Non-Hodgkin's lymphoma diagnosis? How EtO exposure could be the cause

Non-Hodgkin lymphoma (NHL) is a type of cancer that affects B-cells, T-cells, or natural killer cells in the lymphatic system. There are a number of subtypes, including slow-growing follicular lymphoma and aggressive diffuse large B-cell lymphoma (DLBCL). The most common symptoms are painless swollen lymph nodes, night sweats, unexplained weight loss, persistent fatigue, and a fever. If the disease spreads beyond the lymph nodes, specific symptoms may occur, such as abdominal pain, persistent coughing, or skin lesions.

How non-Hodgkin lymphoma is diagnosed

Physical examinations are usually the first step in diagnosing swollen lymph nodes in the neck, underarms, or groin. A variety of diagnostic procedures are used to determine the extent of NHL and confirm its diagnosis:

• Imaging tests, including CT scans, MRI, or PET scans, to detect whether lymphoma has spread throughout the body
• Excisional lymph node biopsy, where tissue is removed and tested for lymphoma cells using histology and immunophenotyping
• Bone marrow aspiration and biopsy to determine if cancer has invaded the bone marrow
• Blood work, urine tests, and sometimes a lumbar puncture, depending on symptoms and suspected disease spread

A definitive diagnosis requires tissue analysis using techniques such as flow cytometry or immunohistochemistry. Staging with PET/CT scans helps doctors determine the extent of the cancer and plan appropriate treatment.

The link between EtO exposure and non-Hodgkin lymphoma

Ethylene oxide is classified as a human carcinogen by the International Agency for Research on Cancer (IARC), the National Toxicology Program (NTP), and the Environmental Protection Agency (EPA). There is an increased risk of lymphoma and leukemia in exposed workers, one of the most consistent health effects. Human data most consistently link EtO exposure with cancers of the lymphatic and hematopoietic system, including non-Hodgkin lymphoma, leukemia, and female breast cancer.

Large occupational studies of sterilization and EtO production workers have reported elevated mortality or incidence from lymphatic and hematopoietic cancers. The NIOSH/Steenland cohort of approximately 18,000 sterilization workers forms the foundation of modern risk assessments, with findings showing stronger cancer signals in workers with higher cumulative exposure. Meta-analyses and systematic reviews find an overall modest positive association between occupational EtO exposures and NHL risk.

EtO emissions near sterilization facilities have been linked to elevated risk for non-Hodgkin lymphoma in nearby residents in several community-level studies. Breast cancer and NHL are more likely to develop in residents living near emitting facilities, according to a study published in the Journal of the National Cancer Institute in 2023.

How EtO causes lymphoma

As an alkylating agent, ethylene oxide forms DNA and protein adducts, which disrupt normal cell function. EtO is mutagenic in laboratory systems and causes chromosomal damage. The development of lymphoid malignancies after sufficient exposure and latency may be due to alkylation and mutagenesis in precursor lymphoid cells. It has been shown in animal studies that EtO can cause systemic cancer by causing multiple types of tumors.

There have traditionally been high, repeated exposures accumulated over years in sterilization facilities, EtO production plants, and spice fumigation operations. Lymphoid malignancies have a long latency period, meaning you may be diagnosed with cancer today after being exposed decades ago.

ELG Law can help with your EtO non-Hodgkin lymphoma claim

Individuals who developed non-Hodgkin lymphoma following workplace EtO contact or while residing near a chemical-emitting facility may be entitled to compensation. The Environmental Litigation Group has handled toxic exposure cases for over 30 years. At our firm, we understand that EtO-related NHL claims require complicated scientific and medical evidence. Let us help you understand your legal options with a free consultation.