Occupational Safety and Health Act of 1970

“To assure safe and healthful working conditions for working men and women; by 

authorizing enforcement of the standards developed under the Act; by assisting 

and encouraging the States in their efforts to assure safe and healthful working 

conditions; by providing for research, information, education, and training in the 

field of occupational safety and health.”

This guidance document is not a standard or regulation, and it creates no new

legal obligations. The guidance document is advisory in nature, is informational

in content, and is intended to assist employers in providing a safe and healthy

workplace. The Occupational Safety and Health Act requires employers to comply

with safety and health standards promulgated by OSHA or by a State with an 

OSHA-approved state plan. However, the Ethylene Oxide standard (29 CFR 

1910.1047) is mandatory for employers and to the extent that this guidance document restates the standard, those restatements are mandatory. In addition, pursuant to Section 5(a)(1), the General Duty Clause of the Act, employers must provide 

their employees with a workplace free from recognized hazards likely to cause 

death or serious physical harm. Citations can only be based on standards, regulations, and the General Duty Clause.

Section 1
Small Business Guide

 for Ethylene Oxide

 U.S. Department of Labor

Occupational Safety and Health Administration

OSHA 3359-04 

 2009

Contents

1. Overview .............................................................................................................3

2. Exposure Monitoring ............................................................................................4

A. Understanding OSHA’s EtO Exposure Monitoring Requirements...............................4

i. Different Types of Exposure Monitoring ...........................................................4

ii. OSHA Requirement for Air Monitoring .............................................................4

a. Personal Monitoring ................................................................................5

b. Area Monitoring ......................................................................................6

c. Leak Detection ........................................................................................6

iii. OSHA Exposure Levels...................................................................................7

a. Permissible Exposure Limits ......................................................................7

B. Monitoring Requirements ....................................................................................8

i. Initial Monitoring .........................................................................................9

ii. Periodic Monitoring .....................................................................................12

C. Actions Triggered by Air Sample Results .............................................................14

D. How to Get Help with Air Monitoring...................................................................17

3. Exposure Reduction/Prevention...........................................................................18

A. Methods of Detecting Emergency EtO Releases ...................................................18

i. Emergency Situations ..................................................................................18

ii. Emergency Plan for EtO...............................................................................18

iii. Emergency Alert Provision............................................................................19

B. Develop a Compliance Program..........................................................................21

C. Reduce Exposures with Engineering Controls or Other Methods .............................22

D. Provide Respiratory Protection ...........................................................................23

4. Other Requirements............................................................................................24

A. Employee Information and Training ....................................................................24

i. Hazard Communication................................................................................24

ii. Establish Regulated Areas............................................................................25

iii. Ensure that Cautionary Labels are Fixed to Containers ....................................26

iv. MSDS ........................................................................................................27

B. Medical Surveillance.........................................................................................27

Cover photos: Getty Images, Washington State 

OSHA, National Institute for Occupational Safety 

and Health (NIOSH)

1
5. Additional Compliance Details and Helpful Information ........................................31

A. Retain the Required Exposure Monitoring Records ...............................................31

B. Accuracy of Sampling and Analytical Methods ....................................................32

C. Exemptions from Initial Monitoring .....................................................................33

D. Work Shifts of Other Than 8 Hours .....................................................................34

E. How to Obtain Further Assistance.......................................................................35

i. Work with Industry and Supplier Representatives............................................35

ii. Locate an Industrial Hygiene Consultant ......................................................35

iii. Find an Analytical Laboratory .....................................................................36

F. How to Find a Healthcare Provider for Your Medical Surveillance Program .............37

G. What a Medical Exam Must Include....................................................................38

H. Accessing OSHA Standards on the Internet.........................................................39

I. Other Names for Ethylene Oxide.........................................................................40

J. Breathing Zone.................................................................................................41

K. Passive Diffusion Dosimeter (or Monitor) ............................................................42

L. Air Sampling Pump and Sorbent Tube ................................................................47

M. Comparison of Passive Dosimeters and Traditional Air Sampling Methods Using a 

Pump and Sorbent Tube....................................................................................59

6. Related OSHA Standards and Other Helpful Resources ........................................61

A. Ethylene Oxide - General...................................................................................61

B. Conducting Personal Monitoring.........................................................................62

C. Respiratory Protection and Personal Protective Equipment ...................................68

D. Exposure Control ..............................................................................................69

E. Hazard Communication .....................................................................................70

F. Work Practices .................................................................................................72

G. Medical Monitoring...........................................................................................73

H. Emergency Planning and Alert Systems ..............................................................74

I. General Occupational Safety and Health Management for Small Businesses...........76

7. References .......................................................................................................77

8. OSHA Assistance ..............................................................................................78

9. OSHA Regional Offices ......................................................................................81

2
1. Overview

E

thylene oxide (EtO) is used extensively by hospitals and other industries as a sterilizing agent. EtO is a colorless, odorless gas, which is both flammable and highly 

reactive. Most importantly, you cannot smell EtO until it reaches levels that can 

cause serious harm to human health (NIOSH, 1989). Human and animal studies consistently show that EtO can be hazardous to human health. Short-term exposures to EtO can 

cause respiratory irritation and lung injury, shortness of breath, headache, nausea, vomiting, and diarrhea. Long-term exposure over many years may cause cancer, reproductive 

effects, genetic changes, and damage to the nervous system (LaMontagne et al., 1990). 

The purpose of this guidance document is to help employers understand the EtO standard, 

with particular emphasis on how to monitor the quality of the air in workplaces where 

EtO is processed, used, or handled. Air monitoring is an important activity that can help 

alert employers when unsafe levels of EtO are present in the air so they can take steps to 

reduce employee exposure. EtO can be used more safely if appropriate precautions are 

taken and if equipment is adequately designed and maintained. This document:

All of the required actions presented in this document are based on OSHA’s EtO standard 

(29 CFR 1910.1047). 

This guidance document provides helpful suggestions for complying with the EtO standard. You will find other general sources of information on EtO listed in Section 6 - 

Related OSHA Standards and Other Helpful Resources. To see a list of other terms 

sometimes used for EtO, see Section 5.I - Other Names for Ethylene Oxide. 

n Clarifies the different types of EtO 

exposure monitoring.

n Reviews the exposure monitoring requirements in OSHA’s EtO standard.

n Lists and explains the exposure levels 

used by OSHA.

n Provides an overview of actions required when monitoring shows that 

employees are exposed to EtO at levels 

exceeding the allowable limits. 

n Outlines the monitoring decisions you 

need to make when employees work in 

areas where EtO is present. 

3 Section 1
2. Exposure Monitoring

A. Understanding OSHA’s EtO Exposure Monitoring Requirements

i. Different Types of Exposure Monitoring 

There are three types of EtO monitoring available for determining levels of EtO in a 

workplace: 1) personal monitoring, 2) area monitoring, and 3) leak detection (a 

special type of area monitoring). However, personal monitoring is required to determine if there is compliance with the exposure limits of the standard.

ii. OSHA Requirement for Air Monitoring

The OSHA EtO standard requires employers who have EtO present in their 

workplace to conduct personal monitoring unless they are specifically exempt 

from the requirement. This guidance document is intended to help employers 

understand the difference between personal monitoring, area monitoring, and leak 

detection, and why area monitoring is complementary to personal monitoring, but 

can never be used instead of it.

Indicates link to more information elsewhere in this document.

Section 2 4
a. Personal Monitoring 

Personal monitoring involves measuring a person’s exposure to EtO by testing the air 

that the person (an employee) would breathe regardless of where the person moves 

in the workplace. To test airborne EtO concentrations, a sampling device is attached 

to the shirt collar or as close as practical to the nose and mouth of the employee. 

This is considered the employee’s “breathing zone.” 

See Section 5.J - Breathing Zone.

The device is worn for a specified period of time. During personal monitoring for 

EtO, the sample is collected for 15 minutes to test for short-term exposures (the 

excursion limit) or for the length of a whole work shift (typically 8 hours) to test for 

average exposures over the course of a workday (time weighted average or TWA). These 

air samples will be referred to here as 15-minute samples and 8-hour samples.

Equipment used for personal monitoring typically includes a passive diffusion monitor (a type of clip-on tag that collects EtO) or, alternatively, a small air pump worn on 

the employee’s belt that pulls a sample of air through a glass tube (called a sorbent 

tube) filled with a substance that captures EtO. These samples typically must be 

sent to a laboratory for analysis. Care must be used in collecting the sample and 

monitoring it to ensure an accurate measurement. 

See Section 5.M - Comparison of Passive Dosimeters and Traditional Air Sampling Methods Using a Pump and Sorbent Tube.

Within 15 days after receiving the results of the monitoring from the laboratory, the 

employer must notify each affected employee of these results. This may be done 

by posting the results in an appropriate location, accessible to the employee (social 

security numbers should not be posted), or by providing the results to the employee 

individually and in writing. If an employer uses representative sampling (see section 

2.B.i), then each employee represented by the sample should be notified of the result.

Passive Dosimeter for personal 

exposure monitoring

Employee wearing a 

passive diffusion monitor 

(or dosimeter).

For more information, see 

Section 5.K - Passive 

Diffusion Dosimeter.

Employee wearing an air sampling pump 

and sorbent tube. 

For more information, see Section 5.L – Air 

Sampling Pump and Sorbent Tube.

5 Section 2
b. Area Monitoring 

Area monitoring is used to show the levels of EtO throughout the general work area and to identify problems and priorities, but this kind of 

monitoring is not required by the EtO standard. Area samples should 

be taken close to a source of emission in order to evaluate concentrations or the effectiveness of steps being taken to control exposure. Alternatively, area samples can be collected at various places in the work area to assess 

how far EtO might have spread. 

Instruments used for area monitoring are often mounted on the wall or placed directly on equipment. The monitoring instrumentation can be similar to that used for 

personal monitoring, or it can be of the “direct-reading” type, which gives an immediate reading of the EtO level. When an employer uses direct reading instruments, 

nothing needs to be sent to a laboratory, but the equipment must be calibrated periodically to ensure accuracy. A wall-mounted emergency alert system used for area 

monitoring is one example of a direct-reading area monitoring instrument.

c. Leak Detection

Employers who are required to create a written compliance program because their 

employees’ exposures are over the permissible exposure limit must also produce a 

schedule for routine leak detection surveys. 

Some businesses that use EtO find it helpful to test equipment such as sterilizers, 

pipes, tanks, and fittings at least every two weeks to confirm that there are no leaks. 

A remote display of an EtO monitoring system. 

Portable EtO gas-detection meters are available to 

check for leaks around equipment such as sterilizers, tanks, fittings and pipes that contain EtO. Leak 

testing is generally performed using hand-held EtO 

detection meters (a type of portable direct-reading 

instrument). See the related Section 3.A.iii - Emergency Alert Provision. 

Interscan Corp

6
iii. OSHA Exposure Levels

The Federal OSHA EtO standard establishes certain allowable exposure levels. This 

section will explain the terms, units, and exposure levels that require action.

Units of Measure: Exposure levels are reported as concentrations — the volume of 

EtO per volume of air. This is typically expressed as “parts per million” (also called 

“ppm”). One part per million means that there is one part of EtO in every million 

parts of air sampled. Alternatively, the concentration of EtO can also be reported 

using weight of EtO per volume of air — milligrams of EtO per cubic meter of air 

(mg/m3). It is important to compare only exposure values that have the same units of 

measure. For example, only compare exposure results reported in the units’ ppm to 

the OSHA levels for EtO provided in ppm.

a. Permissible Exposure Limits 

Action Level: The “action level” is the 8-hour exposure level that triggers certain actions under OSHA’s EtO standard. If an employee’s 8-hour sample result is equal to 

or greater than the action level, the employer must start certain required activities 

such as exposure monitoring and medical surveillance. The action level for EtO is 

0.5 ppm (which equals 0.9 mg/m3).

Actions an employer must take if the personal monitoring test result is greater than, 

or equal to, the “action level” are outlined in Section 2.C - Actions Triggered 

by Air Sample Results.

Permissible Exposure Limit (PEL): This is the exposure level of EtO above which no 

employees may be exposed under normal workplace conditions. You should become 

familiar with two EtO PELs, one for 8-hour samples and one for 15-minute samples.

The action level for 

EtO is 0.5 ppm 

(which equals 0.9 mg/m3)

7 Section 2
n Eight-Hour Time-Weighted Average (8-hour TWA) —This is an 8-hour (or full 

work shift) sample that represents the maximum average EtO level to which an 

employee may be exposed. The 8-hour PEL for EtO is 1 ppm (which equals 1.8 

mg/m3).

n Excursion Limit (15-minute) — This is a 15-minute (short-term) sample that 

represents the maximum EtO exposure level to which an employee may be exposed to for a short period of time. The 15-minute excursion limit for EtO is 5 

ppm (equal to 9 mg/m3).

Rotating employees to different workstations so that they are not exposed to higher 

EtO levels is not an acceptable way of meeting the 8-hour TWA or the Excursion 

Limit requirement.

Both types of samples are important because, taken together, they help employers 

protect employees over the range of exposure conditions that employees are likely to 

experience. Actions an employer must take if these PELs are exceeded are 

outlined in Section 2.C - Actions Triggered by Air Sample Results. 

What if the work shift is not exactly 8 hours?

If the shift is more or less than 8 hours, see Section 5.D - Work Shifts of Not 

Exactly 8 Hours

B. Monitoring Requirements

The OSHA EtO standard requires that each employer with EtO present, whose workplace does not meet the “exemption” clause (1910.1047(a)(2)), to perform personal monitoring to show whether EtO exposures are exceeding the 8-hour and/or the 

15-minute PEL. The OSHA standard requires that these samples be “representative” 

of EtO exposures under the typical workplace conditions. There are two types of 

monitoring requirements: initial and periodic.

