à l'applicabilité
de tout droit de propriété revendiqué à cet égard. À la date de publication du présent document, l'ISO
n'avait pas reçu notification qu'un ou plusieurs brevets pouvaient être nécessaires à sa mise en application.
Toutefois, il y a lieu d'avertir les responsables de la mise en application du présent document que des
informations plus récentes sont susceptibles de figurer dans la base de données de brevets, disponible à
l'adresse www.iso.org/brevets. L'ISO ne saurait être tenue pour responsable de ne pas avoir identifié tout ou
partie de tels droits de brevet.
Les appellations commerciales éventuellement mentionnées dans le présent document sont données pour
information, par souci de commodité, à l'intention des utilisateurs et ne sauraient constituer un engagement.
Pour une explication de la nature volontaire des normes, la signification des termes et expressions
spécifiques de l'ISO liés à l'évaluation de la conformité, ou pour toute information au sujet de l'adhésion de
l'ISO aux principes de l'Organisation mondiale du commerce (OMC) concernant les obstacles techniques au
commerce (OTC), voir www.iso.org/avant-propos.
Le présent document a été élaboré par le comité technique ISO/TC 194, Évaluation biologique et clinique
des dispositifs médicaux, en collaboration avec le comité technique CEN/TC 206 du Comité européen de
normalisation (CEN), Évaluation biologique et clinique des dispositifs médicaux, conformément à l'Accord de
coopération technique entre l'ISO et le CEN (Accord de Vienne).
Cette troisième édition annule et remplace la deuxième édition (ISO 10993-7:2008), qui a fait l'objet d'une
révision technique. Elle incorpore également l'amendement ISO 10993-7:2008/Amd 1:2019 et le rectificatif
technique ISO 10993-7:2008/cor 1:2009.
Les principales modifications sont les suivantes:
— les limites admissibles et les conditions d'extraction ont été établies en fonction de la population de
patients et de la durée d'utilisation;
— l'utilisation d'une appréciation du risque pour établir les limites admissibles a été autorisée;
— des recommandations supplémentaires sur la libération des produits ont été fournies;
— des recommandations supplémentaires concernant la détermination des résidus et les facteurs qui ont
une incidence sur les résidus ont été fournies.
Une liste de toutes les parties de la série ISO 10993 se trouve sur le site web de l’ISO.
Il convient que l'utilisateur adresse tout retour d'information ou toute question concernant le présent
document à l'organisme national de normalisation de son pays. Une liste exhaustive desdits organismes se
trouve à l'adresse www.iso.org/fr/members.html.

v
Introduction
Comme indiqué dans l'introduction de l'ISO 11135:2014, pour déterminer s'il y a lieu d'utiliser de l'oxyde
d'éthylène (OE) pour la stérilisation de dispositifs médicaux, il est important de s'assurer que les taux
résiduels d'oxyde d'éthylène et de chlorhydrate d'éthylène (ECH) présentent un minimum de risque pour
le patient lors de l'usage prévu du produit. Par conséquent, il est important d'envisager l'utilisation de
matériaux et de procédés de stérilisation alternatifs pendant le développement et la conception du produit.
L'oxyde d'éthylène est connu pour présenter de nombreux effets biologiques. Lors de la mise au point du
présent document, ces effets ont été pris en considération et ils comprennent des irritations, des lésions
organiques, une mutagénicité, une carcinogénicité, ainsi que des effets sur la reproduction chez l'être humain
et l'animal. Les effets nocifs du chlorhydrate d'éthylène et de l'éthylène glycol (EG) ont fait l'objet du même
type de considérations. Le chlorhydrate d'éthylène peut se former lorsque l'oxyde d'éthylène entre en contact
avec des ions chlorure libres, tandis que l'EG est un produit de réaction hydrolytique de l'oxyde d'éthylène
et de l'eau. En pratique, pour la plupart des dispositifs, l'exposition à l'oxyde d'éthylène et au chlorhydrate
d'éthylène est considérablement plus faible que les limites maximales admissibles définies dans le présent
document. Aucune limite admissible n'est indiquée pour l'éthylène glycol. En effet, l'appréciation du risque
a démontré que lorsque les résidus d'oxyde d'éthylène sont contrôlés, il est peu probable que des résidus
significatifs d'éthylène glycol soient présents.
