Ethylene Oxide Sterigenics Cancer Lawsuit 2026: What Victims Need to Know

The residents of Willowbrook, Illinois, never knew their neighborhood carried one of the most alarming cancer risk scores ever recorded in an American community. They went about their daily lives — dropping kids at school on Illinois Route 83, grabbing groceries on Plainfield Road, sleeping with windows cracked on summer nights — while an industrial gas they could not see or smell drifted from a medical device sterilization plant less than a mile away.

That changed in 2018. When the EPA released its National Air Toxics Assessment (NATA), built on 2014 monitoring data, the census tract surrounding Sterigenics’ Willowbrook facility registered a lifetime cancer risk of approximately 281.8 per million people. The EPA’s generally acceptable benchmark is one per million; California’s threshold is ten per million. Willowbrook’s score sat at nearly 282 times that mark — the highest cancer risk score in Illinois, landing in the 99.9th percentile nationally. The Agency for Toxic Substances and Disease Registry (ATSDR) separately found cancer risk in the surrounding area to be 64 times the acceptable limit.

People who had lived there for decades read those numbers in news alerts on their phones. Some had already been diagnosed with cancer. Some had already buried spouses and neighbors. What followed was one of the most consequential toxic tort litigations in American history — a wave of lawsuits that produced a $363 million jury verdict, an $408 million mass settlement, and a legal template now being applied to facilities across the country.

The Willowbrook story is not unique. The same 2018 NATA report identified dozens of census tracts across the country where EtO emissions from sterilization facilities were driving cancer risk scores well above the acceptable range. Communities in Georgia, Texas, New Jersey, Ohio, and elsewhere received similar devastating news. In each of those communities, as in Willowbrook, the question was the same: who knew, when did they know it, and what did they do about it?

This post explains what ethylene oxide is, why these lawsuits exist, what courts have decided, who qualifies to file a claim in 2026, and exactly what you need to do if you think you have been exposed.

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What Is Ethylene Oxide, and Why Did It Take So Long to Act?

Ethylene oxide (EtO) is a colorless, flammable gas that has been used since the 1930s to sterilize heat-sensitive medical devices — surgical instruments, catheters, dialysis equipment, implantable devices. It penetrates packaging and kills bacteria, viruses, and fungi. Roughly half of all sterilized medical devices sold in the United States pass through an EtO chamber at some point in their supply chain.

The problem is not what EtO does inside the sterilization chamber. The problem is what escapes into the surrounding air.

The International Agency for Research on Cancer (IARC) classified ethylene oxide as a Group 1 human carcinogen — the highest possible designation, meaning sufficient evidence exists in humans for carcinogenicity — based on epidemiological studies linking occupational EtO exposure to leukemia and breast cancer. The EPA’s Integrated Risk Information System (IRIS) program independently lists EtO as a known human carcinogen, estimating its cancer potency at roughly 30 times higher than the agency had assumed in earlier assessments. That revised IRIS toxicity value, finalized in 2016 after years of review, underpinned the alarming NATA scores published in 2018.

Why the gap between the 2016 IRIS update and the 2018 NATA publication? The IRIS assessment was a scientific document; translating it into NATA risk scores required applying the new potency values to facility-level emissions data from EPA’s National Emissions Inventory, running air dispersion models, and aggregating the results census-tract by census-tract across the entire country. That computational process takes time. And even after the NATA scores were published in August 2018, the regulatory response was not immediate — EtO had been used commercially for decades, regulated facilities had permits, and shutting them down raised genuine questions about the medical device supply chain.

So regulatory agencies had the toxicology. They had updated risk factors. They published a national map that identified Willowbrook as the single most cancer-burdened census tract in Illinois. And yet the Illinois EPA did not issue an emergency seal order shutting down the Sterigenics Willowbrook plant until February 2019 — seven months after the NATA data went public. The plant permanently closed in September 2019.

Plaintiffs’ lawyers and advocacy groups argue that the gap between scientific knowledge and regulatory action left thousands of residents exposed for years — perhaps decades — longer than necessary. Defense counsel argued that Sterigenics was operating within permitted emission limits and that community exposure levels were far below those shown to cause harm in occupational studies. That fundamental dispute — were residential exposures meaningfully dangerous? — sat at the center of every trial and settlement negotiation.

The argument forms the moral and legal core of the litigation.

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Who Is Sterigenics, and What Did It Actually Emit?

Sterigenics International LLC operates commercial medical device sterilization facilities across the United States. Its parent company, Sotera Health Company (Nasdaq: SHC), went public in November 2020 in an IPO that raised approximately $936 million. At the time, the Willowbrook litigation was already looming.

The Willowbrook facility had operated since the 1980s. Sterigenics used ethylene oxide gas in sealed chambers, then vented treated air through emission control systems — systems that plaintiffs allege were inadequate and allowed substantial quantities of EtO to escape into the surrounding residential and commercial neighborhood.

According to the complaint filed in Cook County Circuit Court and parallel federal filings in the U.S. District Court for the Northern District of Illinois, Sterigenics knew, or should have known, that its emissions posed a significant cancer risk to nearby residents. Plaintiffs allege that the company failed to implement available emission controls, failed to warn the community, and continued operating despite its knowledge of EtO’s carcinogenicity.

