sterile
TRANSCRIPT
Sterile | Slide 1 of 62 January 2006
Annex 6. TRS 902, 2002
Sterile Pharmaceutical Products
Supplementary Training Modules on Good Manufacturing Practice
Sterile | Slide 2 of 62 January 2006
Sterile ProductionSterile Production
Objectives
To review basic GMP requirements in the manufacture of sterile pharmaceutical products
To review air classifications for activities related to the manufacture of sterile products
To review the different types of sterilization methods
To review quality assurance aspects in the manufacture and control of sterile products
To consider current issues applicable in your country
Sterile | Slide 3 of 62 January 2006
Sterile Production Sterile Production
GMP Requirements for Sterile Products
Additional rather than replacement
Specific points relating to minimizing risks of contamination
– microbiological– particulate matter– pyrogen
Sterile | Slide 4 of 62 January 2006
Sterile ProductionSterile Production
General Considerations
Production in clean areas
Appropriate standard of cleanliness
Filtered air supplied
Airlocks for entry– Personnel and/or equipment– Materials
Separate areas for operations– component preparation (containers and closures)– product preparation, filling, sterilization, etc. 1.1 – 1-2
Sterile | Slide 5 of 62 January 2006
9.1 – 9.6
Sterile ProductionSterile Production
Premises
Design
– Avoid unnecessary entry of supervisors and control personnel
– Operations observed from outside
In clean areas, all exposed surfaces:
– Smooth, impervious, unbroken
– Minimize shedding and accumulation of particles, microorganisms
– Permit cleaning and disinfection
– No uncleanable recesses, ledges, shelves, cupboards, equipment
– Sliding doors undesirable
– False ceilings sealed
Sterile | Slide 6 of 62 January 2006
9.6.
Sterile ProductionSterile Production
Premises
In clean areas, all exposed surfaces (2):– Proper installation of pipes and ducts, no recesses, no
unsealed openings– Sinks and drains avoided, and excluded in Grade A and B
areas• Where installed, design, location, maintenance• Effective cleanable traps• Air breaks preventing backflow• Floor channels open and easily cleanable
Sterile | Slide 7 of 62 January 2006
9.7 – 9.9
Sterile ProductionSterile Production
Premises
Changing rooms– Designed as airlocks– Effective flushing with filtered air– Separate rooms for entry and exit desirable– Hand washing facilities– Interlocking system for doors– Visual and/or audible warning system
Use filtered air supply to maintain pressure cascade
Pressure differential approximately 10 to 15 Pascales
Zone of greatest risk – immediate environment
Sterile | Slide 8 of 62 January 2006
9.9 – 9.12
Sterile ProductionSterile Production
Premises
Pathogenic, highly toxic, radioactive materials
Pressure cascade may be different
Decontamination procedures – air, equipment, garments
Qualification including airflow patterns– No risk to the product
Warning system to indicate failure in air supply
Pressure indicators – results regularly recorded
Restricted access – e.g. use of barriers
Sterile | Slide 9 of 62 January 2006
10.1 – 10.5
Sterile ProductionSterile Production
Equipment
Conveyer belts
Effective sterilization of equipment
Maintenance and repairs from outside the clean area– If taken apart, resterilized before use– Use clean instruments and tools
Planned maintenance, validation and monitoring– Equipment, air filtration systems, sterilizers, water
treatment systems
Sterile | Slide 10 of 62 January 2006
10.6
Sterile ProductionSterile Production
Equipment
Water treatment plants and distribution system– Design, construction, maintenance– Operation and design capacity– Testing programme
Water for Injection (WFI)– Produced, stored, distributed – prevention of growth of
microorganisms– Constant circulation at temperature above 70, or not more
than 4 degrees Celsius
Sterile | Slide 11 of 62 January 2006
Sterile ProductionSterile Production
Environmental Monitoring - I
Microbiological
Air samples
Surface swabs
Personnel swabs
Sterile | Slide 12 of 62 January 2006
Sterile ProductionSterile Production
Environmental Monitoring - II
