Ethylene Oxide, Hazardous and Toxic Materials Emissions Under Increased Scrutiny

Birth Defects

Across the U.S., facilities that sterilize medical equipment are increasingly under scrutiny for releasing hazardous and toxic materials, including a harmful gas known as ethylene oxide (EO). The U.S. Food and Drug Administration estimates that roughly half of all medical devices in the U.S. are sterilized with EO.

In El Paso, Texas, residents living near a large warehouse operated by Cardinal Health have raised alarms about potential exposure to hazardous substances, including EO. Community members report a range of health issues—including recurring headaches, dizziness and breast cancer—that they believe may be linked to emissions from the facility. While regulatory agencies continue to evaluate exposure levels, residents say the risks they face exceed what they were ever warned about.

Hidden Risks of Industrial Sterilization Facilities

Ethylene oxide is widely used to sterilize heat-sensitive medical equipment because it can penetrate packaging and eliminate bacteria without damaging delicate devices. At the same time, EO is classified by federal regulators as a known human carcinogen. Long-term exposure has been linked to cancers, reproductive harm and other serious health effects.

Studies analyzing emissions near sterilization and storage facilities have raised concerns about the cumulative risks to surrounding neighborhoods. One analysis of EO emissions associated with the El Paso warehouse found that a large majority of the city’s population faces elevated lifetime cancer risk levels—well above benchmarks commonly used by environmental regulators to assess acceptable risk. Residents living closest to the facility were found to face the highest exposure levels.

Local Effects of Hazardous and Toxic Materials

Some families living near industrial sterilization facilities report respiratory issues, chronic headaches and other symptoms that emerged only after moving into the area. In one household near the El Paso warehouse, a parent reported that her daughter developed persistent sinus headaches and her son began using an inhaler for respiratory problems—conditions the family had not experienced previously.

Researchers emphasize that health effects associated with long-term, low-level exposure to hazardous substances like EO often do not present as a single, obvious symptom. Instead, exposure may contribute to a range of health problems that accumulate over time, making it difficult for individuals to immediately connect their symptoms to environmental causes.

Legal Accountability for Ethylene Oxide Exposure

Communities affected by EO emissions are increasingly turning to the legal system for answers and accountability. In 2022, a jury awarded $283 million to residents of Willowbrook, Illinois, who alleged they were exposed to EO emissions from a nearby sterilization facility operated by Sterigenics.

More recently, in May 2025, a Georgia jury awarded $20 million in compensatory damages to a truck driver who developed non-Hodgkin’s lymphoma after exposure to EO from a sterilization facility in Covington operated by C.R. Bard, now part of Becton, Dickinson and Company.

These cases reflect a growing recognition by courts that the risks posed by hazardous substances are neither isolated nor insignificant. They can affect not only workers inside industrial facilities, but also families living in surrounding communities.

EO isn’t the only toxic chemical that is affecting public health. Other examples of toxic substances include PFAS, phthalates, benzene and formaldehyde.

What Is Ethylene Oxide?

Ethylene oxide (EO) is a colorless, odorless gas widely used to sterilize medical equipment that cannot withstand high heat or moisture.

• Why it’s used: EO effectively kills bacteria and pathogens while preserving delicate medical devices.
• Health risks: Federal agencies classify EO as a known human carcinogen. Long-term exposure has been linked to cancers, reproductive harm and developmental effects.
• How exposure occurs: EO can be released into the air during sterilization processes or from stored, sterilized equipment, potentially affecting workers and nearby residents.
• Regulatory oversight: EO emissions are regulated by federal and state agencies, but recent studies and lawsuits have raised questions about whether existing standards adequately protect public health.

How Can Households Protect Themselves?

Residents living near sterilization or chemical storage facilities can take steps to protect themselves from hazardous and toxic materials by seeking information about emissions, engaging with local regulators and working collectively with neighbors to raise concerns. Legal action has also played a critical role in uncovering internal documents, emissions data involving hazardous substances and safety practices that may otherwise remain hidden.

When hazardous substances put public health at risk, the legal system can serve as an important tool for accountability—and for driving safer practices that protect both workers and surrounding communities.

If you live near such a facility, or are planning to move to an area where there is a medical sterilization facility, recognize that the warehouse next door may be a source of toxic exposure. Work with your neighbors to ensure that you are safe from these other toxic substances.