Sterigenics and Sotera Health disputed many of these characterizations, arguing that their emissions complied with applicable regulations and that the plaintiffs could not establish medical causation between their specific cancer diagnoses and EtO emissions from the Willowbrook plant.

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The Susan Kamuda Verdict: A $363 Million Turning Point

Every mass tort has a moment that reorders the financial calculus. For ethylene oxide litigation, that moment came on September 19, 2022, in a Cook County courtroom.

Susan Kamuda had lived within a quarter-mile of the Sterigenics Willowbrook plant for more than 30 years. She was diagnosed with breast cancer in 2007. Her lawsuit alleged that chronic inhalation of EtO emissions from the plant caused her cancer. After a jury trial, the Cook County jury returned a verdict that stunned the defense:

• Compensatory damages: $38 million
• Punitive damages: $325 million
• Total: $363 million

The jury apportioned fault as follows: Sterigenics 65% liable, Sotera Health 30% liable, and Griffith Foods (which had previously owned and operated the facility) 5% liable.

The Griffith Foods allocation deserves a note. Griffith Foods is a food ingredient company that previously occupied and operated the Willowbrook site before Sterigenics. The jury’s finding that a prior operator bore 5% of the fault established an important precedent: liability can attach to former operators who used EtO at the site, not just the current or most recent one. This has implications for other sites with complex ownership histories.

This was the first ethylene oxide trial to reach a jury verdict in American history. The $363 million figure was not just a headline — it was a data point that defense counsel and their clients had to incorporate into settlement valuations for every other case in the queue. Defendants who had been willing to fight suddenly faced the prospect of repeated nine-figure verdicts. Sotera Health’s stock dropped sharply on the day of the verdict announcement, underscoring how directly financial markets were tracking litigation exposure.

Plaintiffs’ attorneys had additional cases queued in Cook County Circuit Court ready to proceed to trial. The prospect of serial eight- and nine-figure verdicts — across 870+ pending claims — made the January 2023 settlement almost mathematically inevitable.

Within months, settlement negotiations accelerated dramatically.

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The $408 Million Illinois Settlement and What Followed

In January 2023, Sterigenics and Sotera Health reached a global settlement resolving more than 870 pending Illinois lawsuits for a total of $408 million. For context, this was one of the largest toxic tort settlements in Illinois history.

The settlement covered cases filed in both Cook County Circuit Court and the Northern District of Illinois. Importantly, the Willowbrook EtO litigation did not proceed through a federal Multidistrict Litigation (MDL) mechanism — there is no MDL docket number to cite here. The parallel state and federal filing structure meant plaintiffs had choices about venue, and both tracks fed into the same ultimate settlement pool.

The litigation did not end there. Sterigenics’ facility in Smyrna, Georgia became the next major battleground. In October 2023, Sterigenics settled approximately 79 lawsuits related to the Smyrna facility for roughly $35 million, while approximately 400 additional cases remained pending in Cobb County Superior Court.

Settlement activity continued through 2024 and into 2025:

• April 2025: Sterigenics settled 97 additional Illinois claims for $31 million
• July 2025: Sterigenics settled 129 additional Illinois claims for $34 million
• March 2025: STERIS subsidiary Isomedix (which operates a facility in Waukegan, Illinois) settled the majority of its pending Cook County EtO claims for up to $48.15 million

These numbers illustrate a litigation that is still very much active. While the largest single tranche — the $408 million 2023 settlement — resolved the majority of Willowbrook claims, new plaintiffs continue to file, and separate defendants in other states are now facing their own reckoning.

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The Georgia Cases: C.R. Bard and the Walker Verdict

Illinois is not the only state where EtO lawsuits are reshaping litigation strategy. Georgia has emerged as a second major front, and for a different reason: the defendants there include Becton Dickinson (BD) and its C.R. Bard subsidiary, which operates a medical device manufacturing and sterilization facility in Covington, Georgia.

In May 2025, a Georgia jury delivered a significant verdict in the case of Gary Walker, a truck driver who alleged that decades of exposure near the C.R. Bard Covington plant caused his non-Hodgkin lymphoma. The jury awarded $20 million in compensatory damages. The punitive phase ended in a mistrial after jurors could not agree, but the compensatory award itself sent a clear signal about jury sympathy in Georgia EtO cases.

The Walker verdict matters for several reasons. First, it demonstrates that Sterigenics is not the only corporate target — BD/Bard is a Fortune 500 company with deep pockets and a significant litigation history of its own (see the AFFF firefighting foam lawsuit → for a comparable pattern of large-company environmental liability). Second, it confirms that Georgia juries are willing to hold industrial defendants accountable for EtO emissions even when the defendant frames its operations as essential to the medical device supply chain.

Other defendants active in EtO litigation across multiple states include B. Braun, Midwest Sterilization Corp., and PCS (Precision Castparts’ sterilization subsidiary). The legal theory across all these cases is substantively similar: EtO emissions, inadequate controls, community exposure, cancer causation.

