The truth about EtO (Ethylene Oxide)

Ethylene Oxide (EtO) is a colorless, odorless and flammable gas used as a sterilizing agent, disinfectant, and fumigant in various industries including healthcare. It is known to cause cancer to humans, especially when inhaled. In addition to being a highly toxic carcinogen, ethylene-oxide is also mutagenic, meaning it can damage DNA, and is known to cause birth defects and severe reproductive issues (1)

In 2016, the U.S. Environmental Protection Agency (EPA) reclassified EtO as a Level 1 carcinogen (causes cancer in humans). In Laredo,Texas, ethylene oxide is used by Midwest Sterilization Corporation to sterilize medical equipment. It is an effective tool in killing bacteria, viruses, and other microorganisms by infiltrating cells and damaging its DNA structure (2). However, after a comprehensive review of scientific studies, the EPA found that ethylene oxide is 60 times more toxic to children and 30 times more toxic to adults than previously estimated (3).

According to the National Cancer Institute, exposure to high levels of ethylene oxide can cause a range of health effects including

• Lymphoma
• Leukemia
• Stomach cancer
• Breast cancer

Short term exposure to ethylene oxide can cause (4):
• Respiratory irritation and lung injury
• Headache
• Nausea
• Vomiting
• Diarrhea
• Shortness of breath
• Cyanosis

In 2019, Midwest emitted more than 16,000 pounds of this toxin into the air, based on its self-reported data to the EPA, making Laredo the second leading EtO emitter in the country for that year.
Because EPA science shows that long-term exposure to high concentrations of EtO can increase the lifetime risk of getting cancer, the agency held an in-person public meeting in Laredo on September 15, 2022. (Watch here)

As a community being affected by this chemical, it is important for us to be aware of the dangers of ethylene oxide and take action. Midwest Sterilization has a responsibility to control their emissions and ensure the safety of the community and their employees. 
Laredo has the right to demand clean air and apply public pressure against Midwest Sterilization.
(1) “Our Current Understanding of the Human Health and Environmental Risks of Ethylene Oxide.” EPA, Environmental Protection Agency, 8 Dec. 2022, https://www.epa.gov/hazardous-air-pollutants-ethylene-oxide/our-current-understanding-human-health-and-environmental .

(2) “Ethylene Oxide - Cancer-Causing Substances.” Ethylene Oxide, National Cancer Institute, 5 Dec. 2022, https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/ethylene-oxide#:~:text=In%20smaller%20amounts%2C%20ethylene%20oxide,for%20its%20cancer%2Dcausing%20activity .

(3) “Frequent Questions about Ethylene Oxide (EtO).” EPA, Environmental Protection Agency, 13 Jan. 2023, https://www.epa.gov/hazardous-air-pollutants-ethylene-oxide/frequent-questions-about-ethylene-oxide-eto#2 .

(4) “Ethylene Oxide - Overview.” Ethylene Oxide - Overview | Occupational Safety and Health Administration, United States Department of Labor, https://www.osha.gov/ethylene-oxide#:~:text=EtO%20is%20both%20flammable%20and,shortness%20of%20breath%2C%20and%20cyanosis .

EtO & Children

It is important to be aware of the specific dangers ethylene oxide (EtO) poses to children in our community. According to the National Cancer Institute, long term exposure to high levels of EtO can cause a range of health effects including lymphoma, leukemia, stomach and breast cancer.

Because children’s bodies are constantly growing, they are more susceptible to the toxic effects caused by EtO. This is because EtO is largely mutagenic, meaning it can damage DNA. As children grow, they tend to be more susceptible to the harmful effects caused by chemicals, including chemicals that are mutagenic (1).

According to a study conducted in 2019 by the University of Massachusetts Amherst Political Economy Research Institute (PERI), 17 Laredo schools were amongst the top 1st percentile in the United States in terms of industrial air toxics pollution. Julia Bird Jones Muller Elementary School is at the top of that Laredo list.

Muller Elementary, is located less than 1.5 miles away from Midwest Sterilization Corporation and has an air toxic concentration 227.99 times the national average at schools. Ranking it amongst the top 20 schools in the United States with the worst air toxic concentrations.
(1) “Our Current Understanding of the Human Health and Environmental Risks of Ethylene Oxide.” EPA, Environmental Protection Agency, 8 Dec. 2022, https://www.epa.gov/hazardous-air-pollutants-ethylene-oxide/our-current-understanding-human-health-and-environmental .

(2) “Air Toxics at School Search Results.” Political Economy Research Institute, University of Massachusetts Amherst, https://www.grconnect.com/tox100/schoolry2019/index.php?search=yes&school_name=&city=Laredo&state=TX&state_sum=&page=1 .

EtO In Our Neighborhoods

In 2022, the Environmental Protection Agency (EPA) released a list of 23 sterilizer facilities across the United States that pose a lifetime cancer risk at or above 100-in-a-million, or 1-in-1,000—a level that the Environmental Protection Agency deems unacceptable; Midwest Sterilization Corp. located in Laredo is among that list.

This map shows EPA’s estimate of lifetime cancer risks from EtO near Midwest Sterilization Corporation in Laredo, TX based on self-reported emissions in 2022 (1).

The area in blue shows estimated lifetime cancer risks of 1 in 10,000 from breathing air containing EtO emitted from the facility. This means people that live around this area have a 1 in 10,000 chance risk of getting cancer due to this ONE facility.
The effects of EtO on our neighborhoods are significant and should not be ignored.
The coalition has made requests to Midwest Sterilization and the EPA to conduct air monitoring in our community. Both have denied our requests, leaving the financial burden of air monitoring to the coalition and our community. 
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