By Avery Foster and David Perez, South Texas Project
LAREDO, Texas – A year ago, residents and environmental activists here applauded the Environmental Protection Agency for what seemed like a victory against air pollution. New EPA regulations would drastically curb emissions of ethylene oxide, a known carcinogen, from a medical device sterilization facility located near a residential neighborhood.
But the EPA’s March 2024 “final rule” may not be the last word, as the Trump administration reconsiders many Biden-era regulations, placing the implementation of emissions reductions in uncertainty. As the EPA now reconsiders its own rule, residents living near the Laredo facility that utilizes ethylene oxide worry about the potential health risks and wonder how much of the toxic chemical they are being exposed to.
The effort to study ethylene oxide emissions in Laredo was an all-hands-on-deck mission that began several years ago under the Clean Air Coalition in Laredo, which involved activist groups, elected officials and school districts.
“Everybody is learning [about ethylene oxide] to advocate to the community and at the same time advocate it to city council and to the people that can actually make changes,” said Edgar Villaseñor, advocacy campaign manager at the environmental justice group Rio Grande International Study Center (RGISC).
Ethylene oxide is a flammable, colorless gas used to sterilize medical equipment. It is also a carcinogen. According to the National Cancer Institute, “the ability of ethylene oxide to damage DNA makes it an effective sterilizing agent but also accounts for its cancer-causing activity.”
In Laredo, the activism to reduce ethylene oxide emissions is focused on a medical equipment sterilization facility owned by Midwest Sterilization Corporation. The facility, which has operated since 2005, is tucked away in an industrial park in north Laredo, but only two miles away from the nearest residential neighborhoods.
Midwest Sterilization Corporation uses ethylene oxide to sterilize medical equipment that is used in the United States. For many medical devices, particularly those made from certain polymers, metals, or glass, or those with complex designs or packaging, sterilization with ethylene oxide is a method that has proved to ensure sterility without damaging the device.
Following a 2022 investigative report published by ProPublica and The Texas Tribune, many residents became aware for the first time that Laredo is one of the cities with the highest levels of excess cancer risk. The same investigative report analyzed a five-year period of emissions across the country and found that Midwest Sterilization’s plant in Laredo released more ethylene oxide on average than any other sterilization facility in the country between 2014-2018.
The company has said its emissions are within legal limits.
Based on reports by the Political Economy Research Institute’s Air Toxics at School tool, in 2022, Julia Bird Jones Mueller Elementary in Laredo falls within the 2nd percentile of toxic hazard in the nation. The school is located about 2.5 miles from the Midwest Sterilization plant.
Alarmed by these statistics, activists in Laredo engaged the community and fought to assess the risk and reduce it.
Tighter regulation enforcement stalled
In 2022, RGISC and other environmental groups partnered with EarthJustice to file a lawsuit to compel the EPA to update its standards on ethylene oxide, alleging it was in violation of the Clean Air Act.
Under Biden EPA administrator Michael Regan, the agency agreed to adopt new standards. The agency touted the new “final rule,” announced in March 2024, as historic.
“Through the installation of proven and achievable air pollution controls, commercial sterilizers will reduce emissions by more than 90%” the EPA said in a statement at the time. The new restrictions would affect 50 companies and 90 plants, including the Midwest facility in Laredo.
Following the transition to a new administration in Washington, however, the Trump EPA is rethinking the rules. And, environmental advocates say, there is a risk that the tighter regulations may never go into effect.
Tricia Cortez, Executive Director of RGISC, said, “This administration has taken a different approach to that industry that is incredibly favorable [to it].”
The Ethylene Oxide Sterilization Association, an industry trade group, filed a legal action calling for a review of the final rule, arguing that the Clean Air Act only gives the EPA the authority to regulate emission standards once. According to the EOSA, the EPA regulated it in 2006 and can no longer establish new rules.
Meanwhile, EarthJustice, representing RGISC and others, petitioned to compel the EPA to enforce its 2024 final rule.
Amid the dueling petitions, the EPA – now under the Trump EPA administrator Lee Zeldin – filed its own motion for a temporary suspension of the proceedings because “the agency has now determined that it wishes to revisit and reconsider” the 2024 final rule.
The motion for abeyance, as it is known, was filed on March 25, just days after the Trump EPA announced publicly that it will reconsider multiple air pollution emissions standards, including those related to the commercial sterilization of medical devices.
“The EPA is going to take that new rule and they’re basically going to take it back and just rewrite it,” Cortez said.
