Beyond EtO: The Race to Reinvent Sterilization

Tougher EtO emissions rules are speeding cold plasma innovation, with Aurora aiming for commercialization in 2026

27 Feb 2026

A shift is under way in the medical sterilisation market as regulators tighten emissions standards for ethylene oxide (EtO), long used to sterilise complex and heat-sensitive devices. While the gas remains central to the industry, tougher environmental and workplace safety rules are prompting manufacturers to reassess long-term strategy and explore complementary technologies such as cold plasma.

In the US and Europe, authorities have introduced stricter emissions thresholds, closer monitoring and higher compliance requirements for EtO facilities. The measures stop short of a ban but increase operating costs and regulatory risk for sterilisation providers. Medical device makers and hospital systems are responding by diversifying sterilisation methods to reduce reliance on a single process.

France-based Aurora Sterilisation is among the companies seeking to capitalise on the shift. The group has secured a €2.5mn grant from the European Innovation Council’s Accelerator programme to advance its low-temperature cold plasma system towards industrial production. The company is targeting commercial milestones in 2026.

Aurora’s technology replaces chemical gases with ionised air to deactivate bacteria and other pathogens. Operating at between 30°C and 40°C, the system is designed for delicate instruments, including endoscopes and devices containing polymers or embedded electronics. With cycle times of about one hour, it is intended to fit within existing low-temperature workflows in hospital sterile processing departments.

Cold plasma remains at an early stage of adoption and is not positioned as a direct substitute for EtO in all applications. Ethylene oxide continues to play a critical role in sterilising high volumes of complex devices, particularly those with intricate geometries or sealed packaging. Any transition requires validation across device categories, regulatory approvals and capital investment. Hospitals have also invested heavily in hydrogen peroxide and other gas-based systems, which may slow rapid change.

Nonetheless, sustainability targets, regulatory pressure and rising device complexity are pushing sterilisation higher up corporate agendas. If emerging platforms can demonstrate consistent performance at scale, cold plasma may develop into a complementary option within a broader mix of technologies shaped increasingly by environmental and compliance considerations.