Water, Water, Everywhere

Everyone probably feels like the above illustration sooner or later about their water system.

The Critical Role of Water in Pharmaceutical Manufacturing

In the pharmaceutical industry, we often joke that we’re primarily water companies that happen to make drugs on the side. This quip underscores a fundamental truth: water is a crucial component in drug manufacturing processes. Its purity and quality are paramount to ensuring the safety and efficacy of pharmaceutical products.

Why Water Quality Matters

Water is ubiquitous in pharmaceutical manufacturing, used in everything from cleaning equipment to serving as a key ingredient in many formulations. Given its importance, regulatory bodies like the FDA and EMA have established stringent Good Manufacturing Practice (GMP) guidelines for water systems in pharmaceutical facilities.

GMP Requirements for Water Systems

The GMPs mandate that water systems be meticulously designed, constructed, installed, commissioned, qualified, monitored, and maintained. The primary goal? Preventing microbiological contamination. This comprehensive approach encompasses several key areas:

System Design: Water systems must be engineered to minimize the risk of contamination.
Construction and Installation: Materials and methods used must meet high standards to ensure system integrity.
Commissioning and Qualification: Rigorous testing is required to verify that the system performs as intended.
Monitoring: Ongoing surveillance is necessary to detect any deviations from established parameters.
Maintenance: Regular upkeep is crucial to maintain system performance and prevent degradation.

Key Regulatory Requirements

Agency	Title	Year	URL
EMA	Guideline on the quality of water for pharmaceutical use	2020	https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-quality-water-pharmaceutical-use_en.pdf
WHO	Good manufacturing practices: water for pharmaceutical use	2012	https://www.who.int/docs/default-source/medicines/norms-and-standards/guidelines/production/trs970-annex2-gmp-wate-pharmaceutical-use.pdf
US FDA	Guide to inspections of high purity water systems	2016	https://www.fda.gov/media/75927/download
PIC/S	Inspection of utilities	2014	https://picscheme.org/docview/1941
US FDA	Water for pharmaceutical use	2014	https://www.fda.gov/media/88905/download
USP	<1231> Water for pharmaceutical purposes	2020	Not publicly available
USP	<543> Water Conductivity	2020	Not publicly available
USP	<85> Bacterial Endotoxins Test	2020	Not publicly available
USP	<643> Total Organic Carbon	2020	Not publicly available
Ph. Eur.	Monograph 0168 (Water for injections)	2020	Not publicly available
Ph. Eur.	Monograph 0008 (Purified water)	2020	Not publicly available

Specific Measures for Contamination Prevention

To meet these GMP requirements, pharmaceutical manufacturers must implement several specific measures:

Minimizing Particulates

Particulate matter in water can compromise product quality and potentially harm patients. Filtration systems and regular cleaning protocols are essential to keep particulate levels in check.

Controlling Microbial Contamination

Microorganisms can proliferate rapidly in water systems if left unchecked. Strategies to prevent this include:

Regular sanitization procedures
Maintaining appropriate water temperatures
Implementing effective water treatment technologies (e.g., UV light, ozonation)

Preventing Endotoxin Formation

Endotoxins, produced by certain bacteria, can be particularly problematic in pharmaceutical water systems. Measures to prevent endotoxin formation include:

Minimizing areas where water can stagnate
Ensuring complete drainage of pipes
Regular system flushing

The Ongoing Challenge

Maintaining water quality in pharmaceutical manufacturing is not a one-time effort but an ongoing process. It requires constant vigilance, regular testing, and a commitment to continuous improvement. As regulations evolve and our understanding of potential contaminants grows, so too must our approaches to water system management.

Types of Water

These water types are defined and regulated by pharmacopeias such as the United States Pharmacopeia (USP), European Pharmacopoeia (Ph. Eur.), and other regional standards. Pharmaceutical manufacturers must adhere to the specific requirements outlined in these references to ensure water quality and safety in drug production.

