By Michael Bartlett on February 24th, 2026 in Ethylene Oxide
The biggest challenge in reducing ethylene oxide exposure is the heavy reliance of critical medical equipment supplies on EtO sterilization. The US Environmental Protection Agency (EPA) released new guidelines in 2025, expecting commercial sterilizers to reduce their workers’ exposure in the next 10 years.
Ethylene oxide (EtO) is a widely known sterilizing agent, which makes it an important reagent in the food, manufacturing, and medical industries. However, its ability to kill microorganisms in equipment also makes it dangerous for humans exposed to it. For decades, workers assigned to sterilization plants have been exposed to dangerous levels of EtO and may have suffered both short-term and long-term effects of this toxic chemical.
There are various sterilization methods available in the healthcare industry, including dry heat and steam sterilization. However, EtO gas is the most effective method for equipment sensitive to heat and moisture, especially critical devices that are directly in contact with tissue, any part of the vascular system, or with patient blood. EtO is also used to sterilize semicritical devices that need high-level disinfection because they are in contact with mucous membranes or broken (non-intact) skin. Effectivity of sterilization and EtO exposure both depend on multiple factors, like how much gas concentration is used (450-1200 mg/L) or how long the device is exposed to the gas (typically 1-6 hours). In the U.S., EtO is used to sterilize nearly half of all sterile medical devices, amounting to about 20 billion devices sterilized each year.
Previously, the standard limit for ethylene oxide exposure set by the Occupational Safety and Health Administration (OSHA) was at 1 ppm since 1984. Under the EPA's interim decision released in January 2025, commercial sterilization companies are required to reduce workers' exposure to the following limits:
The EPA also aims to set a stricter limit on sterilization cycles, establishing a concentration limit of 600 mg/L within 10 years. For medical devices that require more than 600 mg/L, the sterilizer needs to justify the higher application rate. The interim decision also aims to reduce EtO exposure in the working environment of commercial sterilizers through the following:
Scientific studies have found an association between EtO exposure and increased risk of different types of cancer. The same property that makes it effective in sterilizing devices also makes it a potent carcinogen when inhaled. Because of this exposure pathway, both workers of EtO-emitting plants and nearby residents are at risk of increased cancer odds, particularly the following types of cancer:
If you have worked at a sterilization facility or lived within four miles of one, you may be eligible for an ethylene oxide claim for cancer. ELG has a team of toxic exposure attorneys who have been assisting victims in filing cancer claims. Our EtO attorneys only need to check your proof of exposure (either your employment records or residence proof) and medical documents (showing your cancer diagnosis) to evaluate your eligibility. If eligible, we can file an ethylene oxide claim on your behalf while you focus on treatment and recovery.