Les exigences du présent document s'ajoutent aux exigences en matière d'évaluation biologique indiquées
dans l'ISO 10993-1. Les exigences relatives à l'évaluation, associées aux valeurs limites résiduelles du procédé
de stérilisation à l'oxyde d'éthylène, justifient ainsi la sécurité d'emploi d'un dispositif stérilisé à l'oxyde
d'éthylène pour la durée de contact prévue. Les taux résiduels maximaux admissibles pour le chlorhydrate
d'éthylène (ECH) pouvant être présents dans les dispositifs médicaux stérilisés à l'oxyde d'éthylène sont
également spécifiés. Les effets locaux (par exemple, les irritations) ont été pris en compte et sont intégrés
dans la TCL comme traité en 4.3.6.2 et dans l'Annexe D pour l'oxyde d'éthylène et en 4.3.6.3 et dans l'Annexe E
pour le chlorhydrate d'éthylène.
Dans cette édition du présent document (c'est-à-dire l'ISO 10993-7:2025), une approche par coefficient
d'incertitude est utilisée pour dériver les valeurs de la prise tolérable (TI) spécifiques à la durée d'exposition
à l'oxyde d'éthylène et au chlorhydrate d'éthylène (exprimées en µg/kg/j). En outre, cette édition du présent
document (c'est-à-dire l'ISO 10993-7:2025) introduit la conversion de chaque valeur de prise tolérable d'oxyde
d'éthylène et de chlorhydrate d'éthylène en valeurs limites admissibles d'exposition cumulée spécifiques
à une sous-population (exprimées en milligramme par dispositif), qui sont utilisées pour déterminer la
mesure dans laquelle l'oxyde d'éthylène et le chlorhydrate d'éthylène, extraits dans des conditions et des
périodes cliniquement pertinentes, doivent être réduits après la stérilisation.
La présente édition du présent document (c'est-à-dire l'ISO 10993-7:2025) applique une approche différente
de celle de l'ISO 10993-17:2023 en matière de détermination des limites admissibles de manière à faciliter le
développement, la validation et le contrôle de routine de la stérilisation à l'oxyde d'éthylène dans la fabrication
de dispositifs médicaux finis, en mettant l'accent sur l'appréciation du risque associé à trois constituants
chimiques potentiellement présents dans les dispositifs médicaux stérilisés à l'oxyde d'éthylène. Le présent
document étend ces connaissances en calculant la plus grande quantité d'oxyde d'éthylène, de chlorhydrate
d'éthylène ou d'EG pouvant être présente dans un dispositif médical de manière à ce qu'il satisfasse toujours
aux exigences de l'ISO 10993 17 lorsque ce dispositif a été exposé aux paramètres validés du cycle de
stérilisation. Cette quantité maximale ou limite admissible est exprimée en milligramme par dispositif jugé
acceptable en cas d'absorption par l'organisme à la suite d'une exposition à ce dispositif médical. Lors de
la validation du procédé de stérilisation à utiliser pour un produit ou un groupe de produits, ces limites
admissibles aideront à déterminer les paramètres de stérilisation appropriés tels que la concentration de
gaz stérilisant, le temps d'exposition, la température d'aération et le temps de maintien en quarantaine. En
outre, les organismes de réglementation, les fabricants et les distributeurs modifiant le dispositif peuvent
utiliser ces limites admissibles afin d'optimiser leurs procédés, pour aider à la sélection et à la qualification
de matériaux alternatifs, en vue de protéger la santé des patients.

