Underground Knowledge — A discussion group discussion

Excerpt from Chapter 14 of Vaccine Science Revisited: Are Childhood Immunizations As Safe As Claimed?:

Polysorbate 80, the ambusher

“I freed a thousand slaves. I could have freed a thousand more if only they knew they were slaves.” –Harriet Tubman (American abolitionist and political activist)


Many ingredients go into the making of a vaccine. Once you’ve inserted them all into the vaccine batch, you need a way to blend them together. If you have ever spent time in the kitchen cooking or baking, (we’d imagine) you know that there are certain ingredients that don’t mix, like oil and water, unless they receive a helping hand.

The same goes for vaccines. In order to blend vaccine ingredients together a change in temperature won’t do the trick. A substance that stabilizes or blends the vaccine ingredients together is needed. One such ingredient is polysorbate 80 (p80), often referred to as tween 80. It’s a vaccine stabilizer, surfactant or emulsifier, which means something that evenly blends the ingredients together that wouldn’t otherwise blend.

When p80 is exposed to oxygen, it automatically forms formaldehyde (FA). In a Swedish study from 1997, it was shown to form the same amount of formaldehyde as found in “allergic individuals”. P80 already had allergens in it before being exposed to oxygen. But, after the exposure, new additional allergens were formed. The researchers conclude that it’s also a “possibility that allergenic compounds can be formed during storage and handling” .

When p80 is added to the vaccine, it becomes aggravated. This was shown in a study from 2002 which comments that:

“Literature studies report that the oxidation of polysorbates is greatly accelerated once placed into aqueous solution.”

Oxidation means that the molecule (p80 in this case) is giving away one of its electrons. For instance, when it attaches to an oxygen molecule, it is giving one of its electrons to the oxygen molecule.

A study by the biopharmaceutical company, Pfizer, showed the impact formaldehyde and other impurities can have on the proteins used in their pharmaceutical products. The authors of this paper made note of the fact that p80 is efficient at forming formaldehyde:

“Both formaldehyde and formic acid can be formed from oxidative degradation of polysorbates.”

The authors don’t just concern themselves with polysorbates, of which polysorbate 80 appears most potent, they state that:

“These residual impurities and contaminants can potentially impact the protein stability significantly.”

In their conclusion they summarize the limitations of the manufacturing process by saying that:

“Although many process-related impurities are routinely monitored, contaminants are generally not, […]. This is because the level of these contaminants in a drug product is often too low to be detected by traditional analytical methods, and does not lead to serious safety concerns.”

We find their comment that “it does not lead to safety concerns” after stating these “contaminants can potentially impact the protein stability significantly” rather interesting given much of the paper is about safety concerns.


Stormtroopers

Polysorbate 80 has the ability to both form formaldehyde and attack our body.

In previous chapters we talked about how formaldehyde (FA) affects the body. In this chapter we’ll explain how p80 attacks the body.

A couple of important concerns we were unable to find papers on was how much of the p80 is converted to formaldehyde once injected and how the increased oxidation affects the process we’re about to describe.

The immune process that p80 emulates is called the MAC attack, or in more proper terms, the Membrane Attack Complex (MAC). In order to understand what we mean by that, let’s first brush up on what MAC is.

The MAC is a complement cascade that takes place within our innate immune system (first responders). It consists of proteins labeled with the letter “C” and a number (and a letter) that tells you its location in the cascade. A complement basically means that it consists of a bunch of proteins (in the blood) that form a structure (a complex). So, a complement cascade becomes a sort of a domino sequence where each protein activates the next.

There are three different pathways to a MAC. We won’t get into any of them in great detail, preferring to refer only to the relevant portion of it for this chapter. The portion that pertains to the p80 in vaccines consists of the proteins C5b through C9. This is called the Terminal Complement Pathway.

When invading substances trigger the immune system, the proteins C5b through C8 link together to form a chain. On the end of this chain, a bunch of C9 proteins form a circle. This chain attempts to attach itself to both our own cells and invader cells. The circle consisting of a bunch of C9s burrow a hole in invading cells, allowing the contents to leak out. This kills the invading cell.

Fortunately, our cells found a way to protect themselves. So, even though the MAC doesn’t know the difference between our own cells and invading cells, it leaves our cells alone. This is not only fortunate, but logical in terms of evolution.

On the surface of our cells, we have something called protectin . When this cascade is being assembled and C8 has been added, the protectin steps in and blocks C9 from attaching. This prevents the complement from being completed. Since C9 never gets attached, nothing happens. No drill, no spill.

