When should chemical indicators (CIs) be used? What's the difference between an indicator and an integrator? What's the role of CIs in load release? OR Manager posed frequently asked questions to Cynthia Spry, RN, MA, MSN, CNOR, cochair of the working group that recently issued a comprehensive update to the steam sterilization standard from the Association for the Advancement of Medical Instrumentation (AAMI). The new edition of the Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities (ANSI/AAMI ST79) was issued in Fall 2006. Spry is also a consultant for Advanced Sterilization Products.