By Kiah Collier TEXAS TRIBUNE AND PROPUBLICA Maya Miller PROPUBLICA
Jennifer Jinot didn’t expect to retire early from her role as an environmental health scientist for the federal government. She’d spent 26 years assessing the dangers of toxic chemicals for the U.S. Environmental Protection Agency. The job could be frustrating but, more than that, rewarding.
Early in her career, Jinot evaluated the impacts of secondhand smoke. It took four years — a pace she remembers thinking was “crazy slow” — to develop a final risk assessment, published in 1993, that determined secondhand smoke causes lung cancer in adults and impairs children’s respiratory systems. The tobacco industry sued the agency. But, in the end, her work spurred changes to the law. She found the victory invigorating .
In 2002, she joined an EPA team evaluating new research to determine whether ethylene oxide, one of the world’s most widely used chemicals, caused cancer. A key building block for an endless array of consumer goods and a common product used for sterilizing medical equipment, the colorless, low-odor gas wafts out of at least 160 facilities across America. Jinot’s colleagues had already spent four years reading studies, scrutinizing data and consulting with experts. She was hopeful it wouldn’t take much longer. The team published a draft assessment in 2006 that found the chemical was significantly more carcinogenic than the agency had previously concluded and especially damaging to children.
But industry lobbyists and company executives attacked the draft. Audry E. Eldridge, then-president of the Missouri-based Midwest Sterilization Corporation, argued in a 2006 letter that the EPA’s findings were flawed and that the cancer risk posed by the chemical was “thousands of times less than portrayed in EPA’s risk estimates.”
Amid the pressure, the agency agreed to another round of scrutiny from independent scientists and the public before finalizing its findings.
A process that, according to a director for the U.S. Government Accountability Office, should last no more than four years ended up taking another decade. In 2016, the EPA published the final version of its assessment. It concluded that ethylene oxide was 30 times more carcinogenic to people who continuously inhale it as adults and 50 times more carcinogenic to those who are exposed since birth than the agency previously thought. The chemical, which alters DNA in the human body and increases the risk of certain types of cancer such as leukemia, is particularly harmful to children because their developing bodies can’t mend the genetic damage as effectively as adult bodies.
Texas became the only state to officially reject the agency’s conclusions. In August 2017, the Texas Commission on Environmental Quality, the state’s environmental regulatory agency, announced it would launch a review of EPA’s science; it eventually ruled that the chemical was significantly less toxic than the federal agency had found. That resulted in Texas enacting a new standard that could allow plants to emit more of the chemical.
Meanwhile, Eldridge’s sterilization company dramatically expanded its new facility in the border city of Laredo. The facility, a ProPublica analysis determined, emitted far more ethylene oxide than any other sterilizer plant in the country that reports emissions to the EPA.
Families along its fence line were raising a generation of children who would grow up in the plant’s shadow.
Karla and Cesar Ortiz had a baby girl they named Yaneli, after a Spanish-language television character who embodied kindness and humility, traits they hoped their daughter would share.
Nidia and Rafael Nevares were raising their two boys, Rafael Jr. and Juan Jose, or JJ, about 2 miles from the plant. The younger of the two, JJ was more outgoing.
In 2018, two years after the EPA published its final report, JJ was diagnosed with acute lymphocytic leukemia, a cancer that has been linked to ethylene oxide exposure. He turned 6 the next month.
Yaneli’s diagnosis came soon after. Doctors found that she had the same type of cancer as JJ in June 2019, three months before her 13th birthday.
By then, Jinot was no longer at the EPA. She had grown frustrated with industry’s increased influence over the agency and with a bureaucracy that stalled critical scientific research. So when the Trump administration sought to shrink the agency’s staffing in 2017 by offering employees buyouts, Jinot accepted.
“I couldn’t stand the process anymore,” she said. “There’s no reason it should take so long.”
Left in the dark
Communities such as Laredo, where the vast majority of the residents are Latino and more than a quarter live in poverty, have been left in the dark for years by regulators who had evidence of the dangers posed by ethylene oxide but never told the public about them.
Out of all the pollutants that the EPA regulates, ethylene oxide is the most toxic, contributing to the majority of the excess cancer risk created by industrial air pollutants in the United States, according to an unprecedented analysis of the agency’s most recent modeling data by ProPublica, in collaboration with The Texas Tribune. That risk is in addition to those Americans already face from other factors like genetics or lifestyle.
The EPA says it strives to minimize the number of people exposed to emissions that create excess cancer risk worse than 1 in 1 million — meaning that if a million people were exposed to the toxic air pollutants over a lifetime of 70 years, there would likely be at least one additional case of cancer. But the agency is far more permissive about the cancer risk it considers unacceptable: greater than one additional cancer death per 10,000 people.
