This case study documents the problem-solving approach used to implement all pertinent sections of the Ethylene Oxide Standard (29 CFR 1910.1047) during an exhaust ventilation system upgrade at an ethylene oxide hospital sterilizer unit. The approach for implementation of the standard utilized the following methodology: A. Review of proposed work plan with hospital and contractor representatives to identify items which must be addressed to assure compliance. B. Establishment of regulated areas and implementation of engineering controls and work practices to minimize potential exposure. C. Development of written project program which addresses chemical and physical characteristics, project hazards, permissible exposure limits, safe handling precautions, personal protective equipment, monitoring strategy, emergency procedures (29 cfr 1910.38) and project tasks and timing. D. Development and implementation of a project respiratory program to include employee respirator training, fit testing, and preparation of a written respirator program. E. Field inspection and procurement of real time area samples and full shift personal samples to verify safe working conditions and characterize and document worker exposures during project. The industrial hygiene concerns addressed here are unique since they involve a retrofit maintenance program implemented by tradesmen working around a potentially hazardous chemical not regularly encountered in routine circumstances.