The 8-hour PEL for 

EtO is 1 ppm 

(which equals 1.8 mg/m3

)

The 15-minute 

excursion limit for 

EtO is 5 ppm 

(equal to 9 mg/m3

)

Section 2 8
i. Initial Monitoring 

Do I need to collect initial EtO samples?

Yes. If you have EtO present in the workplace you are required to conduct personal 

EtO monitoring of employees who might be exposed to EtO to accurately measure 

the airborne concentrations of EtO. Most employers should assume that they must 

conduct exposure monitoring: 1) if their business involves processing, using, or 

handling products containing EtO, 2) if they are not exempt as described in Section 

5.C - Exemptions from Initial Monitoring, and 3) if they have never conducted 

personal monitoring. 

This level of caution is important because accidental releases of EtO may occur from 

several sources, including leaking cartridges, sterilizer discharge lines, and leaks or 

routine changing of EtO supply cylinders. A relatively small quantity of EtO released 

into an average-sized office space can result in concentrations that are many times 

the action level or PEL (NIOSH, 1989; LaMontagne and Kelsey 1998). If there are 

special circumstances that would suggest monitoring is not required for your workplace and you need further clarification, we encourage you to contact your local area 

OSHA office by calling 1-800-321-OSHA or visiting www.osha.gov/html/RAmap.html.

When carrying out initial monitoring, you must collect both 8-hour samples (full 

work shift) and 15-minute samples (short-term). At least one sample of each type is 

required for:

n Each work shift,

n Each job classification, and

n Each work area of the workplace.

Section 2

as-detection meters 

o check for leaks 

ment such as steril

ttings and pipes that 

eak testing

Ethylene oxide pipe leak in joint.

9
Do I need to collect initial personal monitoring samples for every employee, on every 

work shift?

No. But you do need to determine the exposure level of every employee. If you have 

only one employee, or just a few who all do different jobs, you need to collect personal samples for each employee. If you have two or more employees who do the 

same job, however, you may be able to collect personal samples for one of these 

employees and use the results to document exposure levels for all of these employees. This is known as representative sampling. To decide whether the results for one 

employee will represent the EtO exposure of other employees in the group, you must 

evaluate certain criteria:

Criteria for Using Results from Similar Work Conditions

n Do the employees do the same work?

n Are their working conditions similar (e.g., do the employees use similar 

equipment and EtO products)?

n Do the employees have similar work practices, with similar EtO control 

measures?

n Do they work in the same area or in areas with similar air movement patterns?

n Do the employees use the same EtO product for the same amount of time 

during their shifts?

n Do the employees work the same distance from possible sources of EtO?

If the answer is “no” to any of the questions above, you may not use one person’s results to represent the EtO exposure of other employees. Instead you need to identify 

a smaller group of employees that have all of these criteria in common. Alternatively, 

you can conduct individual personal monitoring for each employee. 

If the answer to all of the above questions is “yes,” you may use the results from one 

or more employee(s) to represent the exposure of other employees in the group. You 

must, however, select the employee who is likely to have the highest EtO exposure 

(due to slight variations in work area, work practices, or experience) as the employee 

whose EtO exposure will represent that of the other employees in the group. 

Daily Staffing

Day Shift

Supply Technician (Level 1) 

Supply Technician (Level 2) 

Janitor 

Housekeeper 

Maintenance Operator 

Receiving Dock Manager

Evening Shift

Supply Technician (Level 1) 

Supply Technician (Level 2) 

Janitor

Night Shift

Supply Technician (Level 2) 

Housekeeper

Question: At your workplace, do all supply technicians have the same level of EtO exposure? What 

about janitors?

Answer: The employees’ exposure to EtO will not 

be the same if their tasks are different or if they 

work with EtO for a different length of time than 

other employees.

Section 2 10
You must also keep a record stating your reasons for selecting an employee from 

one work shift to represent employees on another shift. One way to document the 

similarity of shifts is by sampling employees on each shift one time to show that the 

employee exposures are the same on each shift. If the exposures are the same, you 

can conduct required periodic sampling in the future on a single shift and consider 

it representative of all shifts. You may use this option with 8-hour samples and with 

15-minute samples. 

Am I permitted to use results of air samples collected at another time or at a different 

location from my initial monitoring results? 

Yes, but the work conditions must have been similar on the two dates, or at the two 

locations. The criteria listed above for using results from similar work conditions 

also applies in this situation. Again, if the answer is “no” to one or more of these 

questions, it is likely that you must conduct initial monitoring. If the answer to all 

of these questions is “yes,” then OSHA allows you to meet the initial monitoring 

requirements by using personal monitoring results collected for other employees at 

an earlier date or different location in the workplace. Be sure to keep a document 

explaining why it was appropriate to use those results to meet your initial monitoring 

requirements.

Which 15-minute period should I monitor? 

You must collect a 15-minute air sample during the portion of the work shift when 

you have reason to believe that the employee’s EtO exposure will be the highest. You 

may need to collect several 15-minute samples during the same shift (see text box 

“Why Is It So Important to Collect 15-Minute Samples?” on the next page).

Today’s Schedule

Day Shift

7:00 Sign in

7:05 Attend training

7:45 Change sterilizer gas cylinder

8:05 Paperwork

9:30 Break

9:45 Meet with Jose M.

10:15 Delivery due/inventory

11:30 Lunch

12:00 Remove batch from sterilizer #3

12:15 Paperwork

12:30 Sterilizer duty 

2:00 Break

2:15 Sterilizer duty

3:30 Sign out

Question: When should 15-minute samples be 

collected?

Answer: Collect a 15-minute sample for 15 of 

the 20 minutes between 7:45 and 8:05. Another sample should be collected at 12:00. It 

might also be necessary to collect an additional 

15-minute sample during the afternoon sterilizer 

duty, for example when the employee is pumping 

EtO out of the equipment.

11 Section 2
ii. Periodic Monitoring

Do I need to repeat the EtO personal monitoring and, if so, what is the monitoring schedule? 

Whether you need to repeat EtO personal monitoring depends on the results of your 

initial personal monitoring. Under certain situations, a long-term schedule for personal monitoring for EtO must be established. Tables 1 and 2 provide the “periodic 

monitoring” schedule required by the EtO standard. The personal monitoring results 

may also trigger other requirements, which are listed in Tables 3 and 4 later in this 

guidance document.

Table 1 – Schedule for OSHA Exposure Monitoring

If your initial employee monitoring results... Then...

...show that employee exposure is below the 

8-hour action level...

...discontinue monitoring for only those employees whose exposures are represented by the 

initial monitoring.

...are between the 8-hour action level (0.5 

ppm) and the 8-hour permissible exposure 

limit (PEL) of 1 ppm (including the value 0.5 

ppm)...

...conduct additional 8-hour personal exposure 

monitoring at least every 6 months.

...are above the 8-hour PEL of 1 ppm or above 

the 15-minute PEL of 5 ppm...

...conduct additional personal exposure monitoring (either 8-hour or 15-minute, depending 

on the sample type that initially exceeded the 

limit) at least every 3 months. Where the 15 

minute PEL is exceeded, frequent monitoring may be needed to evaluate the employee’s 

short-term exposures.

See Table 3 - Actions Triggered by Air Sample Results.

Why Is It So Important to Collect 

15-Minute Samples?

Research suggests that EtO exposures above 

the 15-minute OSHA PEL continue to occur in 

workplaces that are involved in processing, using, or handling products containing EtO. Recent 

studies have also shown that personal monitoring 

activities often fail to detect accidental exposures 

during EtO leaks and spills (LaMontagne et al., 

2004; LaMontagne and Kelsey 1998). Therefore, 

it is important to carefully consider the types 

of activities for which 15-minute monitoring is 

most useful. The following examples should help 

provide some guidance:

•	 A common situation in which accidental exposures to EtO may occur involves changing EtO 

supply cylinders. Consider collecting 15-minute personal samples while the employees 

being sampled are replacing EtO cylinders.

•	 Employees who work directly with, or in close

proximity to, EtO sterilizers or similar equipment should be monitored frequently for shortterm (i.e., 15-minute) exposures to EtO at the 

times when they are most likely to experience 

exposure (such as when the employee opens 

the door at the end of the cycle, or while EtO is 

being pumped in or out of the equipment).

Section 2 12
When would I be allowed to reduce the frequency of air monitoring?

You may reduce the frequency of periodic air monitoring for an employee or group of 

employees only if two consecutive air test results for that employee (or group) meet 

the criteria listed in Table 2. To qualify as “consecutive” tests, the tests must be 

conducted one after the other, at least a week apart, but not more than 3 months 

apart. The results for the tests must both be below the 8-hour action level or they 

must both be below the 15-minute PEL. Table 2 also lists the requirements for 

discontinuing periodic tests.

Table 2 – Requirements for Reducing or Discontinuing Monitoring

If your periodic employee monitoring results had been 

above the PEL (either the 8-hour TWA or the 15-minute 

excursion limit)* and...

Then...

... are currently between the 8-hour action level (0.5 

ppm) and the 8-hour PEL of 1 ppm (including the value 

0.5 ppm) for two consecutive tests (these samples must 

be collected at least 7 days apart, but no more than 3 

months apart)...

...you can decrease the 8-hour personal 

monitoring frequency from every 3 months to 

every 6 months.

Note: If 15-minute exposures exceed the 

excursion limit of 5 ppm, you will still need 

to conduct the 15-minute (excursion limit) 

monitoring at least every 3 months, or more 

often as necessary to evaluate short-term 

exposure.

...are currently less than the 8-hour action level (0.5 

ppm) for two consecutive tests (the samples must be 

collected at least 7 days apart, but no more than 3 

months apart)...

...you are no longer required to conduct 

periodic personal monitoring unless a change 

in the workplace makes additional monitoring 

necessary.

...currently indicate that employee exposures are at or 

below the 15-minute PEL of 5 ppm (the excursion limit) 

for two consecutive tests (the samples must be collected 

at least 7 days apart, but no more than 3 months 

apart)...

...you may discontinue 15-minute (excursion 

limit) monitoring for those employees whose 

exposures are represented by the monitoring.

* See Section 2.A.iii for definitions of OSHA Exposure Levels.

Example of 15-minute Air 

Monitoring Results for Employees 

Emptying Sterilizer #3

Test 

Date

Exposure 

Level

Action to Take

Feb. 6 7.53 ppm Use PPE to protect 

employees. Repair 

ventilation system 

power switch. Monitor 

15-minute exposure 

level every 3 months 

(next test due by May 

6).

May 2 8.79 ppm Fix exhaust ventilation 

fan (by May 4).

May 6 5.22 ppm Adjust ventilation 

suction angle at 

machine door (by May 

6 evening).

May 10 2.18 ppm Retest air...wait at 

least 7 days (but not 

more than 3 months) 

to do test.

May 25 2.01 ppm Two test results are 

less than the 15-

minute PEL of 5 ppm 

and the tests are more 

than 7 days apart. 

We may discontinue 

monitoring!

13 Section 2
When must I resume air monitoring? 

You must start monitoring again whenever there is a change that could result in new 

or additional exposures to EtO. Examples of changes that would trigger EtO sampling 

include:

n Changing EtO process equipment or increasing the volume of EtO used.

n Modifying the exhaust ventilation system.

n Hiring new or inexperienced employees.

n Changing work practices.

You also must resume sampling any time that you have a reason to suspect that a 

change could result in new or additional exposures.

C. Actions Triggered by Air Sample Results

Tables 3 and 4 provide the lists of actions you need to take if your EtO monitoring 

results exceed specific levels. Your need to take these actions is based on how your 

results compare to the OSHA action level and/or PELs (8-hour and/or 15-minute 

samples). 

Section 2 14
Table 3 – Actions Triggered by Air Sample Results

Result Interpretation: 8-Hour Sample Is equal to 

or above Action Level but 

equal to or below PEL

8-Hour Sample Is 

above Permissible 

Exposure Limit

15-Minute Sample Is 

above Excursion Limit

Other OSHA Standards 

That Apply

For More Information, 

See Section:

Action Triggered by Monitoring Results:

Develop and put into action a 

written compliance program for 

reducing exposure and establishing 

a schedule for periodic leak 

detection

Not required Yes Yes 3.A and .B

Take steps to reduce exposure 

levels with engineering controls or 

other methods

Not required Yes Yes 3.C

Provide respirators* Not required Yes Yes 1910.134 3.D

Provide information and training Yes Yes Yes 1910.1200 4.A.i

Establish a regulated area Not required Yes Yes, also if expected to 

exceed this level

4.A.ii

Ensure that caution labels are 

fixed to containers (also when 

container contents are capable 

of causing or can be reasonably 

expected to cause these exposure 

levels)

Yes Yes Yes 1910.1200 4.A.iii

Provide medical surveillance (if 

employee’s exposure is more than 

30 days per year)**

Yes Yes Not required 1910.1020 4.B

Establish periodic air monitoring 

programs

Yes, at least every 6 

months

Yes, at least every 3 

months

Yes, at least every 3 

months

Table 1

* Respirators are required for those correcting an emergency condition, regardless of air concentrations during normal operations.

** Medical examinations are also required if there is an exposure related to an emergency situation.

View the provided standard number to see other OSHA standards that apply.

Review section numbers in this document to see a summary of the additional action(s) required when exposure levels are elevated. These sections are not intended to be all-encompassing 

instructions for compliance; instead, they expand on the limited information in Table 3 by offering you an overview of the general requirements triggered by air sampling results.

Return to Section 2.A.iii.a - Permissible Exposure Limits. 15 Section 2
You must keep records of any air monitoring that you perform. For more details on 

which records must be kept (and for how long), see Section 5.A – Retain the Required 

Exposure Monitoring Records.

