Cancer
Community Cancer Incidence Evaluations Near Ethylene Oxide Sterilization Facilities Hannah Mazzotta* Hannah Mazzotta Tony Cappello Alex Riordan
Introduction: Ethylene oxide (EtO) is a highly reactive alkylating agent and gas used as a sterilizing agent in medical equipment and food, among other uses. Exposure to EtO has been associated with lymphoma, leukemia, stomach, and breast cancers, and recent literature has indicated that EtO emissions from commercial sterilization facilities could contribute to elevated cancer risks in nearby communities. However, much research to date has been focused on calculated risks with little to no information available on actual EtO-related cancer incidence rates experienced by residents living near sterilization facilities. Methods: A literature search was conducted to identify state or local health department reports that assessed EtO-related cancer incidence in locations near sterilization facilities. Reports which only assessed EtO exposure or were not located near sterilization facilities were excluded. Eight state health department cancer assessment reports across five states published between 2018 and 2023 were selected and assessed by location, years evaluated, cancer type, latency period, and standardized incidence ratios (SIRs). Results/Conclusion: The number of calculated SIRs assessed in each report ranged from 10 to 52. The proportion of statistically significant SIRs per each report was calculated to provide a means of comparison between locations, ranging from 0% to 13.3% for each report with an average of 8.3% [10 out of 120 total reported SIRs] across all reports. As such, communities living near sterilization facilities were largely found not to have experienced significantly increased EtO-related cancers relative to their respective regional or state data. These results are consistent with the available peer-reviewed environmental EtO exposure literature, which have generally reported non-significant to weak associations between environmental EtO exposure and cancer rates in their assessed spatial regions. While these community reports represent a small sample size and did not attempt to control for confounding variables such as SES or occupation, they remain a valuable tool for assessing the burden of EtO-related cancer in communities surrounding sterilization facilities until further data can be collected.