This decision exempts facilities like Sterigenics and Becton Dickinson from a 2024 EPA rule, citing the critical need for EtO-sterilized medical equipment and the lack of commercially viable emission reduction technology.
In a move that has ignited debate among public health advocates and industry leaders, President Donald Trump last week issued an executive order that effectively reverses stricter Environmental Protection Agency (EPA) standards designed to limit the release of ethylene oxide (EtO) from medical equipment sterilization facilities. The decision grants exemptions to key plants, including those in metro Atlanta that have been at the heart of contentious lawsuits regarding EtO emissions and associated health risks.
The executive order specifically targets a rule issued by the EPA under former President Joe Biden in 2024, which aimed to significantly reduce EtO emissions. Ethylene oxide is a gas crucial for sterilizing a vast array of medical devices, from surgical instruments to catheters. However, it is also classified as a carcinogen, with the National Cancer Institute linking occupational exposure to lymphoma and leukemia, and potentially stomach and breast cancers.
For residents in metro Atlanta, the rollback of these regulations reopens a sensitive wound. Facilities such as the Sterigenics plant in Cobb County and the Becton Dickinson (BD) sites in Covington and Madison have faced numerous lawsuits from local residents who claim that exposure to ethylene oxide (EtO) emissions led to their cancer diagnoses. In October 2023, Sterigenics agreed to a \$35 million settlement resolving nearly 80 of these cases. More recently, a jury awarded \$20 million to a 75-year-old Covington man in his lawsuit against BD.
Under an executive order issued by President Trump, the Sterigenics facility near Smyrna, along with BD’s plants in Covington and Madison, have been granted a two-year exemption from the EPA’s 2024 regulations. The order also leaves open the possibility for further two-year extensions, potentially keeping these facilities operating under less stringent environmental controls for an extended period.
The administration justifies the reversal by emphasizing the critical nature of medical equipment sterilized with EtO. The executive order argues that the "continued utilization of ethylene oxide by commercial sterilization facilities is essential to ensuring that our Nation provides its sick and injured with the best outcomes possible." It further contends that the 2024 EPA rule "places severe burdens" on these facilities, asserting that without the supply of EtO-sterilized equipment, the country's health system would be "unable to adequately supply the sterilized medical equipment that medical personnel need." A key point in the executive order is the claim that the technology required to reduce EtO emissions at sterilization facilities "does not exist in a commercially viable form sufficient to allow implementation of and compliance with the EtO Rule."
This rationale, however, stands in stark contrast to the concerns raised by public health organizations and affected communities. While acknowledging the importance of sterilized medical equipment, critics argue that the long-term health of residents living near these facilities should not be sacrificed. The National Cancer Institute has explicitly stated that despite precautions taken due to EtO's highly explosive and reactive nature, "workers and people who live near industrial facilities that produce or use ethylene oxide may be exposed to ethylene oxide through uncontrolled industrial emissions."