Table 4 – Actions Triggered by the Air Sampling Process

Other Actions Triggered by Air Monitoring When to Take Action Other OSHA Standards That Apply

Post monitoring results within 15 days of receiving 

them, or give employees the written results 

individually within 15 days. Mention steps being 

taken to reduce exposures.

Any time that samples are collected 

– regardless of the results

Maintain records of monitoring for 30 years. Any time that samples are collected 

– regardless of the results

1910.1020

Allow employees or their representatives to observe 

air monitoring. The observer must wear PPE and 

follow safety procedures provided by the employer.

Any time that samples are collected

View the provided standard number to see other OSHA standards that apply.

Section 2 16
D. How to Get Help with Air Monitoring

If you need help with air monitoring, contact the OSHA On-Site Consultation Service 

office for your area. This service is free of charge to employers. Alternatively, you can 

hire an industrial hygiene consultant who specializes in workplace air monitoring. 

For more information on how to locate these services in your area, 

See Section 5.E - How to Obtain Further Assistance.

Laboratories provide analytical services and sometimes advise employers on selecting air sampling equipment and test media. Some laboratories provide the media 

or loan the equipment as part of the analysis package. Laboratories that analyze 

workplace air samples are typically listed in the Yellow Pages (under environmental 

– analysis) and also on the American Industrial Hygiene Association (AIHA) website. 

When selecting a laboratory, one important question to ask is “Does your laboratory 

meet the accuracy requirements of OSHA’s EtO standard?” 

See Section 5.B - Accuracy of Sampling and Analytical Methods.

17 Section 2
3. Exposure Reduction/Prevention

A. Methods of Detecting Emergency EtO Releases

There are a number of options available to monitor and test for emergency leaks of 

EtO. These methods may be appropriate in addition to, but not instead of, personal 

air monitoring. They cannot be used as a substitute for personal monitoring to satisfy 

OSHA personal air monitoring requirements.

i. Emergency Situations

The OSHA EtO standard requires that each workplace have a written plan for emergency situations. 

ii. Emergency Plan for EtO

The following are some simple steps to ensure that your workplace meets the emergency plan requirements in OSHA’s EtO standard:

n For employers with more than 10 employees, the emergency plan must be in 

writing and available to employees. If you have 10 or fewer employees, the plan 

may be communicated verbally to employees.

n The plan must contain procedures for emergency evacuation, including the type 

of evacuation and exit route assignments (refer to OSHA’s standard for Emergency Action Plans 29 CFR 1910.38). Although not specifically required, you can be 

proactive in emergency planning preparations by conducting employee evacuation drills for potential EtO emergencies.

n You must have a system for alerting employees to emergency EtO exposures. 

You do have the flexibility to choose any effective method of alerting employees 

to potential EtO releases that could result in harmful exposures. 

n The plan must specifically provide that employees engaged in correcting emerSection 3 18
gency conditions be equipped with respiratory protection as required by 29 CFR 

1910.1047(g) until the emergency is abated and must be implemented in accordance with 29 CFR 1910.134, Respiratory Protection.

n The plan must include the elements contained in 29 CFR 1910.38 and 

29 CFR 1910.39, OSHA’s standards on Emergency Action Plans and Fire 

Prevention Plans.

iii. Emergency Alert Provision

The emergency alert provision of OSHA’s EtO standard allows employers to choose 

the most effective method of alerting employees. As part of the emergency plan, you 

must develop a system for alerting your employees. The precise type of alert system 

is not specified in the OSHA EtO standard.

OSHA considers the following alert methods acceptable for an EtO monitoring system:

n A bell or other alarm system: A bell or alarm system must have a distinctive signal to alert employees to an EtO leak (refer to 29 CFR 1910.165 Employee Alarm 

Systems).

n A voice-activated system: Like other alarm types, this system must have a distinctive signal to alert employees to an EtO leak.

n Voice communications: For those employers with 10 or fewer employees in a 

particular workplace, the requirements under OSHA’s Employee Alarm Systems 

standard state that direct voice communication is an acceptable method of 

alerting employees, providing that all employees at their respective workstations 

can hear the alarm given in this manner. For workplaces with more than 10 employees, simple voice communication is not acceptable. 

Monitoring Systems

Alarm systems basically function as a monitor to test the surrounding air for EtO levels. 

To monitor EtO levels near sterilizers, some 

employers find it convenient to install a wallmounted or equipment-mounted system. 

Commercially available alarms that monitor EtO levels and use both visual and sound 

alarms can alert employees in noisy or 

crowded areas when the level of EtO is higher 

than it should be. 

Personal alarm systems, worn by an employee, are useful when employees handle 

portable components of EtO sterilization 

equipment. The EtO sensors used in personal 

alarm systems can detect emergency release 

levels of EtO and sound an alarm. When they 

include data-recording (“logging”) ability, 

the instruments can calculate an average 

exposure level that may be read directly from 

the instrument screen. These instruments, 

however, typically do not provide accurate 

results at concentrations at the PEL or lower 

and, thus, are not the best choice for measuring 8-hour TWA employee exposures. 

19 Section 3
Is there a specific EtO level that I should use to trigger an alert? 

OSHA has not established an “alert” level; you should choose an alert trigger level that 

is appropriate for your workplace. When evaluating alarms, it is important to remember 

that the alarm’s purpose is to alert employees to unintended and hazardous EtO releases, 

rather than to average EtO concentrations measured over an 8-hour work shift. It is not 

necessary to base the EtO alarm trigger specifically on the OSHA action level (0.5 ppm) 

or permissible exposure limits for 8 hours (1 ppm) or 15 minutes (5 ppm). 

You should also be aware that there is a wide range in the cost and sensitivity of commercially available monitors. Some systems alert employees to EtO levels greater than 20 

ppm, while other highly sensitive monitoring devices can trigger an alarm at much lower 

levels, such as 1 ppm or even lower (NIOSH, 1989). 

See Section 6.H - Emergency Planning and Alert Systems.

Return to Section 2.A.ii.C - Leak Detection.

Section 3 20
B. Develop a Compliance Program

If your exposure monitoring results are at a level that requires you to develop and 

put into action a written compliance program, write a memorandum or summary 

report that outlines the steps you need to take at your facility to comply with the 

EtO standard. This document will serve as your written compliance program. Include 

some background information, such as which employees or job categories may be 

exposed to EtO and the known or suspected sources of exposure. Then describe 

what methods are being or will be taken to control exposures and include a schedule 

of leak-detection surveys, a list of personal protective equipment (PPE) employees 

will wear to protect their eyes and skin from possible contact with EtO or EtO solutions (using PPE selected by methods required in 29 CFR 1910.132, OSHA’s Personal 

Protective Equipment standard), and a written emergency plan. Outline how you will 

implement the required actions triggered by the air sampling results obtained in your 

facility. You may wish to include an action plan worksheet, such as the one available 

as Appendix A in OSHA’s Small Business Handbook.

Be sure to follow this plan and take the necessary steps that will put the plan into 

action. You are required by the EtO standard to review the plan at least every 12 

months. If your planned actions change, be sure to update the written compliance 

program to match your plan. Remember that rotating employees between different 

workstations does NOT constitute an acceptable compliance program.

Return to Table 3 - Actions Triggered by Air Sample Results.

Section 3

Personal Protective Equipment

OSHA’s general PPE requirements (29 CFR 

1910.132, Personal Protective Equipment) 

mandate that employers conduct a hazard 

assessment of their workplaces to determine 

what hazards are present that requie the use 

of PPE, provide employees with appropriate 

PPE, and require them to use it. Employers 

must also maintain the PPE in a sanitary and 

reliable condition. Under OSHA’s EtO standard, employees who could have eye or skin 

contact with EtO or EtO solutions must be 

provided appropriate protective clothing and 

equipment, at no cost to the employee, and 

the employer must ensure that the employees 

use it. Besides spectacles and goggles, PPE 

such as special shields, spectacles with side 

shields, and face shields can protect employees from the hazards of splashes or mists. 

Employees exposed to EtO through skin absorption can be protected by hand protection, 

in appropriate cases. In some cases, employees must shield most or all of their bodies 

against EtO exposure in the workplace.

You can find more information about PPE, 

including the full text of OSHA’s standards, on 

OSHA’s website at www.osha.gov. In addition, 

publications explaining the subject of PPE 

in greater detail are available from OSHA. 

Personal Protective Equipment (OSHA 3151) 

and Assessing the Need for Personal Protective Equipment: A Guide for Small Business 

Employers (OSHA 3151) are available on 

OSHA’s website. 

21
C. Reduce Exposures with Engineering Controls or Other Methods

If your exposure monitoring results are at a level that requires you to take steps to 

reduce exposures with engineering controls or other methods, investigate options 

for modifying or enclosing your EtO equipment. Also consider options for improving 

ventilation to capture and remove EtO before employees are exposed. Train employees to use work practices that will help lower exposure levels. One example of such a 

practice is waiting a pre-determined time before opening the sterilizer door when the 

equipment finishes its cycle. Also, employers may wish to upgrade their equipment 

with improved sterilizers that have built-in exposure control features (e.g., built-in 

aerators). 

Employers can often obtain helpful information on exposure reduction methods from 

the sterilization equipment manufacturer, trade associations, OSHA Consultation 

Program offices, and private consultants that specialize in industrial ventilation or industrial hygiene (see Section 5.E - How to Obtain Further Assistance).

Return to Table 3 - Actions Triggered by Air Sample Results.

Section 3 22
D. Provide Respiratory Protection

If your exposure monitoring results are at a level that requires you to provide respirators, a written respiratory protection program must describe how the respirators are 

selected, stored, cleaned, and maintained at your facility. A written program is also 

necessary when employees use respirators for certain tasks, as required by the EtO 

standard (e.g., maintenance and vessel cleaning activities for which controls are not 

feasible, operations for which controls are not yet sufficient to reduce exposures, and 

for controlling emergency releases of EtO). 

The written respiratory protection program must state how employees are trained, 

medically qualified, and fit tested for respirator use. As part of your program, you 

must try to reduce employee exposures by installing engineering controls and modifying work practices so that respirators will not be necessary. For more information, 

including information on selecting respirators, review the respiratory protection requirements of OSHA’s EtO standard in section 29 CFR 1910.1047(g). For assistance 

with respiratory protection program requirements, review OSHA’s Respiratory Protection standard (29 CFR 1910.134) and the documents listed in Section 6.C – 

Respiratory Protection and Personal Protective Equipment.

Return to Table 3 - Actions Triggered by Air Sample Results.

A positive-pressure supplied-air respirator might be 

required. To protect the eyes, use a respirator with 

a full-facepiece (above) or hood.

Section 3

Photos courtesy of NIOSH

23
4. Other Requirements

A. Employee Information and Training

i. Hazard Communication

If your exposure monitoring results are at a level that requires you to provide information and training, you must arrange a training class for all employees who are 

potentially exposed to EtO at or above the action level or the 15-minute excursion 

limit. New employees must be trained before they are assigned to an area where 

exposure might occur. You must also provide annual (repeated every year) training to 

all potentially exposed employees. See Section 5.E - How to Obtain Further Assistance for information on locating sources of help with employee training. 

The training must cover the following topics:

n The OSHA EtO standard, including an explanation of the requirements of the 

standard and its Appendices A and B. Employees must also be informed (1) 

that a copy of the standard is available to them and (2) where they can find a 

copy. The copy of the standard may be a paper copy stored in an area open to 

employees. Alternatively, the copy may be in an electronic format (accessible 

from a computer), but only if every potentially exposed employee can access a 

workplace computer and knows how to locate the electronic copy. 

n	 Any operations in the employees’ work area where EtO is present or may be used.

n	 The medical surveillance program for employees exposed to EtO and an explanation of the information contained in Appendix C of the OSHA EtO standard.

n	 The ways EtO is detected and monitored at your facility (for example, by personal exposure monitoring, continuous air monitoring devices, or other methods).

n	 The physical and health hazards associated with EtO use and potential exposures.

Section 4 24
n	 The steps employees can take to protect themselves from the hazards of EtO, 

including the procedures used in your workplace to protect employees (e.g., 

work practices, emergency procedures, and personal protective equipment).

n	 Details of the workplace hazard communication program, the corresponding 

labeling system, and how employees can find and use hazard information. 

n	 Having access to and being familiar with the material safety data sheet (MSDS).

For additional information on employee hazard communication and training 

see Section 6.E - Hazard Communication. 

Return to Table 3 - Actions Triggered by Air Sample Results

ii. Establish Regulated Areas

If your exposure monitoring results are at a level that requires you to establish regulated areas in your facility, you must identify, mark, and make employees aware of 

the regulated areas in their workplaces. 

n Identify regulated areas by determining where EtO levels may exceed the permissible exposure levels (PELs) in your facility. Also include areas where the 

EtO levels can reasonably be expected to exceed the excursion limit. These two 

types of areas will be your regulated areas. You must only allow authorized persons to enter regulated areas. 

n Mark the boundary of these regulated areas by posting required signs and using 

any other methods you decide are needed to prevent unauthorized people from 

entering the areas. The goal is to limit the number of people in regulated areas 

to the minimum number needed to do the work. If the regulated area is a portion of a larger space, you must use signs to mark each point where an employee might enter the regulated area. See box at left for what the signs must state.

