Fundamentally, the expectation is straightforward: no job should come with concealed health hazards, nor should a home sit in a path where it is susceptible to exposure to harmful airborne pollutants.
However, for countless employees and families in Texas, that expectation has quietly come under strain as they work or live near facilities that heavily rely on ethylene oxide (EtO).
Renowned for its tremendous volatility and powerful alkylating agent, this colorless and highly flammable gas has become integral in the sterilization of medical instruments, as well as in chemical manufacturing processes that support hospitals and broader supply chains since its first domestic production in 1925.
Yet what makes EtO’s pervasive presence especially unsettling is not only the scale of its use but also the growing scientific probe into long-term exposure risks. And across parts of Texas where substantial concentrations of such a compound are emitted, workers report for their shifts while nearby residents carry on with their everyday routines under perilous conditions they did not actively choose or deeply understand.
Over time, the gap between presumed safety and emerging evidence has become increasingly difficult to ignore—even raising urgent questions about what meaningful protection looks like.
Despite remaining largely invisible to the public, EtO continues to play a central role in myriad industrial and healthcare operations across the country. Consistent with this, just in 2015, five to ten billion pounds of this combustible compound were produced nationwide. And to this day, the majority—roughly 97%—is utilized to create other chemicals that are ultimately integrated into everyday consumer products.
Beyond its widespread commercial applications, EtO is indispensable in modern medicine, as about half of all medical equipment—around 20 billion items—is sterilized using this gas. This process eradicates harmful microorganisms while still preserving the integrity of delicate materials—thereby ensuring safety and efficacy in healthcare.
Nonetheless, the very characteristic that makes such a composition so effective is also what has drawn growing scrutiny from researchers and public health agencies. Because EtO is highly reactive, it can cause lasting biological damage that may eventually trigger the development of debilitating illnesses, most notably non-Hodgkin lymphoma and breast cancer. And as scientific understanding of these effects has advanced, concerns have correspondingly grown over the potential consequences for individuals who encounter the chemical not only in occupational settings but also in the communities surrounding facilities where it is processed, produced, or used.
Regrettably, these issues have raised an alarm in Texas, which sits at the center of the nation's EtO industry. In fact, a study shows that the Lone Star State alarmingly accounted for nearly half of all reported gas emissions nationwide—a concentration significant enough to prompt its Commission on Environmental Quality to conduct a carcinogenic assessment of the chemical.
Consequently, the conversation surrounding EtO in Texas has expanded beyond its industrial and medical value to include a more pressing question: what lasting perils may have been borne by workers and communities located closest to the affected zones. 'These concerns are far from hypothetical, as in Laredo, Webb County, air modeling at the Midwest Sterilization Corporation plant revealed cancer risks were alarmingly 100 times greater than what the Environmental Protection Agency (EPA) deems acceptable.
Similarly, in Willowbrook, Illinois, residents living near a Sterigenics facility faced a 64-fold spike in malignancy vulnerability—also surpassing federal safety benchmarks. Even more disturbing is that neither case involved facilities operating entirely outside established regulatory frameworks. 'Instead, the assessments raised difficult queries about whether existing safeguards adequately reflect the current scientific understanding of EtO and its health tolls.
Ultimately, the repercussions of EtO exposure in Texas go far beyond the confines of industrial facilities. Although workers are at the forefront of exposure, the impact on nearby residents—many of whom have lived in proximity to these emissions for years—cannot be overlooked. For these communities, the critical concern is not just whether facilities comply with current regulations but also whether those regulations truly account for the serious implications of long-term exposure. And as scientific understanding progresses, it becomes even clearer that the dangers faced by those living near EtO-emitting facilities are often underestimated and hidden from daily awareness.
That concern becomes even more critical when viewed alongside the regulatory framework governing such exposure. Notably, the primary workplace standard implemented by the Occupational Safety & Health Administration for EtO utilization dates back to 1984—raising broader questions about whether existing safeguards have kept pace with advances in scientific understanding as well as risk assessment.
Yet the challenge extends beyond occupational settings alone. The situation has become even more troubling following the recent removal of several federal web pages containing information about EtO’s health hazards, reducing the amount of readily accessible guidance to comprehend the crisis better. 'For nearby residents, protection depends not only on workplace rules—it also heavily depends on effective emissions controls, transparent reporting, reliable monitoring, and public access to information about potential environmental risks.
Without these measures, communities may be left with limited visibility into a hazard that can persist long after emissions leave a facility. The public and authorities must ponder that genuine protection goes beyond mere compliance with existing regulations—it demands assurance that the standards governing emissions as well as exposure are grounded in the latest scientific research and that those at greatest risk are fully informed at all times. After all, no worker should face the impossible choice between providing for their family and protecting their health. Equally important is the need for families to have peace of mind, knowing that years spent living near such facilities won’t lead to health repercussions that only emerge after decades.
Editor's Note: The above guest column was penned by Jordan Cade, an attorney at Environmental Litigation Group, P.C., a Birmingham, AL-based legal firm representing victims of toxic exposure.
