The Atlanta Journal-Constitution
For cancer survivors, emissions unnerving
Sterigenics controversy raises health questions for many.
The luxury subdivisions in this well-to-do corner of suburban Atlanta belie its industrial past with names like Stonehall, Polo Place and Olde Vinings.
But the red brick plant that came to be owned by Sterigenics has been here on the Cobb County side of the Chattahoochee River since the early 1970s, legally emitting the cancer-causing gas ethylene oxide over decades.
Today, the area is home to tens of thousands of residents who recently discovered the plant has potential implications for their health and home values.
Sterigenics uses ethylene oxide to sterilize single-use med
‘It was just as alarming and surprising a few weeks later when news broke of the plant. It’s hard to ignore that it could be a part of the puzzle.’ Todd Smith diagnosed with a form of nonHodgkin’s lymphoma
‘You just want answers. You want to know what’s in your air. I’m planning my wedding, and it’s bittersweet because I want my father to be there, and ... He’s just not here for that. It’s hard.’ Mariam Slaibi whose father died of cancer
ical devices, such as syringes and catheters, because it can penetrate packaging and hard-toreach surfaces. The Food and Drug Administration says the chemical may be the only way to effectively sterilize many devices without damaging them.
Ethylene oxide has been considered a probable carcinogen for many years. But facing mounting evidence of its toxicity, the federal government reclassified the chemical as a definite carcinogen in 2016.
Federal regulators also concluded that ethylene oxide is dangerous at much lower levels than previously thought and began recalibrating the cancer risks from known sources — including Sterigenics, which is how the plant became a target of public protest and calls for closure.
State and federal officials have pledged to investigate public health concerns. But experts say establishing links between cancer and environmental pollutants is a challenge. There are many genetic and external factors that cause people to develop cancer.
“Causality is really hard to prove, especially in environmental exposures, because we’re never exposed to ( just) one compound,” said Richard Peltier, an expert in air pollution exposure at the University of Massachusetts, Amherst. “Your neighbor burning brush in their back yard; someone walking by holding a cigarette; a diesel truck driving by — we’re exposed to all of it.”
Georgia’s state epidemiologist, Cherie Drenzek, told the audience at a town hall meeting in Cobb that a preliminary survey of the cancer registry did not show an increased incidence of cancer in the six ZIP codes surrounding the plant.
“Again, this is preliminary data,” she emphasized. “Again, it may be reassuring to us, but it’s only the first step.”
A Sterigenics spokesman declined to comment for this story, but company officials have said that the plant’s operations are safe and pose no threat to nearby residents.
In the meantime, news of the plant’s toxic emissions has had a dramatic effect on the community. The children at a local school are kept indoors for recess. Some residents have bought expensive air filters. “For Sale” signs are going up on front lawns.
And for those whose lives have already been upended by cancer, it has revived painful questions about the origins of the disease for which there are no easy answers.
Here are three of their stories.
‘I just keep going’
Barry Goppman is happiest when he’s zooming down the tree-lined Silver Comet Trail on his road bike, Pittsburgh Steelers tattoo proudly bared on his right forearm. It was his morning ritual before he was diagnosed with chronic lymphocytic leukemia three years ago.
Now, Goppman tries to make it out to the trail at least once a week but said he finds his disease very limiting at times.
“I never thought I was going to be a nap guy, but now I have to be a nap guy to make it through the day,” he said. “I just keep going. Lean forward versus lean back.”
The 72-year-old Pennsylvania native moved to the Smyrna area, not far from the plant, about 20 years ago after giving up a career in advertising to pursue his passion for fitness and personal training. Since his diagnosis, Goppman has undergone several rounds of chemotherapy and medication-based treatments, some of which had severe side effects.
Goppman said he is angry at what he sees as government inaction toward toxic emissions from the Sterigenics plant. He wants the plant shut down and an independent investigation of the potential health effects.
“You wonder, when you come down with a life-threatening disease, how did I get it? What did I do? What did I eat?” he said. “I’m working on beating this disease, and if I can at least tie the string together of why and how, that will at least make me feel a little better.”