What makes the Georgia litigation structurally different from Illinois is the identity of the defendants and the nature of the facility. Covington’s C.R. Bard plant is not primarily a contract sterilization service — it is a manufacturing facility that sterilizes its own products, primarily medical catheters and vascular grafts. This distinction matters because it affects the corporate hierarchy: the entity responsible for the emissions is not a third-party sterilizer but the manufacturer itself. Becton Dickinson acquired C.R. Bard in 2017 for approximately $24 billion, making the parent company a deep-pocketed defendant with significant insurance coverage.

Plaintiffs in the Georgia cases include residents of Newton and Rockdale counties who lived in areas the EPA flagged in its NATA data, as well as employees of businesses near the Covington facility. The EtO plume from the Covington plant did not stop at county lines; air dispersion modeling introduced at trial showed the gas migrating into residential neighborhoods at concentrations that, over decades of exposure, plaintiffs allege produced statistically elevated cancer rates.

The Smyrna, Georgia facility (the second Sterigenics plant in the state) sits in Cobb County, a suburban Atlanta county that is home to roughly 760,000 people. The October 2023 settlement resolving 79 cases there for approximately $35 million left nearly 400 claims pending — a pool large enough to suggest the Smyrna litigation has years of activity remaining.

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Which Cancers Qualify? The Science Behind the Claims

Not every cancer diagnosis in the vicinity of an EtO facility gives rise to a cognizable legal claim. Attorneys and their medical experts must establish a credible scientific link between EtO exposure and the specific cancer type. Based on IARC classifications and the epidemiological literature referenced in the litigation, the following cancers are currently recognized as qualifying diagnoses in EtO lawsuits:

Cancer Type	IARC / EPA Basis	Notes
Non-Hodgkin lymphoma	Strong epidemiological association	Most frequently claimed in litigation
Leukemia (all subtypes)	IARC Group 1 primary basis	Lymphocytic leukemia most cited
Multiple myeloma	Supported by occupational studies	Blood/bone marrow cancer
Breast cancer	IARC Group 1 (hormone-dependent)	Kamuda case; 30+ years proximity
Liver cancer	Supported in animal and human data	Less common but accepted
Lung cancer	Occupational exposure studies	Requires ruling out tobacco
Uterine/endometrial cancer	Hormone-disruption pathway	Emerging claims
Kidney cancer	Supported in some studies	Requires strong proximity data
Pancreatic cancer	Limited but recognized	Typically requires high exposure

Two important caveats. First, the scientific link is probabilistic — EtO increases relative risk but cannot be shown to have definitively caused any individual’s cancer. Plaintiffs’ experts use epidemiological data to argue that absent the exposure, the plaintiff would have had a lower baseline risk. Defense experts argue that causation cannot be established at the individual level. Courts have generally allowed both sides to present this evidence to juries.

Understanding how causation arguments work in practice matters when evaluating your case’s strength. Plaintiffs’ epidemiologists typically testify about studies of workers in EtO-exposed occupations — nurses who handled EtO-sterilized supplies, factory workers at sterilization plants, agricultural fumigant applicators — where exposure levels could be measured and cancer incidence rates could be compared against control populations. The IARC’s Group 1 designation for EtO was based in large part on studies of female factory workers in Sweden and male chemical workers in the United States that found significantly elevated rates of breast cancer and leukemia, respectively, compared to unexposed populations.

The translation from occupational exposure data to residential exposure litigation requires a second layer of expert testimony: air dispersion modeling. Atmospheric scientists calculate how much EtO a person at a given address, in a given wind pattern, at a given time of year, would have inhaled over their period of residence. This modeled dose is then compared against dose-response relationships from the occupational literature to estimate relative risk elevation. Defense experts routinely challenge both the air dispersion models and the dose-response extrapolations, arguing that residential exposures were orders of magnitude lower than the occupational exposures studied. Courts and juries ultimately decide whose science is more persuasive.

Second, certain cancers are excluded or face high barriers — prostate cancer, colorectal cancer, and brain tumors, for example, have weaker scientific support in the context of EtO exposure and have not been accepted in the main Sterigenics litigation.

If you have a cancer type not on this list, that does not mean a lawsuit is impossible — it means you need an attorney with a strong medical science team who can evaluate whether the current literature supports your specific diagnosis.

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Who Qualifies to File in 2026? Eligibility Breakdown

Eligibility for an EtO lawsuit is fact-specific, but four core criteria apply in virtually every case:

1. Geographic proximity: You must have lived or regularly worked within approximately 4 miles of a qualifying EtO sterilization facility for at least one continuous year. For Willowbrook, the relevant facility is the former Sterigenics plant. For Covington, Georgia, it is the C.R. Bard/BD plant. Other facilities exist across the country — the EPA’s NATA data can help identify high-risk zones.

2. Duration of exposure: A single year of residence is typically the minimum floor. Cases with strong exposure profiles involve 5, 10, or 20+ years of proximity. The longer the exposure, the stronger the causation argument.

3. Qualifying cancer diagnosis: The cancer must be on the accepted list (see table above). It must have been diagnosed by a licensed medical professional with adequate documentation.

4. Latency period: Most environmental cancers have a latency of years to decades between exposure and diagnosis. As a rough benchmark, most EtO litigation criteria require at least 2 years from first exposure to diagnosis; for blood cancers and breast cancer, some attorneys apply a 5-year minimum latency window.

