Ethylene Oxide

Properties

• Appearance & Smell: Colorless, flammable gas with a sweet, fruity odor.

• Solubility: Dissolves in water, alcohol, and most organic solvents.

• Half-life:

  • Air: 69-149 days.

  • Water: 12-14 days (decreases with increased salinity).

Uses

• Primary Use: Production of ethylene glycol (antifreeze).

• Sterilization & Fumigation: Used for medical devices (50% of all sterile medical devices), cosmetics, and food.

• Penetration Power: Can pass through packaging like cardboard, paper, and shrink wrap.

Sources

• Natural: Formed in the body during metabolism.

• Man-made: Released into air, water, and soil at production or use sites.

• Primary Route: Air emissions (>99%).

• Occupational Exposure: Factories, sterilization facilities, fumigation plants.

• Consumer Exposure: Tobacco smoke, sterilized hospital equipment, fumigated food.

Routes of Exposure

• Inhalation (Primary Route):

  • Occupational: Workers in manufacturing, sterilization, fumigation, hospitals, and farms.

  • Environmental: General population through ambient air or tobacco smoke.

• Dermal Exposure: Skin contact in occupational settings.

Populations at Risk

• Proximity to Facilities: People living near ethylene oxide-releasing sites.

• Children: Higher respiratory rate and immature detoxification pathways.

• Smokers: Seven times higher blood levels of ethylene oxide biomarkers.

Biological Fate

• Absorption: Rapidly taken up by lungs and bloodstream.

• Elimination:

  • Half-life: ~42 minutes.

  • 90% eliminated in ~2 hours.

  • Urinary excretion of metabolites within 48 hours.

Health Effects: Short term Exposure

• Neurological: Headache, dizziness, nausea, fatigue, memory loss.

• Respiratory: Coughing, wheezing, shortness of breath, bronchial constriction.

• Gastrointestinal: Vomiting, diarrhea, dry mouth.

• Ocular & Skin: Eye irritation, skin rashes.

• Fetal Risk: Animal studies show low birth weight, kidney abnormalities.

Health Effects: Chronic Exposure

• Non-Cancer Effects:

  • Eye, skin, and respiratory irritation.

  • Nervous system effects: Cognitive impairment, memory loss, numbness.

  • Hematological effects: DNA damage, changes in blood cell counts.

• Cancer Risks:

  • Increased risk of lymphohematopoietic cancers (non-Hodgkin lymphoma, leukemia, myeloma).

  • Increased breast cancer risk in females.

  • EPA, NTP, and IARC classify EtO as a human carcinogen.

Clinical Evaluation

• Diagnosis: Based on exposure history and symptoms.

• Laboratory Tests: CBC, liver/kidney function, chest radiography, pulse oximetry.

• Biomarkers: Hemoglobin adducts, DNA adducts, urinary metabolites

Treatment & Management

• No Antidote: Supportive care is the only option.

• Removal from Exposure: Essential for all cases.

• Decontamination: For skin/eye exposure.

• Symptom Monitoring: Chronic effects may worsen with continued exposure

Patient Counseling & Exposure Reduction

• Preventive Screenings: Regular cancer screenings recommended.

• Workplace Protection: Use of personal protective equipment (PPE).

• Environmental Controls: Improved ventilation, alternative sterilization methods.

• Pregnancy Risks: Possible risk of miscarriage; medical counseling advised.

• General Advice: Seek medical attention if respiratory or neurological symptoms develop.