Ethylene oxide: Monitoring blind spots and inequities in rural or small‑town America

In recent years, there have been high-profile shutdowns of suburban sterilization facilities for emitting excessive volumes of ethylene oxide (EtO). This colorless gas is an effective sterilizer used across many industries, but it has also been linked to DNA damage and an increased risk of developing cancer. While EtO emissions in urban and suburban communities are coming to light, small towns and rural communities may still be unaware of this air pollutant. The EPA admits that not all US counties have air quality monitors, and that counties with monitors may not be able to measure all types of pollutants. If you live in a rural area near a sterilization plant, you may be exposed to EtO gas without your knowledge.

Study shows more than half of US counties lack air quality monitoring

In a 2025 study published in the Proceedings of the National Academy of Sciences, researchers found that 1,848 counties (58.8%) in the US have no monitoring station for air quality. They also found that rural counties or areas with high populations of vulnerable groups (adults without a high school diploma and people of color) were more likely to lack air quality monitoring stations. As of September 2024, only Connecticut, Delaware, and Washington had full coverage of air quality monitoring. Meanwhile, states with current air pollution issues and ongoing ethylene oxide claims also have some of the lowest monitoring coverage, including Louisiana (40.6%), Tennessee (53.7%), and Arkansas (18.75%).

The Union of Concerned Scientists published an analysis in 2023 that found evidence of inequities in locations of ethylene oxide-using sterilization plants. They found that EtO-emitting facilities were disproportionately located near low-income communities or near populations of color and non-English speakers. In particular, the DeRoyal Industries plant in New Tazewell was found to elevate cancer risks to an additional 3000 cases per 1 million people.

EtO-using facilities in suburban or rural areas may have put you at risk of exposure

Because of the disparities in air quality data, especially in suburban and rural communities, there is a possibility that you are being exposed to more volumes of EtO than you realize. Working at or living near an EtO sterilization facility increases your risk of EtO exposure. Even if you live in a suburban or rural community with no air monitoring facility, you may still qualify for an ethylene oxide claim with proof of exposure and medical records that show a diagnosis of any of the following EtO-related conditions:

• Leukemia
• Non-Hodgkin's lymphoma
• Multiple myeloma
• Liver cancer
• Lung cancer
• Breast cancer (male, female)
• Stomach cancer

Proof of exposure to ethylene oxide can be any of the following documents:

• Employment records (for workers who are or have been employed in a facility that used ethylene oxide)
• Residential records like mortgage documents, lease agreements, utility bills, etc. (for residents who lived within four miles of an EtO-using facility)

ELG Law can help you file an ethylene oxide claim for cancer

If you live in a small town or rural community and developed an EtO-associated medical condition, do not hesitate to file an EtO exposure claim. If you cannot find air quality data for your town due to the lack of monitoring stations, your proof of exposure can be used to strengthen your claim. ELG Law attorneys can evaluate your employment records or proof of residence within a four-mile radius of the EtO facility. If you are eligible, ELG Law can file your claim and pursue the compensation you deserve.