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How this story came about

When Grist reporters began talking to environmental advocates about ethylene oxide in 2023, we repeatedly heard that warehouses were a threat and that neither regulators nor community activists had any idea where they were. The advocates emphasized that, even as the Environmental Protection Agency was cracking down on emissions from sterilization facilities, it was overlooking warehouses. No one knew exactly how many of these warehouses existed, where they were located, or how much ethylene oxide they emitted. Ethylene oxide is a highly toxic substance, so we were taken aback by how little was known. We decided to try to fill in those gaps. 

What we found 

We found that two Cardinal Health warehouses in El Paso, Texas, likely pose a greater threat than a sterilization facility nearby. The emissions were resulting in additional cancer risk for a neighboring community that is higher than allowed by the EPA. We also identified about 30 other warehouses that emit ethylene oxide across the country. They are used by companies such as Boston Scientific, ConMed, and Becton Dickinson, as well as Cardinal Health. And they are not restricted to industrial parts of towns — they are near schools and playgrounds, gyms and apartment complexes.

From the outside, the warehouses do not attract attention. They look like any other distribution center. Many occupy hundreds of thousands of square feet, and dozens of trucks pull in and out every day. But when medical products are loaded, unloaded, and moved from these facilities, they belch ethylene oxide into the air. Most nearby residents have no idea that the nondescript buildings are a source of toxic pollution. Neither do most truck drivers, who are often hired on a contract basis, or many of the workers employed at the warehouses.

When Grist reported on the Cardinal Health warehouses in El Paso, our reporters handed out flyers to residents and workers so they could learn more and contact us. They’re available to view and download below:

How we identified the warehouses

The first list of roughly 30 warehouses primarily includes facilities that have reported ethylene oxide emissions to either the EPA or South Coast Air Quality Management District. We obtained these addresses by submitting public records requests to the agencies. We also identified a few warehouses on this list by speaking with truck drivers transporting medical devices from sterilization facilities to warehouses. 

The second list consists of warehouses that are owned or operated by some of the nation’s major medical device manufacturers. Since we had a list of 30 warehouses we know emit ethylene oxide, we identified the medical device manufacturers and distributors utilizing those warehouses for storage. We then expanded the search to all warehouses used by those companies. To be clear, there is no evidence to suggest that every warehouse on the second list emits ethylene oxide. Instead, they are being presented for further research by local reporters and concerned citizens. 

How to find warehouses in your area

Look through the two lists we’ve compiled. Are any in your area? Are there any companies that operate in your region or your state? 

If you don’t find any warehouses in your region on our lists, make a list of the medical device companies and distributors in your state. The major companies we’ve come across in our research are Cardinal Health, Medline, and Owens & Minor. Then attempt to identify where they warehouse products. You can find this information by looking at:

The company’s website

Some companies list their facilities — including warehouses — in the “About Us” or “Locations” sections of their website. If the company maintains a jobs portal, look for any warehouse-related positions and whether it lists a location of employment. 

SEC filings

If the company is publicly traded, it will need to submit financial information to the Securities and Exchange Commission. Search the SEC’s EDGAR database for the company’s filings. Sometimes, companies disclose their risk to litigation or regulation related to ethylene oxide. Some companies also list their assets, including facility locations, in these filings. 

Google Maps

Search for a medical device company in your area. For instance, if you’re interested in Medline, you can try “Medline warehouse” or “Medline distribution center” and see if any come up near you. 

If I’m a local reporter or a concerned resident, what can I do with this information now that I know where a warehouse is? 

Once you’ve identified a warehouse that you suspect might store products sterilized with ethylene oxide, you can try to confirm whether it emits the chemical through one of these methods:

Submit records requests to local and state environmental agencies

Reach out to the city or state agency that permits air quality in your region. Often it’s the state department of environmental quality, but sometimes they can be regional air quality districts (like in California) or city environmental offices. Ask for all air quality permit applications submitted by the warehouse operator in question or all correspondence by the warehouse operator that mentions ethylene oxide.

Try to connect it to a sterilization facility

Products are first fumigated with ethylene oxide at sterilization facilities before being sent to warehouses for storage. If products are being delivered from a sterilizer to the warehouse you’re investigating, that’s a strong indicator that the warehouse emits some amount of ethylene oxide. There are two main approaches to take when trying to flesh out the supply chain to warehouses.

• Talk to the drivers dropping off at warehouses: You can try to determine where products are coming from by talking to the truck drivers delivering shipments to the warehouse. 
• Talk to the drivers leaving sterilization facilities: There are fewer than 100 sterilization facilities in the country, and the EPA maintains a list of them here. If one is near you, you can ask drivers for information about where they are taking the products.
• Contact the company: Some companies have public relations or community engagement staff who respond to resident questions. Try reaching out to see if they’re open to talking to you. 

Talk to workers

Try to speak with the warehouse workers while they’re on break or at the end of their shift. Companies are required to inform their workers about ethylene oxide exposure, so you could ask questions about whether they’ve been in any meetings where managers referenced exposure to a chemical. Even still, many workers aren’t aware that they’re being exposed to ethylene oxide. But ask them if the facility has air quality monitors, and if so, whether they know what it’s monitoring for.

If I’m a resident wanting to get involved but have no journalism experience, what can I do to get more information?

• Take a look at this 2023 map and report assessing 104 facilities that emit ethylene oxide by the Union of Concerned Scientists.

• Any member of the public can file a Freedom of Information Act, or FOIA, request to get public information from the federal government. You can also file an open records request to get information from local and state agencies. There are many resources to help you craft these:
  – FOIA Wiki, made by Reporters Committee for Freedom of the Press
  – The federal FOIA website