ETHYLENE OXIDE

CANCER AND REPRODUCTIVE HAZARD 

AUTHORIZED PERSONNEL ONLY 

RESPIRATORS AND PROTECTIVE CLOTHING 

MAY BE REQUIRED

TO BE WORN IN THIS AREA

DANGER

Mandatory Sign for Regulated Area

25 Section 4
n Consider using a combination of methods to mark the area and restrict entry. In 

addition to posting signs, you might also lock the doors to keep unauthorized 

employees from entering a room that is a regulated area. 

n Other methods of alerting people to the potential hazard include changing the 

floor color, adding physical barriers such as gates, fences, or partitions, or taking other steps to mark the boarder of the regulated area. Regardless of the 

methods used, it is important that you make sure that unauthorized employees 

are able to recognize the regulated areas and know to stay out. For example, 

if you use special floor markings to indicate the regulated area, you must also 

train employees so that they know what that floor marking means. 

Return to Table 3 - Actions Triggered by Air Sample Results.

iii. Ensure that Cautionary Labels are Fixed to Containers

All containers of EtO, the contents of which are capable of causing employee exposure at or above the action level or may reasonably be foreseen to cause exposure 

above the 15-minute excursion limit, must be properly labeled. Be sure that employees understand that the labels on containers must not be removed or covered. Check 

incoming chemical and gas containers to be sure that the labels are readable and 

firmly attached when they are delivered to your facility. 

EPA regulates EtO as a pesticide under the Federal Insecticide, Fungicide and 

Rodenticide Act (FIFRA) when it is used as a fumigant or sterilant for medical items. 

As a part of this regulation, EPA has specific requirements for labels for EtO containers. In 1996, EPA modified its FIFRA labels to include statements mandating that 

all users of EtO-containing sterilants and fumigants observe the requirements of 29 

CFR 1910.1047.

The label must also include a warning against breathing air contaminated with EtO. 

One example of a suitable label at bottom left.

Section 4

 A Container Label Statement Warning Against 

Breathing Contaminated Air is Mandatory

USE ONLY WITH ADEQUATE 

VENTILATION 

OR RESPIRATORY PROTECTION1

1 This is the statement suggested by the California 

Code of Regulations, Title 8, Subchapter 7 - General Industry Safety Orders, Section 5520 - Ethylene Oxide < http://www.dir.ca.gov/title8/5220.html>

26
If the label on a container in your facility is damaged, you may copy the information 

to a new label and attach it to the container, or you may contact the product manufacturer to see if you can obtain a replacement label.

iv. MSDS 

Hazard Communication standard requires that you maintain an MSDS, which the 

manufacturers or distributors are required to provide to you. It must be kept in an 

area that is accessible to employees exposed to EtO.

Return to Table 3 - Actions Triggered by Air Sample Results.

B. Medical Surveillance

If your exposure monitoring results are at a level that requires you to enroll employees in a medical surveillance program, you must develop a medical surveillance program that provides required medical exams for employees who meet certain criteria. 

Specifically, the OSHA EtO standard requires medical exams for all employees who 

are exposed to EtO at or above the action level (0.5 ppm) for at least 30 days per 

year or if any employees are exposed to EtO during an emergency event. Emergency 

means any occurrence such as, but not limited to, equipment failure, rupture of 

container, or failure of control equipment that is likely to or does result in an unexpected significant release of EtO. Important points to remember when determining 

whether an employee meets the criteria for the medical surveillance program:

n Recognize that the 30 days of exposure might be scattered throughout the 

year. Therefore, if the number of days of exposure for one employee adds up to 

a total of 30 or more days in one year, that employee must be included in the 

medical surveillance program. 

n Count each day when the employee has 8-hour EtO exposure at or above the 

action level (0.5 ppm), even if the employee is wearing a respirator.

n Include in the program any newly hired employee who is taking a job that involves this amount of exposure. 

27 Section 4
n If you are certain that an employee will be exposed to the EtO action level for 

less than 30 days per year (for example: exposed only once per month, or 12 

times per year), then you do not need to include that employee in the medical 

surveillance program.

n Enroll an employee in the medical surveillance program as soon as you realize 

that he or she meets the program criteria. If working conditions change so that 

an employee who was not included in the program will now be exposed at or 

above the action level for 30 or more days in the year, enter that employee in 

the program as soon as you know of the change.

The OSHA EtO standard requires that employers provide their employees who are in 

the medical surveillance program an opportunity to have medical exams at the employer’s expense. This means that the employer must pay for the exams. 

See Section 5.F - How to Find a Healthcare Provider for Your Medical 

Surveillance Program.

Each employee who is enrolled in the medical surveillance program must be offered 

several different types of exams: an initial exam, an annual (repeat) exam each year, 

and a final exam. Additional evaluations might also be required under certain circumstances. Although OSHA’s EtO standard provides minimum requirements, it is up to the 

healthcare provider to determine what specific medical tests to include in the exam. 

See Section 5.G - What a Medical Exam Must Include. 

1. The initial exam must be performed before the employee is assigned to 

work in an area where his or her exposure may be at or above the action 

level for 30 or more days per year. 

2. The employer must continue to offer an annual (repeat) medical exam each 

year as long as the employee is exposed to EtO above the action level on at 

least 30 days per year. 

If an employee wears a respirator, 

OSHA’s Respiratory Protection 

standard, 29 CFR 1910.134, 

requires that the employee receive 

a medical evaluation for respirator 

use, even if the employee is 

not included in the EtO Medical 

Surveillance Program. 

Section 4 28
3. The employee must also be offered a final medical examination: 

n When the employee leaves the place of employment (i.e., retires, quits, 

or is fired from the job). 

n When the employee transfers to another job with less EtO exposure 

(i.e., exposure below the criteria for the medical surveillance program).

4. Additional medical evaluations must be provided if:

n The employee develops symptoms of possible overexposure to EtO.

n The employee requests medical advice about whether their past or current EtO exposure could affect his or her ability to have a healthy baby. 

n The healthcare provider determines that more frequent exams are 

necessary.

n The employee is exposed during an emergency.

The exams must be provided at no cost to the employee, without loss of pay, and at 

a reasonable time and place. This means scheduling the exam during working hours 

and allowing the employee to attend the exam on paid time or scheduling it at a reasonable time and place outside working hours and paying the employee for the time 

and travel expenses incurred in attending the exam.

The employer must provide the healthcare provider with certain information, 

such as:

n A copy of OSHA’s EtO standard and Appendices A, B, C and D (at left).

n A description of the employee’s job duties associated with EtO.

n The employee’s EtO exposure level (or anticipated exposure level).

n A description of any PPE and/or respiratory equipment used by the employee.

n	 Any information from previous medical examinations not otherwise available to 

the healthcare provider (e.g., if the previous exam was conducted by another 

healthcare provider).

Ethylene oxide standard

29 Section 4
Exams related to OSHA’s EtO standard may be combined with other exams that the 

employer might need to provide for an employee. For example, if the employee will 

wear a respirator, any medical exam that the healthcare provider determines is necessary for respirator qualification may be performed during the same visit as the EtO 

medical surveillance exam.

After each medical exam, the healthcare provider will send to the employer a “physician’s written opinion” that indicates whether the healthcare provider found any 

condition(s) that would place the employee at increased risk if exposed to EtO. The 

written opinion must also list any limitations on the employee’s personal protective equipment use, and a statement that the physician has informed the employee 

of the results of the exam. To help keep medical information private, the employer 

should instruct the healthcare provider not to reveal in the written opinion given to 

the employer any specific findings or diagnoses that are unrelated to EtO exposure. 

The employer must provide the employee with a copy of the written opinion within 

15 days of receiving it from the physician.

The employer must keep the written opinion as long as the individual is employed at 

that workplace and for an additional 30 years beyond the last date that the individual is employed at the workplace. Along with the written opinion, the employer should 

keep any other information provided by the physician under OSHA’s EtO standard, 

the employee’s name and social security number, and a record of any EtO-related 

medical complaints made by the employee. Follow the requirements for maintaining these records and allowing employees to access them established in 29 CFR 

1910.1020, OSHA’s standard on Access to Employee Exposure and Medical Records. 

For additional resources, also see Section 6.G - Medical Monitoring. 

Return to Table 3 - Actions Triggered by Air Sample Results. 

“Employee medical records. The 

medical record for each employee shall be preserved and maintained for at least the duration 

of employment plus thirty (30) 

years,...”

Quote from OSHA’s standard on Access 

to Employee Exposure and Medical 

Records, 29 CFR 1910.1020

Section 4 30
5. Additional Compliance Details and Helpful 

Information

A. Retain the Required Exposure Monitoring Records

You must maintain documentation of your employees’ exposure monitoring. Employee monitoring documentation must include the following:

n The date of measurement.

n The operation involving exposure to EtO that is being monitored.

n Sampling and analytical methods used and evidence of their accuracy 

 (see Section 5.B - Accuracy of Sampling and Analytical Methods). 

n Number, duration, and results of samples taken.

n Type of protective devices worn, if any.

n Name, social security number, and exposure levels of the employees whose 

exposures are represented.

The employer is required to maintain this record for at least 30 years beyond last 

date of employment (following the requirements of 29 CFR 1910.1020). Employees 

must be informed of their personal monitoring results within 15 working days after 

the employer receives the results. 

If you use respresentative sampling, i.e., results from other employees (or other locations or dates) in place of initial monitoring results, you must document your reasons 

for considering the working conditions and exposure levels to be similar.

Return to Table 3 - Actions Triggered by Air Sample Results.

31 Section 5
B. Accuracy of Sampling and Analytical Methods 

To record the sampling and analytical methods, document the type of equipment 

you used to obtain the samples (make, model) and the sampling media on which you 

collected the samples (manufacturer, description, part number). 

When conducting sampling required by OSHA’s EtO standard, you may only use 

sampling and analytical methods that meet minimum standards of accuracy which 

appear in OSHA’s EtO standard 29 CFR 1910.1047(d)(6). 

n If the EtO exposure level is at the PEL (1 ppm) you may only use methods that 

provide a confidence level of 95 percent ±25 percent. 

n If the EtO level is at the action level (0.5 ppm) your method must be able to 

achieve a confidence level of 95 percent ±35 percent.

n Monitoring shall be accurate to a confidence level of 95 percent ± 35 percent 

for the excursion limits.

The laboratory that analyzes your samples can confirm that the method will meet 

this level of accuracy. For your records, ask the laboratory to provide the name of the 

analytical method and evidence that the analysis meets OSHA’s accuracy requirements for EtO.

If a direct-reading instrument is used to obtain samples, keep a copy of the most recent calibration documentation and of the instrument manufacturer’s specifications 

for the accuracy of the instrument. At this time, most direct-reading instruments are 

intended to alert the user to very high levels of EtO caused by an emergency release. 

These instruments typically do not meet the accuracy requirements for personal 

monitoring at the level of the PEL or action level.

Return to Section 2.D - How to Get Help with Air Monitoring.

Instrument Manufacturer’s

Certificate of Calibration

For 

Ethylene Oxide Detection Meter

Manufacturer:

Model: Serial #:

Date of calibration:

Next calibration due:

Conditions of testing:

Accuracy: 

Authorized signature____________

Section 5 32
C. Exemptions from Initial Monitoring

Initial monitoring is not always required. Employers are exempt from initial monitoring for 

a specific job or task if “objective data” show that airborne releases associated with the 

processing, use, or handling of products containing EtO are not capable of resulting in 

concentrations at or above the OSHA action level (0.5 ppm). 

These objective data might include specific information from chemical manufacturers, 

industry studies, or trade associations that documents why your facility’s processing, use, 

or handling of EtO would not result in workplace concentrations exceeding the action level.

To show that a job or task is exempt, you will need the following supporting information 

(see 29 CFR 1910-1047(k)(i)): 

n The name (make, model, or product name) of the equipment or product that qualifies for an exemption (e.g., a manufacturer might have shown that a specific type of 

sterilizer or a certain sterilant solution qualifies for an exemption as long as it is used 

as instructed by the manufacturer).

n The source of the objective data (where you obtained the information).

n The testing protocol, results, and/or analysis of data.

n The operation (job or task) at your facility that is exempt and an explanation of why 

the operation is exempt. Specifically describe how the objective data apply to your 

situation and how the data support your exemption. Any other data relevant to the 

operations, materials, processes, or employee exposures covered by the exemption.

n Any other data relevant to the operations, materials, processes, or employee exposures 

covered by the exemption.

Objective data records must be kept as long as the employer relies on the data to show 

that monitoring is not required. Depending on the type of jobs performed at the facility and 

the objective data that are available, the data might show that all of the operations in the 

facility are exempt. Alternatively, the data might show that only one job is exempt, while 

other jobs in the facility require initial monitoring.

Return to Section 2.A.ii - OSHA Requirement for Air Monitoring. 

Return to Section 2.B.i - Initial Monitoring.

33 Section 5
D. Work Shifts of Other Than 8 Hours

When you collect an 8-hour sample, OSHA expects you to collect the sample for the 

length of the whole work shift, no matter how long it is. The shift might be more or 

less than 8 hours. Although not every sample will have a duration of exactly 8 hours, 

any sample to determine exposure to the OSHA action level or 8-hour permissible 

exposure limit must be compared to an 8-hour sample result. 

To avoid confusion caused by samples collected for more or less time, OSHA allows 

you to use a simple equation that converts any full-shift sample result to an 8-hour 

equivalent result (also called an 8-hour time-weighted average or an 8-hour TWA 

result). 

Equation: 

C8 = [ CA (TA) ] / T8

C8 = The 8-hour equivalent result for your sample (in ppm) 

CA = The actual result (concentration) for your sample (in ppm)

TA = The actual time during which your sample was collected (in minutes) 

T8 = 480 minutes (this is the number of minutes in 8 hours)

Fortunately, most analytical laboratories will do the calculation for you. Ask the laboratory to “Report the full-shift results as 8-hour time weighted averages (or 8-hour 

TWAs).” You do not need to make this arrangement for 15-minute samples, which 

should always be collected for exactly 15 minutes. 