Eligibility Criterion	Typical Requirement
Distance from facility	Within ~4 miles
Duration of residence/employment	≥ 1 continuous year
Cancer diagnosis	Qualifying type (see table above)
Latency from first exposure	≥ 2 years (5+ years for some cancers)
Age at time of exposure	Any
Immigration/citizenship status	Generally not a bar to civil claims
Prior smoker	Does not automatically disqualify; reduces but doesn’t eliminate claim

One common misconception: people who smoked cigarettes sometimes assume they cannot sue because tobacco is a known lung cancer risk. In lung cancer claims, prior tobacco use complicates (but does not necessarily defeat) a claim — it is a comparative fault issue, not an absolute bar. For non-Hodgkin lymphoma, leukemia, or breast cancer, prior tobacco use is largely irrelevant.

Another nuance worth understanding: you do not need to have lived continuously in the same house for years. Courts have accepted cumulative exposure arguments — if you lived at Address A (2 miles from the plant) for 3 years, then at Address B (1 mile from the plant) for 5 years, then returned to Address A for another 2 years, your total proximity history is evaluated in the aggregate. What matters is the total cumulative EtO dose you allegedly absorbed, which air dispersion modeling can estimate for each address and time period.

Workers at nearby businesses — restaurants, retail stores, schools, and offices within the 4-mile zone — may also have valid claims. Eight hours a day, five days a week at a location close to the emission source can represent significant cumulative exposure. Teachers at schools near the Willowbrook plant were among the plaintiffs in the Illinois litigation. First responders who regularly worked near the facility may also qualify. The key question is always: what was your cumulative modeled exposure dose, and is it sufficient to establish a meaningful risk elevation above background rates?

A note on children and deceased plaintiffs: Children who lived near EtO facilities during developmental years — when cancer susceptibility is often heightened — may have valid claims if they were later diagnosed with qualifying cancers. For plaintiffs who have already died from their cancer, the estate or surviving family members may be able to pursue a wrongful death claim (see wrongful death lawsuit settlement 2026 → for the full legal framework).

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Statute of Limitations by State: Don’t Miss Your Window

The deadline to file an EtO lawsuit varies by state. Most follow the discovery rule — the statute of limitations begins running when you know (or reasonably should have known) that your cancer may have been caused by your exposure, not necessarily at the time of your first exposure. In practice, this often means the clock starts at your cancer diagnosis date, though it can be earlier if you received public health warnings.

State	Statute of Limitations	Discovery Rule?	Notes
Illinois	2 years	Yes	Key Willowbrook state; most cases filed in Cook County or N.D. Ill.
Georgia	2 years	Yes	Key Covington/Smyrna state; Cobb County and DeKalb County cases
Texas	2 years	Yes	Some EtO facilities; TDP (Texas discovery rule) applies
Ohio	2 years	Yes	BD Bard and other facilities
New Jersey	2 years	Yes	Several EtO sterilization sites
California	2 years	Yes	3-year window for fraud-based claims
Florida	2 years	Yes	Changed from 4 years in 2023; check if prior law applies
New York	3 years	Yes	Environmental claims may get extended
North Carolina	3 years	Yes	Statute starts at discovery
Federal court (N.D. Ill.)	Applies state SOL	N/A	Federal diversity cases borrow state limitations period

This table is illustrative only — confirm current deadlines with an attorney in your state. Statutes of limitations are subject to legislative change, court interpretation, and tolling arguments that vary case by case. Missing your deadline is almost always fatal to a claim, and there are very few exceptions once time has run.

A few scenarios where the SOL clock may run differently than you expect:

You were a minor during exposure. Most states toll (pause) the statute of limitations while a plaintiff is a minor. The clock typically begins running when the minor reaches the age of majority — 18 in most states — or, if later, when the cancer diagnosis is made. If you lived near an EtO facility as a child and were diagnosed with leukemia at age 22, your SOL window in most states would run from the date of diagnosis at 22, not from your childhood.

The defendant concealed the risk. In some jurisdictions, active fraudulent concealment by the defendant can toll the statute of limitations, extending the filing window. Plaintiffs in Illinois argued that Sterigenics knew its emissions were unsafe and failed to disclose this to regulators and the public. Courts have allowed discovery to explore this argument. Whether it succeeds in any individual case is highly fact-dependent.

Class action tolling. If you were a member of a putative class action that was later decertified or not certified, American Pipe tolling may have preserved your individual claim during the class action’s pendency. This is a technical legal argument that requires attorney evaluation.

The safest approach: contact an attorney immediately if you think you may have a claim, even if you are unsure. Most EtO attorneys offer free consultations and will evaluate your timeline at no cost.

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Settlement Math: What Does a Real Recovery Look Like?

Understanding what you might actually receive — net of attorneys’ fees, medical liens, and taxes — is essential before you file. Most plaintiffs are surprised by how much comes out of a gross settlement before they see a check.