vi
PROJET FINAL Norme internationale ISO/FDIS 10993-7:2025(fr)
Évaluation biologique des dispositifs médicaux —
Partie 7:
Résidus de stérilisation à l'oxyde d'éthylène
1 Domaine d'application
Le présent document spécifie les limites admissibles (AL) des résidus d'oxyde d'éthylène (OE) et de
chlorhydrate d'éthylène (ECH) pour des dispositifs médicaux stérilisés à l'oxyde d'éthylène, les modes
opératoires pour le mesurage de l'oxyde d'éthylène et du chlorhydrate d'éthylène et les méthodes de mesure
en vue de déterminer leur conformité et de procéder à leur libération. Des informations supplémentaires,
comprenant des recommandations et un organigramme montrant comment le présent document est
appliqué, sont également incluses dans les Annexe A, Annexe B, Annexe C, Annexe D, Annexe E, Annexe F,
Annexe G, Annexe H, Annexe I, Annexe J et Annexe K.
Les dispositifs stérilisés à l'oxyde d'éthylène ne présentant pas de contact direct ou indirect avec le patient
ou avec l'utilisateur (par exemple, les dispositifs de diagnostic in vitro) ne sont pas couverts par le présent
document. Le présent document ne s'applique pas aux dispositifs dont il a été démontré qu'ils n'absorbent
ni ne retiennent l'oxyde d'éthylène ou son produit de dégradation, le chlorhydrate d'éthylène, tels que les
[228]
dispositifs médicaux constitués exclusivement d'alliages métalliques et de verre, voir l'Article C.5 .
NOTE Le présent document ne spécifie pas les limites pour l'éthylène glycol (EG). Aucune limite d'exposition
n'est définie pour l'éthylène glycol (EG), car l'estimation du risque dans l'Annexe F indique que les niveaux admissibles
calculés sont supérieurs à ceux susceptibles d'être trouvés dans un dispositif médical.
2 Références normatives
Les documents suivants sont cités dans le texte de sorte qu'ils constituent, pour tout ou partie de leur
contenu, des exigences du présent document. Pour les références datées, seule l'édition citée s'applique. Pour
les références non datées, la dernière édition du document de référence s'applique (y compris les éventuels
amendements).
ISO 10993-1:2018, Évaluation biologique des dispositifs médicaux — Partie 1: Évaluation et essais au sein d’un
processus de gestion du risque
ISO 10993-23:2021, Évaluation biologique des dispositifs médicaux — Partie 23: Essais d'irritation
3 Termes et définitions
Pour les besoins du présent document, les termes et les définitions de l'ISO 10993-1 ainsi que les suivants
s'appliquent.
L'ISO et l'IEC tiennent à jour des bases de données terminologiques destinées à être utilisées en normalisation,
consultables aux adresses suivantes:
— ISO Online browsing: platform: disponible à l’adresse https:// www .iso .org/ obp
— IEC Electropedia: disponible à l'adresse https:// www .electropedia .org/

3.1
aération
phase du cycle (3.5) de stérilisation durant laquelle l'agent stérilisant et/ou ses produits de réaction sont
désorbés du produit de santé jusqu'à l'obtention de niveaux prédéterminés
Note 1 à l'article: L'aération peut être effectuée dans la chambre de stérilisation ou dans une chambre ou salle séparée.
[SOURCE: ISO 11139:2018, 3.7, modifié — La Note 1 à l’article a été ajoutée.]
3.2
limite admissible
AL
quantité de résidus (3.20) d'oxyde d'éthylène ou de chlorhydrate d'éthylène sur un seul dispositif comme
condition de libération
Note 1 à l'article: Les limites admissibles s'expriment en milligramme par dispositif pour chaque période d'exposition.
Ces limites représentent des risques biologiques acceptables pour les dispositifs médicaux dans les circonstances de
leur durée de contact prévue.
3.3
exposition cumulée
quantité totale d'oxyde d'éthylène et de chlorhydrate d'éthylène qui entre en contact avec le corps pendant
une période de temps déterminée
Note 1 à l'article: L'exposition cumulée peut s'appliquer en cas d’utilisations consécutives du même dispositif ou lors
de l’application de nouveaux dispositifs du même type pour le même patient (par exemple, utilisation répétée d'un
dispositif pendant une période de temps spécifiée).
