Allergy to Ethylene Oxide

 

Factors associated with an increased risk for an allergic reaction:

(1) repeated occupational exposure to ethylene oxide, including operating room nurses

(2) repeated exposure to products sterilized in ethylene oxide, especially when used for the infusion of blood or fluids (hemodialysis, apheresis donors or recipients)

(3) sterilization of a material that absorbs and retains the ethylene oxide

 

Factors associated with a decreased risk:

(1) flushing or rinsing the device with sterile water or saline prior to use

(2) nonparenteral exposures

 

Clinical features:

(1) exposure to ethylene oxide or something sterilized in ethylene oxide

(2) allergic signs and symptoms (see below)

(3) evidence of allergy to ethylene oxide (by skin testing, RAST, basophil histamine release or other method)

(4) no other explanation for the findings

(5) disappearance of reaction when switched to a ethylene oxide device or environment

 

Signs and symptoms of an allergic reaction may include:

(1) periorbital edema, chemosis, tearing

(2) pruritis/itching

(3) urticaria

(4) rhinorrhea

(5) abdominal cramping or nausea

(6) diarrhea

(7) chest tightness

(8) anaphylaxis

 

Problems in detection:

(1) false negative skin test (due to concurrent disease)

(2) sedation or coma

(3) pretreatment with antihistamines

(4) reaction ascribed to another cause

 

Differential diagnosis:

(1) latex allergy

(2) allergy to other allergens

(3) chemical toxicity associated with the ethylene oxide