Both families live near the Midwest Sterilization Corporation, a medical equipment sterilization facility in north Laredo that uses in its process ethylene oxide, a known carcinogen.
For the Nevares and the Ortiz families, their cancer battles took on a different light once they learned about that nearby plant. They wonder if the illnesses that turned their lives upside down were caused by cancer-causing emissions from the factory and worry about how air contamination may harm others.
The Midwest Sterilization Corporation facility in Laredo uses ethylene oxide, a carcinogen, to sterilize medical equipment. The process is known to emit cancer-causing gas into the air. Photo by Sean Jimenez/South Texas Project
Local activists have been bringing attention to ethylene oxide emissions for years, advocating for more air monitoring and emission regulations. In March 2024, they applauded the Environmental Protection Agency (EPA) for what seemed like a victory: new federal regulations that would drastically curb emissions of ethylene oxide, including those at the facility in Laredo.
But the EPA’s 2024 “final rule” may not be the last word, as the Trump administration has been reconsidering many Biden-era regulations, placing the implementation of emissions reductions in uncertainty.
The Midwest Sterilization Corporation uses ethylene oxide to sterilize medical devices. Some families living near the plant say they understand the purpose of the facility, but struggle to see how it justifies the potential health risks.
“The products that they have, yes, they saved my son's life, because they are products for hospitals,” said Nidia Nevares, whose son survived from leukemia. But pollutants from the same plant may have made him sick in the first place, she added.
Rafael and Nidia Nevares, with their son Juan Jose "JJ”, at Father Charles M. McNaboe Park in Laredo, Texas. Photo by Sean Jimenez/South Texas Project
Thirteen year-old Juan Jose Nevares, who goes by JJ, was diagnosed with acute lymphocytic leukemia in 2018, when he was just six. He beat the disease, but his family still lives just a few miles from the Midwest plant.
His mom, Nidia Nevares, remembers the original checkup as a “minor nuisance,” having to travel to San Antonio for tests to be done and news to get back.
The “nuisance” trip turned into a life-changing experience once the cancer diagnosis came back.
“At first, they said it was two years of treatment,” she said. “Two years passed, but after two years they told us the leukemia came back, so it was another three years of treatment.”
Nidia Nevares holds her son JJ's hand at their home, which is one of many residences located just minutes away from a controversial facility for using a carcinogen to sterilize medical equipment. Photo by Sean Jimenez/South Texas Project
“I didn’t really understand anything,” JJ recalls of his years battling cancer. “I didn’t really have adult feelings yet, so I didn’t really just know. I just said, okay, we’re doing this now.”
The Nevares family rallied around JJ and his treatment. It wasn’t until later that they learned about the potential ethylene oxide exposure from the nearby Midwest Sterilization plant and that the chemical raises the risk of cancers such as leukemia.
It was an “ugly” feeling to consider that her son’s cancer may have been linked to the toxic emissions, Nidia Nevares said. The school is close to the plant, too. She thinks about the other children that go to JJ’s school and feels “sad that more children are at risk.”
Juan Jose “J.J.” Nevares holds his end-of-treatment day poster from The Children's Hospital of San Antonio at his home in Laredo. Photo by Sean Jimenez/South Texas Project
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 brought together 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).
Edgar Villaseñor, advocacy campaign manager at the environmental justice group Rio Grande International Study Center (RGISC). Photo by Sean Jimenez/South Texas Project
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.”
For many medical devices, 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.
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.
“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.
The report states there are some concerns with the reliability of the data, to which it recommends ongoing monitoring. “[Ethylene oxide] exposure poses an important risk to communities and should not be dismissed,” it says.
Edgar Villaseñor explains the varying levels of air contamination affecting schools across Laredo, Texas, using data measured by the Rio Grande International Study Center (RGISC). Photo by Sean Jimenez/South Texas Project
Midwest Sterilization Corporation has stated its emissions are within legal limits. The company 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.
The Nevares family’s neighbor, Xavier Ortiz, was diagnosed in September 2024 with lymphoma.
There are reported cases of others who live near to the plant getting cancer, and many people and organizations, such as the Rio Grande International Study Center (RGISC), believe that the plant’s ethylene oxide emissions are linked to these illnesses.
No specific cancer case has been proven linked to the plant. However, activists and concerned residents point to studies that show Laredo to be a hotspot of ethylene oxide exposure.
Ortiz had no idea that emissions from the plant may be linked to his cancer until receiving a brochure from activists.
“They brought it to me and put it on the door. I checked the page and I told my wife, ‘Look, they say there's going to be a talk about this contamination, and the main effect it has is lymphoma,’” he said.