3.4
coefficient d'exposition concomitante
CEF
facteur de sécurité (3.21) numérique qui tient compte de l'exposition du patient à l'utilisation simultanée
d'autres dispositifs médicaux stérilisés à l'oxyde d'éthylène, différents du dispositif médical en question
Note 1 à l'article: Le CEF est calculé à partir de la réciproque du nombre de dispositifs (1/dispositif) utilisés au cours
d'une procédure. La valeur par défaut (3.6) de 0,2 suppose que cinq autres dispositifs sont utilisés au cours d'une
procédure, voir le 4.4.5 et l'Article D.6 pour plus de détails.
3.5
cycle
ensemble de paramètres du processus de stérilisation
3.6
valeur par défaut
valeur ou facteur utilisé dans le calcul d'un niveau de contact tolérable (3.22) ou d'une prise tolérable (3.24),
en l'absence de données spécifiques [par exemple, un coefficient d'incertitude (3.26)]
[SOURCE: ISO 10993-17:2023, 3.5, modifié — «dose d'exposition la plus défavorable» a été supprimé des
définitions.]
3.7
dose-réponse
relation entre le dosage et le dommage observable
Note 1 à l'article: En général, il existe deux types de relations dose-réponse. Le premier type concerne la variation de
la réponse d'un individu à une gamme de doses. Le deuxième type concerne la distribution de la réponse parmi les
individus à une gamme de doses.
[SOURCE: ISO 10993-17:2023, 3.6]

3.8
extraction exhaustive
extraction en plusieurs étapes réalisée pour que la quantité de matériau extraite retrouvée dans une étape
d'extraction ultérieure représente moins de 10 % de celle détectée lors de l'étape d'extraction initiale
Note 1 à l'article: Compte tenu du point d'ébullition de l'oxyde d'éthylène (OE) (10,7 °C) et du fait que des substances
autres que l'oxyde d'éthylène et le chlorhydrate d'éthylène peuvent être extraites du dispositif évalué, l'analyse
gravimétrique n'est pas appropriée pour déterminer le niveau d'exhaustivité.
[SOURCE: ISO 10993-18:2020, 3.15, modifié — «par analyse gravimétrique (ou obtenue par d'autres moyens)»
a été supprimé de la définition et la Note 1 à l'article a été ajoutée.]
3.9
atteinte à la santé
réaction indésirable, telle qu'une altération de la morphologie, de la physiologie, de la croissance, du
développement, de la reproduction ou de la durée de vie, qui:
a) altère la fonction d'un organe/système, d'un organisme ou d'une (sous-)population;
b) réduit la capacité à tolérer une fonction altérée; ou
c) augmente la vulnérabilité à d'autres influences qui altèrent la fonction
Note 1 à l'article: Les exemples de (sous-)population comprennent, sans toutefois s'y limiter, les hommes, les femmes,
les nouveau-nés prématurés, les adultes.
[SOURCE: ISO 10993-17:2023, 3.8]
3.10
charge
lot de stérilisation
charge de stérilisation
produit, équipement ou matériaux à traiter ensemble dans un cycle (3.5) de fonctionnement
[SOURCE: ISO 11139:2018, 3.155, modifié — ajout des termes admis «lot de stérilisation» et «charge de
stérilisation».]
3.11
implant
dispositif médical destiné à être introduit entièrement dans le corps humain ou à remplacer une surface
épithéliale ou la surface de l'œil au moyen d'une intervention clinique et qui est destiné à rester en place
après l'intervention
[SOURCE: ISO 10993-1:2018, 3.10]
3.12
irritation
réaction inflammatoire non spécifique localisée à une application unique, répétée ou continue d'une
substance/d'un matériau
Note 1 à l'article: L'irritation de la peau est une réaction réversible qui se caractérise principalement par un érythème
local (rougeur) et un gonflement (œdème) de la peau.
[SOURCE: ISO 10993-23:2021, 3.7]
3.13
niveau le plus bas d'effet indésirable observé [lowest observed adverse effect level]
LOAEL
concentration ou quantité la plus faible d'un constituant identifié découvert par expérience ou par
observation qui provoque une atteinte à la santé (3.9) identifiable de l'organisme cible dans des conditions
d'exposition définies
[SOURCE: ISO 10993-17:2023, 3.13, modifié — La Note 1 à l'article a été supprimée.]