Potable Water

Potable water, also known as drinking water, may be used for some pharmaceuticals bt is more commonly used in cosmetics. It can also be used for cleanings walls and floors in non-asceptic areas.

Key points:

Must comply with EPA standards or comparable regulations in the EU/Japan
Can be used to manufacture drug substances (bulk drugs)
Not suitable for preparing USP dosage forms or laboratory reagents

Purified Water (PW)

Purified water is widely used in pharmaceutical manufacturing for non-sterile preparations.

Specifications (USP <1231>):

Conductivity: ≤1.3 μS/cm at 25°C
Total organic carbon (TOC): ≤500 ppb
Microbial limits: ≤100 CFU/mL

Applications:

Non-parenteral preparations
Cleaning equipment for non-parenteral products
Preparation of some bulk chemicals

Water for Injection (WFI)

Water for Injection is used for parenteral drug products and has stricter quality standards.

Specifications (USP <1231>):

Conductivity: ≤1.3 μS/cm at 25°C
TOC: ≤500 ppb
Bacterial endotoxins: <0.25 EU/mL
Microbial limits: ≤10 CFU/100 mL

Production methods:

Distillation
Reverse osmosis (allowed by Ph. Eur. since 2017)

Sterile Water for Injection (SWFI)

SWFI is WFI that has been sterilized for direct administration.

Characteristics:

Sterile
Non-pyrogenic
Packaged in single-dose containers

Highly Purified Water (HPW)

Previously included in the European Pharmacopoeia, but now discontinued.

Type of Water	Description	USP Reference	EP Reference
Potable Water	Meets drinking water standards, used for early stages of manufacturing	Not applicable	Not applicable
Purified Water (PW)	Used for non-sterile preparations, cleaning equipment	USP <1231>	Ph. Eur. 0008
Water for Injection (WFI)	Used for parenteral products, higher purity than PW	USP <1231>	Ph. Eur. 0169
Sterile Water for Injection (SWFI)	WFI that has been sterilized for direct administration	USP <1231>	Ph. Eur. 0169
Bacteriostatic Water for Injection	Contains bacteriostatic agents, for multiple-dose use	USP <1231>	Ph. Eur. 0169
Sterile Water for Irrigation	Packaged in single-dose containers larger than 1L	USP <1231>	Ph. Eur. 1116
Sterile Water for Inhalation	For use in inhalators, less stringent endotoxin levels	USP <1231>	Ph. Eur. 1116
Water for Hemodialysis	Specially treated for use in hemodialysis, produced on-site	USP <1231>	Not specified

Additional relevant USP chapters:

USP <645>: Water for Pharmaceutical Purposes – Microbial Attributes
USP <85>: Bacterial Endotoxins Test

Always refer to the most current versions of the pharmacopoeial monographs and regulatory guidelines for detailed information.

Good Water System Design

Hygienic and Sanitary Design

The cornerstone of any good water system is its hygienic and sanitary design. This principle encompasses several aspects:

Smooth, cleanable surfaces: All surfaces in contact with water should be smooth, non-porous, and easily cleanable to prevent biofilm formation.
Self-draining components: Pipes and tanks should be designed to drain completely, eliminating standing water that could harbor microorganisms.
Accessibility: All parts of the system should be easily accessible for inspection, cleaning, and maintenance.

Material Selection

Choosing the right materials is crucial for maintaining water quality and system integrity:

Corrosion resistance: Use materials that resist corrosion, such as stainless steel (316L grade for high-purity applications) or appropriate food-grade plastics.
Smooth internal finish: Crevices are places where corrosion happens, electropolishing improves the resistance of stainless steel to corrosion.
Leachate prevention: Select materials that do not leach harmful substances into the water, even under prolonged contact or elevated temperatures.
Non-adsorptive surfaces: Avoid materials that may adsorb contaminants, which could later be released back into the water.