Illustrative Scenario A: $300,000 Gross Settlement, 33% Contingency

Item	Amount
Gross settlement	$300,000
Attorney’s contingency fee (33%)	−$99,000
Case expenses advanced by attorney	−$8,000
Medicare/Medicaid lien (illustrative)	−$25,000
Health insurance lien (illustrative)	−$10,000
Net to plaintiff	$158,000

Illustrative Scenario B: $500,000 Gross Settlement, 40% Contingency

Item	Amount
Gross settlement	$500,000
Attorney’s contingency fee (40%)	−$200,000
Case expenses advanced by attorney	−$15,000
Medicare/Medicaid lien (illustrative)	−$45,000
Health insurance lien (illustrative)	−$18,000
Net to plaintiff	$222,000

These are hypothetical illustrations only. Actual recoveries depend on your specific cancer diagnosis, length and intensity of exposure, the defendant’s financial position, negotiating leverage, and the specific facts of your case. They are not predictions of any actual outcome.

Illustrative Scenario D: Contingency Fee Math at Two Different Rates on the Same $250,000 Settlement

	33% Fee	40% Fee
Gross settlement	$250,000	$250,000
Attorney fee	$82,500	$100,000
Case expenses ($7k)	$7,000	$7,000
Medicare lien ($20k)	$20,000	$20,000
Health insurance lien ($8k)	$8,000	$8,000
Net to plaintiff	$132,500	$115,000
Difference from fee structure	—	−$17,500

The 7-percentage-point difference in contingency rate on a $250,000 settlement produces a $17,500 swing in what you actually take home. On higher settlements, the impact grows proportionately. This is why negotiating the contingency rate at intake — when you have the most leverage — matters. Some firms will move from 40% to 33% for plaintiffs with very strong exposure and cancer facts. Others won’t budge. It is always worth asking.

For a detailed breakdown of how contingency fees work and how to negotiate them, see personal injury lawyer fee 2026 →.

The Medicare Lien Problem

Medicare and Medicaid have a statutory right to seek reimbursement for medical expenses they paid related to your cancer treatment — from your settlement proceeds. This is called a “lien” or “conditional payment.” If you received Medicare or Medicaid-covered chemotherapy, surgery, radiation, or hospitalizations, expect a lien demand. These can be negotiated down, but they cannot be ignored. Failing to satisfy a Medicare lien can expose both you and your attorney to personal liability to the federal government.

Under the Medicare Secondary Payer Act, your attorney is required to satisfy Medicare’s lien before disbursing funds to you. This is non-negotiable. Factor it into your expectations from the start.

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Tax Treatment of Your EtO Settlement: IRC §104 Explained

One of the most frequent questions plaintiffs ask is: “Do I pay taxes on my settlement?” The short answer is: it depends on the type of damages.

Under Internal Revenue Code §104(a)(2), compensatory damages received on account of personal physical injury or physical sickness are excluded from gross income. Cancer caused by toxic exposure is clearly a physical sickness. So compensatory damages — medical costs, pain and suffering, lost wages arising from the physical injury — are generally not taxable at the federal level.

Punitive damages are a different story. Under current law, punitive damages do not fall within the §104(a)(2) exclusion and are taxable as ordinary income. Given that the Kamuda verdict included $325 million in punitives — roughly 90% of the total award — the tax treatment of punitive damages matters enormously in high-value cases.

Interest on a delayed settlement or judgment is also fully taxable, even if the underlying compensatory damages are tax-free.

Illustrative Scenario C: Tax Treatment of a Mixed Award

Component	Gross Amount	Taxable?
Compensatory damages (medical, pain and suffering)	$80,000	No (§104(a)(2))
Lost wages (arising from physical injury)	$40,000	No (§104(a)(2))
Emotional distress not tied to physical injury	$10,000	Yes
Punitive damages	$150,000	Yes
Pre-judgment interest	$5,000	Yes
Total	$285,000	$165,000 taxable

State tax treatment varies. Some states follow the federal exclusion; others do not. For a full analysis of how lawsuit settlements are taxed, see IRS §104 lawsuit settlement tax 2026 →.

Illustrative Scenario E: Gross-Up Calculation for Taxable Portion

Suppose your settlement gross is $400,000, allocated as $300,000 compensatory (tax-free under §104) and $100,000 punitive (taxable). You are in the 22% federal income tax bracket with a state rate of 5%.

Item	Amount
Total punitive/taxable damages	$100,000
Federal income tax (22%)	−$22,000
State income tax (5%)	−$5,000
Net after tax on taxable portion	$73,000
Add tax-free compensatory portion	$300,000
Total net to you (pre-fee, pre-lien)	$373,000

The practical takeaway: if you are expecting a mixed award with significant punitive damages, set aside roughly 25–30% of the punitive portion for federal and state taxes from the moment you know the allocation. Running short on tax payments is a problem that compounds with penalties and interest.

Always consult a CPA or tax attorney before receiving a large settlement. The difference between handling taxes correctly and incorrectly on a $400,000 settlement could easily be $40,000–$60,000.

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EtO vs. Other Mass Torts: How Does It Compare?

Ethylene oxide litigation shares structural features with other large-scale toxic tort and pharmaceutical cases, but also has some important distinctions.