Lillian Zhou, an EarthJustice attorney representing the petitioners in the lawsuit, said the process is typical of cases that transition between administrations.
“A lot of the time, a new administration will ask pending lawsuits to be put in abeyance so they could go back and change whatever the underlying standards are,” Zhou said.
While there is no indication on what steps the Trump administration will take, Zhou said there has been a lot of industry pressure against the 2024 final rule due to the costs and time it takes to comply.
In the EPA announcement about reconsidering rules that include ethylene oxide regulation, Zeldin said, “Breathing clean air, living on clean land, and drinking clean water are all shared goals while we also do our part to usher in a Golden Age of American success.”
In Laredo, that balance between protecting the environment and boosting American companies hits close to home.
“So all of these things are happening more at a national level, with the rule and the agency that regulates this air toxin that then impacts communities like ours here,” Cortez said. “In terms of how a local community can protect itself or act toward these kinds of companies is somewhat limited. You know, you have to have these two battles, the national one, and then what’s happening on the local front as well.”
Community fights for air quality
Upon learning of the contamination risk from ethylene oxide, Laredo city officials funded a fenceline monitoring study administered by RGISC. The center hired Richard Peilter, an air quality scientist at the University of Massachusetts at Amherst, to consult on the air quality within the community.
Peltier published a report detailing the presence of ethylene oxide in Laredo. Because there is no effective way to filter ethylene oxide from homes, the best way to control the contamination is at its source, the report states.
“Particularly elevated concentrations were consistently observed in areas proximate to the facility, indicating a localized source of emission,” according to the 2024 report, referring to the Midwest Sterilization plant.
There are some concerns with the reliability of the data, the report states, to which it recommends ongoing monitoring. “[Ethylene oxide] exposure poses an important risk to communities and should not be dismissed,” the report says.
Peltier’s report suggests that sources of ethylene oxide emissions – such as Midwest – should also find ways to reduce and limit contamination.
Many residents in the surrounding area were unaware of the high-risk carcinogen. For some, that awareness came in the form of illness, including the kinds of cancer that have been linked to ethylene oxide exposure. Residents have attended town halls hosted in Laredo and spoken up in front of attendees and organizers to question whether their cancer diagnosis is related to their proximity to the Midwest Sterilization plant.
Midwest Sterilization Corporation did not respond to multiple requests for comment regarding their emissions and procedures and practices, including whether they have considered alternative sterilizers to ethylene oxide.
In response to the Texas Tribune investigation, the company said it remains in compliance with regulations, and touted its role in critical medical device sterilization services. “Midwest is taking all steps necessary to ensure that patients across the nation and residents locally remain safe,” the company told the Tribune in a statement.
While many in the community recognize the facility's contributions to healthcare, the release of the carcinogen into the air has raised serious health concerns among Laredo residents.
Nidia Nevares, whose son JJ was diagnosed with leukemia and beat it, lives near the plant.
She said, “The products that they have, yes, they saved my son's life, because they are products for hospitals,” She acknowledged the necessity of the plant but also suggested that manufacturers and planners in charge of deciding on the facility’s location should take into account the surrounding areas and the health risk they bring.
Besides renewing the regulations, advocates also consider pushing the facility’s location away from the city limits to reduce the risk of contamination.
Edgar Villaseñor of RGISC said, “We have talked to people that have actually moved ethylene oxide [producers] from their city. [We ask] how did you do that? Again, Texas is very unique. Especially with land. That’s very hard here in Texas. Other people have organized to move ethylene oxide a little bit further or to reduce emissions. So we have been in contact to see what other strategies they used.”
The 2024 EPA final rule at the center of the current debate would place stricter limits on how much ethylene oxide commercial sterilizers can release into the air. Facilities would be required to install pollution control equipment, conduct continuous monitoring and file quarterly reports to the EPA.
With that rule now in uncertainty before it ever takes effect, families in Laredo want to be assured that their community is safe to live in. Rafael Nevares, JJ’s father, expressed, “First, we need to be guaranteed that the air is free of contaminants. That is best.”
According to Zhou, the industry still operates under the 2024 EPA rule while the legal challenges work their way through the courts. However, facilities have been invited by the current administration to ask for exemptions from the final rule requirements, she said.
In the meantime, families living in Laredo wonder when answers may come as to how their air quality is protected. The EPA is expected to roll out a new set of finalized standards on ethylene oxide by March of 2026.
Avery Foster is a journalism student at Texas A&M University and David Perez is a journalism student at Texas A&M International University. Texas A&M journalism students Callaghan Mitchell and Olivia Biggs contributed to this report.