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Editorial
Ethylene oxide and cancer
  1. O Axelson
  1. Correspondence to:
 Professor Emeritus O Axelson
 Division of Occupational and Environmental Medicine, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköpings University, Sandgatan 32A, Borgholm 38735, Sweden; olav.axelsonimk.liu.se

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    Is the evidence for its carcinogenicity conclusive?

    For decades, ethylene oxide (ETO) has attracted considerable research interest as a direct alkylating agent and likely human carcinogen. Nevertheless, the epidemiological findings from occupationally exposed populations have not been convincingly strong and consistent to permit Working Groups of the International Agency for Research on Cancer (IARC) to conclude, in the terminology used, that there is sufficient rather than limited evidence that exposure to ETO causes cancer in humans. In 1994, ETO was nevertheless upgraded in the overall evaluation from group 2A to group 1—that is, from being probably carcinogenic to humans to be a human carcinogen as based on supporting evidence from other data relevant to the evaluation of carcinogenicity and its mechanisms. Normally a group 1 classification requires sufficient evidence for a carcinogenic effect in humans.

    In view of the exceptionable IARC evaluation from 1994, the present follow up and extended mortality analyses from 1987 to 1998 …

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