According to OSHA (Occupational Safety and Health Administration), Ethylene Oxide (ETO) is a human-made, highly toxic, colorless, flammable gas that, at room temperature, produces a sweet odor.
Ethylene Oxide gases are hazardous substances utilized in the production of ethylene glycol used in numerous products, including pharmaceuticals, polyurethane foam, adhesives, detergents, textiles, anti-freeze, and solvents.
Even minimal exposure to highly toxic Ethylene Oxide gas can create an increased risk of adverse health effects, including blurred vision, difficulty with breathing, breast cancer, and nervous system conditions.
The medical industry uses ETO-derived ethylene glycol manufactured in commercial sterilization facilities to sterilize medical equipment, medical devices, surgical instruments, and other medical products.
Unfortunately, the ethylene oxide sterilization process, storage, transfer, and handling can cause a toxic workplace if the employee is injured through skin contact or air pollution with both ethylene glycol and ETO.
ETO – A Known Carcinogenic
The United States International Agency for Research on Cancer (IARC) classifies the harmful chemical ETO as carcinogenic. Recent evidence by the EPA revealed that Ethylene Oxide exposure through inhalation could elevate the potential risk of developing lymphohematopoietic cancers like lymphocytic leukemia, myeloma, and non-Hodgkin lymphoma.
To ensure safety, state regulators require employers to take numerous actions to ensure occupational safety when chemical plant employees are exposed to permissible levels of ETO and other hazardous chemicals.
To minimize occupational exposure, state officials and the federal government control measures of chemical exposure should include:
- Limit each worker’s exposure to hazardous chemicals.
- Develop and follow essential work practices that limit employee exposure to ETO and ethylene glycol.
- Implement an established compliance program effective at reducing occupational exposure or ethylene glycol and oxide levels.
- Monitor chemical plant workplace air environments to identify hazardous air pollution and provide training and information to employees on ethylene glycol and ethylene oxide exposure.
- Use effective air testing control measures to regulate areas with higher airborne concentrations of ETO that could likely exceed regulated eight-hour exposure limitations and elevate health risks.
- Maintain a medical surveillance program in areas known to have high levels of Ethylene Oxide and ethylene glycol concentrations to minimize adverse health effects.
- Ensure that every vessel containing higher concentrations of hazardous chemicals that might expose humans to ETO contains a warning label to minimize unnecessary release ethylene oxide.
- Never rotate employee interaction with the harmful chemical as a means of compliance of limiting exposure.
- Ensure that every employee is utilizing a respirator to control exposure to toxic gas and minimize health risks associated with air pollution.
- Allow every worker affected by the gas to observe the air testing monitoring process, including those who received medical care.
- Notify any worker affected by ETO of the harmful chemical air testing monitoring results no more than fifteen working days after the company receives the results.
Employers with workers exposed to Ethylene Oxide in the workplace environment must provide the workers with eye protection, personal protective equipment, and respiratory protection to decrease adverse health effects caused by air pollution and disease control.
OSHA and state regulators mandate that eye protection must be non-vented and formed with impact-resistant materials to protect the worker against vapors, gases, and fumes.
In addition to eye protection, the worker should wear a face shield when in proximity to toxic, highly irritating, or corrosive substances.
The respirator should fit the worker’s face properly to ensure it does not allow the inhalation of poisonous gas. to maximize an environmental quality workplace, personal protective equipment (PPE) should also include proper clothing and gloves fabricated from non-permeable or non-degrading materials.
Proper ETO Handling Procedures Are Necessary
The Food and Drug Administration states that every worker should be trained on the use of ethylene oxide and how to handle and store liquid and gas Ethylene Oxide properly to eliminate dangerous accidents. The chemical must be transferred and stored in metal containers that are grounded and bonded to reduce the possibility of a catastrophic explosion.
A periodic report from the Environmental Protection Agency states that to maintain the safety of public health and reduce adverse health effects, human exposure to Ethylene Oxide should be “limited to one part per million parts of air measured as an eight-hour time-weighted average.”
