Associations between observed concentrations of ethylene oxide in whole blood and smoking, exposure to environmental tobacco smoke, and cancers including breast cancer: data for US children, adolescents, and adults

For the first time, National Health and Nutrition Examination Survey released data on ethylene oxide (ETO) into public domain for US children aged 6–11 years, adolescents aged 12–19 years, and adults aged ≥ 20 years for 2013–2016. This study was undertaken to evaluate the associations between concentrations of ETO in whole blood and smoking, exposure to environmental tobacco smoke (ETS), and self-reported diagnosis of cancers including breast cancer. Both adolescent (29.6 vs. 49.6 pmol/g Hb, p < 0.01) and adult smokers (31.5 vs. 142.7 pmol/g Hb, p < 0.01) were found to have substantially higher adjusted levels of ethylene oxide than nonsmokers. Non-Hispanic blacks had higher levels of ethylene oxide than other race/ethnicities for children and adolescents. Non-Hispanic Asians had higher levels of ethylene oxide than other race/ethnicities for adults. Exposure to ETO measured by the number of smokers smoking inside the home (p < 0.01) and number of days smokers smoked inside the home (p = 0.03) during the prior week was found to be associated with elevated levels of ETO (p < 0.01) among US adults. Increased age was associated with elevated levels of ETO among adolescents (p = 0.02) and adults (p < 0.01) but the reverse was true for children (p = 0.04). For the general US population, levels of ETO were not found to be associated with cancers including breast cancer.