When exposure levels are high, it may be necessary to collect a series of mid-length 

samples (e.g., 1 to 2 hours each) instead of a single 8-hour sample for an employee. 

In this case, ask the laboratory to combine all of the results from one employee to 

create a single 8-hour TWA result.

Return to Section 2.A.iii.a - Permissible Exposure Limits.

Try to sample the 

employee’s entire 8-hour 

work shift. 

If the work shift is more 

than 8 hours, consult 

an industrial hygienist 

for assistance with your 

air sampling plan (see 

the next section on 

How to Obtain Further 

Assistance).

Section 5 34
E. How to Obtain Further Assistance

i. Work with Industry and Supplier Representatives

Talk to the manufacturer of the sterilization equipment used in your facility. The 

company may have helpful recommendations for adjusting your equipment and 

implementing engineering controls to minimize employee exposure.

Contact the manufacturer of the EtO product that you use (gas or solution). As a 

benefit to customers, several manufacturers offer materials and services that can 

help you with training and other OSHA compliance activities.

Inquire about assistance offered through industry trade associations and employees’ 

union health and safety programs. 

Check with your workers’ compensation insurance carrier. Some insurance carriers 

will provide or recommend professionals who can assist you. 

ii. Locate an Industrial Hygiene Consultant 

You can obtain the services of a health and safety professional, called an industrial 

hygienist, who has expertise in employee training, exposure monitoring, engineering 

controls, respiratory protection, compliance program development, and other related 

areas. This type of professional assistance is offered through several sources:

n OSHA offers free health and safety consultation services through offices in each 

state. For more information, visit www.osha.gov/dcsp/smallbusiness/consult.html.

n Alternatively, you might wish to contract with a private industrial hygiene consultant. 

To find a private consultant in your area, ask for recommendations from other employers whose employees handle chemicals. You can also look in the Yellow Pages 

under a heading such as “Environmental Services.”

Consultation Program

35 Section 5
n Another way to locate a private consultant is through the American Industrial Hygiene 

Association (AIHA) Consultants Listing on the Internet. To use the AIHA consultants 

listing, go to the AIHA website (www.aiha.org) and click on “Consultants Listing,” 

then choose “Consumer.” You can enter your city/state and choose a consultant specialty for your search. Depending on the type of assistance needed, many employers 

concerned about EtO might be most interested in a consultant with a specialty in 

one or more of the following categories: 

n Ventilation/engineering 

n Exposure assessment 

n Respiratory protection/PPE

n Communication/training 

iii. Find an Analytical Laboratory 

You can locate an industrial hygiene laboratory that will analyze EtO exposure monitoring samples by using the same sources listed above for locating an industrial hygienist. If you obtain the services of an industrial hygiene consultant, that individual 

will also be able to coordinate laboratory services, if necessary.

Return to Section 2.D - How to Get Help with Air Monitoring. 

Return to Section 3.C - Reduce Exposures with Engineering Controls or Other 

Methods.

Return to Section 3.D - Provide Respiratory Protection.

Return to Section 4.A.i - Hazard Communication.

Sources of Assistance

Industry and supplier representatives

OSHA (or State-OSHA) Consultation Programs

Industrial hygiene consultants

Laboratories specializing in environmental 

analysis

Section 5 36
F. How to Find a Healthcare Provider for Your Medical Surveillance 

Program 

Medical exams must be performed by, or under the supervision of, a licensed physician. Many employers locate a healthcare provider who performs occupational medical surveillance services (also called “medical monitoring”) by asking other local 

employers for recommendations. Some hospitals and clinics offer medical surveillance services or can recommend a medical office that does. The following questions 

might help you determine whether a healthcare provider is knowledgeable about 

general OSHA requirements: 

n Are you familiar with OSHA’s recordkeeping requirements? 

n Do you provide medical evaluations of employees required to wear respirators? 

n Do you have a process for maintaining employee medical records according to 

29 CFR 1910.1020?

A healthcare provider who regularly conducts occupational medical evaluations, is 

likely to answer “yes” to each of these questions. The provider should also be able to 

offer a reasonable description of how these processes are accomplished at the medical office. 

You must provide the healthcare provider with a copy of the EtO standard, or 

mention that he or she must get the standard at OSHA’s web site. In 29 CFR 

1910.1047(i), the standard provides information on the patient medical history and 

tests that the healthcare provider must include in the medical exam for EtO. Appendix C of the standard offers additional details for healthcare providers and individuals who are interested in more information.

Return to Section 4.B - Medical Surveillance.

37 Section 5
G. What a Medical Exam Must Include

The healthcare provider must include the following elements in the routine medical 

exam: 

n Medical and work histories with special emphasis directed to symptoms related 

to the pulmonary, hematological, neurological, and reproductive systems and to 

the eyes and skin.

n Physical examination with particular emphasis given to the pulmonary, hematological, neurological, and reproductive systems and to the eyes and skin.

n Complete blood count to include at a minimum a white cell count (including 

differential cell count), red cell count, hematocrit, and hemoglobin.

n Any laboratory or other test that the examining physician deems necessary 

based on sound medical practice. OSHA’s EtO standard allows the healthcare 

provider to decide whether other tests are necessary.

If requested by the employee, the medical examinations shall also include pregnancy testing or a laboratory evaluation of fertility if considered appropriate by the 

physician.

Return to Section 4.B - Medical Surveillance.

Section 5 38
H. Accessing OSHA Standards on the Internet

OSHA’s website contains a complete listing of all OSHA standards. To see the complete text of any standard listed in this document, you may go to www.osha.gov. 

Once at OSHA’s website, select the “Regulations” tab at the top. Then click the tab 

for “General Industry.” You can also access standards by selecting “Laws & Regulations” at OSHA’s website.

All general industry standards start with “1910.”, followed by another number (for 

example, the Ethylene Oxide standard is number 1910.1047). Scroll down the list 

of standards to the number of the standard that you want to view.

www.osha.gov

39 Section 5
I. Other Names for Ethylene Oxide

The term ethylene oxide is often shortened to:

n EtO

n EO

n E.O.

The National Institute for Occupational Safety and Health (NIOSH) also lists the following other terms (synonyms) that are sometimes used for ethylene oxide (NIOSH 

2006):

Return to Section 1 - Overview.

n 1,2 - Epoxy ethane

n 1,2 - Epoxyethane

n Amprolene

n Anprolene

n Anproline

n CAS #: 75-21-8

n Dihydrooxirene

n Dimethylene oxide

n ENT - 26263

n Epoxyethane

n Ethene oxide

n Ethox

n FEMA No. 2433

n Merpol

n NCI - C50088

n Oxacyclopropane

n Oxane

n Oxidoethane

n Oxiran

n Oxirane

n Oxirene, dihydro -

n Oxyfume

n Oxyfume 12

n RCRA waste number U115

n Sterilizing gas ethylene oxide 

100%

n T - Gas

n alpha,beta - Oxidoethane

No matter what it is 

called, if a substance 

is ethylene oxide the 

CAS number listed on 

the material safety data 

sheet (MSDS) for the 

substance will be 

CAS Number 75-21-8.

Section 5 40
J. Breathing Zone

Return to Section 2.A.ii.a - Personal Monitoring.

6 - 9”

6 - 9”

Personal air samples should 

represent the air the employee 

breathes. Position the sample 

media (air intake point) in the 

breathing zone, the hemisphere 

forward of the shoulders with a 

radius of approximately six to 

nine inches and centered on the 

employee’s nose.

6 - 9”

6 - 9”

6 - 9”

6 - 9”

41 Section 5
K. Passive Diffusion Dosimeter (or Monitor) 

Before using a passive dosimeter

When planning air monitoring, first decide which jobs and which employees will 

be monitored. Then determine whether passive dosimeters are the right monitoring method for the expected situations (i.e., does the monitoring session involve a 

routine 8-hour period with exposure levels similar to the PEL or lower, or a 15-minute period with exposure in the range of the excursion level?). If the work shift will 

be shorter or longer than 8 hours, discuss this possibility with the laboratory or an 

industrial hygienist before you start the test. Some passive dosimeters become less 

accurate if used for too short or too long a period of time. If your work shifts vary 

greatly, you might need to use a different sampling method. The same is true if you 

think that your EtO levels are likely to exceed OSHA’s PEL, which might overload the 

dosimeter. Another possible problem is interference from other chemical substances 

in the air. If other chemicals will also be used, you will need to determine whether 

they could affect the results. 

You may need professional advice to make these decisions. In such cases, consult 

the laboratory, an industrial hygienist, or your Consultation Service to get help planning a sampling procedure that will work well in your workplace. Professional advice 

may save you time and effort. It can also increase your confidence that the resources 

you expend on sampling and analysis will provide you with valid results and are not 

wasted on inappropriate monitoring methods.

See Section 5.E - How to Obtain Further Assistance.

Passive dosimeter

Front Back

Section 5 42
If you decide to use a passive dosimeter

Tell your laboratory or dosimeter supplier what type of sampling you are planning. 

This information will help ensure that you order the correct type and number of 

dosimeters. Be sure to inquire about the need for “blank samples” used for quality 

assurance purposes. When you call the laboratory, you should be able to answer the 

following questions:

•	 What air contaminant will you be monitoring (e.g., ethylene oxide)?

•	 What will be the sample durations (i.e., 15-minute or 8-hour/full-shift)? 

•	 How many samples of each type do you plan to collect? (This will also affect how many blank quality assurance samples you will need to submit to 

the lab.) 

•	 When do you plan to monitor employee exposure?

•	 How soon do you need your results? (rush analysis is typically available, but

at a premium cost).

Each passive dosimeter will arrive from the supplier or laboratory in an airtight package (a canister or pouch). The dosimeter typically comes with instructions. Before 

you begin sampling, carefully read the instructions and be sure that you understand 

them. If necessary, contact your dosimeter supplier for clarification. 

The sampling period begins when you expose the passive dosimeter to air. Do not 

open the airtight container until you are ready to begin monitoring! 

Before you begin sampling, talk to employees so that they understand the process. 

Provide adequate advance notice to afford employees (including those who work in 

the area but will not be monitored) or their representatives an opportunity to observe 

the monitoring if they wish.

Package of sampling supplies.

Do not open the sealed container or pouch until it 

is time to begin collecting the sample.

43 Section 5
Beginning a sampling period

Start 8-hour, full-shift samples at the beginning of the work shift so that you can 

monitor the whole shift. Start 15-minute samples so that the period of highest exposure is included in the 15 minutes.

Once you are ready to begin air monitoring, open the container or pouch, remove the 

dosimeter, and label it with the date and time the sampling period is started, the 

sample number, and the name of the employee or area.

For each sample, record on a sampling form or in a log book the same information that 

you wrote on the dosimeter label, plus any additional details that may be useful or relevant. Useful details include the temperature and relative humidity in the work area, 

a description of the employee’s activities, the products and equipment used by the 

employee, the name of the person performing the sampling, the instruments used to 

conduct the monitoring, and information about other chemicals also used in the work 

area during the shift. 

For personal monitoring, place the dosimeter on the employee’s lapel (within the 

breathing zone, as described in the previous section). 

Open the container, 

remove the 

dosimeter, and 

label it.

Document the sample.

Personal monitoring.

Section 5 44
For a general area sample, place the dosimeter in an open space, away from walls 

and closed spaces that might have poor air circulation. Results could be inaccurate 

if air movement across the face of the dosimeter is not adequate. Clip the dosimeter 

to a clean object that will help keep the dosimeter suspended well away from surfaces. 

Handle blank samples (quality assurance samples) in the same way as your other 

samples, except do not expose the dosimeter to air for the sampling period. Instead, 

open the dosimeter and then immediately seal it according to the instructions that 

came with the dosimeters. Issue the blank sample a number as if it were an air 

sample; however, instead of noting the sample start and stop time, write “BLANK” 

on the sample form.

Ending the sampling period

At the end of the sampling period, enter on the sampling form or log book the time 

that the sampling period ended, then remove the passive dosimeter from the employee or work area. Immediately seal the dosimeter using the same process that you 

used for the blank sample (following the instructions that came with the dosimeter). 

The model of dosimeter shown here included a plastic cover that snaps in place to 

seal the dosimeter. Small holes in the cover, to be used by the laboratory during 

analysis, must be covered with the attached caps. This dosimeter can now be packaged and shipped to the laboratory along with a copy of the sampling form.

Sending samples to the laboratory for analysis

The procedure for sealing and shipping will be different for each model of passive 

dosimeter. Consult the instructions that come with your dosimeter. Section 6.B - 

Conducting Personal Monitoring contains links to Web-based instructions for 

several models and brands of dosimeters. 

Area monitoring.

Snap-on cap.

Complete the label.

45 Section 5
Many samples, including most ethylene oxide samples, can be wrapped in padding 

and shipped to the laboratory in a rigid (crushproof) box. Some types of samples, 

however, require refrigeration or require you to avoid some packaging materials that 

might contaminate the sample. To be certain, ask the analytical laboratory whether 

your sample needs any special handling. 

If the laboratory directs you to ship a sample “on ice” or under refrigeration, you 

can put the sample in a rigid, compact ice chest and add a freezer pack to ship the 

sample using an overnight express service. Use care in packing the sample to prevent it from being battered by the freezer pack if the ice chest receives rough handling in transit.

For more information on exposure monitoring for employees, 

see Section 6.B - Conducting Personal Monitoring.

Return to Section 2.A.ii.a - Personal Monitoring.

Follow the laboratory’s shipping instructions.

Section 5 46
L. Air Sampling Pump and Sorbent Tube

Before using an air sampling pump and sorbent tube

Several important factors must be considered before you use a pump and sorbent 

tube. First, do you have the expertise and equipment needed to perform the task? If 

you have access to appropriate equipment, do you also have the knowledge to determine an appropriate sampling procedure that will provide useful (and valid) results?