3.14
niveau d'irritation minimal [minimally irritating level]
MIL
plus petite quantité par unité de surface d'un constituant identifié qui est irritant pour le tissu au niveau du
site de contact, déterminée par des preuves expérimentales ou des preuves par observation valides
Note 1 à l'article: Le niveau d'irritation minimal est exprimé en microgrammes par centimètre carré (μg/cm ).
[SOURCE: ISO 10993-17:2023, 3.15]
3.15
coefficient de correction [modifying factor]
MF
produit mathématique des coefficients d'incertitude (3.26)
[SOURCE: ISO 10993-17:2023, 3.16]
3.16
niveau de non-irritation [non-irritating level]
NIL
plus grande quantité par unité de surface d'un constituant identifié qui ne provoque pas d'irritation (3.12)
pour le tissu au niveau du site de contact, déterminée par des preuves expérimentales ou des preuves par
observation valides
Note 1 à l'article: Le niveau d'irritation minimal est généralement exprimé en milligrammes ou microgrammes par
2 2
centimètre carré (mg/cm ou μg/cm ).
[SOURCE: ISO 10993-17:2023, 3.17, modifié — Note 1 pour ajouter «généralement», «milligrammes ou» et
«mg/cm ». ]
3.17
niveau sans effet indésirable observé [no observed adverse effect level]
NOAEL
concentration ou quantité la plus grande d'un constituant identifié découverte par expérience ou par
observation qui ne provoque aucune atteinte à la santé (3.9) identifiable de l'organisme cible dans des
conditions d'exposition définies
Note 1 à l'article: Le niveau sans effet indésirable observé est exprimé en microgrammes par kilogramme de masse
corporelle par jour (μg/kg/j).
[SOURCE: ISO 10993-17:2023, 3.18]
3.18
modélisation pharmacocinétique à base physiologique
modélisation PBPK
système de modélisation des effets biologiques qui tient compte des différences métaboliques et pharmaco-
cinétiques au sein des espèces d'animaux
Note 1 à l'article: Il convient d'utiliser ces données chaque fois qu'elles sont disponibles et qu'elles s'appliquent à la
durée de contact prévue pour le dispositif médical.
3.19
résiduel
résiduelle
quantité d'oxyde d'éthylène, de chlorhydrate d'éthylène ou d'éthylène glycol qui reste dans ou sur le produit
après stérilisation à l'oxyde d'éthylène
3.20
sécurité
absence de risque inacceptable
[SOURCE: ISO 14971:2019, 3.26]

3.21
extraction avec simulation d'utilisation
extraction selon une méthode qui simule l'utilisation clinique
Note 1 à l'article: Une extraction avec simulation d'utilisation est réalisée pour estimer le type et la quantité de
substances supposées être libérées par un dispositif médical au cours de son utilisation clinique. Une extraction avec
simulation d'utilisation est conçue pour produire un profil de produits extractibles qui représente le profil de produits
relargables le plus défavorable. Cela signifie que tous les produits relargables sont aussi extractibles et que les niveaux
de tous les extractibles individuels sont au moins égaux aux niveaux de tous les relargables individuels.
[SOURCE: ISO 10993-18:2020, 3.35]
3.22
niveau de contact tolérable [tolerable contact level]
TCL
estimation de l'exposition par contact de surface à un constituant identifié, sans irritation (3.12) significative
Note 1 à l'article: Le niveau de contact tolérable est exprimé en microgrammes par centimètre carré (μg/cm ) de tissu
au site de contact.
[SOURCE: ISO 10993-17:2023, 3.25]
3.23
exposition tolérable [tolerable exposure]
TE
produit de la prise tolérable (3.24), de la masse corporelle et du coefficient d'exposition concomitante (3.4)
Note 1 à l'article: l'exposition tolérable est généralement exprimée en milligrammes par jour pour le patient.
