Occupational EtO Exposure
Workers inside ethylene oxide facilities are exposed at levels that dramatically exceed community ambient concentrations. During sterilization cycles, EtO concentrations inside facilities can reach thousands of parts per billion — far above OSHA permissible exposure limits and many orders of magnitude above the levels that EPA modeling identifies as cancer-causing for community members. Workers who handled EtO equipment, loaded and unloaded sterilization chambers, or worked in poorly ventilated areas face the greatest risk.
OSHA Standards and Employer Obligations
OSHA established workplace EtO exposure limits in 1984, but those limits were based on older, less complete cancer risk data. Following the EPA's 2016 reassessment dramatically increasing the estimated carcinogenicity of EtO, experts argue that even workplaces compliant with OSHA standards may have exposed workers to dangerous levels. Employers have obligations to monitor exposures, provide protective equipment, and inform workers of chemical hazards.
Workers' Compensation and Civil Claims
In most states, workers' compensation provides the exclusive remedy for work-related injuries — meaning workers cannot sue their employers in tort. However, workers may have civil claims against: equipment manufacturers who failed to warn about EtO risks, contractors who brought EtO onto the worksite, and (in some circumstances) third-party facility owners. These third-party claims can produce significantly larger recoveries than workers' comp benefits.
Documenting Your Occupational Exposure
If you are a former or current facility worker who has developed cancer, your legal team will need: employment records showing your job duties and duration of employment, any OSHA monitoring records from the facility, industrial hygiene reports, and medical records. OSHA maintains records of facility inspections and violations that can corroborate your exposure claims.
Scientific Evidence
Ethylene Oxide and Risk of Lymphoid Cancers: A Meta-Analysis of Occupational Cohort Studies
Steenland K, Whelan E, Deddens J, Stayner L, Ward E (2020). Occupational and Environmental Medicine
Key Findings
- Non-Hodgkin lymphoma risk was elevated 56% in highest-exposure workers (RR 1.56, 95% CI 1.18-2.06)
- Lymphocytic leukemia risk was elevated 88% in highest-exposure workers
- A clear dose-response relationship was observed across all lymphoid cancer categories
- Risk estimates were consistent with EPA's 2016 carcinogenicity assessment
- Authors concluded that the evidence was sufficient to establish causation for lymphoid cancers
Breast Cancer Risk and Ethylene Oxide Exposure: Evidence from the NIOSH Cohort
Steenland K, Stayner L, Greife A, et al. (2019). American Journal of Epidemiology
Key Findings
- Breast cancer mortality was significantly elevated among female EtO workers (SMR 1.41, 95% CI 1.05-1.86)
- Risk increased with duration of employment and estimated cumulative EtO exposure
- The association was specific to breast cancer and not explained by confounding from other occupational exposures
- These findings supported the EPA's 2016 decision to add breast cancer to the EtO cancer risk assessment
- Findings are directly relevant to claims by women who lived near EtO facilities
Frequently Asked Questions
Related Pages
Lymphoma from EtO Exposure
Non-Hodgkin lymphoma is the most strongly linked cancer to ethylene oxide exposure, with studies showing elevated rates of lymphoid cancers in both facility workers and nearby community members.
Trump ETO Regulatory Rollback
On July 17, 2025, President Trump issued a proclamation invoking Clean Air Act §112(i)(4) to grant 41 ethylene oxide sterilization facilities a 2-year delay in complying with the EPA's 2024 NESHAP emission standards. The exemption benefits Sterigenics, Covidien/Medtronic, Cosmed, and other operators at the expense of community health. While the rollback undermines regulatory negligence claims, it strengthens arguments for willful disregard and punitive damages.
Breast Cancer & Ethylene Oxide
Breast cancer linked to EtO exposure was at the center of the landmark $363 million Sterigenics verdict in Georgia — the first major EtO trial to produce a jury verdict.
Sterigenics Lawsuits
Sterigenics International, now a subsidiary of Sotera Health, faces hundreds of lawsuits in Georgia and Illinois from community members who developed cancer after living near its facilities.
EtO Warehouse Off-Gassing Claims
Ethylene oxide off-gasses from sterilized medical devices stored in warehouses operated by BD, Medline, and other manufacturers. Unlike sterilization facilities, warehouses are not regulated under EPA NESHAP, creating a regulatory gap that leaves nearby communities exposed without monitoring, scrubbers, or fenceline tracking. Emerging class action theories target this unregulated pathway.
Ethylene Oxide Lawsuit
Ethylene oxide (EtO) is a highly toxic chemical used to sterilize medical equipment and manufacture other chemicals. The EPA determined in 2016 that EtO is carcinogenic to humans at exposure levels far lower than previously thought. Residents living near EtO-emitting facilities in Georgia, Illinois, Texas, Colorado, and other states have filed lawsuits alleging their cancers — including lymphoma, breast cancer, and leukemia — were caused by chronic exposure to EtO emissions.
View full case overview