If you are not sure, you should consider obtaining professional assistance from an 

industrial hygienist or your on-site Consultation Service. The following information 

will help you understand what is involved in the sampling process.

Overview

To conduct this type of monitoring, you will need to:

n Obtain sample media (sorbent tubes of an appropriate type), a personal air 

sampling pump that provides a suitable air flow rate, and an air flow meter 

to calibrate the pump.

n Ensure that the pump battery is adequately charged.

n Calibrate the pump before and after the sampling period.

n Correctly place the pump and sorbent tube on the employee (see information in the subsection on preparing the equipment and collecting samples 

presented later in this section).

n Monitor the pump performance during the air sampling period.

n Change the media (sorbent tube) at appropriate intervals.

n Maintain accurate records for use by you and the analytical laboratory.

Plastic tube from pump on hip.

Sorbent tube

Pump

47 Section 5
About sorbent tubes

A sorbent tube consists of a slim glass tube containing a material (sorbent) that 

traps certain air contaminants. One example of a sorbent material is specially treated charcoal, to which many air contaminants adhere. Different air contaminants 

require different types of sorbent tubes and sampling procedures. The sorbent tube 

supplier will help ensure that you obtain the correct tube for your intended purpose.

These tubes are easily overloaded with air contaminant if the sampling period is long 

or if the concentration of air contaminant is high. Results from an overloaded tube 

may be invalid. To avoid this problem, it may be necessary to use several sorbent 

tubes, one after the other, to sample an entire shift. 

It is also important to sample a large enough volume of air on each sorbent tube, so 

that the contaminant can be detected at the concentration of interest (for EtO, this 

level is usually the OSHA 15-minute PEL or the 8-hour action level). This means 

that in order to obtain a valid result, each tube must be attached to the pump for 

no less than a minimum amount of time, but no more than a maximum time. Unfortunately, the minimum and maximum times vary depending on the model of tube 

used, the specific air contaminant being measured, the anticipated concentration 

of contaminant in the air, the air flow rate through the pump, and factors associated 

with the analytical laboratory methods. An industrial hygiene professional will use 

available workplace and laboratory information to estimate how often tubes must be 

changed.

Another possible problem is interference from other chemical substances in the air. 

If other chemicals will also be used, it is necessary to determine whether they could 

affect the results. Historically, substances such as isopropyl alcohol, Freon 12, and 

certain other oxides have interfered with some ethylene oxide analytical methods. 

Note other possible chemical substances that could be present in your workplace 

and discuss them with the laboratory that will analyze your samples. This step will 

A typical sorbent tube.

Section 5 48
Excerpt: OSHA’s Sampling and Analytical Method 50

help to determine whether an interference could exist and to identify an appropriate 

sampling strategy.

You may wish to obtain professional advice to address these issues. Consult an industrial hygienist to get help planning a sampling procedure that is suitable for your 

workplace. Professional advice may save you time and effort. It can also increase 

your confidence that the resources you expend on sampling and analysis will provide 

you with valid results. See Section 5.E - How to Obtain Further Assistance.

Preparing the equipment and collecting samples

 

OSHA’s Sampling and Analytical Method 50 – Ethylene Oxide, 

Sections 2.1 and 2.3, www.osha.gov/dts/sltc/ 

methods/organic/org050/org050.html provide the following 

instructions for using an air sampling pump and sorbent tube 

(Figures 1 through 12 on the next pages illustrate key points):

2.1. Apparatus

2.1.1. A constant flow personal sampling pump is used which 

can be calibrated to within ±5% of the recommended 0.1 L/min 

flow rate while the sampling train is in line. See Figures 1-6. 

2.3. Technique 

2.3.1. Properly label the sampling tube before sampling. See 

Figure 7. 

2.3.2. Attach the sampling tube to the pump using a section of 

flexible, plastic tubing such that the large, front section of the 

sample tube is exposed directly to the atmosphere. Do not place 

any tubing in front of the sampling tube. The sampling tube 

should be attached in the worker’s breathing zone vertically such 

that it does not impede work performance. See Figures 8 and 9. 

2.3.3. After sampling for the appropriate time, remove the sampling tube from the pump, replace the plastic caps and seal the 

tube with an official seal. See Figure 10.

2.3.4. Include at least one blank for each sampling set. The 

blank should be handled in the same manner as the samples 

with the exception that air is not drawn through it. See Figure 

11.

2.3.5. List any potential interferences on the sample data sheet. 

See Figure 12.

49 Section 5
Figure 1: Select a personal air sampling pump that provides a suitable 

range of air flow rates. The pump shown here requires a special added lowflow valve to adjust the air flow rate to the correct level for sampling EtO, 

which is 100 milliliters of air per minute (ml/min) or the equivalent 

of 0.100 liters per minute (l/min).

Section 5 50
Figure 2: Communicate with the analytical laboratory to select an 

appropriate sorbent tube for the situation to be monitored. Sorbent tubes 

come in several sizes, which may appear similar to, but not necessarily 

identical to the tube shown here. 

Figure 3: Tubes usually arrive in an envelope, along with caps for 

sealing the tube after air sampling is completed. 

51 Section 5
Figure 4: Just before using a tube, use a commercially available “tube breaker” 

(left) or pliers (right) to gently break the glass tip off each end of the tube so that 

air can flow through it. As a rule of thumb, break the tip at a point that will make 

an opening about half the diameter of the tube body. Check that both ends of the 

tube are open – improperly opened tubes will cause the air sampling effort to fail. 

Section 5 52
Figure 5: While breaking the glass, wear safety glasses and hold the tube in a box or trash receptacle. 

Handle the tube with care to avoid injury. The broken glass tips can be sharp.

53 Section 5
Figure 6: The pump must be calibrated to adjust the air flow to the correct flow rate. A wide variety of flow 

meters are commercially available and one should be used to confirm the rate of air flow before and after each 

sampling session. During calibration, air flow through older pump models is adjusted using a set screw, while 

some recent models may be programmed electronically. These calibration tests must always be performed with 

a sorbent tube, of the same model as that used for sampling, placed in-line between the pump and the flow 

meter. Hint: Order an extra sorbent tube to use for pump calibration. This calibration tube is never sent to the 

laboratory for analysis.

Direction of Air Flow

Cap removed from air flow

meter inlet and outlet ports

Low Airflow Adapter

Adjustment Screw

Sorbent Tube

Attach so the arrow

printed on the tube

is pointed in the

direction of the 

plastic tubing leading

to the pump

Personal

Air Sampling

Pump

Low-flow Adaptor

(for use with certain

pump models)

Direction of Air Flow

{ }

Direction of Air Flow (toward pump)

{

Section 5 54
Figure 7: Wrap a strip label around the tube and print the sample number on the 

label. Include any additional information needed to track the sample. Enter this 

number and relevant information about the sample on a sampling form and a log 

book (date, work location, employee name, job title/activities, contaminant being 

sampled, name of person performing the sampling).

Before you begin sampling, talk to employees so that they understand the process. Provide adequate advance notice to allow employees or their representatives to observe the monitoring if they wish.

55 Section 5
Figure 8: Attach the pump to a belt at 

the employee’s hip. Insert the sorbent 

tube in a commercially available tube 

holder or similar device and clip it in the 

area of the employee’s lapel, with the 

sorbent tube hanging down. 

Figure 9: Air sampling professionals often use duct tape to hold excess plastic 

tubing in place so that it will not get in 

the employee’s way. Provide adequate 

slack in the plastic tubing to allow the 

employee to reach and bend. For each 

sorbent tube used, enter on the sampling 

form the time that sampling starts with 

that tube. Turn the pump ON and check 

periodically to be sure that it is running 

smoothly. Use a fully charged pump battery to ensure that the pump will run for 

the full sampling period.

Section 5 56
Figure 10: When it is time to remove a sorbent tube from the pump, mark the 

sample form with the time that sampling with that tube stopped (if sampling 

continues with another tube, also mark the start time for the new tube). Next, 

place a cap on either end of the sorbent tube to make it airtight. Then, if desired, 

fold the tube and its label in a strip of paper (blue in the photo series above) and 

seal the edges of the paper with tape to create a tamper-resistant seal. Mark the 

outside of the sealed sorbent tube with its original label number and other identifying information requested by the laboratory (e.g., company name, date, security 

seal and signature).

Many samples, including most ethylene oxide samples, can be placed in a plastic 

zip bag, wrapped in padding, and shipped to the laboratory in a rigid (crushproof) box. Some types of samples, however, require refrigeration or require you 

to avoid some packaging materials that might contaminate the sample. To be 

certain, ask the analytical laboratory whether your sample needs any special 

handling.

Figure 11: For quality control 

purposes, the laboratory will request at least one “blank” sample per group of sorbent tubes 

submitted for analysis. A blank 

sample is a sorbent tube of the 

same lot number as the tubes 

used to conduct the air monitoring. The blank tube should 

be opened (tube tips broken 

off), but no air should be drawn 

through it (do not connect the 

blank sorbent tube to a pump). 

Label and seal the blank sorbent 

tube in the same manner as the 

other samples. Issue the blank 

sample a number as if it were an 

air sample; however, instead of 

noting the pump flow rate and 

sample time, write “BLANK” on 

the sample form.

Figure 12: Record sample information and notes to the laboratory on 

the sample data sheet.

57 Section 5
For more information on exposure monitoring for employees, 

see Section 6.B - Conducting Personal Monitoring. 

Return to Section 2.A.ii.a - Personal Monitoring.

If the laboratory directs you to ship a sample “on ice” or under refrigeration, you can put the sample in a rigid, compact ice chest (as shown) and 

add a freezer pack to ship the sample using an overnight express service. 

Use care in packing the sample to prevent it from being battered by the 

freezer pack if the ice chest receives rough handling in transit.

Section 5 58
M. Comparison of Passive Dosimeters and Traditional Air Sampling 

Methods Using a Pump and Sorbent Tube

Consideration Passive dosimeter Personal air sampling pump and 

sorbent tube

Alternate names Passive Dosimeter 

Passive Diffusion Monitor 

Personal Monitoring Badge 

Passive (Diffusive or Diffusion) Sampler

Sorbent Tube 

Charcoal Tube 

Coated/treated Charcoal Tube

Ease of use Easy to use under routine conditions, 

including 8-hour sampling sessions 

with exposures in the range of the 

PEL or lower, or 15-minute sessions 

of exposure in the range of the 

excursion limit or lower. Under other 

circumstances, special calculations 

may be required to determine whether 

and how passive dosimeters should be 

used.

Requires some training and experience 

to obtain reliable results. Additionally, 

a sample plan should be developed 

in advance to evaluate task and shift 

duration, anticipated exposure levels, 

and sorbent tube capacity. These 

factors determine whether and how 

often tubes need to be changed during 

the sampling session.

Accuracy of results Natural air currents might not be 

adequate to ensure reliable sampling. 

Results might be affected if the 

dosimeter is placed in an area with 

poor air circulation (such as in a corner 

or next to a wall).

When routine sampling is conducted 

correctly and analysis is performed by 

a qualified laboratory, results typically 

meet OSHA accuracy requirements.

An air sampling pump allows more 

control over the sampling process, 

and, therefore, produces more 

reliable results under a wider range of 

conditions (e.g., during irregular work 

shifts, short sampling periods, periods 

of high exposure levels, and locations 

with poor air circulation). Under these 

conditions, results obtained with a 

pump may be more accurate and 

precise than results obtained using a 

passive dosimeter.

When sampling is conducted correctly 

and analysis is performed by a 

qualified laboratory, results typically 

meet OSHA accuracy requirements.

59 Section 5
Consideration Passive dosimeter Personal air sampling pump and 

sorbent tube

Cost of sampling 

media (not including 

analysis).

Cost more than sorbent tubes (in 

the range of $20 to $25 per passive 

dosimeter).

Cost less than passive dosimeters 

(usually less than $5 per sorbent 

tube).

Cost of analysis (may 

include sampling 

media and other 

options).

Variable depending on how quickly results are needed. Cost of analysis is similar 

for these two types of media (passive dosimeter and sorbent tube).

Cost of additional 

equipment.

No additional equipment required. An air sampling pump and pump 

calibration equipment are required 

and can cost hundreds of dollars 

each. However, pump rental or loan 

is sometimes included in the cost of 

the sampling and analysis. Check with 

an industrial hygienist or analytical 

laboratory.

Chemicals that can 

be monitored.

Passive dosimeter models are 

commercially available for a limited 

but growing number of airborne vapors. 

Check with your analytical laboratory.

Manufacturers offer a selection 

of sorbent tubes appropriate for 

monitoring a wide range of airborne 

vapors. Check with your analytical 

laboratory.

Interferences Can be affected by temperature, 

humidity, and the presence of other 

chemical substances. Discuss your 

situation with the analytical laboratory.

Can be affected by temperature, 

humidity, and the presence of other 

chemical substances. Discuss your 

situation with the analytical laboratory.

Return to Section 2.A.ii.a - Personal Monitoring.

See Section 6 - Related OSHA Standards and Other Helpful Resources.