The highly reactive and explosive chemical can cause damage when ingested or inhaled. Humans living or working near industrial companies producing or using the gas could be exposed to industrial emissions.
Acute (Short-Term) ETO Exposure Affects
Animal studies show that short-term inhalation of elevated concentrations of Ethylene Oxide can cause severe respiratory irritation that leads to wheezing, shortness of breath, and coughing.
Laboratory animal research reveals that individuals will experience fatigue, nausea, dizziness, cyanosis (skin discoloration due to inadequate oxygen levels or poor blood circulation), headaches, or vomiting caused by gastrointestinal distress.
A National Air Toxics Assessment report on national emission standards states that when Ethylene Oxide is inhaled or consumed, the absorbed gas is widely distributed in the human body. Damage to the body can lead to one or more of the clinical effects listed below. These include:
- Ingested ETO Exposure – Health care providers know that consuming the liquid form of the gas can cause vomiting or other gastrointestinal distress.
- Inhaled ETO Exposure – Inhaled exposure to releases of airborne toxins of Ethylene Oxide as a vapor or gas could lead to pulmonary edema and other pulmonary irritations. The victim might have notable signs and symptoms, including lethargy, headaches, seizures, dizziness, and syncope (temporary loss of consciousness, including fainting). Delayed symptoms associated with inhaled exposure could increase cancer risks and involve generalized weakness, fatigue, and ataxia (impaired coordination or loss of balance caused by muscle, nerve, or brain damage).
- Skin Exposure to ETO – Skin contact with toxic ethylene oxide causes numerous dermatological problems. Direct contact with the chemical on the skin might form:
- Thermal burns,
- Vesical blistering (vesiculation),
- Serous fluid blistering (bleb),
- Erythema (reddened skin), or
- Skin peeling (desquamation).
- ETO Eye Exposure – A Splashing of liquid Ethylene Oxide can cause injury to the victim’s cornea. Workers should not wear contact lenses while in the presence of the toxic ETO gas due to hazardous air pollution.
Chronic (Long-Term) Exposure Affects
The National Air Toxics Assessment report reveals that short-term ETO exposure can cause dramatic adverse effects on the body. Additionally, long-term exposure can create chronic, dangerous situations to public health, including neurological impairments, non-Hodgkin lymphoma, and breast cancer.
Both the liquid and gas forms of ETO exposure can impair motor and sensory functions that lead to severe life-threatening human health conditions, including muscular atrophy.
Additionally, carcinogenicity (a substance producing carcinogen), reproductive toxicity, and mutagenicity (chemically induced genetic mutations, including DNA alterations) are known to occur from long-term exposure to the highly toxic chemical.
U.S. EPA Classifies Ethylene Oxide As a Carcinogen
In December 2016, the U.S. Environmental Protection Agency (EPA) classified ethylene oxide gas as a human carcinogen. Comprehensive health effects studies revealed a direct link to cancers and long-term exposure to ethylene oxide emissions. Ethylene glycol and ETO compounds are known to increase the risk of cancer development because it affects the immune system’s infection-fighting cells (white blood cells).
The development of leukemia and lymphoma is thought to be associated with long-term exposure to the highly toxic chemical in the work environment. Additionally, exposure to Ethylene Oxide may also be associated with liver, lung, kidney, stomach, and breast cancers.
Children experiencing the effects of chronic exposure to Ethylene Oxide can be significantly more severe than the damage caused to adults due to its human carcinogen properties. Children are at greater risk due to the potential for the more extended latency period to ETO.
Eliminated Quickly from the Body
While the chemical leaves the body relatively quickly, dropping by about 50% every forty minutes or so, it can cause lifelong injury. The Agency for Toxic Substances for Disease Registry (ATSDR) states that doctors can measure the levels of Ethylene Oxide in the bloodstream through two methods.
However, the testing methods are designed for more long-term exposure at higher concentrated levels compared to lower levels of Ethylene Oxide.
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