Unique Motivational Initiative to Avoid Misuse of Used ETO Gas Cartridges in a Healthcare Institution and Enhance Revenue Generation Out of Waste

Abstract

Background: The Central Sterile Services Department (CSSD) is a critical unit in any healthcare institution, ensuring that all reusable medical items are rendered free of microorganisms before patient use. Ethylene Oxide (ETO) gas sterilization is widely employed for heat- and moisture-sensitive items, but improper handling or misuse of used ETO cartridges can compromise infection control practices and pose safety hazards.
Objective: This study presents a simple, unique, and cost-effective initiative implemented in the CSSD to prevent misuse and adulteration of used ETO gas cartridges, while simultaneously enhancing revenue generation through structured waste segregation.
Methods: The initiative involved segregating the aluminum body and mild steel cap of empty ETO gas cartridges. Multiple methods—hammering, angle grinder, chop saw, and cutting plier—were evaluated, and the nail puller was identified as the most effective, safe and replicable tool for separating the two metal components. The process was incorporated into routine CSSD workflow without affecting sterilization efficiency or manpower distribution.
Results: A monthly generation of approximately 150 used ETO cartridges enabled significant material recovery. Removing the mild steel cap not only eliminated the possibility of refilling and adulteration of empty cartridges by external vendors but also doubled the scrap value, from ₹70/kg to ₹150/kg due to metal segregation. The initiative also strengthened compliance with infection control and occupational safety guidelines.
Conclusion: This low-cost, zero-waste initiative successfully integrated sustainability into healthcare sterilization practices. By preventing cartridge misuse, improving resource recovery, and supporting infection control protocols, the intervention demonstrates how simple innovations within CSSD operations can generate measurable economic and safety benefits.