Microbial Control

Preventing microbial growth is essential for water system safety:

Elimination of dead legs: Design piping to avoid areas where water can stagnate and microorganisms can proliferate.
Temperature control: Maintain temperatures outside the optimal range for microbial growth (typically below 20°C or above 50°C).
Regular sanitization: Incorporate features that allow for effective and frequent sanitization of the entire system.

System Integrity

Ensuring the system remains sealed and leak-free is critical:

Proper sealing: Use appropriate gaskets and seals compatible with the system’s operating conditions.
Pressure testing: Implement regular pressure tests to identify and address potential leaks promptly.
Quality connections: Utilize sanitary fittings and connections designed for hygienic applications.

Cleaning and Sanitization Compatibility

The system must withstand regular cleaning and sanitization:

Chemical resistance: Choose materials and components that can tolerate cleaning and sanitizing agents without degradation.
Thermal stability: Ensure all parts can withstand thermal sanitization processes if applicable.
CIP/SIP design: Incorporate Clean-in-Place (CIP) or Steam-in-Place (SIP) features for efficient and thorough cleaning.

Capacity and Performance

Meeting output requirements while maintaining quality is crucial:

Proper sizing: Design the system to meet peak demand without compromising water quality or flow rates.
Redundancy: Consider incorporating redundant components for critical parts to ensure continuous operation.
Efficiency: Optimize the system layout to minimize pressure drops and energy consumption.

Monitoring and Control

Implement robust monitoring systems to ensure water quality:

Sampling points: Strategically place sampling ports throughout the system for regular quality checks.
Instrumentation: Install appropriate instruments to monitor critical parameters such as flow rate, pressure, temperature, and conductivity.
Control systems: Implement automated control systems to maintain consistent water quality and system performance.

Regulatory Compliance

Ensure the system design meets all relevant regulatory requirements:

Material compliance: Use only materials approved for contact with water in your specific application.
Documentation: Maintain detailed documentation of system design, materials, and operating procedures.
Validation: Conduct thorough system qualification to demonstrate consistent performance and quality.

By adhering to these principles, you can design a water system that not only meets your capacity requirements but also ensures the highest standards of safety and quality. Remember, good water system design is an ongoing process that requires regular review and updates to maintain its effectiveness over time.

The Challenge of Cleanroom Classification Harmonization

In the world of pharmaceutical manufacturing, cleanroom classifications play a crucial role in ensuring product quality and patient safety. However, a significant hurdle in the global harmonization of regulations has been a pain in our sides for a long time, that highlights the persistent differences between major regulatory bodies, including the FDA, EMA, and others, despite efforts to align through organizations like the World Health Organization (WHO) and the Pharmaceutical Inspection Co-operation Scheme (PIC/S).

The Current Landscape

United States Approach

In the United States, cleanroom classifications are primarily governed by two key documents:

The FDA’s “Sterile Drug Products Produced by Aseptic Processing” guidance
ISO 14644-1 standard for cleanroom classifications

The ISO 14644-1 standard is particularly noteworthy as it’s a general standard applicable across various industries utilizing cleanrooms, not just pharmaceuticals.

European Union Approach

The European Union takes a different stance, employing a grading system outlined in the EU GMP guide:

Grades A through D are used for normal cleanroom operation
ISO 14644 is still utilized, but primarily for validation purposes

World Health Organization Alignment

The World Health Organization (WHO) aligns with the European approach, adopting the same A to D grading system in its GMP guidelines.

The Implications of Disharmony

This lack of harmonization in cleanroom classifications presents several challenges:

Regulatory Complexity: Companies operating globally must navigate different classification systems, potentially leading to confusion and increased compliance costs.
Technology Transfer Issues: Transferring manufacturing processes between regions becomes more complicated when cleanroom requirements differ.
Inspection Inconsistencies: Differences in classification systems can lead to varying interpretations during inspections by different regulatory bodies.

The Missed Opportunity in Annex 1

The recent update to Annex 1, a key document in GMP regulations, could have been a prime opportunity to address this disharmony. However, despite involvement from WHO and PIC/S (and through them the FDA), the update failed to bring about the hoped-for alignment in cleanroom classifications.

