Integrative literature review: Ethylene oxide exposure signs and symptoms

Abstract

BackgroundAlthough ethylene oxide (EtO) gas is designated as a human carcinogen, extant literature reports mixed findings on the health effects of exposure. The disparate findings may reflect industry bias as many studies were funded by a large chemical industry lobby.ObjectiveTo conduct an integrative review of studies free from industry bias to facilitate compilation of a comprehensive list of reported signs and symptoms of EtO exposure.MethodsWe reviewed 1887 papers of which 42 articles met inclusion criteria. The authors conducted this review in accordance with PRISMA guidelines. The presence of bias was assessed using Joanna Briggs Institute checklists.ResultsNon‐industry biased literature confirmed serious adverse health effects associated with EtO exposure at the occupational, hospital, and community level. EtO represents a carcinogen, neurotoxin, and respiratory irritant.ConclusionAfter removal of industry‐biased studies, EtO was unequivocally found to pose a threat to human health. There remains a gap in the number of studies examining community‐level exposure, which is essential to understanding the impact of EtO. Given that EtO‐emitting facilities are concentrated in diverse and disadvantaged communities, further study of EtO exposure health effects is warranted to inform public policy on toxic air emissions.

The Cost of Industry Funding and Sponsorship

“…Many articles found no statistically significant findings of exposure effects while others found significantly increased rates of cancer, neurologic symptoms, and respiratory problems. 1 Upon further investigation, it was found that organizations with vested interests in the research outcomes, namely a well-funded lobby and individual chemical-producing companies, funded or sponsored all but one of the articles with no reported significant ill health effects. At the first read, the methods appeared sound.…”

Associations of ethylene oxide exposure with depression in American adults

“…Ethylene oxide (EO) is a toxic industrial chemical used in medical device sterilization, plastics and textile manufacturing, and other industrial applications 7 . It forms hemoglobin adducts of EO (HbEO) by binding with hemoglobin (Hb), which serves as a specificity indicator to assess ethylene oxide exposure 8 .…”

Positive association of ethylene oxide levels with young stroke: a population-based study

“…Previous studies on EtO have primarily focused on its carcinogenicity. Numerous investigations unequivocally established EtO’s carcinogenic properties ( O'Kelley et al, 2023 ), particularly its link to lympho-hematopoietic cancer and breast cancer ( Jinot et al, 2018 ; Marsh et al, 2019 ). As a result, the International Agency for Research on Cancer (IARC) classified EtO as a Group 1 human carcinogen ( Vincent et al, 2019 ).…”