EPA, state health department concerned with long-term cancer risk near Terumo facility in Lakewood

Ethylene oxide emissions at center of discussions


The EPA and the Colorado Department of Public Health and Environment voiced long-term cancer risk concerns for an area of Lakewood during a community meeting on Sept. 22.

They focused on ethylene oxide, or EtO, emissions from the Terumo Blood and Cell Technologies sanitation facility by Kipling Street and W Colfax Avenue in Lakewood. While the amount of EtO released by the facility is well within regulation, the EPA expressed concerns that currrent regulations are not protective enough.

EtO is a common gaseous chemical used in sanitation of many medical supplies, including hospital gowns and surgical masks. At Terumo, it’s used to sanitize machines and products used for blood testing and treatment. The regulations Terumo must adhere to, and EPA references, concerns the amount of EtO allowed to escape the sanitation facility into the air.

The EPA stressed concerns with cancer risk in the long-term — they see no short-term health risks. During the EPA presentation, representatives said they commonly use extremes to portray risks to be sure of health and safety, defining long-term impacts in their research  as looking at people living near the facility, breathing in EtO 24 hours a day from birth to age 70.

Within that definition, Senior Risk Communication Advisor Madeline Beal said the EPA sees younger children and workers as having higher risk. Workers due to possibly of more direct long-term exposure, and children because they are more vulnerable to the effects, she said.

Considering the way EtO is used in Terumo’s facility, the equipment handling it, information about the community and weather patterns, the EPA created a “Lifetime Residential Cancer Risk” map around the facility. It shows a gradient starting at 600 cases in a million where residential neighborhoods start near the facility, to 100 cases in a million at its farthest reaches.

When asked whether Terumo accepts EPA’s concern about the long-term cancer risk, Jessi Dóne, Terumo's senior sterilization manager, said, “I think that contextual information is important, because they say themselves that it shouldn’t be looked at as actual risk — they say this is a screening tool to see if there is additional risk.”

She also points out that there are other sources of EtO, including from cars and even from the body itself. Beal does highlight within the EPA presentation that their calculated risk is specifically from Terumo’s facility’s emissions, and “we’re calculating that risk over and above any of these other sources.”

“What I think is pretty interesting and important is that CDPHE has conducted a review of the cancer registry of Colorado, and what they found was that the area around Turomo has no different incidents of cancer than any other area,” Dóne said.

Kristy Richardson, Colorado’s state toxicologist at CDPHE, highlighted this, but stressed the study is limited. 

“We may not be able to identify an increase in cancer cases even if there is one,” she said. “That's because we may not have information on every person who’s ever lived in this area, and there may be too few people living in the impacted area for us to be able to measure the difference in cancer in this community, and compare that across the state.”

Terumo has voluntarily updated their EtO emission control systems. When EPA first released health risks concerns over EtO emissions in 2018, Terumo implemented controls that reduced emissions five-fold, but the EPA says more work is needed.

According to Dóne, another emissions control system that began work in 2018 will be running by 2023, replacing the current two systems.

Kerry Hicks, EPA air toxics coordinator for region 8, said the new system will reduce emissions incrementally further, and reduce risk in the community, “although we do not anticipate it will eliminate all concerns.”

“I think the EPA is doing what it’s intended to do,” said Dóne.

All emissions controls and emergency plans for EtO leaks are approved by CDPHE, she highlighted. The facility has continuous monitoring of EtO levels, monitors individual worker’s exposures once or more a year, and said there were engineering controls preventing EtO leaks across the facility.

“The laws we have, the rules we have, the regulations we have now on the books, are not protective enough,” said Beal. “And they’re not protective enough because we didn’t understand how dangerous this chemical was when we passed those regulations.”

She continued that more stringent regulations are being pushed in Colorado, and this push is why the EPA had the community meeting — which was recorded and can be found on their website, along with further information.


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