Unfortunately, there are some germs that have figured this out. They have acquired protectin-like protein on their own cell membrane. HIV, for instance, figured out how to insert this code into its own DNA and therefore blocks the MAC attack.

P80 attacks our cells in a very similar manner to that which our MAC attacks invaders. In addition, the polysorbate 80 also activates C3a, which is an anaphylatoxin, and C5a, which is another anaphylatoxin. Anaphylatoxins trigger all the signs and symptoms of instant anaphylaxis (hypersensitivity). They do this without involving help from antibodies.

The C3a actually causes the B cells (acquired immunity) to respond, while C5a brings in the Th1 cells to strengthen the acquired immune response. This way they’re able to recruit immune cells to the site of inflammation, keeping the inflammation fired up.

This makes p80 yet another substance to increase the inflammation process in our body. A question we were unable to find the answer to was whether individuals who have been vaccinated with vaccines containing p80 have a higher incidence of anaphylaxis than individuals vaccinated with vaccines without p80.

P80 has been considered to be a concealed “inductor of anaphylactoid reactions.” What this means is that the protectin on our cell surface that protects us from the MAC attack does not protect us from a p80 attack. When the protectin is not protecting our cells, the cells will be punctured and start leaking. Consequences of this include damaged kidneys, arthritis and nerve damage.

Excerpt (cont'd)from Chapter 14 of Vaccine Science Revisited: Are Childhood Immunizations As Safe As Claimed?:

It's in everything

Vitamin E supplements are sometimes given intravenously to babies soon after they are born. Some infants have suddenly died after such a treatment. The authors of a study looking into toxic effects on intravenous administration of vitamin E conclude that:

“The life-threatening hazard of such treatment has been attributed mainly to polysorbates that are used as detergents in preparations of vitamin E for intravenous use rather than vitamin E itself”.

Another paper covered p80’s role as an ingredient in antiretroviral therapy (ART), which is often used to treat HIV/AIDS patients. Here, the scientists coated nanoparticles with p80 and watched it spread inside the body. They then compared it to a drug not coated with p80.

They found that p80 coated nanoparticles magnified the “delivery into various organs by several fold in comparison to the free drug”.

The study also discovered that organs containing numerous macrophages may be the reason for the increased uptake of p80 coated nanoparticles. The macrophages eat the p80 since it is a foreign substance. They will then transfer it straight to our organs, lymph nodes and brain. It was also shown that p80 coated particle “concentration in brain, was seven times higher and in lymph nodes six times higher than that of the free drug.”

It appears to be a well-known fact in the medical field that p80 helps drugs across the blood-brain barrier (BBB). One of the papers we looked at concludes:

“A non specific permeabilization of the BBB, probably related to the toxicity of the carrier, may account for the CNS [Central Nervous System] penetration of […] and polysorbate 80.”

When the permeability of the blood-brain barrier is not being picky or specific about what it’s allowing into the brain, our nerve cells become vulnerable to foreign attacks. Continuing on with the paper, the authors also observed that in addition to causing a leaky blood-brain barrier, p80 also caused:

“[P]otent and prolonged analgesia, [. . .]. Locomotor activity dramatically decreased in mice [. . .] also caused occasional mortality.”

P80 has also been shown to be toxic to the liver. The tricky part with p80 is that it takes very little of it to alter our cells. It changes some of the parts on the cell surface and also some of the functions inside the cell. The tricky part is that it does all this without changing the normal function of the cell.

Perhaps P80 doesn’t alter the cell’s normal functions, as this study states. That doesn’t mean it will not damage or make the cell weaker so other substances have an easier access into our cells.

Another paper on how polysorbate coated particles affects the Central Nervous System (CNS), shows similar results. The authors observed that certain cells in the brain picked up 20 times more of the p80 coated particles than uncoated ones.

The brain has fluid filled cavities called choroid plexuses. These cavities are lined with cells called ependymal (covering in Greek) cells, which produce cerebrospinal fluid (CSF).

There is also a sensitive membrane that covers the brain and spinal cord called pia mater (Latin for tender mother).

Polysorbate 80 is capable of increasing the space between the ependymal cells. When this happens, unwanted substances are able to squeeze through between the cells and make the brain and spinal cord toxic.


Safety Data Sheet

Unfortunately, all the research papers we found on p80 were unrelated to vaccines. As with the other substances, in order to truly understand the potential effects when these are injected into the body, we dug deeper to gain a better understanding of p80. One of these angles in this case was looking at the Safety Data Sheet (SDS) for p80.

