Five NC warehouses, including one 1,100 ft from homes in Four Oaks, store devices that off-gas cancer-linked ethylene oxide. The state doesn’t track it and neighbors demand answers.
Jeffrey Rodgers spends most evenings on his front porch, swapping stories with his wife while the sun sinks behind the pines. Lately, a new habit has crept in: wondering what might be floating on the breeze.
Roughly 1,100 feet away, a Becton Dickinson warehouse stores medical devices sterilized with ethylene oxide, or EtO, an odorless gas the Environmental Protection Agency calls a known human carcinogen.
“This is something that should be monitored,” Rodgers said. “We ought to know what’s in the air around us.”
Why EtO matters
EtO is indispensable in modern health care. About half of all U.S. medical devices are fumigated with the gas because it can disinfect soft materials used in catheters and syringes that would melt under steam or radiation.
Scientists say exposure at concentrations as low as one part per trillion — the equivalent of one second out of 31,709 years — can increase the risk of breast cancer, non-Hodgkin lymphoma and other illnesses over a lifetime.
After sterilization, devices can off-gas EtO for days or weeks. That turns warehouses, trucking depots and even delivery vans into potential emission sources that, unlike sterilization plants, are largely unregulated.
Four Oaks resident B.J. Lee worries the community could pay the price. “Many folks here are elderly and more vulnerable,” Lee said. “We need transparency so people understand the potential risk.”
Georgia’s wake-up call
In 2019, a Becton Dickinson compliance report estimated that its distribution center in Covington, Georgia, released about 5,694 pounds of EtO in a year — more than eight times higher than emissions from the adjacent sterilization plant, which had pollution-control scrubbers. Georgia is now the only state to require warehouse air permits and continuous monitoring.
“We are regulating them because we feel that if they are left uncontrolled, that they would pose a health risk,” said Jim Boylan, who heads the state’s Air Protection Branch.
Last year, a Georgia jury awarded $20 million to a former truck driver who said decades of hauling EtO-treated products caused his lymphoma.
A regulatory gap in North Carolina
North Carolina and federal rules do not address EtO that escapes from storage sites. The N.C. Department of Environmental Quality tracks EtO only if a warehouse keeps more than 10,000 pounds of the raw gas or handles unused material, classified as hazardous waste. The agency does not measure emissions from sterilized products.
The EPA says it has set strict limits on sterilization plants but has “not yet proposed standards” for off-site warehouses.
What Becton Dickinson says
BD declined an on-camera interview but said in a statement that employee monitoring shows exposures below Occupational Safety and Health Administration limits. The company noted that not every product in Four Oaks is EtO-sterilized so emissions there “would be even lower” than in Georgia. BD also pointed out that everyday sources, from cars to campfires to the human body, release small amounts of EtO.
The company did not provide emission data for Four Oaks or say whether scrubbers or other controls are installed.
Journalist Naveena Sadasivam, who investigated EtO warehouses for the nonprofit newsroom Grist, said only fence-line monitors can prove what neighbors breathe. “Dismissing industrial EtO because trace amounts exist in nature is like shrugging off climate-changing carbon dioxide because humans exhale CO?,” she said.
Where the warehouses are
At least five North Carolina sites store EtO-sterilized products:
Medline and Owens & Minor declined to comment for this story.
The EPA told WRAL it is “evaluating options” for warehouse oversight but has not proposed a rule.
For Rodgers, calm will come only when the state installs monitors outside the Four Oaks facility.
“Peace of mind starts with numbers,” he said. “Until we have them, we’re in the dark.”