Physical
Particulate matter
Differential pressures
Air changes, airflow patterns
Clean-up time/recovery
Filter integrity
Temperature and relative humidity
Airflow velocity
Sterile | Slide 13 of 62 January 2006
Sterile ProductionSterile Production
Sanitation
Frequent, thorough cleaning of areas necessary
Written programme
Regular monitoring to detect resistant strains of microorganisms
Chemical disinfection
Monitoring of disinfectants and detergents
Dilutions– Clean containers, stored for defined periods of time– Sterilized before use, when used in Grade A or B areas
3.1 – 3.2
Sterile | Slide 14 of 62 January 2006
Sterile ProductionSterile Production
Sanitation
Monitoring of clean areas
Monitoring of personnel and surfaces after critical operations
Frequent monitoring in areas where aseptic operations are carried out
– Settle plates, volumetric air samples, surface sampling (swabs and contact plates)
– Sampling methods should not contaminate the area
Results considered when batch release is done3.3
Sterile | Slide 15 of 62 January 2006
Sterile ProductionSterile Production
Sanitation
Limits of detection established
Alert and action, and monitoring trends of air quality
Table 1. Limits for microbial contamination (Information only)
3.4
Grade Air sample
(CFU/m3)
Settle plates
(90mm diameter)
(CFU/4hours)
Contact plates
(55mm diameter)
(CFU/plate)
Glove print
(5 fingers)
(CFU/glove)
A < 3 < 3 < 3 < 3
B 10 5 5 5
C 100 50 25 -
D 200 100 50 -
Sterile | Slide 16 of 62 January 2006
8.1 – 8.3
Sterile ProductionSterile Production
Personnel
Minimum number of personnel in clean areas– Especially during aseptic processing
Inspections and controls from outside
Training to all including cleaning and maintenance staff– Initial and regular– Manufacturing, hygiene, microbiology
Special cases– Supervision in case of outside staff– Decontamination procedures (e.g. staff who worked with animal tissue
materials)
Sterile | Slide 17 of 62 January 2006
8.4 – 8.6
Sterile ProductionSterile Production
Personnel
High standards of hygiene and cleanliness
Periodic health checks
No shedding of particles
No introduction of microbiological hazards
No outdoor clothing
Changing and washing procedure
No watches, jewellery and cosmetics
Sterile | Slide 18 of 62 January 2006
8.7
Sterile ProductionSterile Production
Personnel
Clothing of appropriate quality:
– Grade D
• hair, beard, moustache covered
• Protective clothing and shoes
– Grade C
• Hair, beard, moustache covered
• Single or 2-piece suit (covering wrists, high neck), shoes
• no fibres to be shed
– Grade A and B
• Headgear, beard and moustache covered, masks, gloves
• No shedding of fibres, and retain particles shed by operators
Sterile | Slide 19 of 62 January 2006
8.8 – 8.9
Sterile ProductionSterile Production
Personnel
Outdoor clothing not in change rooms leading to grade B and C rooms
Change at every working session, or once a day (if supportive data)
Change gloves and masks at every working session
Disinfect gloves during operations
Washing of garments – separate laundry facility
No damage, and according to validated procedures
Sterile | Slide 20 of 62 January 2006
Sterile ProductionSterile Production
Group session 1
You are asked to visit a factory producing the following
product lines:
– Injections in ampoules and vials, including insulin, vaccines and heat-stable pharmaceuticals
– Sterile eye ointment
Describe the type of facility you would expect to find
List the typical rooms, their purpose and air classification
Sterile | Slide 21 of 62 January 2006
Sterile ProductionSterile Production
Possible Issues
Poor design of the building
Poor design of the systems, e.g. water, HVAC
Flow of personnel
Flow of material
No validation or qualification
Old facilities not complying with current requirements
Sterile | Slide 22 of 62 January 2006
Sterile ProductionSterile Production
Possible Issues (continued)
Particulate levels/microorganisms
Differential pressures
Air changes
Temperature/humidity
Sterile | Slide 23 of 62 January 2006
Sterile ProductionSterile Production
Two categories of manufacturing operations:
