The EtO-Lymphoma Connection
Non-Hodgkin lymphoma (NHL) encompasses a group of cancers that originate in lymphocytes — the white blood cells of the immune system. Ethylene oxide's classification as a human carcinogen is based largely on its ability to alkylate DNA in lymphoid tissues. Epidemiological studies of EtO-exposed workers consistently show elevated rates of lymphoid malignancies, including NHL, Hodgkin lymphoma, lymphocytic leukemia, and multiple myeloma.
Epidemiological Evidence
The most comprehensive study of EtO and lymphoma — the NIOSH cohort study following over 18,000 EtO-exposed workers — found statistically significant increases in non-Hodgkin lymphoma mortality among heavily exposed workers. The association was dose-dependent: workers with higher cumulative EtO exposure had higher lymphoma rates. Community studies near major emitters have found similar patterns at lower exposure levels.
Proving Causation in Your Case
For a successful lymphoma claim, your legal team will need to demonstrate: (1) you lived or worked near an identified EtO-emitting facility; (2) your exposure was significant in duration and intensity; (3) you were diagnosed with a lymphoid cancer consistent with EtO causation; and (4) the facility's operators knew or should have known about the cancer risk. EPA emissions data, residential records, and expert epidemiological testimony are the cornerstones of these cases.
What to Do If You Have Lymphoma
If you have been diagnosed with non-Hodgkin lymphoma, Hodgkin lymphoma, lymphocytic leukemia, or multiple myeloma, and you lived or worked near an EtO facility, contact an attorney immediately. The statute of limitations for these claims typically begins running at the time of diagnosis, so timing is critical.
Records You May Need
Records Checklist
- Cancer diagnosis records and pathology reports
- Treatment records (chemotherapy, radiation, transplant)
- Residential history documentation (lease agreements, utility bills)
- Employment records if occupational exposure
- EPA facility emissions data for relevant time period
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
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.
Facility Worker Exposure Claims
Workers inside EtO sterilization and chemical manufacturing facilities face the highest exposure levels — often hundreds of times greater than community ambient levels — and have the strongest causation cases.
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