Trump delays limits on gas used to clean medical equipment. What it means for LA families worried about cancer

President Donald Trump issued a proclamation this month that delays a rule meant to tighten ethylene oxide emissions at companies that use the gas to sterilize medical equipment.

The decision grants two-year exemptions to several facilities, including two in Vernon, a city in southeast L.A. County. These facilities are currently embroiled in a lawsuit with local residents.

The proclamation targets a rule issued by the Environmental Protection Agency in 2024, which imposes new emissions-control requirements on commercial sterilization facilities.

What is ethylene oxide? And what harm can it cause?

Ethylene oxide is a flammable, colorless gas used to sterilize a broad range of medical devices — everything from syringes to heart valves. The gas is also classified as a carcinogen. According to the EPA and the National Cancer Institute, sustained exposure to ethylene oxide increases the risk of lymphoma, leukemia and stomach and breast cancer.

In the short-term, inhaling high amounts of ethylene oxide can cause headaches, fatigue, respiratory issues, nausea and other kinds of gastrointestinal distress.

Why was a rule put in place to limit it? And why undo it?

The rule was the product of years of community advocacy across the United States. Advocates say it’s designed to reduce the risk of exposure to ethylene oxide for people who live, work and go to school near these facilities.

According to the president, the exemptions are needed to ensure "that our Nation provides its sick and injured with the best outcomes possible.”

But to advocates like Darya Minovi, senior analyst the Union of Concerned Scientists, Trump’s decision “flies in the face of public health.”

Companies that use the gas to sterilize medical equipment can be found throughout the country. Minovi was the lead author on “Invisible Threat, Inequitable Impact," a 2023 report from the Union of Concerned Scientists that found more than 14 million people live within 5 miles of commercial sterilizers who emit ethylene oxide. And the people who live around these facilities are disproportionately people of color.

In his proclamation, Trump said the technology to implement the ethylene oxide rule “does not exist in a commercially viable form.”

The rule, he added, “will likely force existing sterilization facilities to close down, seriously disrupting the supply of medical equipment.”

Minovi told LAist that the potential health effects of ethylene oxide have been known for decades. And last year, the Food and Drug Administration approved the use of hydrogen peroxide for medical sterilization.

Communities across the country advocated for this rule to protect their families and neighbors, she added.

“It is immensely frustrating to spend years going through public participation processes — writing technical comments, writing research, gathering stories, testifying to EPA staff, joining community meetings that EPA held — just [to see the president] announce that, suddenly, [companies] can avoid compliance for another two years,” she said.

What the exemptions could mean for Southeast L.A. residents

In his list of exemptions, the president includes two facilities that belong to commercial sterilizer Sterigenics U.S. LLC.

These Sterigenics facilities are located in Vernon, a small, industrial city located 5 miles southeast of Downtown Los Angeles. The plaintiffs who’ve sued the company are current and former residents of Maywood, an adjoining city that’s predominantly Latino and working class. The plaintiffs also include long-term Maywood residents who’ve lost a parent or spouse.

Court documents show that the plaintiffs seek compensation for past and future medical expenses, along with funeral costs, lost wages, and the fear and “mental anguish” of being sick or watching a family member die.

Most of the plaintiffs have been diagnosed with breast cancer. The others — including a toddler and a man who fell ill while he was in high school — have been diagnosed with leukemia, non-Hodgkin lymphoma, stomach cancer, or precancerous conditions. The Vernon Sterigenics facilities are blocks away from where the Maywood plaintiffs reside. There are also four elementary schools within a 1.5-mile radius.

In an email, a spokesperson previously told LAist that the company “empathizes with anyone battling cancer,” but that it’s “confident that it is not responsible for causing the illnesses.”

“We will vigorously defend our essential and safe operations against these claims,” the spokesperson added.

The residents’ ongoing lawsuit against Sterigenics doesn’t dispute the importance of maintaining a steady supply of sterilized medical equipment, but it argues that this work shouldn’t be done at their expense.

Jay Parepally, a federal climate justice legal fellow at Communities for a Better Environment, a nonprofit that’s helped Southeast L.A. fight a host of pollution issues, echoed this point.

The community is overburdened, he said. Among other issues, it continues to grapple with contamination from Exide, a now-shuttered battery recycler that spewed lead and arsenic into Bell, Boyle Heights, Commerce, East L.A. Huntington Park and Maywood for decades.

Delaying regulation at a federal level could, in turn, preempt state and local regulation, which “further endangers our communities,” Parepally added. In his view, the health of Southeast L.A. residents “should not be further jeopardized," particularly at a time when it’s become “extremely vulnerable to arbitrary immigration detentions and civil rights violations."

How will Sterigenics be regulated now?

The South Coast Air Quality Management District is charged with monitoring the air and enforcing regulations in L.A., Orange, Riverside, and San Bernardino counties. In an email, a spokesperson said it cannot comment on Trump’s proclamation.

When asked if the Sterigenics facilities in Vernon are currently in compliance with its rules, regulations and permit requirements, the agency said: “South Coast AQMD regulates [ethylene oxide] emissions from sterilization facilities under Rule 1405 and works to ensure compliance with our rules and permit requirements."

In some aspects, the spokesperson added in a follow up email, the 2024 EPA rule is "more stringent" than what's currently in place at the state and local level.

In recent years, Sterigenics and its parent company, Sotera Health, have been hit with hundreds of lawsuits throughout the U.S. In 2023, for instance, Sterigenics and Sotera paid $408 million to settle 870 additional lawsuits in Illinois for exposure to elevated levels of ethylene oxide. In a statement, the companies denied liability or that emissions from its facilities posed any safety hazard to surrounding communities.

In addition to commercial sterilizers in Vernon, Trump’s proclamation exempts seven other Sterigenics facilities. Most are in other states and Puerto Rico, but one is located in Ontario, a city in southwestern San Bernardino County.

William Boyd, faculty co-director of UCLA’s Emmett Institute on Climate Change & the Environment, said no other president has made use of the authority Trump tapped into to issue his proclamation, which he expects environmental justice advocates to challenge.

“What it'll come down to is the president's claim that the technology is unavailable and that this is in the national security interest, is that an accurate and valid claim, [and] does he have sufficient reasons to support that?” he said.

“If you read EPA's rule on ethylene oxide, they say very clearly that the control technology and the limitations that they are including in this new rule [are] available and out there in the world,” he added. “Just because it might be more expensive, doesn't mean it's not available.”

“As a general matter,” Boyd told LAist, the public “thinks this is sort of abstract. [But] there are real people living real lives in real places that are going to end up getting cancer because of what the president is doing.”