Terminally sterilized– prepared, filled and sterilized
Aseptic preparation– some or all stages
1.3
Sterile | Slide 24 of 62 January 2006
Sterile ProductionSterile Production
Manufacture of sterile preparations
Classification of clean areas
Manufacturing operation in an appropriate environment cleanliness level
Minimize risks – particulate and microbiological contamination – product and material
Meet classification "at rest"– (i.e. "completed installation, equipment installed and operating,
but no operating personnel present").4.1
Sterile | Slide 25 of 62 January 2006
Sterile ProductionSterile Production
Manufacture of sterile preparations
For sterile pharmaceutical preparations:
Grade A
– Local zone, high risk operations, e.g. filling, aseptic connections
– Usually UDAF systems used
Grade B
– Background environment to grade A (in case of aseptic preparation and filling)
Grade C and Grade D
– Clean areas for less critical operations4.1
Sterile | Slide 26 of 62 January 2006
Air Classification System
Sterile ProductionSterile Production
Grade At rest In operation
maximum permitted number of particles/m3
0.5 - 5.0 µm > 5 µm 0.5 - 5.0 µm > 5 µ
A 3 500 0 3 500 0
B 3 500 0 350 000 2 000
C 350 000 2 000 3 500 000 20 000
D 3 500 000 20 000 not defined not defined
3.1
Sterile | Slide 27 of 62 January 2006
Sterile ProductionSterile Production
Manufacture of sterile preparations
To reach Grade B, C and D, the number of air changes should be appropriate to the size of the area, number of personnel, equipment present
Minimum of 20 air changes per hour
Clean up time about 15-20 minutes
Good airflow pattern in the area
HEPA-filtered air
Suitable methods to determine particulate matter and micro-– e.g. EU, ISO, Japan, USA 4.1 – 4.2.
Sterile | Slide 28 of 62 January 2006
Sterile ProductionSterile Production
Manufacture of sterile preparations
Control particulate during operation
Monitoring during operation
Alert and action limits for particulate and micro
Action taken when exceeded
Area grades should be proven (e.g. validation runs, media fills, environment, time limits – based on microbiological contamination/bioburden found)
4.3 – 4.5
Sterile | Slide 29 of 62 January 2006
Airborne particulate classification
Sterile ProductionSterile Production
WHO GMP US 209E US Customary ISO/TC (209) EEC GMP
Grade A M 3.5 Class 100 ISO 5 Grade A
Grade B M 3.5 Class 100 ISO 5 Grade B
Grade C M 5.5 Class 10 000 ISO 7 Grade C
Grade D M 6.5 Class 100 000 ISO 8 Grade D
4.1
Sterile | Slide 30 of 62 January 2006
4.15 – 4.16, 4.20 – 4.21
Sterile ProductionSterile Production
Processing
Minimise contamination – all stages including before sterilization and during processing
No unsuitable materials, e.g. live microbiological organisms
Minimize activities– staff movement controlled and methodical– avoid shedding of particles
Temperature and humidity comfortable
Containers and materials in the area
Sterile | Slide 31 of 62 January 2006
4.17, 4.18, 4.28
Sterile ProductionSterile Production
Processing
Validation – should not compromise the processes
Aseptic process validation: Sterile media fill (“broth fills”)– Simulate actual operation – intimate as closely as possible– Simulate worst expected condition– Use appropriate medium/media– Sufficient number of units - e.g. equal to batch size (small batches)
• acceptable limit• investigations
– Revalidation: periodic and after change
New processing procedures validated– Revalidation after significant changes– And regular intervals
Sterile | Slide 32 of 62 January 2006
4.19
Sterile ProductionSterile Production
Processing
Water sources, water treatment systems and treated water
Monitored regularly– Chemicals– Biological contamination– Endotoxin
Water specification
Records of results and action taken
Sterile | Slide 33 of 62 January 2006
4.22 – 4.23
Sterile ProductionSterile Production
Processing
Components, bulk product containers and equipment– fibre generation– no recontamination after final cleaning– stage properly identified– sterilized when used in aseptic areas
Used in clean areas, passed through double-ended sterilizers or use triple wrapping