Feature	EtO (Sterigenics)	PFAS/Water Contamination	Roundup (Glyphosate)	AFFF (Firefighting Foam)
Primary defendant(s)	Sterigenics, BD/Bard, STERIS	3M, DuPont, various utilities	Bayer/Monsanto	3M, DuPont, Chemours
Carcinogen classification	IARC Group 1	IARC 2B (PFOA/PFOS)	IARC 2A	PFAS-based (see above)
Primary cancer(s) claimed	NHL, leukemia, breast cancer	Kidney, testicular cancer	Non-Hodgkin lymphoma	NHL, kidney, testicular
Federal MDL?	No (parallel state/federal)	Yes (MDL 2873, D.S.C.)	Yes (MDL 2741, N.D. Cal.)	Yes (MDL 2873, D.S.C.)
Largest single verdict/settlement	$363M verdict (2022)	$10.3B+ (3M)	$2.25B verdict (2023)	$1.185B (3M/AFFF)
Exposure pathway	Airborne emissions	Drinking water	Herbicide contact	Water/fire suppression
Geographic focus	Illinois, Georgia	National	National	National/Military bases
Litigation status (2026)	Active, ongoing settlements	Mostly settled	Active appeals	Active MDL

Each of these litigations has its own scientific, procedural, and damages landscape. For the PFAS water contamination cases, see PFAS drinking water contamination lawsuit 2026 →. For Roundup NHL claims, see Roundup non-Hodgkin lymphoma lawsuit 2026 →. For AFFF firefighting foam cases, see AFFF firefighting foam lawsuit 2026 →.

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The Regulatory Landscape in 2026: EPA Rule Suspension and State Pushback

The regulatory environment surrounding EtO is in flux, and understanding it matters for anyone evaluating the long-term litigation landscape.

In July 2025, the Trump administration issued an executive order suspending EPA enforcement of its ethylene oxide emissions rules for medical sterilization companies for two years. The administration argued that the sterilization industry plays a critical role in the medical device supply chain and that abrupt enforcement would disrupt hospital supply lines.

Reaction was swift. By May 2026, 16 state attorneys general had filed formal opposition to the EPA’s proposed repeal of the 2024 EtO emissions regulations, arguing that rollback would re-expose communities to carcinogenic risk. The coalition included Illinois, Georgia, California, and New York — states with both significant EtO facility populations and politically engaged public health constituencies.

What does this mean for your lawsuit? Critically: the regulatory suspension does not bar civil litigation for past harm. A company that emitted EtO for 20 years before any rule suspension is still potentially liable for the cancer diagnosed in someone who breathed that air. Regulatory compliance — even where it existed — has not historically been an absolute defense in toxic tort cases. Courts have allowed juries to consider whether the defendant knew more about the risks than regulators did, or whether it lobbied against tighter rules it knew were scientifically warranted.

That said, the regulatory rollback matters for ongoing exposure. If facilities that were shut down or voluntarily reduced emissions now restart operations under reduced enforcement scrutiny, new exposure claims could follow. Environmental advocates are tracking this closely.

For context on how regulatory status interacts with mass tort litigation dynamics, see mass tort settlement payout timeline 2026 →.

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Step-by-Step Action Checklist for Potential Plaintiffs

If you think you may have a claim — whether because you lived near Willowbrook, the Covington plant, the Smyrna facility, or another EtO site — here is exactly what to do.

Step 1: Confirm your location history. Pull together proof that you lived or regularly worked within approximately 4 miles of an EtO sterilization facility. Acceptable documentation includes:

• Utility bills from the relevant address(es) and years
• Lease agreements or mortgage documents
• Employment records with site address
• Tax returns showing prior addresses
• School enrollment records (for childhood proximity)
• Government mail (driver’s license, voter registration)

Step 2: Gather your medical records. You need documentation of your cancer diagnosis, including:

• Pathology/biopsy report naming the specific cancer type
• Oncology treatment records (chemotherapy, radiation, surgery)
• All diagnostic imaging (CT scans, PET scans, MRI reports)
• Primary care physician records referencing the cancer diagnosis
• Medicare/Medicaid records of covered cancer treatment

Step 3: Identify your facility. Cross-reference your address against known EtO sterilization facilities. The EPA’s NATA data and the Sterigenics facility list are starting points. Your attorney will have access to more current and complete facility databases. Key facilities in active litigation include:

• Sterigenics, Willowbrook, Illinois (closed 2019)
• Sterigenics, Smyrna, Georgia
• C.R. Bard/Becton Dickinson, Covington, Georgia
• STERIS/Isomedix, Waukegan, Illinois
• B. Braun facilities (multiple states)
• Midwest Sterilization Corp. locations

Step 4: Determine your statute of limitations window. Use the table above as a rough reference, but confirm with an attorney. In Illinois, you have 2 years from discovery. In Georgia, also 2 years. Do not assume you have more time than you do.

Step 5: Contact an EtO attorney. Most mass tort firms handling EtO cases offer free consultations and work on contingency. When you call, have your address history, cancer diagnosis, and medical records summary ready. The attorney will screen for eligibility and advise on next steps.

Step 6: Do not sign anything without legal review. Some defendants or their insurance companies may reach out directly to claimants, especially if litigation is public. Do not sign any release, waiver, or settlement document without your attorney reviewing it. These documents typically waive all future claims.

