Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2004 Apr;61(4):358–362. doi: 10.1136/oem.2003.008268

Mortality of workers exposed to ethylene oxide: extended follow up of a British cohort

D Coggon 1, E Harris 1, J Poole 1, K Palmer 1
PMCID: PMC1740757  PMID: 15031395

Abstract

Aims: To obtain further information about the risks of cancer associated with occupational exposure to ethylene oxide

Methods: Follow up was extended by 13 years for a cohort of 2876 men and women with definite or potential exposure to ethylene oxide in the chemical industry or in hospital sterilising units. Subjects were traced through National Health Service and social security records, and their mortality was compared with that expected from rates in the national population by the person-years method.

Results: Analysis was based on 565 deaths, of which 339 had occurred during the additional period of follow up. Mortality was close to or below expectation for all causes (565 deaths v 607.6 expected), all cancers (188 v 184.2), and for all specific categories of malignancy including stomach cancer (10 v 11.6), breast cancer (11 v 13.2), non-Hodgkin's lymphoma (7 v 4.8), and leukaemia (5 v 4.6). All five deaths from leukaemia occurred in the subset of subjects with greatest potential for exposure to ethylene oxide, but even in this group the excess of deaths was small (2.6 expected).

Conclusions: The balance of evidence from this and other epidemiological investigations indicates that any risk of human cancer from ethylene oxide is low, particularly at the levels of occupational exposure that have occurred in Britain over recent decades. This may reflect the capacity of human cells to repair DNA damage caused by the chemical, which is a potent genotoxin and animal carcinogen.

Full Text

The Full Text of this article is available as a PDF (133.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bisanti L., Maggini M., Raschetti R., Alegiani S. S., Ippolito F. M., Caffari B., Segnan N., Ponti A. Cancer mortality in ethylene oxide workers. Br J Ind Med. 1993 Apr;50(4):317–324. doi: 10.1136/oem.50.4.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Dellarco V. L., Generoso W. M., Sega G. A., Fowle J. R., 3rd, Jacobson-Kram D. Review of the mutagenicity of ethylene oxide. Environ Mol Mutagen. 1990;16(2):85–103. doi: 10.1002/em.2850160207. [DOI] [PubMed] [Google Scholar]
  3. Gardner M. J., Coggon D., Pannett B., Harris E. C. Workers exposed to ethylene oxide: a follow up study. Br J Ind Med. 1989 Dec;46(12):860–865. doi: 10.1136/oem.46.12.860. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Greenberg H. L., Ott M. G., Shore R. E. Men assigned to ethylene oxide production or other ethylene oxide related chemical manufacturing: a mortality study. Br J Ind Med. 1990 Apr;47(4):221–230. doi: 10.1136/oem.47.4.221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hagmar L., Mikoczy Z., Welinder H. Cancer incidence in Swedish sterilant workers exposed to ethylene oxide. Occup Environ Med. 1995 Mar;52(3):154–156. doi: 10.1136/oem.52.3.154. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hagmar L., Welinder H., Lindén K., Attewell R., Osterman-Golkar S., Törnqvist M. An epidemiological study of cancer risk among workers exposed to ethylene oxide using hemoglobin adducts to validate environmental exposure assessments. Int Arch Occup Environ Health. 1991;63(4):271–277. doi: 10.1007/BF00386377. [DOI] [PubMed] [Google Scholar]
  7. Hogstedt C., Aringer L., Gustavsson A. Epidemiologic support for ethylene oxide as a cancer-causing agent. JAMA. 1986 Mar 28;255(12):1575–1578. [PubMed] [Google Scholar]
  8. Hogstedt L. C. Epidemiological studies on ethylene oxide and cancer: an updating. IARC Sci Publ. 1988;(89):265–270. [PubMed] [Google Scholar]
  9. Kiesselbach N., Ulm K., Lange H. J., Korallus U. A multicentre mortality study of workers exposed to ethylene oxide. Br J Ind Med. 1990 Mar;47(3):182–188. doi: 10.1136/oem.47.3.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Norman S. A., Berlin J. A., Soper K. A., Middendorf B. F., Stolley P. D. Cancer incidence in a group of workers potentially exposed to ethylene oxide. Int J Epidemiol. 1995 Apr;24(2):276–284. doi: 10.1093/ije/24.2.276. [DOI] [PubMed] [Google Scholar]
  11. Shore R. E., Gardner M. J., Pannett B. Ethylene oxide: an assessment of the epidemiological evidence on carcinogenicity. Br J Ind Med. 1993 Nov;50(11):971–997. doi: 10.1136/oem.50.11.971. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Stayner L., Steenland K., Greife A., Hornung R., Hayes R. B., Nowlin S., Morawetz J., Ringenburg V., Elliot L., Halperin W. Exposure-response analysis of cancer mortality in a cohort of workers exposed to ethylene oxide. Am J Epidemiol. 1993 Nov 15;138(10):787–798. doi: 10.1093/oxfordjournals.aje.a116782. [DOI] [PubMed] [Google Scholar]
  13. Steenland K., Stayner L., Greife A., Halperin W., Hayes R., Hornung R., Nowlin S. Mortality among workers exposed to ethylene oxide. N Engl J Med. 1991 May 16;324(20):1402–1407. doi: 10.1056/NEJM199105163242004. [DOI] [PubMed] [Google Scholar]
  14. Teta M. J., Benson L. O., Vitale J. N. Mortality study of ethylene oxide workers in chemical manufacturing: a 10 year update. Br J Ind Med. 1993 Aug;50(8):704–709. doi: 10.1136/oem.50.8.704. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Thier R., Bolt H. M. Carcinogenicity and genotoxicity of ethylene oxide: new aspects and recent advances. Crit Rev Toxicol. 2000 Sep;30(5):595–608. doi: 10.1080/10408440008951121. [DOI] [PubMed] [Google Scholar]
  16. Yong L. C., Schulte P. A., Wiencke J. K., Boeniger M. F., Connally L. B., Walker J. T., Whelan E. A., Ward E. M. Hemoglobin adducts and sister chromatid exchanges in hospital workers exposed to ethylene oxide: effects of glutathione S-transferase T1 and M1 genotypes. Cancer Epidemiol Biomarkers Prev. 2001 May;10(5):539–550. [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES