{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:43:23Z","timestamp":1770741803346,"version":"3.49.0"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:00:00Z","timestamp":1610409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Given ubiquitous human exposure to ethylene oxide (EO), regardless of occupation or geography, the current risk-specific concentrations (RSCs: 0.0001\u20130.01 ppb) from the U.S. Environmental Protection Agency (EPA) cancer risk assessment for EO are not useful metrics for managing EO exposures to the general U.S. population. The magnitude of the RSCs for EO are so low, relative to typical endogenous equivalent metabolic concentrations (1.1\u20135.5 ppb) that contribute ~93% of total exposure, that the RSCs provide little utility in identifying excess environmental exposures that might increase cancer risk. EO monitoring data collected in the vicinity of eight EO-emitting facilities and corresponding background locations were used to characterize potential excess exogenous concentrations. Both 50th and 90th percentile exogenous exposure concentrations were combined with the 50th percentile endogenous exposure concentration for the nonsmoking population, and then compared to percentiles of total equivalent concentration for this population. No potential total exposure concentration for these local populations exceeded the normal total equivalent concentration 95th percentile, indicating that excess facility-related exposures are unlikely to require additional management to protect public health.<\/jats:p>","DOI":"10.3390\/ijerph18020607","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T14:28:53Z","timestamp":1610461733000},"page":"607","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Ethylene Oxide Exposure in U.S. Populations Residing Near Sterilization and Other Industrial Facilities: Context Based on Endogenous and Total Equivalent Concentration Exposures"],"prefix":"10.3390","volume":"18","author":[{"given":"Patrick J.","family":"Sheehan","sequence":"first","affiliation":[{"name":"Health Sciences, Exponent, Inc., Oakland, CA 94612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan C.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Health Sciences, Exponent, Inc., Oakland, CA 94612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher R.","family":"Kirman","sequence":"additional","affiliation":[{"name":"Summit Toxicology, Bozeman, MT 59722, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather N.","family":"Watson","sequence":"additional","affiliation":[{"name":"Data Sciences, Exponent, Inc., Menlo Park, CA 94025, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Winegar","sequence":"additional","affiliation":[{"name":"Health Sciences, Exponent, Inc., Oakland, CA 94612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S.","family":"Bus","sequence":"additional","affiliation":[{"name":"Health Sciences, Exponent, Inc., Alexandria, VA 22314, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"ref_1","unstructured":"U.S. Environmental Protection Agency (2016). Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide (CASRN 75-21-8) in Support of Summary Information on the Integrated Risk Information System, EPA\/635\/R-16\/350Fa."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.yrtph.2017.10.032","article-title":"Derivation of endogenous equivalent values to support risk assessment and risk management decisions for an endogenous carcinogen: Ethylene oxide","volume":"91","author":"Kirman","year":"2017","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10937404.2020.1852988","article-title":"Ethylene oxide review: Characterization of total exposure via endogenous and exogenous pathways and their implications to risk assessment and risk management","volume":"24","author":"Kirman","year":"2021","journal-title":"J. Toxicol. Environ. Health Part B Crit. Rev."},{"key":"ref_4","unstructured":"Centers for Disease Control and Prevention (2019, January 31). National Report on Human Exposure to Environmental Chemicals: Ethylene Oxide Hemoglobin Adducts, Available online: https:\/\/www.cdc.gov\/exposurereport\/index.html."},{"key":"ref_5","unstructured":"Agency for Toxic Substances and Disease Registry (2020). Toxicological Profile for Ethylene Oxide, Draft for Public Comment."},{"key":"ref_6","unstructured":"Texas Commission on Environmental Quality (2020). Ethylene Oxide Carcinogenic Dose-Response Assessment, Final Development Support Document."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Bogen, K.T., Sheehan, P.J., Valdez-Flores, C., and Li, A.A. (2019). Reevaluation of historical exposures to ethylene oxide among U.S. sterilization workers in the National Institute of Occupational Safety and Health (NIOSH) Study Cohort. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16101738"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/0003-2697(86)90524-5","article-title":"Monitoring of environmental cancer initiators through hemoglobin adducts by a modified Edman degradation method","volume":"154","author":"Mowrer","year":"1986","journal-title":"Anal. Biochem."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/0027-5107(91)90205-3","article-title":"Biological and chemical monitoring of occupational exposure to ethylene oxide","volume":"250","author":"Tates","year":"1991","journal-title":"Mutat. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1093\/carcin\/15.6.1271","article-title":"Transplacental exposure to genotoxins. Evaluation in haemoglobin of hydroxyethylvaline adduct levels in smoking and non-smoking mothers and their newborns","volume":"15","author":"Tavares","year":"1994","journal-title":"Carcinogenesis"},{"key":"ref_11","first-page":"449","article-title":"Monitoring human exposure to 2-hydroxyethylating carcinogens","volume":"104","author":"Farmer","year":"1996","journal-title":"Environ. Health Perspect."