3.24
prise tolérable [tolerable intake]
TI
estimation de l'exposition quotidienne d'un constituant identifié pendant une période déterminée (par
exemple, aiguë, subaiguë, subchronique ou chronique), sur la base de la masse corporelle, qui est considérée
comme ne causant pas d'atteinte à la santé (3.9) significative
Note 1 à l'article: La prise tolérable est généralement exprimée en microgrammes par kilogramme de masse corporelle
par jour (μg/kg/j). Elle est dérivée pour établir une limite admissible (3.2) pour un constituant d'un dispositif médical.
[SOURCE: ISO 10993-17:2023, 3.26, modifié — «normalement» a été ajouté et «limite d'exposition
toxicologique» a été remplacée par «une limite admissible (3.2)» dans la Note 1 à l'article.]
3.25
appréciation du risque toxicologique
détermination de la possibilité qu'une dose d'exposition d'un constituant puisse ou non provoquer une
atteinte à la santé (3.10) significative
[SOURCE: ISO 10993-17:2023, 3.29]
3.26
coefficient d'incertitude [uncertainty factor]
UF
valeur numérique tenant compte des incertitudes lors de l'extrapolation d'un point de départ à des individus
pouvant être exposés à un constituant préoccupant du point de vue toxicologique
EXEMPLE Les types d'extrapolation comprennent, sans toutefois s'y limiter, les types suivants: intraespèce,
inter-espèces, voie d'administration et durée de l'étude.
[SOURCE: ISO 10993-17:2023, 3.31]

4 Exigences
4.1 Généralités
Le présent article spécifie les limites résiduelles maximales admissibles d'oxyde d'éthylène (OE) et de
chlorhydrate d'éthylène (ECH) présentes individuellement dans chaque dispositif médical stérilisé à l'oxyde
d'éthylène. Les effets locaux (aigus) (par exemple, l'irritation) ont été pris en compte et sont incorporés dans
la TCL.
Les exigences du présent document doivent s'appliquer en plus des exigences définies dans l'ISO 10993-1.
Toutes les exigences applicables de l'ISO 10993-1 doivent prendre en compte le taux résiduel d'oxyde
d'éthylène au moment de la libération de chaque dispositif médical individuel. Les résultats de l'estimation
biologique du dispositif peuvent conduire à des limites autres que celles définies en 4.3, qui sont élaborées
pour protéger contre l'irritation locale et les effets systémiques.
Les dispositifs médicaux déjà sur le marché et pour lesquels la conformité à l'édition précédente de ce
document (c'est-à-dire l'ISO 10993-7:2008) a déjà été démontrée n'ont pas nécessairement à réaliser
de nouveaux essais pour être en conformité avec la présente édition de ce document (c'est-à-dire
l'ISO 10993-7:2025). Un examen confirmant qu'aucun des problèmes identifiés dans l'ISO 10993-1:2018, 4.9
ne s'est produit doit être effectué. Si au moins un changement a été effectué sur le dispositif, une nouvelle
appréciation du risque biologique doit être effectuée pour démontrer la conformité aux limites admissibles.
Cela peut nécessiter la réalisation de nouveaux essais pour démontrer la conformité à la présente édition
du présent document (c'est-à-dire l'ISO 10993-7:2025). Les éditions précédentes du présent document
indiquaient une limite de 4 mg pour l'oxyde d'éthylène et de 9 mg pour le chlorhydrate d'éthylène pour les
adultes ayant une exposition limitée [avec le coefficient d'exposition concomitante (CEF) égal à 0,2] pour
une population d'adultes de 70 kg et un coefficient d'incertitude 1 (UF1) de 10 pour la variabilité intra-
espèce. D'un point de vue toxicologique, ces valeurs ne sont pas significativement différentes des valeurs
calculées dans l'édition actuelle du présent document (c'est-à-dire l'ISO 10993-7:2025) et, par conséquent,
ces changements dans les AL ne justifient pas la ré-évaluation d’un produit qui répondait aux limites de
l'édition précédente du présent document (c'est-à-dire l'ISO 10993-7:2008).
Un diagramme de flux présentant des directives pour l'application du présent document dans le cadre de la
détermination des résidus d'oxyde d'éthylène dans les dispositifs médicaux est fourni dans l'Annexe A.