Moving Forward

As the pharmaceutical industry continues to globalize, the need for harmonized regulations continues to be central. I would love to see future efforts towards harmonization here that would:

Prioritize alignment on fundamental technical specifications like cleanroom classifications
Consider the practical implications for manufacturers operating across multiple jurisdictions

While the journey towards full regulatory harmonization may be long and challenging, addressing key discrepancies like cleanroom classifications would represent a significant step forward for the global pharmaceutical industry.

Practicing Humility as Part of a Quality Culture

Cultural humility is an important part of Quality Culture. Cultural humility is often seen as approaching interactions with an attitude of openness, asking questions to learn rather than making assumptions, being willing to admit what you don’t know, and constantly examining your own lens and biases. It’s about creating an environment where all perspectives are valued and people feel respected.

Cultural humility involves several key characteristics and behaviors:

Self-reflection and self-critique: The entire organization, from individual to team to the whole engage in ongoing self-examination of their actions and behaviors.
Openness and curiosity: Those with cultural humility approach problems and interactions with people with genuine interest and a desire to learn, rather than making assumptions.
Lifelong learning: Cultural humility is viewed as a lifelong process of learning about other cultures, not a destination to be reached.
Acknowledging power imbalances: It involves recognizing and working to address power differentials that exist within the organization (hierarchical and otherwise).
Respecting other perspectives: Quality decision making involves intentionally gathering input from people with different backgrounds, experiences, and areas of expertise. This helps broaden the range of ideas and considerations
Avoiding biases: Implicit biases are unconscious attitudes or stereotypes that can affect our understanding, actions, and decisions. By working to understand and address these we strive towards realizing humility in our actions and behaviors.
Active listening: Truly hearing and trying to understand.
Partnership-building: It involves developing mutually beneficial and non-paternalistic partnerships with people from different teams, experience and backgrounds.
Institutional accountability: On an organizational level, humility includes holding oneself accountable to the practice.
Advocacy: Those practicing cultural humility often work to address systemic inequalities and advocate for others.

Leadership Behaviors

Humble leaders exhibit the following behaviors:

Admitting limitations and mistakes
Appreciating others’ strengths and contributions
Being open to new ideas and feedback
Listening before speaking
Encouraging employees to keep trying and viewing mistakes as learning opportunities
Taking responsibility for employees’ mistakes
Modeling openness and fallibility
Maintaining a collective focus

Cultural Attributes

A work culture with humble leadership is characterized by:

Openness to new ideas and continuous learning
Appreciation for diverse perspectives and contributions
Reduced fear of taking interpersonal risks
High-quality interpersonal relationships
Collective humility within teams
Trust between leaders and team members
Inclusivity and reduced power differentials
Emphasis on growth and development rather than blame

Employee Perceptions and Behaviors

In a humble environment, employees are more likely to:

Feel safe expressing themselves and taking risks
Believe in their ability to contribute constructively
Engage in voice behaviors and share ideas
Show themselves freely without fear of adverse consequences
Imitate leaders in showing their own shortcomings and appreciating others
Perceive making mistakes as acceptable
Experience increased job satisfaction and reduced turnover intentions

Organizational Practices

To cultivate humility and psychological safety, organizations can:

Develop policies and practices that promote diversity, equity, and inclusion
Create an inclusive climate for errors and mutual assistance
Implement leadership development programs focused on humble behaviors
Encourage open dialogue and social relationships in teams
Foster an error management climate that doesn’t punish mistakes but learns from them

FDA Nitrosamine Impurities Update

FDA guidance, “Control of Nitrosamine Impurities in Human Drugs,” revises the final guidance of the same name issued on February 24, 2021, by including information about nitrosamine drug substance related impurities (NDSRIs), recommending implementation of new nitrosamine control strategies, and providing an updated timeline for manufacturers and applicants to implement these recommendations.