Step 7: Preserve everything. Do not discard old utility bills, lease agreements, or medical records. If you are unsure whether a document is relevant, keep it. Digital documents should be backed up. Physical documents should be scanned.

Step 8: Apply for SSDI or other benefits if not already done. A cancer diagnosis arising from toxic exposure may entitle you to Social Security Disability Insurance (SSDI), state disability benefits, or workers’ compensation if you were exposed through employment. These benefits are independent of your civil claim and should not be deferred.

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Common Mistakes That Sink EtO Claims

Waiting too long. This is the most common and most fatal mistake. Statutes of limitations are hard deadlines. A plaintiff who files one day late loses the right to sue, regardless of how strong the underlying claim is. Contact an attorney before the anniversary of your cancer diagnosis, every year.

Failing to document residence. Plaintiffs who cannot prove they lived near the facility with contemporaneous documentation face significant hurdles. “I remember living there” is not sufficient evidence. Courts require documentary proof. If you no longer have physical records, try your state’s Department of Motor Vehicles (for license history), IRS tax transcripts, or Social Security Administration records.

Assuming the case is closed. Many people hear that Sterigenics settled 870 lawsuits in 2023 and assume the litigation is over. It is not. The April 2025 and July 2025 Illinois tranches, the ongoing Georgia cases, and the STERIS/Isomedix settlement all reflect active litigation. New plaintiffs are still filing and settling.

Misidentifying the cancer. Some plaintiffs present general cancer diagnoses without understanding the specific pathology required. “Lymphoma” alone is insufficient — the claim needs to specify non-Hodgkin lymphoma as distinct from Hodgkin lymphoma, or the specific leukemia subtype. Get the pathology report and make sure your attorney understands the precise diagnosis.

Ignoring Medicare liens. Plaintiffs who receive a settlement check and do not address their Medicare conditional payments face personal liability. This has happened. Do not let it happen to you.

Signing a release for cash. Some companies offer small nuisance settlements — a few thousand dollars — in exchange for full releases. Plaintiffs who accept these without consulting an attorney often discover too late that they signed away a claim worth tens or hundreds of thousands of dollars.

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What Happens After You File: Timeline Expectations

Mass tort litigation moves slowly. Here is a realistic timeline for EtO cases filed in 2026:

• Month 1–2: Attorney retained; intake documents collected; complaint drafted
• Month 3–6: Complaint filed in state or federal court; defendant served; initial scheduling order
• Month 6–18: Discovery phase — document production, depositions, expert report exchanges
• Month 12–24: Daubert/expert challenge motions (defendants will attempt to exclude plaintiffs’ causation experts)
• Month 18–36: Summary judgment motions; bellwether trial selection (if not yet settled)
• Month 24–48: Bellwether trials or continued settlement negotiations
• Settlement or verdict: Depends on court docket, defendant strategy, and litigation dynamics

For context, the Kamuda case — the first Illinois EtO trial — did not reach verdict until September 2022, years after the initial wave of filings. The $408 million settlement did not come until January 2023. Plaintiffs need financial and emotional patience. A structured settlement option may provide earlier cash access for those who need immediate liquidity; see structured settlement sell cash 2026 → for how that works.

What happens between filing and resolution?

The discovery phase is the period most plaintiffs find most burdensome. You will be asked to produce: all medical records related to your cancer; residential history documentation; employment history; insurance records; pharmacy records; and potentially to submit to an independent medical examination (IME) by a physician retained by the defense. This is not optional — refusal to participate in discovery can result in case dismissal.

Your deposition will be scheduled, where defense counsel will ask you detailed questions about your medical history, family cancer history, lifestyle factors (diet, alcohol, tobacco, radiation exposure, chemical exposure at work), and your residential history near the facility. This typically lasts four to eight hours and is recorded. Preparation with your attorney beforehand is essential.

The Daubert hearing is the critical scientific gating event. Before trial, the defense will move to exclude plaintiffs’ causation experts under the federal or state standard for expert admissibility (Daubert in federal court; Frye or Daubert variants in state court). If the judge excludes the plaintiffs’ expert on general causation, the case typically cannot survive summary judgment. The Willowbrook litigation’s survival of Daubert challenges was essential to driving the settlements.

For context on wrongful death claims (relevant when the cancer patient has already died), see wrongful death lawsuit settlement 2026 →.

For a comprehensive look at class action mechanics, see class action settlement 2026 →.

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Choosing the Right Attorney: What to Look For

Not every personal injury lawyer is equipped to handle mass tort toxic exposure cases. EtO litigation requires specific expertise:

Experience in toxic tort or mass tort litigation. Ask directly: how many EtO cases has the firm filed? In which courts? Have they worked with the expert witnesses needed to establish causation?

Relationships with causation experts. The scientific link between EtO exposure and specific cancers requires epidemiologists, toxicologists, and oncology experts. Firms that already have these relationships — and have had their experts survive Daubert challenges — are significantly better positioned.

Litigation vs. settlement posture. Some firms are pure settlement shops; they file cases and resolve them in the first settlement tranche without ever developing the record for trial. This can be fine for straightforward claims, but for high-value cases (severe cancer, young plaintiff, long exposure), a firm willing to litigate to trial often produces better outcomes.