‘You want to know’
When the Slaibi sisters first saw a post on social media about a cancer-causing gas in their neighborhood, they said it felt like a horror movie. Their first instinct was to close the windows until they realized it wasn’t an accidental leak, but rather ongoing, permitted emissions.
The more they read, the more they thought of their father, Mohamad, who succumbed to renal cell carcinoma last summer after a brief but brutal struggle.
“You just want answers. You want to know what’s in your air,” said Mariam, 23, the youngest of Mohamad’s four daughters. “I’m planning my wedding, and it’s bittersweet because I want my father to be there, and ... He’s just not here for that. It’s hard.”
The Slaibis don’t know why their father got sick — they put their faith in God. He was a smoker, which is a risk factor for renal cell carcinoma.
Regardless, Mohamad Slaibi always put others before himself, they said, and he would want them to speak up for their community.
“Whether or not [ethylene oxide] caused my father’s death is almost irrelevant to me,” said Lamia Slaibi, 33, the second oldest. “What I’m angry about is the government and the EPA and the lax regulations.”
‘Clean air ... should be assumed’
Todd Smith noticed one of his lymph nodes near his jaw was swollen this past winter, but he figured it was one of the many bugs going around. He was, he reasoned, a healthy 42-year-old man.
But when it hadn’t gone away by spring, Smith, who works for The Atlanta Journal-Constitution’s parent company, Cox Enterprises, went to see a doctor. He was shocked when he was diagnosed with B-cell follicular non-Hodgkin’s lymphoma at the end of June.
“It was just as alarming and surprising a few weeks later when news broke of the plant,” Smith said. “It’s hard to ignore that it could be a part of the puzzle.”
Smith has lived within a few miles of the facility for about 17 years. He said if he had known the risk, he might have chosen to live somewhere else. And if the plant doesn’t cease emissions or relocate, he will consider moving his family out.
“I think clean air is something that should be assumed in a first class city,” Smith said.
Last week, Smith joined a legal challenge to an agreement between the state Environmental Protection Division and Sterigenics that allowed the company to continue operations while installing new emission controls. That filing alleges that out of the 101 homes in his subdivision, at least 20 households have had a family member diagnosed with cancer.
The battle over science
Kyle Steenland is the scientist who authored one of the most influential studies linking ethylene oxide to cancer among workers at sterilization plants. His work helped form the basis for the Environmental Protection Agency’s decision to reassess ethylene oxide’s toxicity.
Steenland said comprehensive air testing is needed before the health effects of ethylene oxide from a specific source can be studied.
“I would not be overly alarmed, but still concerned,” Steenland said of residents living near the Sterigenics plant in Cobb.
Smyrna, Atlanta and Cobb County have hired an environmental consultant to conduct air monitoring around the plant for a cost of about $130,000 split among the three. The state is conducting its own air monitoring.
Since the government confirmed ethylene oxide as a carcinogen in 2016, regulators have conducted air tests across the country and found the chemical is far more pervasive at higher levels than they thought. In Georgia, an air sample taken in south DeKalb County, miles from any known source of the gas, showed ethylene oxide at a level 15 times above the threshold deemed acceptable by the EPA.
The chemical industry and Texas state regulators, who are seen as industry-friendly by environmental groups, have seized on these findings to argue that there are likely many sources of ethylene oxide, and that the EPA has been overzealous in calculating cancer risk.
They have also sought to undermine the implications of work like Steenland’s, arguing that regulators should not draw conclusions about the risk from ambient exposure based on the negative health impacts among people who worked closely with ethylene oxide.
Steenland, now a professor of public health at Emory University, said it is customary to use “high dose studies” like his to extrapolate low dose risk.
Peltier, the pollution exposure expert from the University of Massachusetts, Amherst, agreed. He said reputable scientists are not naive to the limitations of their research. After all, he said, it’s not like they can lock people in a lab and expose them to toxic chemicals to see what happens.
“Even low doses of carcinogens still cause cancer,” Peltier said. “We would be not doing our job as scientists and regulators if we turn our back on someone who is putting out a known carcinogen.”