Nitrosamine impurities are important to control because they are potential human carcinogens. Long-term exposure to these impurities at levels above acceptable limits can increase the risk of cancer. Nitrosamines can be found in various consumer products and the environment, and they have been detected in several pharmaceutical products since 2018, prompting recalls and regulatory actions. A lot of regulatory action. Nitrosamine impurities may be one of the biggest drivers of changes in the GMPs.

Current Regulatory View

Regulators, including the FDA, Health Canada, and the European Medicines Agency (EMA), have been actively working to address the presence of nitrosamine impurities in medications. The current regulatory view emphasizes:

Risk Assessment and Control: Regulatory agencies have established acceptable intake (AI) limits for nitrosamines in drug products. These limits are designed to minimize the risk of cancer associated with long-term exposure to these impurities.
Guidance and Frameworks: Agencies have issued guidance documents outlining frameworks for assessing and controlling nitrosamine impurities. For example, the FDA’s guidance includes recommendations for predicting the mutagenic and carcinogenic potential of nitrosamine drug substance-related impurities (NDSRIs) and provides AI limits based on carcinogenic potency categorization.
International Collaboration: There is significant collaboration among global regulators to harmonize approaches and methodologies for controlling nitrosamine impurities. This includes the adoption of the Carcinogenic Potency Categorization Approach (CPCA) to determine AI limits.
Industry Responsibility: Manufacturers are responsible for understanding their processes to prevent nitrosamine formation and for conducting risk assessments. They must implement control strategies and perform confirmatory testing to ensure that nitrosamine levels remain below the established AI limits.

Regulators are focused on ensuring the safety of pharmaceutical products by controlling nitrosamine impurities through comprehensive risk assessments, setting stringent AI limits, and fostering international cooperation. Companies need to make sure they are ahead of this matter.

Conducting A Hazard and Operability Study (HAZOP)

A Hazard and Operability Study (HAZOP) is a structured and systematic examination of a complex planned or existing process or operation to identify and evaluate problems that may represent risks to product, personnel or equipment. The primary goal of a HAZOP is to ensure that risks are managed effectively by identifying potential hazards and operability problems and developing appropriate mitigation strategies.

Why Use HAZOP?

Biotech facilities involve intricate processes that can be prone to various risks, including contamination, equipment failure, and process deviations. Implementing a HAZOP can:

Risk Identification and Mitigation: HAZOPs help identify potential hazards associated with biotech processes, such as contamination risks, equipment malfunctions, and deviations from standard operating procedures. By identifying these risks, facilities can implement mitigation strategies to prevent accidents and ensure safety.
Process Optimization: Through the systematic analysis of processes, HAZOPs can identify inefficiencies and areas for improvement, leading to optimized operations and enhanced productivity.

Part of a Continuum of Risk Tools

A HAZOP (Hazard and Operability) study differs from other risk assessment methods in a few key ways:

Systematic examination of process deviations: HAZOP uses a very structured approach of examining potential deviations from the intended design and operation of a process, using guidewords like “more”, “less”, “no”, “reverse”, etc. This systematic approach helps identify hazards that may be missed by other methods.
Focus on operability issues: The HAZOP examines operability problems that could impact process efficiency or product quality.
Node-by-node analysis: The process is broken down into nodes or sections that are analyzed individually, allowing for very thorough examination.
Qualitative analysis: Unlike quantitative risk assessment methods, HAZOP is primarily qualitative, focusing on identifying potential hazards rather than quantifying risk levels. HAZOPs do not typically assign numerical scores or rankings to risks.
Consideration of causes and consequences: For each deviation, the team examines possible causes, consequences, and existing safeguards before recommending additional actions.
Applicable to complex processes: The structured approach makes HAZOP well-suited for analyzing complex processes with many variables and potential interactions.