Contingency fee structure. The standard range in mass tort cases is 33–40% of gross recovery. Some firms charge higher percentages in contingency arrangements for younger, riskier claims. Ask for the fee agreement in writing before signing. Also ask who pays case expenses — in most mass tort firms, the firm advances expenses and recoups them from the settlement before taking its percentage fee.

Communication. These cases last years. Make sure the firm has the infrastructure to keep you informed — a dedicated case manager, a client portal, or regular written updates. Nothing is more frustrating than being a plaintiff in a multi-year litigation with no information about your case status.

For a detailed breakdown of how to evaluate attorney fee agreements in personal injury cases, see personal injury lawyer fee 2026 →.

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Why This Litigation Matters Beyond Individual Recoveries

EtO litigation is not just about individual plaintiffs recovering compensation for their cancer diagnoses. It is also a mechanism of accountability for an industry that operated with significant information asymmetry — knowing, or having reason to know, that its emissions posed community health risks while the surrounding residents remained unaware.

The Kamuda verdict’s $325 million punitive damages component was explicitly designed to punish and deter. Cook County juries, presented with evidence of what plaintiffs allege was deliberate risk minimization by Sterigenics and its parent, concluded that compensatory damages alone were insufficient. Punitive awards of that scale are intended to change corporate behavior industry-wide.

There is evidence it has worked, at least partly. After the Willowbrook plant’s closure and the verdict, several EtO sterilization companies invested in alternative sterilization technologies and upgraded emission controls at remaining facilities. The question of whether those upgrades are sufficient — and whether regulatory rollback will reverse the progress — is still being argued at state attorneys general offices and in EPA comment periods.

Meanwhile, the human cost remains concrete. In Willowbrook, residents who spent decades of their lives within walking distance of a plant they had no reason to distrust now carry diagnoses, treatment histories, and grief that no settlement can fully repair. The litigation gives them a legal remedy; it cannot give them back what was taken.

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Frequently Asked Questions

Is there a federal MDL for EtO cases?

No. The Sterigenics/Willowbrook litigation was handled in parallel in Cook County Circuit Court and the U.S. District Court for the Northern District of Illinois — not through a federal Multidistrict Litigation consolidation. This is different from cases like Roundup (MDL 2741 in the Northern District of California) or AFFF (MDL 2873 in the District of South Carolina). The parallel state/federal structure in Illinois allowed plaintiffs more venue flexibility but also complicated coordination.

Can I still file if Sterigenics closed the Willowbrook plant in 2019?

Yes. The closure date does not affect your right to sue for past exposure. As long as you were exposed before closure and developed a qualifying cancer, and the statute of limitations has not expired, you can still file. The key is the discovery rule — your clock typically runs from your diagnosis date.

What if I was exposed through my job at the facility, not as a neighbor?

Workers at EtO sterilization facilities often had much higher exposure levels than nearby residents. Workers may have workers’ compensation claims in addition to civil tort claims. However, workers’ compensation typically bars civil suits against your direct employer in most states. An attorney can analyze whether any third-party defendants (equipment manufacturers, chemical suppliers) may be liable even if your employer is shielded.

My relative died of cancer after living near the plant. Can the family sue?

Yes, through a wrongful death claim. Most states permit the deceased’s estate or immediate family members to file a wrongful death lawsuit if the cancer that caused death is attributable to EtO exposure. Statute of limitations for wrongful death claims can differ from personal injury claims — consult an attorney promptly. See wrongful death lawsuit settlement 2026 → for a full analysis of the wrongful death claim framework.

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Disclaimer

This post is for general informational purposes only and does not constitute legal advice. Nothing in this article creates an attorney-client relationship. The information provided may not apply to your specific circumstances, jurisdiction, or case facts. Past verdicts and settlements — including the $363 million Kamuda verdict and the $408 million Illinois settlement — are historical outcomes in specific cases and do not guarantee similar results in any future case. Settlement values vary widely based on individual facts, cancer severity, exposure duration, defendant financial position, and applicable law.

The statute of limitations information in this article is illustrative only and may not reflect current law in your state. Laws change, and exceptions and tolling rules vary. Retain a licensed attorney in your jurisdiction before making any legal decisions. Free consultations are available from most mass tort law firms handling EtO cases.

Tax information in this article is based on general principles of federal tax law and does not constitute tax advice. Consult a certified public accountant or tax attorney regarding your specific situation. State tax treatment varies.

The regulatory information regarding EPA rule suspensions reflects the state of affairs as of June 2026 and may change. Civil lawsuits for past harm are not affected by regulatory compliance decisions or rule suspensions.

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Related reading:

• PFAS drinking water contamination lawsuit 2026 →
• AFFF firefighting foam lawsuit 2026 →
• Roundup non-Hodgkin lymphoma lawsuit 2026 →
• Mass tort settlement payout timeline 2026 →
• Personal injury lawyer fee 2026 →
• Wrongful death lawsuit settlement 2026 →
• Class action settlement 2026 →
• Structured settlement sell cash 2026 →
• IRS §104 lawsuit settlement tax 2026 →