Section 5 60
6. Related OSHA Standards and Other Helpful 

Resources 

A. Ethylene Oxide - General

OSHA Standard – Ethylene Oxide: 29 CFR 1910.1047

This is the standard that lists the OSHA requirements for ethylene oxide in the 

workplace. This website also includes direct links to the appendices associated with 

OSHA’s EtO standard.

www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10070

NIOSH Health and Safety Topic Page for Ethylene Oxide

This website provides links to several NIOSH publications on topics related to employee exposure to ethylene oxide (e.g., laboratory analytical methods, NIOSH Alerts, 

employee notification information). Some of these documents are quite technical, 

while others are intended for employees and their supervisors.

www.cdc.gov/niosh/topics/ethyleneoxide

Example of an Ethylene Oxide Management Plan 

The Medical University of South Carolina Ethylene Oxide Management Plan is one 

example of an EtO management plan. The plan outlines how the university complies 

with the requirements of OSHA’s EtO standard and lists the work practices used by 

employees at the university to help keep exposures below the action level. 

www.musc.edu/fanda/risk/osha/safetymanual2005/ethylene.pdf#search= 

%22Ethylene%20Oxide%20Safety%20plan%22

61 Section 6
State of Washington Ethylene Oxide Standard (Chapter 296-855, WAC, January 2006) 

This document presents Washington State’s EtO standard. Because Washington is an 

OSHA State Plan State, this standard is at least as protective as Federal OSHA’s EtO 

standard and many of the provisions are identical, although the Washington State 

standard may also include additional provisions not found in the federal standard. 

The Washington EtO standard applies only in Washington; however, even if employers do not have facilities in Washington, some may find the user-friendly presentation style of the Washington State standard helpful.

www.lni.wa.gov/WISHA/Rules/ethylene/PDFs/296-855Complete.pdf

Return to Section 1 - Overview.

B. Conducting Personal Monitoring

OSHA Technical Manual – Personal Sampling for Air Contaminants (Section II, Chapter 1)

This chapter of the manual for OSHA personnel provides basic instructions on performing personal air monitoring. It covers general procedures, sample media, instrument preparation and calibration, and a discussion of sampling and analytical error. 

Although the manual is intended for OSHA personnel and lists forms and sample 

shipping instructions specific to OSHA, the chapter provides a good overview of the 

air sampling process. Anyone planning to conduct air sampling should contact their 

analytical laboratory of choice before any monitoring is performed. This step is important to coordinate the choice of methods and sampling media.

http://www.osha.gov/dts/osta/otm/otm_ii/otm_ii_1.html

Section 6 62
3M Air Monitoring Systems (Document 4026) 

Simple illustrations on the first page of this 2-page document show how to attach a 

passive dosimeter to the collar in the employee’s breathing zone. The guide also lists 

dosimeter accuracy information. Dosimeter placement information contained in this 

guide applies to all types of passive dosimeters. Employers conducting air sampling, 

however, should ensure that they obtain accuracy information from the supplier for 

the specific brand of dosimeters they use. The accuracy must meet OSHA’s minimum requirements of 95 percent ± 25 percent (for 1 ppm samples) or ± 35 percent 

(for 0.5 ppm or for 15-minute excursion samples) as discussed in Section 5.B. 

http://multimedia.mmm.com/mws/mediawebserver.dyn?6666660Zjcf6lVs6EVs6667MCCOrrrrQ3M Technical Data Bulletin #1028 – Organic Vapor Monitor Sampling and Analysis Guide 

This 11-page technical publication provides general background information on the 

use of passive dosimeters for sampling under a variety of circumstances. Although 

not specific to ethylene oxide, it introduces relevant topics such as homogeneous 

exposure groups (HEG), monitor capacity, laboratory analysis procedure, recovery 

coefficients, and work shifts that are not 8 hours.

http://multimedia.mmm.com/mws/mediawebserver.dyn?6666660Zjcf6lVs6EVs666CswCOrrrrQ63 Section 6
3M Air Monitoring Guide (for passive dosimeters including models 3550/3551 for 

ethylene oxide)

This guide provides detailed illustrated instructions for using passive dosimeters for 

personal and area monitoring. The monitoring instructions apply to all passive dosimeters, but the dosimeter preparation instructions apply specifically to 3M monitors (including those for ethylene oxide). Although the examples in this guide refer 

to specific models of 3M equipment, you may substitute other equivalent equipment 

made by other manufacturers; however, you should consult with your supplier for 

dosimeter preparation instructions for the specific model you use.

http://multimedia.mmm.com/mws/mediawebserver.dyn?6666660Zjcf6lVs6EVs666MFPCOrrrrQSKC Passive (Diffusive) Samples

A cross-sectional view inside a passive dosimeter and illustrated instructions for 

using passive dosimeters for personal monitoring. Although the examples in this 

guide refer to specific models of SKC equipment, you may substitute other equivalent equipment made by other manufacturers; however, you should consult with your 

supplier for dosimeter preparation instructions for the specific model you use.

www.skcinc.com/prod/575-001.asp

SKC Application Guide: Sampling Train - Sorbent Sampling Tubes 

This document describes the process for collecting personal exposure samples using 

an air sampling pump and sorbent tubes (one of the ways to conduct personal monitoring). The instructions illustrate how to connect the sorbent tube to the pump and 

where to attach both of these items to the employee. Special note: although the examples in this guide refer to specific models of equipment, you may substitute other 

equivalent equipment made by other manufacturers.

www.skcinc.com/instructions/1168.pdf

Section 6 64
Ethylene Oxide – OSHA 50 (SKC chemical fact file) 

This document includes air flow rate, sample time, and air volume for collecting a 

personal monitoring sample for ethylene oxide using a sorbent tube and personal air 

sampling pump. It also outlines the steps for handling a sorbent tube and pump. 

This specifically targeted 1-page fact sheet is adapted from the 21-page OSHA 

Method 50 for laboratory analysis of ethylene oxide samples. Although the examples 

in this guide refer to specific models of equipment, you may substitute other equivalent equipment made by other manufacturers.

www.skcinc.com/cff/1014.pdf

OSHA Sampling and Analytical Method 50 (sorbent tube method)

This highly technical 21-page document contains detailed information on laboratory analysis of ethylene oxide. It contains instructions for using a sorbent tube and 

air sampling pump; however, most small business employers might prefer to get the 

same information in summary form by requesting instructions from their analytical 

laboratory of choice.

www.osha.gov/dts/sltc/methods/organic/org050/org050.html 

SKC Application Guide: Calibrating a Pump Using an Electronic Calibrator 

(Pub 1014 rev 208)

This 2-page guide provides detailed illustrated instructions for using an electronic 

flow meter to calibrate a personal air sampling pump fitted with a sorbent tube. 

Although the examples in this guide refer to specific models of equipment, you may 

substitute other comparable equipment made by other manufacturers.

www.skcinc.com/instructions/1366.pdf 

65 Section 6
OSHA Sampling and Analytical Method 49 (passive dosimeter method) 

This highly technical 16-page document contains detailed information on laboratory analysis of ethylene oxide monitors. It contains instructions for using a passive 

dosimeter; however, most small business employers might prefer to get the same 

information in summary form by requesting instructions from their analytical laboratory of choice.

www.osha.gov/dts/sltc/methods/organic/org049/org049.html

Return to Section 5.K - Passive Diffusion Dosimeter.

Section 6 66
The mention of any instrument provider, product, or 

process in this publication does not constitute or imply 

endorsement by the Occupational Safety and Health 

Administration. This list is not meant or able to be 

comprehensive, as there may be other suppliers that 

have not been brought to our attention.

Suppliers of passive diffusion dosimeters/monitors 

for ethylene oxide monitoring

Assay Technology, Pleasanton, CA. Tel: 800-833-1281.

SKC Inc., Eighty Four, PA. Tel: 800-752-8472. 

www.skcinc.com

3M, St. Paul, MN. Tel: 800-869-4223. 

www.3M.com/occsafety

Suppliers of sorbent tubes suitable for ethylene oxide 

monitoring

Assay Technology, Pleasanton, CA. Tel: 800-833-1281.

SKC Inc., Eighty Four, PA. Tel: 800-752-8472. 

www.skcinc.com

Supelco (Sigma-Aldrich Group) St. Louis, MO. Tel: 800-

247-6628. www.sigmaaldrich.com

Suppliers of low-flow personal air sampling pumps suitable for ethylene oxide monitoring (100 ml/minute flow 

rate)

A.P. Buck Inc. Orlando, FL. Tel: 800-330-2825. 

www.apbuck.com

Sensidyne (Gillian pumps), Clearwater, FL. Tel: 800-451-

9444. www.sensidyne.com

SKC Inc., Eighty Four, PA. Tel: 800-752-8472. 

www.skcinc.com

TSI Inc. Shoreview, MN. Tel: 800-874-2811. 

www.tsi.com

Other sources of sampling instruments and media: Some 

analytical laboratories will loan pumps and provide sample 

media as part of the analytical fee. Alternatively, you 

may rent or lease air sampling pumps and gas detection 

equipment from laboratories and technical equipment 

rental agencies (for example, conduct an Internet search 

for “rent – personal air sampling pump”). If you use an 

industrial hygiene consultant, that professional will likely 

arrange to have all the necessary equipment and supplies 

available.

Return to Section 5.K - Passive Diffusion Dosimeter (or Monitor).

Return to Section 5.L - Air Sampling Pump and Sorbent Tube.

67 Section 6
C. Respiratory Protection and Personal Protective Equipment

OSHA Standard – Respiratory Protection: 29 CFR 1910.134

This is the standard that lists the OSHA requirements for respiratory protection.

www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=12716

OSHA Booklet – Small Entity Compliance Guide for the Revised Respiratory Protection 

Standard (OSHA 9071), 1998

This document provides general information about respiratory protection in the workplace and OSHA’s Respiratory Protection standard. The guide is intended to assist 

small business employers to set up a respiratory protection program.

www.osha.gov/Publications/secgrev-current.pdf

OSHA’s Respiratory Protection eTool

The purpose of this eTool is to help you comply with the OSHA Respiratory Protection 

standard. It provides instruction on the proper selection of respiratory protection.

www.osha.gov/SLTC/etools/respiratory/index.html

OSHA Standard – Personal Protective Equipment General Requirements: 29 CFR 

1910.132 

This is the standard that requires employers to perform a hazard assessment to determine what PPE employees need. It also requires that employees be trained to use 

the PPE and that the PPE fits the employee.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_

id=9777

Section 6 68
OSHA Booklet – Personal Protective Equipment (OSHA 3151), 2003

This OSHA guide reviews procedures for determining what PPE is required to protect 

employees and discusses OSHA requirements for training employees to use the PPE 

correctly. To help employers evaluate the need for PPE, the guide includes select 

questions to ask about the jobs employees perform.

http://www.osha.gov/Publications/osha3151.pdf

OSHA Letter of Interpretation – Requirements under the Ethylene Oxide Standard

This is the letter OSHA provided in response to a question about whether EtO-equipment service personnel must be issued PPE and respirators if they visit workplaces 

where ethylene oxide is used.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_

table=INTERPRETATIONS&p_id=21749

Return to Section 3.D - Provide Respiratory Protection.

D. Exposure Control

Ethylene Oxide Sterilizers in Health Care Facilities: Engineering Controls and Work Practices 

This link provides information on accessing NIOSH Current Intelligence Bulletin-52 

(1989, July 13), 15 pages, which describes exposure control methods for sterilizers.

http://www.cdc.gov/niosh/89115_52.html

69 Section 6
OSHA Letter of Interpretation – Procedures for Ethylene Oxide (EtO) Spills and Ethylene 

Oxide Disposal

This is the letter OSHA provided in response to a question about the procedures for 

handling material during EtO spill cleanup.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_

table=INTERPRETATIONS&p_id=19343

Return to Section 3.C - Reduce Exposures with Engineering Controls or 

Other Methods. 

E. Hazard Communication

OSHA Standard – Hazard Communication: 29 CFR 1910.1200

This is OSHA’s regulation on providing information to employees who might be exposed to hazardous substances (not just EtO) in the workplace. 

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_

id=10099

OSHA Safety and Health Topics – Hazard Communication 

This website provides links to resources that are useful for employers developing or 

updating a hazard communication program. Among the listings at this site, you will 

find downloadable software developed for the Mine Safety and Health Administration 

and intended to help those responsible for writing an OSHA hazard communication 

program; a self-inspection checklist; and a sample online HazCom training program 

developed by the state of Oregon. 

http://www.osha.gov/SLTC/hazardcommunications/solutions.html

Section 6 70
Ethylene Oxide Training Program

This editable training program from the Washington State Department of Labor and 

Industries is available at no charge in PDF or PowerPoint formats for use in employee education. The website also includes a script. Both the presentation and 

script may be downloaded and customized to reflect the situation in the area where 

employees work.

http://www.lni.wa.gov/Safety/TrainTools/Trainer/Kits/EthyleneOxide/default.asp

Sample Hazard Communication Program 

This is a program from the Division of Safety, Florida Department of Labor and 

Employment Security. Employers may customize this model hazard communication 

program to create a program for their own worksites. 

http://www.cdc.gov/elcosh/docs/d0300/d000384/d000384.html

Ethylene Oxide (EtO) Fact Sheet

From the California Department of Public Health, this 6-page fact sheet (updated 

1999) includes information that could be used as part of an employee communication and training program.

http://www.dhs.ca.gov/ohb/HESIS/eto.htm#TESTS_FOR_EXPOSURE_AND_MEDICAL_TESTS

71 Section 6
NIOSH Worker Notification on Sterilization of Medical Instruments and Treatment of 

Spices (Ethylene Oxide). April 2004 

This summary report describes the results of a study of employees who were exposed 

to EtO while working at sterilization plants. The study was conducted to determine if 

exposure to EtO is associated with cancer and other diseases. 

http://www.cdc.gov/niosh/pgms/worknotify/EthyleneOxide.html

Return to Section 4.A.i. - Hazard Communication. 

