Opinion: Ethylene oxide science has changed. OSHA should too

Every day, employees in sterilization plants, medical supply warehouses, and industrial facilities inhale a chemical that could quietly kill them. Ethylene oxide (EtO) is used to sterilize about 20 billion medical devices annually in the US, making it indispensable to health care. But its importance doesn’t diminish its health hazards. The growing body of scientific evidence connecting EtO exposure to chronic illnesses has not been met with updated federal protections. The US Occupational Safety and Health Administration (OSHA) standards have remained virtually unchanged since the 1980s, leaving workers vulnerable while regulators fail to act.Workers are legally subject to unhealthy amounts of EtO in daily operationsEtO’s value lies in its ability to sterilize heat- and steam-sensitive medical equipment. Its effectiveness, however, comes with health-altering consequences for those working with or near it. The Environmental Protection Agency classifies EtO as a known human carcinogen. Prolonged exposure, even at low concentration levels, can cause cell mutations, while short bursts of concentrated contact can trigger lung irritation, dizziness, and neurological issues. The Centers for Disease Control and Prevention (CDC) and the EPA have long recognized links between EtO exposure and cancers such as lymphoma, leukemia, multiple myeloma, and breast cancer. The consequences of federal inaction are already visible. A 2023 report by the National Library of Medicine revealed that employees who work at 31 of 654 EtO-emitting facilities in the US were suspected of having an estimated cancer risk greater than 100 in 1 million, which is beyond the risk level that the EPA generally considers acceptable. For