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1093\/mutage\/11.4.363","article-title":"Biomonitoring human exposure to environmental carcinogenic chemicals","volume":"11","author":"Farmer","year":"1996","journal-title":"Mutagenesis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s004200050312","article-title":"Ethylene oxide-protein adduct formation in humans: Influence of glutathione-S-transferase polymorphisms","volume":"71","author":"Angerer","year":"1998","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1006\/enrs.1998.3937","article-title":"Formation of N-(2-hydroxyethyl)valine due to exposure to ethylene oxide via tobacco smoke: A risk factor for onset of cancer","volume":"81","author":"Bono","year":"1999","journal-title":"Environ. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1080\/00039890209601430","article-title":"Tobacco smoke and formation of N-(2-hydroxyethyl)valine in human hemoglobin","volume":"57","author":"Bono","year":"2002","journal-title":"Arch. Environ. Health"},{"key":"ref_16","first-page":"705","article-title":"Hemoglobin adducts from acrylonitrile and ethylene oxide in cigarette smokers: Effects of glutathione S-transferase T1-null and M1-null genotypes","volume":"9","author":"Fennell","year":"2000","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.mrgentox.2003.12.011","article-title":"Formation of N-(2-hydroxyethyl)valine in human hemoglobin-effect of lifestyle factors","volume":"559","author":"Wu","year":"2004","journal-title":"Mutat. Res."},{"key":"ref_18","unstructured":"Sterigenics International (2019). Sterigenics Announces Plan to Exit Willowbrook Operations Following Approval from State and Illinois EPA to Implement Changes, Sterigenics International."},{"key":"ref_19","unstructured":"Michigan Department of Environment, Great Lakes, and Energy (2019). In the Matter of Administrative Proceedings against Viant Medical, Inc. Stipulation for Entry of Final Order by Consent."},{"key":"ref_20","unstructured":"Lake County Health Department and Community Health Center (2020, October 19). EtO Monitoring Results, Available online: https:\/\/www.lakecountyil.gov\/4188\/EtO-Monitoring-Results."},{"key":"ref_21","unstructured":"U.S. Environmental Protection Agency (2020, October 19). EPA in Illinois: Outdoor Air Monitoring Data in the Willowbrook Community, Available online: https:\/\/www.epa.gov\/il\/outdoor-air-monitoring-data-willowbrook-community."},{"key":"ref_22","unstructured":"Ramboll US Corporation (2019). Ambient Air Monitoring Report: Ethylene Oxide Background Concentrations in Chicago Metro Area, Sterigenics US, LLC."},{"key":"ref_23","unstructured":"Georgia Department of Natural Resources (2020, October 19). Cobb County Air Quality Monitoring Test Results, Available online: https:\/\/epd.georgia.gov\/cobb-county-air-quality-monitoring."},{"key":"ref_24","unstructured":"Georgia Department of Natural Resources (2020, October 19). Covington Air Quality Monitoring Test Results, Available online: https:\/\/epd.georgia.gov\/covington-monitoring-results."},{"key":"ref_25","unstructured":"Georgia Department of Natural Resources (2020, October 19). Fulton County Air Quality Monitoring Test Results, Available online: https:\/\/epd.georgia.gov\/fulton-county-monitoring-results."},{"key":"ref_26","unstructured":"Georgia Department of Natural Resources (2020, October 19). General Coffee State Park Air Quality Monitoring Test Results, Available online: https:\/\/epd.georgia.gov\/gneral-coffee-monitoring-results."},{"key":"ref_27","unstructured":"Georgia Department of Natural Resources (2020, October 19). South DeKalb Air Quality Monitoring Test Results, Available online: https:\/\/epd.georgia.gov\/south-dekalb-monitoring-results."},{"key":"ref_28","unstructured":"Michigan Department of Environment, Great Lakes, and Energy (2020, October 19). Viant Medical, Inc, Available online: https:\/\/www.michigan.gov\/egle\/0,9429,7-135-3310_70314_89277---,00.html."},{"key":"ref_29","unstructured":"Colorado Department of Public Health & Environment (2018). Ethylene Oxide\/Terumo BCT Air Sampling Study: Pre- and Post-Control Air Monitoring Report."},{"key":"ref_30","unstructured":"Battelle (2016). Technical Assistance Document for the National Air Toxics Trends Stations Program."},{"key":"ref_31","unstructured":"U.S. Environmental Protection Agency (2020, November 30). Ethylene Oxide Measurements by TO-15 Method, Available online: https:\/\/www3.epa.gov\/ttnamti1\/files\/ambient\/airtox\/EtO-Method-for-NATTS-labs-2019.pdf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1080\/00102207208952315","article-title":"Combustion of n-pentane in a shock tube","volume":"6","author":"Barnard","year":"1972","journal-title":"Combust. Sci. Technol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"20912","DOI":"10.1007\/s11356-020-08564-z","article-title":"Associations between observed concentrations of ethylene oxide in whole blood and smoking, exposure to environmental tobacco smoke, and cancers including breast cancer: Data for US children, adolescents, and adults","volume":"27","author":"Jain","year":"2020","journal-title":"Environ. Sci. Pollut. Res. Int."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/2\/607\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:10:14Z","timestamp":1760159414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/2\/607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,12]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,1]]}},"alternative-id":["ijerph18020607"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18020607","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,12]]}}}