For more than a year, medical device manufacturer Becton Dickinson has been working with government officials in Tucson, Arizona, to erect a plant that would sterilize products vital to the supply chain. But many residents in the local community don’t want it.
“I have very serious concerns,” Tucson resident Marcos Urrea said at a public hearing last November. “We don’t have a full understanding of the ramifications of the emissions and how severely this would impact the community,” said Urrea, who later waged a short-lived campaign as a Democrat for the U.S. House.
Facilities like the one proposed for Tucson have been under fire since the Environmental Protection Agency designated the chemical involved, ethylene oxide, as a human carcinogen in 2016. Emissions from these sites have been found to leak into the air of nearby communities. And studies have linked long-term exposure to the colorless gas to cancer.
The situation puts the healthcare system in a quandary. Without ready access to medical devices and supplies, patients would go without needed treatments. But the chemical that ensures those products are safe to use can sicken others.
State and federal regulators have slowly been developing policies to reduce ethylene oxide emissions but are caught in the middle of two public health priorities. Health systems have taken some steps to limit use of the chemical but remain beholden to the companies that manufacture and sterilize the supplies they need.
Companies that sterilize medical products say their operations only emit trace amounts of ethylene oxide, also known as EtO, into the air and fear further regulation will hamstring a supply chain that was volatile even before the COVID-19 pandemic. Environmental scientists say alternative means exist to sterilize medical equipment, but reconfiguring plants and processes would require time and investment.
In the coming months, the EPA plans to strengthen protocols for manufacturers that emit ethylene oxide. It would be the agency’s first action on the issue since 2006. But according to industry watchers, little except an outright ban on EtO emissions could make a difference.
“When you’re talking about the safe use of a known human carcinogen, in general, government consensus and government agencies believe in reduction to zero, because we don’t think there’s any safe level of known carcinogen exposure to people,” said Dr. Peter Orris, professor and chief of Occupational and Environmental Medicine at University of Illinois Health.