Method	Description	Strengths	Limitations
HAZOP (Hazard and Operability Study)	Systematic examination of process/operation to identify potential hazards and operability problems	– Very thorough and structured approach – Examines deviations from design intent – Team-based	– Time consuming – Primarily qualitative
FMEA (Failure Mode and Effects Analysis)	Systematic method to identify potential failure modes and their effects	– Quantitative risk prioritization – Proactive approach – Can be used on products and processes	– Does not consider combinations of failures – Can be subjective
HACCP (Hazard Analysis and Critical Control Points)	Systematic approach to food safety hazards	– Focus on prevention – Identifies critical control points	– Requires prerequisite programs in place
PHA (Preliminary Hazard Analysis)	Early stage hazard identification technique	– Can be used early in design process – Relatively quick to perform – Identifies major hazards	– Not very detailed – Qualitative only – May miss some hazards
Bow-Tie Analysis	Combines fault tree and event tree analysis	– Visual representation of risk pathways – Shows preventive and mitigative controls – Good communication tool	– Does not show detailed failure logic – Can oversimplify complex scenarios – Time consuming for multiple hazards

Key differences:

HAZOP focuses on deviations from design intent, while FMEA looks at potential failure modes
HACCP is specific to identify hazards and is commonly used in food safety, while the others are more general risk assessment tools
PHA is used early in design, while the others are typically used on existing systems
Bow-Tie provides a visual risk pathway, while the others use more tabular formats
FMEA and HAZOP tend to be the most thorough and time-intensive methods

The choice of method depends on the specific application, stage of design, and level of detail required. Often a combination of methods may be used.

Instructions for Conducting a HAZOP

Preparation

Assemble a multidisciplinary team comprising appropriate experts
Define the scope of the HAZOP study, including the specific processes or operations to be analyzed.
Gather and review all relevant documentation, such as process flow diagrams, piping and instrumentation diagrams, and standard operating procedures.

Execution

Divide the Process into Nodes: Break down the process into manageable sections or nodes. Each node typically represents a specific part of the process, such as a piece of equipment or a process step.
Identify Deviations: For each node, guidewords are applied to identify potential deviations from the intended design or operation. Common guidewords include:
- No: Complete absence of a process parameter (e.g., no flow).
- More: Quantitative increase (e.g., more pressure).
- Less: Quantitative decrease (e.g., less temperature).
- As well as: Presence of additional elements (e.g., contamination).
- Part of: Partial completion of an action (e.g., partial mixing).
- Reverse: Logical opposite of the intended action (e.g., reverse flow).
Analyze Causes and Consequences: Determine the possible causes of each deviation and analyze the potential consequences on safety, environment, and operations. This involves considering various factors such as equipment failure, human error, environmental conditions, or procedural issues that could lead to the deviation.
- Use of Experience and Knowledge: The team relies on their collective experience and knowledge of the process, equipment, and industry standards to hypothesize potential causes. This may include reviewing historical data, previous incidents, and near misses.
Recommend Actions: Develop recommendations for mitigating identified risks, such as changes to the process, additional controls, or procedural modifications.

Documentation and Follow-Up

Document all findings, including identified hazards, potential consequences, and recommended actions.
Assign responsibilities for implementing recommendations and establish timelines for completion.
Conduct follow-up reviews to ensure that recommended actions have been implemented effectively and that the process remains safe and operable.

Review and Update

Regularly review and update the HAZOP study to account for changes in processes, equipment, or regulations.
Ensure continuous improvement by incorporating lessons learned from past incidents or near misses.
Iterative Process: The process is iterative, with the team revisiting and refining their analysis as more information becomes available or as the understanding of the process deepens.

Node	Guideword	Parameter	Deviation	Cause	Consequence	Safeguards	Recommendations	Actions
Specific section or equipment being analyzed	Guideword applied (e.g. No, More, Less, Reverse, etc.)	Process parameter being examined (e.g. Flow, Temperature, Pressure, etc.)	How the parameter deviates from design intent when guideword is applied	Possible reasons for the deviation	Potential results if deviation occurs	Existing measures to prevent or mitigate the deviation	Suggested additional measures to control the risk	Specific tasks assigned to implement recommendations