Gas used to purge solution or blanket a product – passed through a sterilizing filter
Sterile | Slide 34 of 62 January 2006
4.26, 5.3
Sterile ProductionSterile Production
Processing
Bioburden monitored– Products: Before sterilization– Working limits established– Solutions to be filtered before filling (especially LVP)– Pressure release outlets – hydrophobic microbiological air
filters
Starting materials – microbiological contamination should be minimal
Monitored as per specification
Sterile | Slide 35 of 62 January 2006
4.23 - 4.24
Sterile ProductionSterile Production
Processing
Time intervals: Components, bulk containers, equipment
Washing and drying and sterilization; and sterilization and use– As short as possible– Time limit validated
Time intervals: Product
Start of preparation of solution and sterilization (filtration)– As short as possible– Maximum time set for each product
Sterile | Slide 36 of 62 January 2006
Sterile ProductionSterile Production
Group session 2
Considering the same factory as in the previous group session, discuss the process of sterilization.
List all the items that will need to be sterilized (and indicate the choice of sterilization process).
What are the key features you should find in each sterilization situation?
Discuss the relevance, need, and the extent of qualification and validation required.
Sterile | Slide 37 of 62 January 2006
Sterile ProductionSterile Production
Possible Issues
Autoclave - no pressure gauge
Autoclave - no temperature recorder
Autoclave - superheated steam
Clean room - pressure differentials
Exposure for settle plates
Interlocks turned off
Rusty Laminar airflow cabinets
HEPA filters not checked regularly
Sterile | Slide 38 of 62 January 2006
5.1 – 5. 2
Sterile ProductionSterile Production
Sterilization
Methods of sterilization:– Moist or dry heat– Irradiation (ionizing radiation)– Sterilizing gaseous agents (e.g. ethylene oxide)– Filtration with subsequent aseptic filling
Whenever possible: Terminal sterilization by heat in their final container - method of choice
Sterile | Slide 39 of 62 January 2006
5.4 – 5.5
Sterile ProductionSterile Production
Sterilization
Validation – All sterilization processes– Special attention when non-pharmacopoeia methods are used– Non-aqueous or oily solutions
Before the method is adopted – its suitability and efficacy demonstrated with desired conditions:
– All parts of the load– Each type of load– Physical measurements and biological indicators (where
appropriate)– Verified at least annually and after change– Records maintained
Sterile | Slide 40 of 62 January 2006
5.6 - 5.7
Sterile ProductionSterile Production
Sterilization
For effective sterilization:
Whole of the material subjected to the treatment
Biological indicators:
Additional method of monitoring
Storage and use, quality checked through positive control
Risk of contamination
Sterile | Slide 41 of 62 January 2006
5.8 - 5.9
Sterile ProductionSterile Production
Sterilization
Differentiation between sterilized and not-yet-sterilized products
Each basket/tray or other carrier, properly labelled– Name of material– Batch number– Sterilization status
Use of autoclave tape
Sterilization records for each run – approved as part of the batch release procedure
Sterile | Slide 42 of 62 January 2006
6
Sterile ProductionSterile Production
Terminal Sterilization
Sterilization by heat
Sterilization by moist heat
Sterilization by dry heat
Sterilization by radiation
Sterilization by gases and fumigants
Sterile | Slide 43 of 62 January 2006
6.2 – 6.3
Sterile ProductionSterile Production
Terminal Sterilization
Sterilization by heat
Recording of each cycle, e.g. time and temperature chart– Temperature: validated coolest part– Check from second independent probe– Additional chemical or biological indicators
Heating phase: Sufficient time for the whole load– Determined for each load
Cooling phase: After sterilization cycle– Precautions to prevent contamination– Sterilized cooling fluid/gas
Sterile | Slide 44 of 62 January 2006
6.4 – 6.6
Sterile ProductionSterile ProductionTerminal Sterilization
Sterilization by moist heat (heating in an autoclave)