We discovered that safety data sheets often lack crucial information. Even so, we hoped to find information as it relates to being injected, as in liquid form in a vaccine. What we found was not exactly what we hoped for:

“May cause adverse reproductive effects based on animal test data. No human data found. May cause cancer based on animal test data. No human data found. May affect genetic material (mutagenic)” .

We wondered what the potential chronic health effects were:

“CARCINOGENIC EFFECTS: Not available. MUTAGENIC EFFECTS: Not available. TERATOGENIC EFFECTS: Not available. DEVELOPMENTAL TOXICITY: Not available. Repeated or prolonged exposure is not known to aggravate medical condition. . .. Exposure Limits: Not available.”

According to this safety data sheet (SDS), the Routes of Entry: Inhalation. Ingestion does not include injection. Nowhere does it mention this substance (p80) should be injected.

This substance is injected into, dare we say, the entire human population, yet the SDS fails to cover this route of entry. When a route is this commonly used, it should at least warrant a mention in the safety data sheet.

The SDS continues:

“Special Remarks on Chronic Effects on Humans: May cause adverse reproductive effects based on animal test data. No human data found. May cause cancer based on animal test data. No human data found. May affect genetic material (mutagenic)”

What about other effects that are not chronic? Have these effects been tested on humans?

The toxic effect segment states:

“Ingestion: This material is not likely to cause irritation upon ingestion. [. . .] Animal studies have shown it to cause cardiac changes, changes in behavior (altered sleep time) and weight loss (upon repeated or prolonged ingestion). However, no similar human data has been reported.”

Here the SDS says it’s not likely to cause irritation. It appears to us this statement is based on the fact that there haven’t been any reports on it. But if it’s causing harm in animal studies, shouldn’t that be grounds for observational studies in humans? Why is there no human data? It’s very surprising to us that when a substance is tested on animals, and the observations are cause for concern, the very product is approved for use in humans.

Nor do we understand how a product with such concerning results from animal testing is not at least included in observational studies in humans, since it’s already being injected in us.

It feels like such a substance, until proven safe, should come with a warning label made known to the user. If we understand correctly, it’s not safe for human studies, but it is safe to use in humans without properly testing it first. How does that work?

We took a look at p80 SDS sheet from another company just to compare. We looked at the section covering chronic effects, mutagenicity, carcinogenicity, reproductive toxicity, specific
target organ toxicity, specific organ toxicity, and there was only one entry:

“No information available.”

When there is little or no data available, how can the National Fire Protection Association (NFPA) show in the diamond (health hazard information label) that health hazard is only at 1, meaning it is slightly hazardous?

Neither of these SDS sheets include injection as a potential point of entry. The toxicology fact sheet on p80 on the website for National Institutes of Health (NIH) doesn’t say that p80 may be injected into the body.

If it’s being injected into practically every single person, shouldn’t that qualify for at least a single mention on the SDS sheet?

We would assume the manufacturer is aware that one of the routes of entry being used is via injection. It’s surprising to us, then, that they aren’t required to either list it as one of the options, or warn against using it in injections. We don’t see how the safety hazard of 1 (meaning it is slightly hazardous) can apply to vaccines.

One of our concerns after reading the SDS sheets is whether the demonstrated toxic effects of p80 in animals, including damage to the uterus and ovaries leading to infertility, applies to humans as well.

References for Chapter 14: Polysorbate 80, the ambusher:

Bergh, M., Magnusson, K., Nilsson, J.L, and Karlberg, A.T. (1997). Contact allergenic activity of Tween 80 before and after air exposure. Contact Dermatitis, 37(1), 9-18.
Maggio, E.T. (2012). Polysorbates, peroxides, protein aggregation, and immunogenicity– a growing concern. J. Excipients and Food Chem, 3(2).
Wang, W., Ignatius, A.A., and Thakkar, S.V. (2014). Impact of Residual Impurities and Contaminants on Protein Stability. J Pharm Sci, 103(5), 1315-1330.
Ibid.
Ibid.
Svar Life Science AB (formerly Euro Diagnostica). (n.d.). Lytic part of the complement pathway. Retrieved from http://www.complementsystem.se/termin...
Also referred to as CD59, but we prefer calling it protectin, because it describes what it is for. It is a protector of the cell. Any name that ends with -in is a protein. So the word means a protein that protects.
Nesorgikar, P., Spiller, B., and Chavez, R. (2012). The complement system: History, pathways, cascade and inhibitors. Eur J Microbiol Immunol (Bp), 2(2), 103-111.
Meri, S., Morgan, B. P., Davies, A., Daniels, R. H., Olavesen, M. G., Waldmann, H., & Lachmann, P. J. (1990). Human protectin (CD59), an 18,000-20,000 MW complement lysis restricting factor, inhibits C5b-8 catalysed insertion of C9 into lipid bilayers. Immunology, 71(1), 1-9.
Roitt, I.M, and Delves, P.J., (Eds.). (1998). Encyclopedia of Immunology. U.S.: Academic Press.
Weiszhar, Z., Czúcz, J., Révész, C., Rosivall, L., Szebeni, J., and Rozsnyay, Z. (2012). Complement activation by polyethoxylated pharmaceutical surfactants: Cremophor-EL, Tween-80 and Tween-20. Eur J Pharm Sci, 45, 492-498.
Coors, E.A., Seybold, H., Merk, H.F., and Mahler, V. (2005). Polysorbate 80 in medical products and nonimmunologic anaphylactoid reactions. Ann Allergy Asthma Immunol, 95(6), 593-599.
Price, K.S. and Hamilton, R.G. (2007). Anaphylactoid reactions in two patients after omalizumab administration after successful long-term therapy. Allergy Asthma Proc, 28(3), 313-319.
National Center for Biotechnology Information, U.S. Nation. (n.d.). Search results. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed?c...
Pacifici, M.G. (2016). Effects of Vitamin E in Neonates and Young Infants. Int J Pediatr, 4(5), 1745-1757.
Jenita, J.L., Chocalingam, V., and Wilson, B. (2014). Albumin Nanoparticles Coated with Polysorbate 80 as a Novel Drug Carrier for the Delivery of Antiretroviral drug—Efavirenz. Int J Pharm Investig, 4(3), 142–148.
Ibid.
Olivier, J.C., Fenart, L., Chauvet, R., Pariat, C., Cecchelli, R., and Couet, W. (1999). Indirect evidence that drug brain targeting using polysorbate 80-coated polybutylcyanoacrylate nanoparticles is related to toxicity. Pharm Res, 16(12), 1836-1842.
Ibid.
Giannattasio, F., Salvio, A., Varriale, M., Picciotto, F.P., Di Costanzo, G.G., and Visconti, M. (2002). Three cases of severe acute hepatitis after parenteral administration of amiodarone: the active ingredient is not the only agent responsible for hepatotoxicity. Ann Ital Med Int, 17(3): 180-184.
Ellis, A.G., Crinis, N.A., and Webster, L.K. (1996). Inhibition of etoposide elimination in the isolated perfused rat liver by Cremophor EL and Tween 80. Cancer Chemother Pharmacol, 38(1), 81-87.
Hirama, S., Tatsuishi, T., Iwase, K., Nakao, H., Umebayashi, C., Nishizaki, Y., ... Oyama, Y. (2004). Flow-cytometric analysis on adverse effects of polysorbate 80 in rat thymocytes. Toxicology, 199(2-3), 137-143.
Ramge, P., et al. “Polysorbate-80 coating enhances uptake of polybutylcyanoacrylate (PBCA)-nanoparticles by human and bovine primary brain capillary endothelial cells.” Eur J Neurosci. 2000, 12(6):1931-1940.
Olivier, J.C., Unger, R.E., Oltrogge, J.B., Zenker, D., Begley, D., Kreuter, J.,

Excerpt from Chapter 15 of Vaccine Science Revisited: Are Childhood Immunizations As Safe As Claimed?:


Toxins – Accumulative harmful effects

“The truth is, natural organisms have managed to do everything we want to do without guzzling fossil fuels, polluting the planet or mortgaging the future.” – Janine Benyus (American writer).


In a research paper from 1993, the researchers injected neonatal female rats with polysorbate 80 (p80). The effect was “accelerated maturation” which led to ovaries “without corpora lutea”. These are a cluster of cells that form inside the ovary early on in the pregnancy. They produce progesterone, and “degenerative follicles”. The follicles are a sac inside the ovary that carries the oocyte (egg).

So, we have known this for at least 25 years, yet when it’s added to vaccines scientists don’t bother to test it. It appears that once these substances have been added to the vaccine, the concern for toxicity magically disappears.

P80 attaches very well to Aluminum (Al). Now you have an adjuvant, like aluminum, coating the vaccine-antigen together with p80, and other substances within the vaccine. This new larger vaccine-antigen is then escorted across the blood-brain barrier (BBB). Note that anything that can cross the blood-brain barrier can most likely cross the gut-brain barrier. When in contact with p80, the blood-brain barrier has been shown to become weakened and penetrated, resulting in complications ranging from seizures to death.

