Ethylene Oxide Exposure and Health Implications
Summary
Ethylene oxide (EtO) is a reactive organic compound widely employed as a sterilant in medical and food industries and as an intermediate in chemical manufacturing. Its high volatility and reactivity facilitate both occupational and environmental exposures, primarily via inhalation and dermal contact. Classified as a human carcinogen, EtO induces DNA alkylation and adduct formation, underpinning its genotoxic potential. Chronic low-level exposure has been linked to elevated risks of breast, lymphohaematopoietic and haematological malignancies, while emerging evidence implicates vascular and metabolic perturbations at background concentrations. Biomonitoring of haemoglobin adducts and precise ambient air measurements inform dose–response relationships and regulatory guideline development. Interdisciplinary research, spanning mechanistic assays, long-term cohort studies of sterilisation workers and community assessments near emission sources, underscores the global significance of EtO. Advances in analytical methods and epidemiological approaches continue to refine exposure thresholds, support risk assessment and guide the implementation of effective control strategies to safeguard public health.
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Ethylene Oxide Exposure and Health Implications publication trend
The graph below shows the total number of articles in ethylene oxide exposure and health implications across all publications each year (not limited to Nature Index journals).
Technical terms
Haemoglobin adduct N-2-hydroxyethyl-valine (HbEO): A stable adduct formed by the reaction of EtO with haemoglobin, serving as a biomarker of internal exposure.
Cavity ringdown spectroscopy (CRDS): A laser-based optical technique for quantifying trace gas concentrations by measuring the decay rate of light within an optical cavity.
Carcinogen: An agent capable of inducing cancer through genetic mutations or epigenetic alterations.
Biomarker: A measurable indicator of exposure, biological effect or susceptibility in an organism.
Dose–response relationship: The correlation between the magnitude of exposure to a substance and the frequency or severity of a specific health outcome.
References
- Exposure to Ethylene Oxide and Relative Rates of Female Breast Cancer Mortality: 62 Years of Follow-Up in a Large US Occupational Cohort. Environmental Health Perspectives (2025).
- Suitability of new and existing ambient ethylene oxide measurement techniques for cancer inhalation risk assessment. Environmental Pollution (2023).
- Positive association of ethylene oxide levels with young stroke: a population-based study. Frontiers in Aging Neuroscience (2024).
- Positive association between blood ethylene oxide levels and metabolic syndrome: NHANES 2013-2020. Frontiers in Endocrinology (2024).
- Ethylene Oxide Exposure Attribution and Emissions Quantification Based on Ambient Air Measurements near a Sterilization Facility. International Journal of Environmental Research and Public Health (2019).
- Cancer Incidence and Mortality in Swedish Sterilant Workers Exposed to Ethylene Oxide: Updated Cohort Study Findings 1972–2006. International Journal of Environmental Research and Public Health (2011).
- Genotoxicity as a toxicologically relevant endpoint to inform risk assessment: A case study with ethylene oxide. Environmental and Molecular Mutagenesis (2020).
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