ABSTRACT:
ETHYLENE OXIDE: In 2024 approximately 480,000 metric tons of ETO was used for sterilization and fumigation, primarily for medical devices and some food products1. ETO is a multisystem toxin in the human body affecting the nervous system, respiratory system, reproductive system, kidneys, and other organs2. It is a known human carcinogen, specifically for hematopoietic, lymphatic, and breast cancers, at levels below what have been considered safe in the past 2. It would appear that this carcinogenic impact of EtO is likely to be seen in the general population without direct occupational exposure as a consequence of it’s use as a medical sterilant for what has been estimated up to 50% of medical supplies3. IARC in 2008 estimated that “approximately 2700 workers were employed in commercial sterilization by manufacturers of medical and pharmaceutical products and producers of food spices, as contract sterilizers, and in other sterilization and fumigation facilities.”3 In addition to the exposures to these workers, some sterilized plastics may retain concentrations of ethylene oxide ranging from 3 to 443 mg/kg (ppm) even after seven days of aeration contaminating the hospital environment as well 3. The USEPA’s human-based full lifetime total extra cancer estimate for lymphoid cancers and breast cancer combined produces 50 additional cases per 10,000 civilians exposed which for the United States comes to roughly 2,500 lifetime additional cancer cases.4 This finding has generated programs in the US and abroad to find safer substitute materials and control technologies to reduce this evident cancer risk to both health care and sterilant workers and their communities.5 The widespread knowledge about this practice amongst health care workers and communities around such processes is vitally important to secure safer use and further research into alternatives.