In 2005 a study was published on “organic compounds leached from uncoated rubber stoppers in prefilled syringes containing polysorbate 80” . After looking at patient data from 2001 to 2003, the researchers conclude:

“[…] leachates from uncoated rubber syringe stoppers caused the increased incidence of PRCA” .

Pure red cell aplasia (PRCA) is the type of anemia where the bone marrow stops producing red blood cells. So, the question is how much p80 does it take to cause harm? Obviously, it depends on the individual. But we doubt very much that the amount of p80 contained in the rubber stopper which contaminated the prefilled syringe, was more than barely a trace amount. And yet it was shown to have serious effects.


The transformer

Polymyxin b, an antibiotic used in vaccines, has been shown to work in toxic synergy with p80. This means the toxic effect of both substances is potentiated.

This was known at least as far back as 1971, when it was noted in a study on the synergism between the two substances. It was observed that polymyxin b and p80 worked together to cause “leakage, death and lysis” to bacterial cells. The explanation was that p80 changes the surface membrane of the bacterial cell. This allows polymyxin b a better access to the cell.

Not much is said about this substance in regards to vaccinations, so we had to be a little more creative in our research. We wanted to see what happens to the p80 substance itself once inside our body. It turns out our body tries to break it apart into individual molecules.

P80 consists mainly of oleic acid, ethylene oxide (EtO) and sorbitol. It has about 20 moles of EtO for every mole of sorbitol.

We wondered if these molecules could be harmful to us after p80 was broken apart as the sweet-smelling gas EtO is considered quite hazardous. The International Programme on Chemical Safety (IPCS) wrote about EtO in their Chemical Safety Information from Intergovernmental Organizations (INCHEM). They mentioned studies from various US states and countries, such as Sweden and Italy, where cancers of all sorts had been related to EtO exposure.

The International Agency for Research on Cancer (IARC) reviewed the potency of EtO and observed that in mammalian cells, its:

“[…] effects include gene mutations, micronucleus formation, chromosomal aberrations, cell transformation, unscheduled DNA synthesis, sister chromatid exchange, and DNA strand breaks.”

Sounds to us like the perfect recipe for causing cancer. And on that note, how much does vaccine research take into account long term, harmful health effects as opposed to merely childhood health risks? For example, how much research takes into account whether vaccines in childhood could cause autoimmune disorders in early adulthood, or cancer in middle-age, or Alzheimer’s disease (AD) in old age?

IARC has EtO listed as having ‘limited evidence in humans for breast cancer and Leukemia/lymphoma. On IARCs website, EtO is classified as group 1 agent , which means it is a “Carcinogenic to humans”

According to the Agency for Toxic Substances & Disease Registry, EtO is incompatible with, among other things, aluminum . This means it will react harshly when combined.

Although EtO is not directly injected into the body, it’s still a biproduct of an injected substance. The fact that it’s not meant to be injected into the body is patently evident given none of the safety and exposure information to be found on this element includes injection.

The CDC also mentions EtO on their website:

“Ethylene oxide [. . .] resulting in cellular and tissue dysfunction and destruction. Evidence for human exposure to this chemical is the presence of ethylene oxide adducts of DNA and hemoglobin. Direct contact with liquid ethylene oxide or solutions.”

Another factor that makes it so difficult to assess research on chemicals or substances in relation to vaccines is that injecting infants, toddlers, older children or adults are not necessarily comparable with each other.

Although not vaccine-related, the CDC’s website confirms this when they state that:

“Children do not always respond to chemicals in the same way that adults do.”

Something to keep in mind is that it can take up to three days to experience symptoms because it can take this long for nerve and respiratory reactions to present themselves. This may be a reason why symptoms often are not considered to be related to vaccines.

During vaccine safety testing, the observational period often doesn’t last long enough to record delayed reactions. Yet, those are the studies on which vaccine safety is based.

A study was performed on pregnant women in South Africa who were exposed to EtO when sterilizing medical equipment. It was found that there seemed to be a strong connection between EtO exposure and “spontaneous abortion […] and pregnancy loss [...]” .
According to the Environmental Protection Agency (EPA):

“Many countries have banned the use of ETO on spices and other food due to concerns for public exposure to ETO and its reaction products. [. . .] due to its classification as a known human carcinogen and genotoxic agent. [. . .] some of the countries that have banned the use of ETO on spices (and other foods) include: Belize, China, the European Union (EU, currently numbering 25 countries), Australia, and Japan.”

