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EPA warns of potential cancer risk

A map created by the U.S. Environmental Protection Agency showing the potential increased cancer risk from ethylene oxide emissions in Jackson. Submitted photo

Jackson citizens could be at an increased risk for certain cancers due to the use of the chemical ethylene oxide (EtO) for commercial sterilization, according to a new study by the United States Environmental Protection Agency.

EtO is a colorless and odorless flammable gas used in commercial sterilization and to create several products such as antifreeze and some types of plastic bottles. In recent years, breathing in EtO was discovered to cause breast cancer and lymph cancer.

Midwest Sterilization, located at 1204 Lenco Ave. in Jackson, has used EtO in its process to sterilize medical equipment such as surgical procedure trays since it opened in Jackson in 1999.

“Ethylene oxide can cause health risks, but it’s also a very important chemical to ensure the safety of a wide variety of medical devices used by doctors, dentists and hospitals – so it is also very important for those uses,” EPA Region 7 Air and Radiation Division Director Dana Skelley said.

EPA representatives held two public meetings on Sept. 27 at the Jackson Civic Center to inform Jackson citizens about the most recent risk assessment study, which found that those who lived closest to Midwest Sterilization potentially had an increased cancer risk of 20 in 10,000 people over the course of their lifetime.

The assessment, which is in addition to cancer risks from other causes, estimates the risk if EtO is breathed in 24 hours a day, seven days a week, over the course of a lifetime of 70 years.

“It isn’t likely that someone would spend 100% of their time for 70 years breathing in EtO,” EPA’s Bethany Olson said. “The bottom line is that this assessment is intentionally conservative in order to protect the most sensitive individuals.”

Jeff Wenzel from the Missouri Bureau of Environmental Epidemiology said the state looked into the possible cancer effects in the 63755 zip code, and found the cancer counts to be slightly less than what they would have expected.

Looking at 11 types of cancer since 1999, 2,269 cases of cancer were found compared to the estimated 2,450 cases expected.

Wenzel pointed out the total number of breast cancer cases found was 349 compared to an expected 385 cases, while the number of Hodgkin’s lymphoma cases were 21 compared to an expected count of 13.

Wenzel added that the state could only look into the 63755 zip code, not just the area around Midwest Sterilization that could be at risk.

Olson said risk should be viewed by how close people are from the facility, how long they have lived near the facility and how many hours in the day they spend near the facility. In addition, children and babies may be at higher risk and workers may be exposed at higher levels.

“We do not believe that there are short term risks from this chemical in your community, so that’s an important point,” Olson said. “The science that we’ve done has found only long-term risks over a lifetime of exposure.”

In addition, the EPA has found no indication of any water or ground pollution from the Midwest Sterilization facility in Jackson.

In 2016, EtO was determined to be more dangerous when breathed in, and the EPA learned that EtO might be causing risk near facilities that emit EtO in 2018. At that time, the EPA started working with companies like Midwest Sterilization to reduce EtO emissions.

At that time, Midwest Sterilization voluntarily installedadditional controls to limit the EtO released into the air and participated in a study to provide the EPA more information about EtO emissions.

EPA representatives visited Jackson in 2019 to hold public meetings and speak to the city council about the EtO emissions, saying the work Midwest did led to a decrease in the controlled EtO emissions into the air by 87%.

EPA Region 7 Air Permitting and Compliance Branch Chief Amy Algoe-Eakin said the information provided by Midwest Sterilization and other commercial sterilizers nationwide over the past two years found that the major pollution issue was not the EtO released after being used and cleaned, but with EtO that escaped the facility through leaks, gaps, doors and windows – otherwise known as “fugitive” emissions.

“That was when fugitive emissions were determined to be more significant and that’s why that risk map looks different than previous analyses that had been done since 2018,” Algoe-Eakin said.

In addition to working with state environmental agencies and sterilization companies, the EPA is currently working on new regulations for commercial sterilizers that will limit how much EtO commercial sterilizers can release into the air, as well as how the chemical can be used within facilities.

The EPA representatives stated they believe Midwest Sterilization is in compliance with all current federal and state regulation, but new national air pollution regulations are expected to be proposed this year.

“The original regulation limiting the ethylene oxide from Midwest Sterilization was put in place at a time when we didn’t yet understand how toxic ethylene oxide is and how it creates that risk in communities,” Skelley said. “We learned a lot about that in recent years, and we’re planning now the next step to put that knowledge into use as we develop a new regulation.”

Once the new regulation is final, which is expected sometime next year, facilities typically have three years to comply with new requirements.

More information about the use of EtO in Jackson and how to be involved in the new regulation commenting process can be found at

Jay Forness covers education, county government and community events for The Cash-Book Journal. He graduated from Southeast Missouri State University with a degree in multimedia journalism and has lived in Jackson for the past five years. He can be reached at

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