A few years ago, billboards in suburban Chicago called out to “Stop Sterigenics” as part of a grassroots campaign to close the company’s medical sterilization plant in the area.
Residents of and around Willowbrook, Ill., claimed they had been hit with an abnormal number of cancer cases. They tied those diagnoses to Sterigenics, which for decades used a toxic gas called ethylene oxide to clean medical devices found in hospitals around the country.
Last week, that call was heeded, despite permission from state regulators to reopen the plant after the Illinois Environmental Protection Agency shut it down in February. Sterigenics’ new permit required stricter emissions standards, and company officials said they finally gave up because the Chicago area had become an “unstable legislative and regulatory landscape.”
In the years since the public made its voice clear on ethylene oxide, there’s been fierce debate weighing the public health benefits of maintaining sanitary medical products vs. the potential health risks of using a gas the U.S. Environmental Protection Agency has labeled a human carcinogen.
Studies show that workers exposed to ethylene oxide are more susceptible to some forms of cancer like leukemia, lymphoma and breast cancer. At a minimum, in these studies, employees handling the gas felt lightheaded and showed signs of other neurological symptoms. Two years after calling attention to the compound’s potential danger, the EPA flagged 109 census areas as having higher cancer risks, mostly due to ethylene oxide.
Earlier this year, the agency challenged the healthcare industry to come up with alternatives to ethylene oxide. And because dirty medical devices cause thousands of deaths every year and cost hospitals millions if they are found to be responsible, providers must play a big role in coming up with solutions.
There already are other methods, such as hydrogen peroxide, nitrogen dioxide and steam, to sterilize medical devices. But in some cases they aren’t as effective.
Ethylene oxide doesn’t require high temperatures to kill germs, so it works on items that could melt or change composition under heat. Vascular catheters are one example of a product that can only be cleaned using electron beam or X-ray radiation or ethylene oxide.
Sterilization companies also want alternatives that can clean supplies in bulk, like ethylene oxide can. And both those companies and the hospitals and physicians they serve should be concerned about the potential red tape and high costs they’ll face for any new methods to meet federal sterilization standards.
The American Medical Association’s board of trustees this year issued a resolution urging its members to find alternatives to ethylene oxide sterilization. It also called on providers to choose medical devices that are safe for the environment.
Some Illinois residents pulled out all of the stops to shut down Sterigenics. Village officials and community activists threatened to use eminent domain to seize the land on which the plant sits. The state attorney general sued on behalf of residents. Members of both parties from the Illinois House and Senate are still threatening to ban the use of ethylene oxide in the state—which would greatly impact a Medline Industries facility located in Waukegan.
However the demands they make are what companies like Sterigenics and Medline might have to do anyway.
Sterigenics said it would simply move its operations to other facilities (it has 19 around the globe). And because ethylene oxide gas sterilizes more than half of the nation’s medical supplies—from surgical instruments to catheters and pacemakers to mesh, gauze and bandages—it’s unlikely to lose much business.
Officials at Northwell Health, which late last year opened a medical device sterilization plant in an industrial part of Bethpage, N.Y., said it is entirely moving away from ethylene oxide, calling it an aging method of sterilization that is too expensive, difficult to maintain and comes with a lot of risks.
To the others still considering their options, I say “don’t wait.”