As we can see, there’s research out there showing the serious effects these substances may have on our cells. The dilemma is not whether these substances are toxic, but whether the amount used in vaccines, or the biproducts once injected, is enough to cause concern. Keeping in mind EtO isn’t directly in the vaccine but presents itself after our body has dissected p80.

Polysorbate 80 reacts to yet another vaccine substance. Namely mercury. Mercury was removed from almost all vaccines, but is still found in some multi-dose vials to prevent bacterial contamination. An example of such vaccine is the influenza vaccine. Even though mercury was removed from childhood vaccines, there are still residual amounts left over from the manufacturing process.

A study we came across revealed that p80 is very efficient at removing mercury from contaminated water. This sounds good right? Read on…

If p80 is attracting mercury, we can only assume it is likely some of the mercury is being escorted to the brain. So, if we receive traces of mercury in the vaccines or are exposed to mercury from other sources, and receive a p80 containing vaccine, then a mercury-free vaccine could still potentially cause mercury accumulation in the brain.


References for Chapter 15: Toxins – Accumulative harmful effects:

Gajdová, M., Jakubovsky, J. and Války, J. (1993). Delayed effects of neonatal exposure to Tween 80 on female reproductive organs in rats. Food Chem Toxicol, 31(3), 183-190.
Dib, B. and Falchi, M. (1996). Convulsions and death induced in rats by Tween 80 are prevented by capsaicin. Int J Tissue React, 18(1), 27-31.
Azmin, M.N., Stuart, J.F. and Florence, A.T. (1985). The distribution and elimination of methotrexate in mouse blood and brain after concurrent administration of polysorbate 80. Cancer Chemother Pharmacol, 14(3), 238-242.
Boven, K., Stryker, S., Knight, J., Thomas, A., van Regenmortel, M., Kemeny, D.M., ... Casadevall, N. (2005). The increased incidence of pure red cell aplasia with an Eprex formulation in uncoated rubber stopper syringes. Kidney Int, 67(6), 2346-2353.
Ibid.
Brown, M.R.W. and Winsley, B.E. (1971). Synergism between Polymyxin and Polysorbate 80 against Pseudomonas aeruginosa. Journal of General Microbiology, 68: 367-373
The United States Pharmacopeial Convention. (2017, August 1). Polysorbate 80. Retrieved from https://www.usp.org/sites/default/fil...
U.S. National Library of Medicine. (2009, April 18). Ethylene Oxide. Retrieved from https://toxnet.nlm.nih.gov/cgi-bin/si...
Liteplo, R.G. and Meek, M.E., Health Canada, Ottawa, Canada., and Lewis, M., Environment Canada, Ottawa, Canada. (2003). Ethylene Oxide. Retrieved from http://www.inchem.org/documents/cicad...
Ibid.
International Agency for Research on Cancer. (2018, November 2). List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 123. Retrieved from https://monographs.iarc.fr/wp-content...
International Agency for Research on Cancer. (n.d.). List of classifications, Volumes 1–123. Retrieved from http://monographs.iarc.fr/ENG/Classif...
International Agency for Research on Cancer. (2018, November 9). Agents Classified by the IARC Monographs, Volumes 1–123. Retrieved from http://monographs.iarc.fr/ENG/Classif...
https://www.atsdr.cdc.gov/mmg/mmg.asp...
Ibid.
Ibid.
Ibid.
Gresie-Brusin, D.F., et al. “Occupational exposure to ethylene oxide during pregnancy and association with adverse reproductive outcomes.” Int Arch Occup Environ Health. 200, 80(7): 559-565. PMID: 17165063. DOI: 10.1007/s00420-006-0163-y
US Environmental Protection Agency Office of Pesticide Programs. Reregistration Eligibility Decision for Ethylene Oxide. March 31, 2008. https://archive.epa.gov/pesticides/re...
Agency for Toxic Substances and Disease Registry. (2014, October 21). Toxic Substances Portal - Ethylene Oxide. Retrieved from https://www.fda.gov/BiologicsBloodVac...
Chen, H. R., Chen, C. C., Reddy, A. S., Chen, C. Y., Li, W. R., Tseng, M. J., Liu, H. T., Pan, W., Maity, J. P., … Atla, S. B. (2011). Removal of mercury by foam fractionation using surfactin, a biosurfactant. International journal of molecular sciences, 12(11), 8245-8258.