EPA is proposing new health standards to reduce occupational and community exposures to ethylene oxide (EtO), the agency announced in an April 11 press release. These draft standards would require more stringent air emission controls and additional protections for workers exposed to EtO, such as those employed in facilities where the gas is used to sterilize medical equipment and a range of other products. If finalized, the proposed standards are expected to cut EtO air emissions from commercial sterilization facilities by 80 percent per year and address concerns associated with EtO pollution, such as cancer risks. OSHA and the Agency for Toxic Substances and Disease Registry both warn that EtO is associated with a range of acute health effects, including lung irritation, and may be a carcinogen. However, EPA is advancing its new protections due to a recent assessment that found cancer risks from occupational exposures to EtO to be more significant than previously understood. According to EPA’s analysis, workers who apply EtO in sterilization and healthcare facilities over the course of a 35-year career are at increased risk for certain cancers. Workers in such facilities who do not use EtO directly and community members who live or attend schools nearby may also have increased cancer risks. More information can be found on EPA’s webpage for human health risks associated with EtO. As EtO is considered a hazardous air pollutant, EPA is proposing revisions to the National Standards for Hazardous Air Pollutants specifically to address EtO emissions from commercial sterilization facilities. If finalized, the revised standards would require 86 commercial sterilization facilities nationwide, as well as all new facilities in this sector, to follow stricter pollution controls and employ advanced source monitoring methods to confirm these controls are operating effectively. These facilities would be required to report monitoring results to EPA twice per year. This proposed rule on EtO emissions may be read in the Federal Register. Products containing EtO that are used for sterilization purposes are classified as pesticides under federal law. Therefore, the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) grants EPA the authority to require stronger control measures to protect the health of workers at facilities where EtO is used to sterilize products or equipment. Specifically, EPA is proposing measures that include prohibiting certain uses of EtO where alternatives exist, such as in museums, archival settings, beekeeping, some cosmetics, and musical instruments. Facilities would be required to reduce the amount of EtO used for medical device sterilization, while still meeting applicable standards to ensure sterility, and to implement engineering controls to reduce worker exposures. Workers in commercial sterilization facilities would be required to use personal protective equipment if monitoring technology detects EtO emissions greater than 10 ppb. EPA’s proposal sets different timelines for implementing these controls, given their varied complexity and feasibility. EPA’s proposed interim registration review decision and draft risk assessment addendum for ethylene oxide may be read in the Federal Register, with the agency’s website providing additional information about these actions. EPA encourages stakeholders in the community, industry, and public health to provide comments on the proposed standards. The public comment periods for the agency’s proposals will be open until June 12, 2023. More information can be found in EPA’s press release and on its webpage for EtO resources.

A training module published by NIOSH in March helps workers recognize the signs of heat-related illness and provide appropriate first aid. The training was developed by the NIOSH Mining Program, but the agency notes it is applicable for anyone who works in a hot environment. NIOSH explains that the training module, called “Keeping Cool,” was designed to be led by an instructor but can also provide value for individual learners. The module covers topics including how to self-regulate behaviors while off shift to enhance the body’s ability to handle heat stress and how to assess the risk of heat stress on the job. Protective actions such as maintaining hydration, taking rest breaks, and taking first aid actions when feeling symptoms of heat-related illness are also discussed. Further information about this course can be found on NIOSH’s website. The “Keeping Cool” software is freely available online.

A bill introduced in the Legislative Assembly of Ontario in March would establish a committee to ensure indoor air quality in non-residential workplaces and public settings across the province. The “Advisory Committee to Protect Ontario’s People and Economy from Airborne Pandemics” would comprise occupational hygienists, building ventilation specialists, IAQ researchers, aerosol scientists, and other professionals including epidemiologists, healthcare workers, engineers, and architects. The proposed legislation defines “airborne disease transmission” as “the spread of diseases through the inhalation of infectious respiratory aerosols that remain suspended in the air after being transmitted from an infected person.” If the bill becomes law, the committee would make recommendations related to ventilation, filtration, and other methods to reduce airborne disease transmission. The committee would also consider ways to educate the public about IAQ, cover the costs of IAQ improvements for small businesses, and ensure that personal protective equipment is available during future pandemics. The committee would be required to consult with several stakeholder groups, including the Canadian Aerosol Transmission Coalition, which formed in December 2020 to promote scientifically-based solutions to airborne and aerosol virus transmission. CATC, which supports the bill, includes several AIHA members in its leadership group, including Marianne Levitsky, CIH, ROH; Elham Ahmadpour, MIng; Lydia Renton, CIH, ROH; Simon Smith, PhD; Laurence Svirchev, CIH; and Krista Thompson, ROH. "The proposed legislation is a breakthrough because it recognizes the vital importance of an inter-disciplinary approach to pandemic preparedness and response,” Svirchev said. The website of the Legislative Assembly of Ontario provides the text of Bill 86, the Advisory Committee to Protect Ontario's People and Economy from Airborne Pandemics Act.