Use of Ethylene Oxide to Sterilize Face Masks “Extremely Hazardous”

Source: Anucha Ruenin - 123RF

Citing the Environmental Protection Agency (EPA) and the Centers for Disease Control and Prevention (CDC), the Washington Department of Labor & Industries cautions health care employers and others who sterilize respirators for reuse that ethylene oxide is a carcinogen that “has been linked to neurologic dysfunction and may cause other harmful effects” to the eyes, lungs, brain and nervous system.

Further, prolonged exposure could lead to increased risk of reproductive issues and some cancers.

Ethylene oxide (EtO) is used in healthcare and other industries to sterilize a wide range of equipment. The use of EtO sterilization systems has not been approved by Federal OSHA for emergency use to sterilize filtering facepiece respirators.

The CDC states that “Ethylene oxide is not recommended as a crisis strategy for cleaning filtering facepiece respirators as it may be harmful to the wearer.”

There is evidence and concern that sterilizing PPE with EtO will result in off-gassing of EtO during use into the breathing zone of the wearer.

A shortage of N95 and other filtering facepiece respirators during the COVID-19 pandemic has led some health care facilities to sterilize PPE so it can be reused. In April, the National Institutes of Health recommended three effective methods for sanitizing N95 respirators for limited reuse: vaporized hydrogen peroxide, 70° C dry heat and ultraviolet light.

Major effects observed in workers exposed to ethylene oxide at low levels for several years are irritation of the eyes, skin, and respiratory passages and effects to the nervous system (e.g., headache, nausea, memory loss, numbness).

PPE users should refer to the CDC guidance on optimizing N95 respirator supplies and the Food and Drug Administration’s emergency use authorizations regarding PPE for COVID-19, the alert adds.