WebMD Health News

Georgia City Pledges To Test Air for Toxic Gas

sterigenics rally
From the WebMD Archives

July 31, 2019 -- The city of Smyrna, GA, has pledged to do independent air testing for a cancer-causing chemical released by a medical sterilizing plant there, which would make it one of just a handful of communities nationwide to have its air tested for ethylene oxide.

“We want to be as proactive as we can,” Tim Gould of the Smyrna City Council said to hundreds of residents. They filled the auditorium at a local middle school on Tuesday night to voice concerns about a Sterigenics plant’s longtime releases of the toxic gas ethylene oxide in the area.

Just 5 minutes after the meeting started, police officers were turning people away who wanted to get in, citing fire codes. Many remained outside, watching the meeting through live video streamed to social media sites.

If Smyrna carries through on its plans, it will become one of just five communities to get its air tested for ethylene oxide, used to sterilize medical equipment as well as make other products like antifreeze. The EPA in 2018 flagged 109 census tracts in 26 communities nationally as having higher cancer risks because of exposure to airborne toxins, mainly ethylene oxide. Those risks were based on modeling, not measurement of chemicals in the air.

In other areas that have had their air tested, the estimated cancer risks turned out to be higher than those predicted by the EPA. 

In six census tracts around Willowbrook, IL, which also has a Sterigenics facility, EPA modeling predicted that a lifetime of exposure to ethylene oxide there corresponded to between 73 and 250 extra cases of cancer for every million people exposed. But after air testing, the estimated added risk rose to 6,400 cases of cancer for every million people, according to a health study done by a division of the CDC.  

In Lakewood, CO, which is near the Terumo BCT medical sterilizing plant, EPA modeling predicted exposure to ethylene oxide over a lifetime corresponded to between 89 and 498 extra cases of cancer for every 1 million people who were exposed. After air testing last fall by the Colorado Department of Public Health & Environment, those risks rose to between 905 and 5,652 extra cases of cancer for every million people exposed in residential areas immediately around the plant.

The air testing in Colorado, which continued after the company installed new pollution controls, showed that the new precautions did lower risk somewhat, but even with new controls in place, neighborhoods around the plant faced average extra cancer cases from ethylene oxide ranging from 743 to 1,500 cases for every million people exposed.

In Grand Rapids, MI, EPA modeling predicted that exposure to ethylene oxide around the Viant Medical facility there corresponded to 91 cases of cancer for every 1 million people exposed over a lifetime. Air testing in January by the Michigan Department of the Environment, Great Lakes, and Energy found ethylene oxide levels in neighborhoods around the plant that corresponded to cancer rates between 800 and 1,700 cases for every 1 million people exposed 24 hours a day for a lifetime. A cancer review of the affected census tract found elevated rates of only one cancer around the plant -- multiple myeloma.  The study was just a count of cancer cases. State officials said their results "cannot indicate" what may have caused the cancer increase. Viant says they will stop using ethylene oxide by the end of the year.

In the towns of Waukegan and Gurnee, IL, which have four census tracts impacted by two sterilization facilities, the Lake County Department of Health began air testing in early June. A health study on the results has not yet been completed for residents there.

At the Smyrna meeting, dozens of residents wore orange to show solidarity with a newly formed activist group, Stop Sterigenics -- Georgia, which has organized to fight the plant.

The Georgia group is working with activists from Willowbrook, a Chicago suburb, who shut down a Sterigenics plant in their neighborhood in February, after air testing showed they were being exposed to high levels of ethylene oxide. The company is trying to reopen its plant there after installing new pollution controls.

Sterigenics President Phil Macnabb told the town hall audience that his company has applied for a state permit to do a plant refitting that he said would greatly reduce the amount of ethylene oxide released.

But when pressed by a local resident about whether the company would close the plant until those changes occurred, MacNabb said that a closure would shrink the pipeline of medical devices needed to be delivered to the health care system.

Macnabb said the Georgia Sterigenics facility sterilizes more than a million medical products every day. Those include syringes that have many intricate parts that would be hard to disinfect without ethylene oxide, a chemical prized by medical device manufacturers because it kills germs without the use of heat. The gas also penetrates paper and plastic, allowing facilities that use it to make devices and products germ-free without removing those items from their packaging.

Macnabb said Sterigenics controls 99.9 percent of ethylene oxide emissions at the Smyrna location, and has always operated within the bounds of federal and state laws.

“Our mission is to protect people,” he said, not just patients who need sterile medical devices, but also the workers at their plants and the communities around their plants, he said.

“I’m not pretending it’s not a dangerous material,” he said, adding that the company is “not doing harm” in the area.

But he clearly didn’t convince many members of the audience, who shouted “Shut it down!” after a Willowbrook-area resident addressed him during a question-and-answer period.

Nationally, ethylene oxide is used on about half of the medical devices in the U.S. that need to be sterilized, according to an industry trade group, and it has been in use for decades.

It wasn’t considered to be an environmental threat until 2016, when the EPA completed a 10-year review of the chemical’s safety and declared the gas a human carcinogen.

Georgia state Sen. Jen Jordan, a Democrat who represents parts of Smyrna, told the crowd that she will ask the Atlanta-based CDC to study the emissions at Sterigenics.

“There are a lot of unanswered questions,” she said.

Jordan said she did not trust state regulators to properly address the situation. The state Environmental Protection Division (EPD) “is not going to come in here and say anything or make this company do anything,” she said.

EPD and federal EPA officials were invited but did not attend the town hall event. They are expected to be present at an August meeting.

Elected officials from the Smyrna area toured the Sterigenics plant earlier Tuesday.

State Rep. Erick Allen, a Democrat who represents part of the area, said he faulted state regulators for not informing residents about the ethylene oxide releases.

The communities learned about the cancer-causing pollution from a report by WebMD and Georgia Health News.

The sterilization plant has been operating in the industrial area of Smyrna since the 1970s.

Lauren Kaeseberg, who lives in Darien, IL, flew in from Chicago just to have the chance to address MacNabb, who hasn’t made a public appearance since the shutdown of the Willowbrook plant in February.

“This industry has had a 40-year head start on us,” Kaeseberg said to the crowd. “You should be ashamed of yourselves,” she said to MacNabb.

Many members of the crowd stood to applaud her, shouting “Shut it down!”

After the town hall, Kaeseberg said, “I have young kids. We are literally fighting for our lives.”

Clarification: An earlier version of this story did not include other factors besides ethylene oxide that contributed to increased risk of cancer in affected census tracts. The cancer risk numbers in those census tracts have been adjusted to reflect only the contribution of ethylene oxide to cancer risk.

Additionally, the story clarified that the elevated incidence of multiple myeloma in the census tract around a sterilizing facility in Grand Rapids cannot be directly attributed to ethylene oxide exposure.

Sonam Vashi contributed to this report.

WebMD Health News Reviewed by Brunilda Nazario, MD on July 31, 2019


Tim Gould, Smyrna City Council, Smyrna, GA

Philip MacNabb, president, Sterigenics

Jen Jordan, Georgia State Senatory, District 6, Smyrna, GA.

Lauren Kaesberg, resident, activist, Darien, IL

Erick Allen, Georgia State Representative, District 40, Smyrna, GA.

EPA, the National Air Toxics Assessment, Aug. 22, 2018

Agency for Toxic Substances and Disease Registry, Letter Health Consultation, Aug. 21, 2018

Community Risk Assessment of Ethylene Oxide Near Terumo BCT, Lakewood, Colorado, Colorado Department of Public Health & Environment

© 2019 WebMD, LLC. All rights reserved.