Perhaps PHEs are like kids – impossible to pick a favorite!

by Steve MacArthur, Hospital Safety Consultant

So, now that monkeypox has made it to the big leagues with its declaration as a public health emergency (PHE), I can’t help but think that, for a lot of folks, it’s probably a little ways down on the priority list. (I’m thinking COVID’S still at the top of the list but could very quickly be supplanted by weather-related emergencies; and the opioid crisis is still percolating along with no end in sight).

But I am wondering what impact monkeypox has had on regular operations for hospitals. As one might expect, the greatest numbers of U.S. cases appear to be in what I would describe as “portals” (airline hubs, etc.), so I guess we’ll have to wait and see how the numbers change over time. Hopefully this ends up being not much of a deal. (Did we think that back in 2020? It seems so long ago, I’ve pretty much forgotten…)

In other news, our friends at the Environmental Protection Agency are in the process of their quindecennial (that’s the $5 word for every 15 years – talk about inflation…) registration review of pesticides, which includes, the use of, and the management of risks associated with ethylene oxide (EtO).

From my experience (and based on recent canvassing of colleagues), there’s not a lot of EtO use in hospitals any more (a very good thing, indeed), so I was somewhat surprised to see that it is still widely used in the sterilization of medical equipment/materials. According to EPA information,  50% of medical devices in the US are treated with EtO (that’s much higher that I would have imagined).

It does appear that the EPA is going to be looking at the requirements associated with the continued use of EtO, so I suppose things may reach a point where there’s an impact on the supply chain for medical devices, which would likely have the greatest impact to hospitals.

But, as I think about it, for those of you charged with emergency management and planning, is EtO something for which you’ve done planning? There aren’t a ton of places that use it extensively, but you can find companies that use the stuff in 33 of the U.S. states (check—you’ll see some company names that are more than passingly familiar).

At this point, it sounds like there aren’t a whole lot of alternatives for sterilizing the items that currently can only undergo this type of sterilization, but EPA is encouraging innovation (, so maybe if there are any innovators in the audience, this could help the community and maybe fund a retirement…

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at