Water-wetable materials only, and aqueous formulations
Temperature, time and pressure monitored
Temperature recorder independent of the controller
Independent temperature indicator
Drain – temperature recorded from this position
Regular leak test when vacuum is part of the cycle
Material allows for removal of air and penetration of steam
All parts of the load in contact with steam
Quality of the steam – no contamination
Sterile | Slide 45 of 62 January 2006
6.7
Sterile ProductionSterile Production
Terminal Sterilization
Sterilization by dry heat
For non-aqueous liquids, dry powders
Air circulation in the chamber
Positive pressure in chamber to prevent entry of non-sterile air
HEPA filtered air supplied
When removing pyrogens, challenge tests
– validation (using endotoxins)
Sterile | Slide 46 of 62 January 2006
6.8 – 6.10
Sterile ProductionSterile ProductionTerminal Sterilization
Sterilization by radiation
Suitable for heat-sensitive materials and products– confirm suitability of method for material– ultraviolet irradiation not acceptable
Contracting service – ensure validation status, responsibilities
Measurement of dose during procedure
Dosimeters independent of dose rate– quantitative measurement– number, location and calibration time-limit
Biological indicators only as additional control
Radiation sensitive colour discs
Sterile | Slide 47 of 62 January 2006
6.10 – 6.13
Sterile ProductionSterile Production
Terminal Sterilization
Sterilization by radiation (2)
Information forms part of the batch record
Validation to cover effects of variation in density of packages
Handling procedures to prevent misidentification of irradiated and non-irradiated materials
Each package to have a radiation-sensitive indicator
Total radiation dose administered within a predetermined period of time
Sterile | Slide 48 of 62 January 2006
6.14 – 6.20
Sterile ProductionSterile Production
Terminal Sterilization
Sterilization by gases and fumigants
Only when no other method is suitable
e.g. ethylene oxide, hydrogen peroxide vapour
Validation: Also prove the gas has no damaging effect on product
Time and conditions for degassing (specified limits) - residue
Direct contact with microbial cells essential– Nature and quantity of packaging materials
Humidity and temperature equilibrium
Monitoring of each cycle with biological indicators– time, pressure– temperature, humidity and gas concentration
Sterile | Slide 49 of 62 January 2006
6.21
Sterile ProductionSterile Production
Terminal Sterilization
Sterilization by gases and fumigants (2)
Post-sterilization storage – controlled manner– Ventilated conditions– Defined limit of residual gas– Validated process
Safety and toxicity issues
Sterile | Slide 50 of 62 January 2006
Sterile ProductionSterile Production
Terminally sterilized products
4.6 – 4.7
Grade
Preparation Remark
D Components and product Ensure low microbial and particulate count
C Product at unusual risk of
microbial contamination e.g. product actively supports microbial growth, or is held for a long period of time before sterilization, or is not prepared mainly in closed containers
C Filling before sterilization -
Sterile | Slide 51 of 62 January 2006
Sterile ProductionSterile Production
Terminally sterilized products
4.8 – 4.9
Grade
Preparation Remark
A in C background
Filling before sterilization if product at unusual risk of contamination from environment
e.g. slow filling operation, or Wide neck containers, or Exposure for a few seconds before sealing
C Preparation and filling Ointments, creams, suspensions, emulsions
Sterile | Slide 52 of 62 January 2006
Sterile ProductionSterile Production
Aseptic processing and sterilization by filtration
Aseptic processing
Objective is to maintain the sterility of a product, assembled from sterile components
Operating conditions so as to prevent microbial contamination
What do you think are the aspects that require careful attention? 7.1 – 7.2
Sterile | Slide 53 of 62 January 2006
Sterile ProductionSterile Production
Aseptic processing and sterilization by filtration
Aseptic processing (2)
Careful attention to:
Environment
Personnel
Critical surfaces
Container/closure sterilization
Transfer procedures
Maximum holding period before filling7.3
Sterile | Slide 54 of 62 January 2006
Sterile ProductionSterile Production
Aseptic preparation
4.10, 4.11, 4.14
Grade
Preparation Remark
D Components after washing C Preparation of solutions to be
sterile filtered later in the process
A (in B
background)
Preparation and filling of sterile ointments, creams, suspensions, emulsions
When the product is exposed and filtered
Sterile | Slide 55 of 62 January 2006
Sterile ProductionSterile Production
Aseptic preparation
4.10 – 4.13
Grade
Preparation Remark
A (in B
background)
Sterile starting materials and components
(Unless subjected to sterilization or filtration through a microorganism retaining filter later in the process)
A (in B
background)
Preparation of solutions (if not to be sterile filtered later)
A (in B
background)
Handling and filling of aseptically prepared products,
A (in B
background)
Handling of exposed sterile equipment
A (in B
background)
Transfer of partially closed containers, before complete stoppering
e.g. in freeze drying (Grade B environment if in sealed transfer trays)
Sterile | Slide 56 of 62 January 2006
Sterile ProductionSterile Production
Sterilization by filtration
Through a sterile filter of 0,22 µm or less, into previously sterilized containers
– remove bacteria and moulds– not all viruses or mycoplasmas
Consider complementing with some degree of heat treatment
Double filter layer or second filtration advisable, just before filling - no fibre shedding or asbestos filters
Filter integrity testing immediately after use– also before use if possible
7.4 – 7.7
Sterile | Slide 57 of 62 January 2006
Sterile ProductionSterile Production
Sterilization by Filtration (2)
Validation to include– Time taken to filter a known volume– Pressure difference to be used across the filter
Significant differences to be noted and investigated, recorded in batch records
Integrity of gas and air vent filters checked after use, other filters at appropriate intervals
7.7
Sterile | Slide 58 of 62 January 2006
Sterile ProductionSterile Production
Sterilization by Filtration (3)
Same filter not used for more than one working day, unless validated
No filter interaction with product, e.g.– removal of ingredients– releasing substances into product
7.8 – 7.9
Sterile | Slide 59 of 62 January 2006
Sterile ProductionSterile Production
Quality Control
Samples for sterility testing should be representative
From parts of the batch, most at risk– Aseptic filling – at beginning and end of batch filling, and after
interruptions– Heat sterilized – coolest part of the load
Sterility of the batch ensured through validation– Validated sterilization cycle– Media fill
Sterility test procedure as per pharmacopoeia, and validated for each product
Batch processing records, sterility testing records, environmental records should be reviewed
2.1 -2.2
Sterile | Slide 60 of 62 January 2006
Sterile ProductionSterile Production
Quality Control
Endotoxin testing for injectable products– Water for injection, intermediate and finished product
Always for large volume infusion solutions
Pharmacopoeia method, validated for each product
Failure of the test – investigation
Corrective action 2.3
Sterile | Slide 61 of 62 January 2006
Sterile ProductionSterile Production
Finishing of products
Containers closed by means of validated methods
Samples checked for integrity
Maintenance of vacuum (where applicable) checked
Parenteral products inspected individually
Visual inspection under suitable and controlled conditions:– illumination and background– eyesight checks of operators– allowed frequent breaks
Other methods:– validated, and equipment performance checked at intervals– results recorded
11.1 – 11.3
Sterile | Slide 62 of 62 January 2006
Sterile ProductionSterile Production
Group session 3
Considering the same factory as in the previous group sessions, devise a plan for monitoring of the facility.
List the parameters to be tested, tests to be used, acceptance criteria and frequency of testing.