Overview of Ethylene Oxide (EtO) in Healthcare
Ethylene oxide (EtO) is a flammable gas with a slightly sweet odor used in hospital central supply departments to sterilize items that cannot withstand steam sterilization. Due to its flammability, improper handling can lead to explosions.
Exposure Risks
Healthcare workers may be exposed to EtO through:
- Improper aeration of the sterilizer chamber after the sterilization cycle
- Off-gassing from sterilized items
- Leaks or poor connections in gas lines
Exposure can occur in various areas of healthcare facilities, including:
- Outpatient surgery clinics
- Cardiac catheterization laboratories
- Operating rooms
- Dental laboratories
Health Studies and Findings
The National Institute for Occupational Safety and Health (NIOSH) conducted two major studies—the most comprehensive ever on EtO exposure—to assess its health effects. Researchers evaluated 18,235 men and women working at 14 sterilizer plants across the U.S., most of whom sterilized medical supplies with EtO.
Findings:
- No overall increase in risk for cancer or other diseases compared to the general population.
- Among workers with long-term, high-level EtO exposure, there was evidence of:
- Elevated risk of blood cancers in men
- Elevated risk of breast cancer in women
Conclusions:
Workers exposed to high levels of EtO may face increased cancer risks. Since the implementation of the OSHA EtO standard in 1985, workplace exposures have been significantly reduced, lowering the risk of disease.