NOTE 1 Les informations sur la dérivation des limites dans le présent document, ainsi que d'autres informations et
directives en rapport avec l'utilisation du présent document, se trouvent dans les Annexe C, Annexe D et Annexe E.
NOTE 2 Tout au long du présent document, les chiffres calculés à partir des formules ont été arrondis suivant les
[250]
règles fournies dans la NIST Special Publication 811, Guide for the Use of the International System of Units (SI).
Ainsi, le nombre de chiffres significatifs de la littérature source (généralement deux) a été conservé; il n’a été augmenté
(généralement à trois chiffres significatifs) que quand le résultat calculé ne fournissait une quantité adéquate
d'informations pertinentes qu’avec un plus grand nombre de chiffres significatifs. Cette évaluation est conforme à la
[250]
NIST Special Publication 811, section B.7.2.
4.2 Classification des dispositifs
Pour établir les doses journalières maximales d'oxyde d'éthylène et de chlorhydrate d'éthylène qu'un
dispositif médical peut délivrer aux patients, le dispositif médical doit être classé en fonction de la durée du
contact avec le corps, conformément à l'ISO 10993-1:2018:
a) exposition limitée;
b) exposition prolongée;
c) exposition long terme.
Si un dispositif peut appartenir à plusieurs catégories de durée, les méthodes d'essai ou les évaluations les
plus rigoureuses doivent s'appliquer. Si un dispositif est destiné à une utilisation répétée ou multiples, il faut
décider de la catégorie d'exposition d'un dispositif en tenant compte de l'effet cumulé potentiel, en gardant
à l'esprit la période pendant laquelle l'exposition cumulée se produit. Par exemple, une cartouche de dialyse
est utilisée pendant moins de 24 h par traitement, mais des utilisations répétées de la même cartouche ou

une cartouche de remplacement pendant plus de 30 jours catégorisent la cartouche comme contact à long
terme.
Pour les dispositifs médicaux qui ont un contact très bref avec le corps, généralement pendant moins d'une
minute (par exemple, lancettes, aiguilles hypodermiques, tubes capillaires), il peut être possible de préparer
une justification écrite de l'absence potentielle de risque biologique. Pour les produits à utilisation répétée,
la période d'exposition totale doit être prise en compte. Cependant, en ce qui concerne les dispositifs
médicaux qui peuvent laisser des matériaux en contact avec des tissus après leur retrait (par exemple
revêtements, lubrifiants), une évaluation biologique plus détaillée est requise (voir l'ISO 10993-1 pour des
recommandations supplémentaires).
4.3 Limites admissibles
4.3.1 Généralités
Pour chaque dispositif médical, l'exposition maximale des patients à l'oxyde d'éthylène et au chlorhydrate
d'éthylène ne doit pas dépasser l'AL à l'aide des Formules (1) et (2) sur la base des valeurs par défaut dans
le Tableau 1 pour chacune des catégories d'exposition applicables (voir 4.2). D'autres limites peuvent être
calculées sur la base d'une appréciation du risque qui tient compte de l'utilisation du dispositif et de la
population de patients. La procédure utilisée pour établir la prise tolérable (TI) est décrite à l'Annexe D pour
l'oxyde d'éthylène et à l'Annexe E pour le chlorhydrate d'éthylène.
Les dispositifs à contact prolongé sont soumis à des limites supplémentaires concernant les premières 24 h
d'une période d'exposition et, dans le cas de dispositifs à exposition long terme, concernant la première
période de 24 h et la première période de 30 jours. Ces contraintes définissent des limites sur la quantité
d'oxyde d'éthylène et de chlorhydrate d'éthylène qui peut être délivrée au patient pendant ces premières
périodes.
Le CEF utilise une valeur par défaut de 0,2 sur la base de cinq dispositifs utilisés simultanément. Si des
données sont disponibles sur le nombre de dispositifs utilisés en même temps, par exemple dans les systèmes
à plusieurs dispositifs, les kits, les dispositifs à exposition long terme, le CEF par défaut de 0,2 peut être
modifié (voir 4.4.5, A.3.3 et D.6.1 pour une justification plus détaillée).
