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Ethylene Oxide’s Catch 22: Finding A Good Balance For A Live-Saving But Carcinogenic Gas.

The Quick-Changing US EPA Regulations Are Sparking Debates Over The Use of Ethylene Oxide.


By Richard Xu

Surgical tools typically used in a medical operating room. With tightening EPA regulations on Ethylene Oxide, the medical equipment that surgeons use may face a shortage. Image Source


What is Ethylene Oxide and why has it been the highlight of air quality scrutiny as of late? Ethylene Oxide, or EtO, is a colorless, sweet-smelling gas that is used to make a wide range of products, i.e. antifreeze, textiles, plastics, detergents and adhesives. However, the usage of EtO that has most recently come under fire is its presence in commercial sterilizer centers (CSC): large medical sterilization facilities that use the gas to cleanse medical equipment that cannot be made sterile otherwise.



The harmful threshold for EtO exposure was previously set at the parts-per-million (ppm) level. However, the recent proposed guideline changes to the parts-per-trillion (ppt) level levies a steep challenge for the medical commercial sterilizers sector to adjust to. CSC’s complain that the new guidelines would reduce their capacity to sterilize equipment and thus accentuate the resulting medical supplies shortage.


Although there are calls for the medical industry to find sterilization alternatives to EtO, many in the field assert that it is the only “gentle” sterilization method available for many medical devices because of the risk of damage to components that alternative solutions can cause. One solution could be to continue to sterilize via Ethylene Oxide for the equipment that needs it, but turn to other forms of sterilization for items that do not. Another solution seeing use is installing powerful purifying air scrubbers that remove residual EtO emissions from the internal CSC environment before this air leaves the facility and is released into the open atmosphere.


On the opposing side of this dilemma are the surrounding community members who live in a close proximity to the CSCs, some of them for most of their lives, are gaining awareness and having growing concerns about the risks that they’ve been helplessly and extensively exposed to. Unfortunately, these communities are by-and-large socio-economically disadvantaged and do not possess the financial means to move out or combat mega-corporations. These directly affected communities are generally referred to as “Environmental Justice” communities, or EJ communities, for short. There’s a sad irony in saving certain lives at the possible pain and suffering of others.


Using storymaps.com, users can see whether their place of residence might lie in proximity to these EtO-leaking CSCs. In fact, our own Nikira Labs’s facility, located in Mountain View (CA), is located near one.


Using storymaps.com we are able to see that our Mountain View location is within 3 miles (indicated by the orange area) of a Commercial Sterilizer.


This interactive website offers users the name and location of displayed commercial sterilizers and lists insightful statistics on the affected peoples. For example, at this specific sterilizer located at the NASA-Ames Research Center, there are roughly 298,014 people who live within a five-mile radius of it; of these, approximately 61.4% are people of color, 12.3% are low income, and 5.0% have limited English language proficiency. Besides, there are approximately 279 schools and childcare centers located in this area.


Current perimeter, or fenceline, monitoring methods of regulated chemicals require air sample collection in small passive tubes or canisters over a 2-week period. These air sample collection devices are then replaced with fresh ones and sent to a central lab for analysis and data collection. However, can this method truly offer EJ communities desperately needed peace of mind? The indisputable fact is that high emissions can, and will, occur within these 2 weeks without any realtime awareness. These high and harmful emissions will only be recognized after the lab analysis is completed, dubbing air sample tube collection as a retroactive approach. Here at Nikira Labs, we have developed a life-saving proactive approach to monitor Ethylene Oxide in real-time. The recently developed EtO analyzer continuously measures the ambient air, in-situ, at the fenceline of a commercial sterilizer with 24/7 real-time data insight. With the Nikira Labs technology, communities and companies can be continuously reassured that Ethylene Oxide emissions are meeting regulatory safety thresholds and can take immediate corrective actions when they are not. This way the exposure to EtO and its ensuing cancer risk are significantly reduced and environmental justice is upheld.

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