F. Work Practices

Preventing Worker Injuries and Death from Explosions in Industrial Ethylene Oxide 

Sterilization Facilities – NIOSH Alert, NIOSH Pub: 2007-164, Revised Edition. (August 

2007) 

This document describes several accidents at sterilization facilities and suggests 

work practices and controls to improve safety. 

http://www.cdc.gov/niosh/docs/2007-164

Ethylene Oxide Handling

This guide describes safe handling practices for unloading, handling, and storing 

EtO drums.

http://www.balchem.com/images/pdfs/EOHandlingGuide.pdf

Return to Section 3.C - Reduce Exposures with Engineering Controls or 

Other Methods. 

Section 6 72
G. Medical Monitoring

OSHA Standard – Access to Employee Exposure and Medical Records: 29 CFR 1910.1020

This is OSHA’s standard describing what medical and exposure records you must 

keep and how long you must keep them. It also lists requirements for keeping employee medical records confidential and for providing copies of these records to 

employees and individuals designated to represent them.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_

id=10027

OSHA Booklet – Access to Medical and Exposure Records (OSHA 3110), 2001

This is an easy-to-read summary of the OSHA standard on the same topic. It is intended for employers and their employees.

http://www.osha.gov/Publications/OSHA3110.pdf

OSHA Letter of Interpretation – The Interpretation of the Medical Examinations and 

Consultations for Employees Who are Hired for Areas That Have Ethylene Oxide. August 7, 

1995.

This is the letter OSHA provided in response to a question about what testing is required for medical surveillance examinations and how initial and yearly exams differ 

from exams conducted in response to an exposure.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_

table=INTERPRETATIONS&p_id=21877

Return to Section 4.B - Medical Surveillance.

73 Section 6
H. Emergency Planning and Alert Systems

OSHA Standard – Emergency Action Plans: 29 CFR 1910.38

This OSHA standard lists the minimum requirements for an employer’s emergency 

action plan.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_

id=9726

OSHA Standard – Fire Prevention Plans: 29 CFR 1910.39

This OSHA standard describes the minimum elements that must appear in an employer’s fire prevention plan.

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_

id=12887

Emergency Response Guide (ERG) 119 – Ethylene Oxide (Applicable to ethylene oxide)

This entry from the U.S. Department of Transportation (U.S. DOT) provides basic 

information on responding to a large release of EtO (e.g., hazards, evacuation, spill 

and leak control procedures). Most information is also applicable to smaller releases.

http://hazmat.dot.gov/pubs/erg/g119.pdf

Ethylene Oxide Sterilizer Alarm Systems

This section, from the U.S. Joint Services Pollution Opportunity Handbook (updated 

2003) discusses characteristics of commercially available ethylene oxide alarm systems and provides information from two manufacturers. 

http://p2sustainabilitylibrary.mil/P2_Opportunity_Handbook/3_VII_2.html

Section 6 74
Return to Section 3.A.iii - Emergency Alert Provision.

The mention of any instrument provider, product, or process in this 

publication does not constitute or imply endorsement by the Occupational 

Safety and Health Administration. This list is not intended or able to be 

comprehensive, as there may be suppliers who have not been brought to 

our attention.

Suppliers of handheld and/or fixed position leak detectors and alarm systems 

for EtO

American Gas & Chemical Co., Ltd., Northvale, NJ. Tel. 1-800-288-3647

Anderson Products, Haw River, NC. Tel. 800-523-1276

Dräger Safety, Inc., Pittsburgh, PA. Tel: 1-800-858-1737

BW Technologies, Arlington, TX. Tel: 888-749-8878

Interscan Corporation, Chatsworth, CA. Tel: 800-458-6153

Sierra Monitor Corporation, Milpitas, CA. Tel: 408-262-6611

U.S. Industrial Products, Cyprus, CA. Tel: 714-220-1829

75 Section 6
I. General Occupational Safety and Health Management for 

Small Businesses

OSHA Booklet – Small Business Handbook (OSHA 2209), 2005

This document includes a brief description of employers’ responsibilities for workplace safety and health. The document includes checklists to help employers conduct a self-inspection.

http://www.osha.gov/publications/smallbusiness/small-business.pdf

OSHA Hospital eTool – Central Supply Module

The eTool offers background information on various hazards (including EtO) that 

employees might encounter in the area of a hospital where instruments are sterilized 

- typically the central supply department.

http://www.osha.gov/SLTC/etools/hospital/central/central.html

OSHA Consultation Program

This program offers free and confidential advice to small and medium-sized businesses in all states, with priority given to high-hazard worksites. Employers can find 

out about potential hazards at their worksites and improve their occupational safety 

and health management systems.

http://www.osha.gov/dcsp/smallbusiness/consult.html

Section 6 76
7. References 

LaMontagne, AD, et al. 1990. Ethylene Oxide Health & Safety Manual: Training and 

Reference Materials on the Safe Use of Ethylene Oxide in Sterilizing Equipment. 

Second Edition. (OSHA Docket H200C, exhibit 2-9-L).

LaMontagne, AD, and Kelsey, MD. 1998. OSHA’s Renewed Mandate for Regulatory 

Flexibility: In Support of the 1984 Ethylene Oxide Standard. American Journal of 

Industrial Medicine. 34: 95-104. 

LaMontagne, AD, Oakes, JM, and Lopez, RN. 2004. Long-Term Ethylene Oxide 

Exposure Trends in U.S. Hospitals: Relationship with OSHA Regulatory and Enforcement Actions. American Journal76 of Public Health. 94: (9), 1614-1619.

NIOSH. 1989. Technical Report: Control Technology for Ethylene Oxide Sterilization in Hospitals. Report No. 89-120. National Institute for Occupational Safety and 

Health. 89-120.pdf (179 pages). (Accessed September 17, 2005.) 

http://www.cdc.gov/niosh/pdfs/89-120.pdf

NIOSH. 2006. Ethylene Oxide - Registry of Toxic Effects of Chemical Substances 

(RTECS). National Institute for Occupational Safety and Health (NIOSH). (Accessed 

September 21, 2006.) 

http://www.cdc.gov/niosh/rtecs/kx256250.html#L

77 Section 7
Section 8

8. OSHA Assistance 

OSHA can provide extensive help through a variety of programs, including technical assistance about effective safety 

and health programs, state plans, workplace consultations, 

and training and education. 

Safety and Health Management System Guidelines

Effective management of worker safety and health protection is a decisive factor in reducing the extent and severity 

of work-related injuries and illnesses and their related costs. 

In fact, an effective safety and health management system 

forms the basis of good worker protection, can save time and 

money, increase productivity and reduce employee injuries, 

illnesses and related workers’ compensation costs.

To assist employers and workers in developing effective safety and health management system, OSHA published recommended Safety and Health Program Management Guidelines 

(54 Federal Register (16): 3904-3916, January 26, 1989). 

These voluntary guidelines can be applied to all places of 

employment covered by OSHA.

The guidelines identify four general elements critical to the 

development of a successful safety and health management 

system:

•	 Management leadership and employee involvement,

•	 Worksite analysis,

•	 Hazard prevention and control, and

•	 Safety and health training.

The guidelines recommend specific actions, under each of 

these general elements, to achieve an effective safety and 

health management system. The Federal Register notice is 

available online at www.osha.gov. 

 

State Programs

The Occupational Safety and Health Act of 1970 (OSH 

Act) encourages states to develop and operate their own job 

safety and health plans. OSHA approves and monitors these 

plans. Twenty-four states, Puerto Rico and the Virgin Islands 

currently operate approved state plans: 22 cover both private and public (state and local government) employment; 

Connecticut, New Jersey, New York and the Virgin Islands 

cover the public sector only. States and territories with their 

own OSHA-approved occupational safety and health plans 

must adopt standards identical to, or at least as effective as, 

the Federal OSHA standards. 

Consultation Services

Consultation assistance is available on request to employers 

who want help in establishing and maintaining a safe and 

healthful workplace. Largely funded by OSHA, the service 

is provided at no cost to the employer. Primarily developed 

for smaller employers with more hazardous operations, the 

consultation service is delivered by state governments employing professional safety and health consultants. Comprehensive assistance includes an appraisal of all mechanical 

systems, work practices, and occupational safety and health 

hazards of the workplace and all aspects of the employer’s 

present job safety and health program. In addition, the service offers assistance to employers in developing and imple78
Section 8

menting an effective safety and health program. No penalties are proposed or citations issued for hazards identified 

by the consultant. OSHA provides consultation assistance 

to the employer with the assurance that his or her name 

and firm and any information about the workplace will not 

be routinely reported to OSHA enforcement staff. For more 

information concerning consultation assistance, see OSHA’s 

website at www.osha.gov. 

Strategic Partnership Program

OSHA’s Strategic Partnership Program helps encourage, assist and recognize the efforts of partners to eliminate serious 

workplace hazards and achieve a high level of worker safety 

and health. Most strategic partnerships seek to have a broad 

impact by building cooperative relationships with groups of 

employers and workers. These partnerships are voluntary 

relationships between OSHA, employers, worker representatives, and others (e.g., trade unions, trade and professional 

associations, universities, and other government agencies). 

For more information on this and other agency programs, 

contact your nearest OSHA office, or visit OSHA’s website at 

www.osha.gov.

OSHA Training and Education

OSHA area offices offer a variety of information services, 

such as technical advice, publications, audiovisual aids and 

speakers for special engagements. OSHA’s Training Institute 

in Arlington Heights, IL, provides basic and advanced courses in safety and health for Federal and state compliance 

officers, state consultants, Federal agency personnel, and 

private sector employers, workers and their representatives.

The OSHA Training Institute also has established OSHA 

Training Institute Education Centers to address the increased demand for its courses from the private sector and 

from other federal agencies. These centers are colleges, 

universities, and nonprofit organizations that have been selected after a competition for participation in the program.

OSHA also provides funds to nonprofit organizations, 

through grants, to conduct workplace training and education 

in subjects where OSHA believes there is a lack of workplace 

training. Grants are awarded annually.

For more information on grants, training and education, 

contact the OSHA Training Institute, Directorate of Training 

and Education, 2020 South Arlington Heights Road, Arlington Heights, IL 60005, (847) 297-4810, or see Training on 

OSHA’s website at www.osha.gov. For further information 

on any OSHA program, contact your nearest OSHA regional 

office listed at the end of this publication. 

Information Available Electronically

OSHA has a variety of materials and tools available on its 

website at www.osha.gov. These include electronic tools, 

such as Safety and Health Topics, eTools, Expert Advisors; 

regulations, directives and publications; videos and other 

information for employers and workers. OSHA’s software 

programs and eTools walk you through challenging safety 

and health issues and common problems to find the best 

solutions for your workplace. 

79
Section 8

OSHA Publications

OSHA has an extensive publications program. For a listing of 

free items, visit OSHA’s website at www.osha.gov or contact 

the OSHA Publications Office, U.S. Department of Labor, 

200 Constitution Avenue, NW, N-3101, Washington, DC 

20210; telephone (202) 693-1888 or fax to (202) 693-

2498. 

Contacting OSHA

To report an emergency, file a complaint, or seek OSHA 

advice, assistance, or products, call (800) 321-OSHA or 

contact your nearest OSHA Regional office listed at the end 

of this publication. The teletypewriter (TTY) number is (877) 

889-5627. 

Written correspondence can be mailed to the nearest OSHA 

Regional or Area Office listed at the end of this publication 

or to OSHA’s national office at: U.S. Department of Labor, 

Occupational Safety and Health Administration, 200 Constitution Avenue, N.W., Washington, DC 20210. 

By visiting OSHA’s website at www.osha.gov, you can also: 

•	 File a complaint online,

•	 Submit general inquiries about workplace safety and

health electronically, and 

•	 Find more information about OSHA and occupational

safety and health.

80
Section 9

9. OSHA Regional Offices 

Region I

(CT,* ME, MA, NH, RI, VT*)

JFK Federal Building, Room E340

Boston, MA 02203

(617) 565-9860

Region II

(NJ,* NY,* PR,* VI*)

201 Varick Street, Room 670

New York, NY 10014

(212) 337-2378

Region III

(DE, DC, MD,* PA, VA,* WV)

The Curtis Center

170 S. Independence Mall West

Suite 740 West

Philadelphia, PA 19106-3309

(215) 861-4900

Region IV 

(AL, FL, GA, KY,* MS, NC,* SC,* TN*)

61 Forsyth Street, SW, Room 6T50

Atlanta, GA 30303

(404) 562-2300

Region V

(lL, IN,* MI,* MN,* OH, WI)

230 South Dearborn Street

Room 3244

Chicago, IL 60604

(312) 353-2220

Region VI

(AR, LA, NM,* OK, TX)

525 Griffin Street, Room 602

Dallas, TX 75202

(972) 850-4145

Region VII

(IA,* KS, MO, NE)

Two Pershing Square 

2300 Main Street, Suite 1010

Kansas City, MO 64108-2416

(816) 283-8745

Region VIII

(CO, MT, NO, SO, UT,* WY*)

1999 Broadway, Suite 1690

PO Box 46550

Denver, CO 80202-5716

(720) 264-6550

Region IX

(AZ,* CA,* HI,* NV,* and American 

Samoa, Guam and the Northern 

Mariana Islands)

90 7th Street, Suite 18-100

San Francisco, CA 94103

(415) 625-2547

Region X

(AK,* ID, OR,* WA*)

1111 Third Avenue, Suite 715

Seattle, WA 98101-3212

(206) 553-5930

* These states and territories operate 

their own OSHA-approved job safety 

and health programs and cover state 

and local government employees as 

well as private sector employees. The 

Connecticut, New Jersey, New York 

and Virgin Islands plans cover public 

employees only. States with approved 

programs must have standards that are 

identical to, or at least as effective as, 

the Federal OSHA standards. 

Note: To get contact information for 

OSHA Area Offices, OSHA-approved 

State Plans and OSHA Consultation 

Projects, please visit us online at www.

osha.gov or call us at 1-800-321-

0SHA. 

81