L'exposition tolérable (TE) doit être calculée sur la base de la TI multipliée par la masse corporelle (m ) et le
b
CEF:
TE TI mC EF (1)
b

TE est l'exposition tolérable;
TI est la prise tolérable;
m est la masse corporelle;
b
CEF est le coefficient d'exposition concomitante.
L'AL doit être déterminée sur la base de l'exposition tolérable multipliée par les jours d’exposition de la
catégorie, sauf si une autre limite peut être justifiée. La masse corporelle la plus faible de la population de
patients doit être utilisée sur la base de la durée d'exposition prévue pour le dispositif, voir l'Article C.4.
L'application de masses corporelles plus élevées, associées à des sous-groupes d'âge de population ou de
masses corporelles plus faibles, doit être justifiée et documentée. Voir l'exemple au K.8.1.
D 
ALTE (2)
 
N
 

AL est la limite admissible;
D est le nombre de jours de la durée de contact avec le dispositif médical;
N est le nombre maximal de dispositifs utilisés pendant cette durée.

Lorsque la notion de «nombre de dispositifs» médicaux ne s'applique pas (par exemple, la plus grande
surface du dispositif qui peut être en contact avec le corps n'est pas la même que la surface du dispositif
soumis à essai, ou que le dispositif est en poudre ou liquide), le «nombre de dispositifs utilisés pendant cette
durée» dans la Formule (2) doit être remplacé par «la quantité de dispositifs utilisés pendant cette durée». Il
convient que la quantité soit exprimée en cm , g ou ml, selon le cas, compte tenu de la forme du dispositif, et
l'AL doit être exprimée en mg/cm , mg/g ou mg/ml respectivement. La définition de l'AL doit être modifiée
en conséquence.
NOTE Le nombre de dispositifs (N) pris en compte dans la Formule (2) n'est pas lié au CEF, mais au nombre de
dispositifs utilisés pendant la durée d'exposition, pour un traitement ou une thérapie, qui peut être égal ou supérieur
à 1.
La population visée doit être documentée.
Tableau 1 — Valeurs par défaut de la TE et l'AL pour Formules (1) et (2)
TI pour le
TI pour l'oxyde
chlorhydrate CEF Durée de contact prévue
d'éthylène
d'éthylène
Catégorie de contact
valeur par
mg/kg/d mg/kg/d d
défaut
Limitée 0,3 0,64 ≤ 1
Prolongé 0,3 0,27 ≤ 30
≤ 25 000 jours pour les adultes (>16 a)
0,2
OU
Long terme 0,02 0,029 ≤ 5 840 jours pour la pédiatrie (0 à 16 a);
ET
≤ 19 160 jours pour un adulte (>16 a)
Pour les dispositifs médicaux utilisés dans un groupe d'âge de sous-population pédiatrique, les facteurs à prendre en compte
dans le choix d’un nombre moindre de jours (c'est-à-dire < 5 840 j) sont décrits aux Articles C.4 et D.6.8.
4.3.2 Dispositifs à exposition limitée
Les AL pour les dispositifs à exposition limitée sont basées sur la valeur de la TI de 0,3 mg/kg/jour pour
l'oxyde d'éthylène, 0,64 mg/kg/jour pour le chlorhydrate d'éthylène, avec un CEF = 0,2 (par défaut) comme
établi en Article D.4 et Article E.5 respectivement. L'estimation de l'exposition cumulée totale à l'oxyde
d'éthylène et au chlorhydrate d'éthylène, obtenue par extraction avec simulation d'utilisation ou extraction
exhaustive, doit être comparée à l'AL en cas d'exposition limitée, sauf justification contraire. Par ailleurs,
une évaluation visant à évaluer le risque toxicologique associé à l'exposition à l'oxyde d'éthylène ou au
chlorhydrate d'éthylène par rapport à la durée d'exposition réelle prévue d'un dispositif spécifique, ainsi
que des détails plus pertinents sur le plan clinique pour le dispositif et l'indication, peu
...

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