Ethylene oxide in logistics: risks, legislation and solutions

Ethylene oxide (EtO) has been used for decades for sterilising medical devices and fumigating goods. Recently, it has been recognised that EtO can remain present in the logistics chain far longer than previously assumed, with potentially serious consequences for both employees and organisations.

During the Ethylene Oxide Knowledge Session 2025 on Wednesday 19 November, Euromate, RPS and external experts shared the most up-to-date insights on health effects, legislation and practical control measures. This article summarises the key findings and offers guidance for companies that take responsibility for creating a safe working environment.

EtO: an invisible but persistent hazard

Sophia Franklin Photo: Jeroen Wolbers

EtO is classified as a CMR substance: carcinogenic, mutagenic and reprotoxic. It penetrates deeply into materials, degrades poorly in air and can cause DNA damage at extremely low levels. As occupational physician Sophia Franklin explained:

“There is no safe exposure limit for EtO.”

EtO can be absorbed through inhalation and, to a lesser extent, through the skin. The substance rapidly distributes throughout the body and forms adducts with haemoglobin and DNA. Chronic exposure, even at low levels, can lead to respiratory symptoms, neurological issues, reproductive harm and cancer.

Newly recognised insight: months of off-gassing in warehouses

Huib Lebbing. Photo: Jeroen Wolbers

One of the biggest eye-openers of the session came from lawyer Huib Lebbing: EtO can continue to evaporate from stored products for extended periods due to a chemical reaction that was previously insufficiently recognised.

“In some cases, EtO can still escape from pallets months after sterilisation.”

This means warehouse workers, transport staff and logistics partners may have been unknowingly exposed for prolonged periods. Dutch regulators have confirmed that this risk was previously under-acknowledged.

Legal reality: employers and supply chain partners share responsibility

Chain responsibility was a central theme in Huib Lebbing’s contribution. His message was unequivocal: contracts do not automatically shield organisations from liability. It is essential to understand that Dutch law requires employers to manage all risks that are known, or that could reasonably have been known.

In practice, Lebbing observes that the Labour Inspectorate and the Public Prosecution Service are becoming increasingly stringent, and that administrative, civil and even criminal enforcement is possible. Managers and directors may even be held personally criminally liable in cases of negligence.

Lebbing summarised it in one memorable phrase:

“Be good and show it.”

dr. Erik van Deurssen. Photo: Jeroen Wolbers

In other words: implement measures and demonstrate that everything reasonably possible has been done.

Monitoring is mandatory, but not every measurement counts

Occupational hygienist Dr Erik van Deurssen stressed that companies often believe they are operating safely simply because they use a gas monitor or perform a container spot measurement. In reality, many of these measurements fail to detect low yet relevant concentrations.

With gas monitors, it is important to understand that they do not provide a time-weighted average. Container spot measurements provide no insight at all into employees’ actual exposure. And while continuous monitoring can reveal peaks, it is still insufficient to demonstrate legal compliance.

“Measurement is mandatory, and only the right measurement counts.”

For compliance with Dutch legislation, standard NEN-EN 689 is leading. This standard requires:

• Measurements per similar exposure group (SEG)
• At least three measurements below 10% of the limit value
• Active personal sampling (the “gold standard”)
• Reassessment when processes or control measures change

Practical control measures: from pallet choice to air cleaning

The session showed that many practical steps can be taken to reduce EtO. The STOP strategy provides the foundation.

• Substitution, replacing EtO where possible, for example by using sterilisation methods based on radiation or heat. In addition, wooden pallets can be substituted with plastic alternatives to limit adsorption and off-gassing.
• Technical measures such as improving ventilation or using local exhaust extraction when opening or unloading containers. Activated carbon filtration or chemical neutralisation can also be applied. As a sector-specific solution, Euromate’s Kinetic-425 technology is available to support effective EtO reduction.
• Organisational measures including structured procedures for receiving sterilised or fumigated goods, staff training, and measures such as job rotation or limiting time spent in areas with potential exposure.
• Personal protective equipment (PPE) to be used only as a temporary measure or in emergency situations, and never as a long-term or standalone solution.

Joint conclusion: work together across the chain

The experts emphasised that EtO is not only a health issue, but also a legal, reputational and compliance risk. Ultimately, it creates a chain-wide responsibility, where risks will persist unless producers, sterilisation companies, logistics partners and warehouse operators work together.

Next steps for organisations

• Conduct a retrospective risk assessment
• Carry out SEG measurements in accordance with NEN-EN 689
• Install continuous monitoring in warehouses
• Investigate technical air purification solutions
• Document every step: for inspectors, employees and insurers
• Train staff and embed procedures within the organisation
• Collaborate with supply chain partners, knowledge sharing prevents incidents

Conclusion

The knowledge session made one thing clear: the time for assumptions is over. EtO demands insight, responsibility and cooperation. Euromate continues to support organisations with knowledge, advice and advanced air purification technology to help create a healthy, safe and future-proof working environment.