ProPublica’s analysis of ethylene oxide assessed the impact of the chemical for an intermediate risk level, 1 in 100,000, which experts say is not sufficiently protective of public health. Using that threshold, the analysis, which examined data from 2014 to 2018, shows that more than 60 percent of the 6.9 million Americans who face heightened excess cancer risk from industrial air pollution are imperiled solely based on their exposure to ethylene oxide. (Though the analysis identifies elevated risk for geographical areas, it can’t be used to determine the specific causes of individual cancer cases.)
The risk is particularly acute in Texas, the nation’s top ethylene oxide polluter and home to 26 facilities that emit the chemical. The state stands out not just for the outsize risk its residents face but because it has emerged as a key ally for companies that emit or use ethylene oxide. Texas has fought stricter federal emissions regulations, even as many other states, including several led by Republicans, have enacted tighter controls on the chemical.
Laredo, home to more than 260,000 people, is among the 20 hot spots in the country with the highest levels of excess cancer risk, according to the analysis. Midwest’s Laredo plant released far more ethylene oxide on average than any other sterilizer plant in the country during the five-year period covered by the analysis, which used emissions estimates that Midwest reported to the EPA. The facility elevates the estimated lifetime cancer risk for nearly half of Laredo’s residents to at least 1 in 100,000, the analysis found. More than 37,000 of those are children.
Midwest said in a statement that the cancer risk posed by its sterilization plant is overstated, asserting that the emissions it reported to the EPA are “worst case scenarios,” rather than specific pollution levels. The law actually requires companies to report “reasonable” estimates of what they release into the air.
In 2019, the EPA directed its regional offices to warn more than two dozen communities facing the highest risks from ethylene oxide pollution, including those near Midwest’s sterilizer plants in Laredo and Jackson, Mo.
Armed with that information, residents across the country organized and pressured their elected officials to act. Attorneys general in Illinois and Georgia sued sterilizer plants over alleged air pollution violations, and lawmakers enacted stricter regulations of the chemical. Georgia’s Republican governor, Brian Kemp, backed the effort. A bipartisan coalition of U.S. representatives from Illinois, Georgia and Pennsylvania formed to push the EPA to adopt stricter regulations on ethylene oxide that reflected the findings in the agency’s final assessment.
The meetings even prompted change at Midwest’s facility in Jackson, which “voluntarily installed additional controls to reduce emissions,” according to Ben Washburn, a regional EPA spokesperson.
No meetings here
But the EPA region that oversees Texas and Louisiana trailed behind. Despite being home to the most “high-priority” ethylene oxide facilities, the region had not scheduled a single meeting on the pollutant as of March 2020. “These communities have not been given the same opportunity to interact with federal and state regulators to become informed on the issue,” said an urgent alert that month from the EPA’s Office of Inspector General. The region didn’t hold its first community meetings anywhere in the two states until August 2021, two years after the EPA directive.
Laredo is still waiting.
Dr. Susan Buchanan, director of the Great Lakes Center for Reproductive and Children’s Environmental Health at the University of Illinois Chicago, said ethylene oxide should not be ruled out as a factor in JJ and Yaneli’s diagnoses.
Acute lymphocytic leukemia, the type of cancer JJ and Yaneli have, is the most common type among children, although pediatric cases remain rare compared to adults. One study also found the disease to be particularly prominent among Latino youths. Studies over the past decade have found links between toxic air pollution and higher rates of blood cancers among children.
“Kids are uniquely susceptible to anything that’s in the air,” Buchanan said. “We should not be putting day cares and schools near the plants that are emitting ethylene oxide.”
More than 40 percent of Laredo’s nearly 70,000 schoolchildren attend campuses that are located in areas with an excess elevated risk of cancer greater than 1 in 100,000 due to ethylene oxide emissions from the Midwest plant, according to the ProPublica and Tribune analysis.
JJ attended Julia Bird Jones Muller Elementary School, a campus that, like his home, is located less than 2 miles from the Midwest plant. ProPublica’s analysis shows the area the school is in faces an estimated elevated lifetime cancer risk of 1 in 3,700. That’s nearly three times higher than the maximum 1 in 10,000 risk level the EPA considers acceptable, making it the most at-risk school in Laredo and one of the most at-risk in the country.
The Nevares family was shocked and angry after learning from ProPublica and the Tribune of the cancer risk posed by the facility. From the EPA to state and local governments, officials at all levels should be responsible for protecting Americans, family members said.
“You think that you can trust in the authorities, and that before they allow companies so close to residents or schools, they should regulate it, and maybe move the company somewhere farther away,” said JJ’s aunt, Sara Montalvo Saldaña, who has been one of his primary caretakers. “Maybe, since we are on the border, there just isn’t that much attention being paid.”
Lylla Younes, Al Shaw, Alyssa
Johnson and Ava Kofman contributed reporting.
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