Javier Ortiz speaks about his diagnosis at Iglesia Cristiana Ministerio De Salvación in Laredo, Texas, on April 5, 2024. Photo by Sean Jimenez/South Texas Project
Ortiz wishes for a clear answer about the cause of his cancer, but while ethylene oxide is known to cause lymphoma, the lack of certainty bothers him.
“I have my children living in the house. I mean, I have more neighbors living there in the area,” Ortiz said. “It's not fair that more people would be contaminated.”
Ortiz's sickness affects him significantly on a daily basis.
“It affects my family’s finances, my health, my finances, my well-being, family problems due to the lack of money from not being able to work,” he said.
Chemotherapy treatments have left him stuck in bed for up to 12 days at a time, and his treatments, he stated, have been “very ugly.”
Even as he suffers, Ortiz recognizes that ethylene oxide is useful as a sterilizer. What he wants, he says, is a definitive answer as to the level of risk and for Midwest to properly mitigate it.
Under President Biden’s EPA administrator Michael Regan, the agency agreed to adopt new standards. The agency touted the new “final rule,” announced in March 2024, as historic.
However, following the transition to a new administration in Washington, the Trump EPA is rethinking the rules. Environmental advocates say there is a risk that the tighter regulations may never go into effect.
“This administration has taken a different approach to that industry, incredibly favorable [to it],” said Tricia Cortez, Executive Director of RGISC.
The Ethylene Oxide Sterilization Association, an industry trade group, had filed a legal action calling for a review of the final rule.
The organization Rio Grande International Study Center (RGISC) has found a localized source of toxic emissions in Laredo, Texas, possibly linked to the Midwest Sterilization Corporation. The company has claimed its ethylene oxide emissions are within legal limits. Photo by Sean Jimenez/South Texas Project
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 President Trump’s 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 motion for abeyance, as it is known, was filed on March 25, just days after 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.
J.J. Nevares and his mother, Nidia Nevares, at the Father Charles M. McNaboe Park. Photo by Sean Jimenez/South Texas Project
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.”
In Laredo, families grapple with air pollution as efforts to reduce toxic emissions stall was first published on palabra and republished with permission.
Olivia Biggs, Avery Foster, and Callaghan Mitchell are journalism students at Texas A&M University. David Perez is a student at Texas A&M International University.
Images by Sean Jimenez, who is an aspiring environmental photojournalist and a junior in Texas A&M International University in his hometown of Laredo, Texas.
Editor Mariano Castillo is a Professor of Practice in journalism at Texas A&M. Previously, he held several roles at CNN, from writer to fact check editor to director of standards and practices.
Editor Rodrigo Cervantes is an award-winning bilingual journalist and communications strategist with extensive experience in the U.S., Mexico, and internationally.
But over the past two decades, prevalence rates of children diagnosed with ASD have grown at an alarming rate. By 2012 (children born in 2004), the CDC's estimate had risen to 1 in 68 eight-year-olds. The most recent data available is of children born in 2014 and examined in 2022. The prevalence rate, over a period of 10 years, had now increased to 1 in 31 children (more than doubling every 10 years).
What is Autism/ASD? It is a mental disorder caused by variations in the brain’s development. These disorders are characterized by difficulties in interacting with others—in social-emotional reciprocity, in nonverbal communicative behaviors, and in developing, maintaining, and understanding relationships—as well as repetitive behaviors.
What do we know about the causes of autism/ASD? Prior to the 70s, autism was thought to be caused by bad parenting, “unloving mothers.” That theory has been thoroughly debunked.
Instead, research has shown that a number of genes are connected with autism. Further, a number of environmental factors before and during birth that influence early brain development, and thus increase the risk, have been identified. They include advanced parental age, maternal illness, maternal exposure to pesticides, and various other factors.
But these factors could not even begin to explain the rapid increase in the rate of autism/ASD. In looking briefly at several recent symposia on the subject, no new ideas were identified. There was just hope in identifying “modifiable risk factors” as we better understand why the prevalence of ASD has increased.
When I first read the definition of autism noted above, I had a “duh” moment. The definition, with the exception of repetitive behaviors, closely tracks what researchers are finding is the negative result of compulsive use of modern technology…the internet, computer games, smart phones, and social media.
We’ve all seen the phenomenon—people, not just young adults, being glued to their screens. The use of social media and other technology has become an addictive behavior.
I am not a scientist, but I knew from research I had done when writing my book, Raising a Happy Child, that “stress in the womb can affect a baby's temperament and neurobehavioral development. ‘Who you are and what you’re like when you are pregnant will affect who that baby is,’ says Janet DiPietro, a developmental psychologist at Johns Hopkins University. ‘Women's psychological functioning during pregnancy—their anxiety level, stress, personality—ultimately affects the temperament of their babies. It has to ... the baby is awash in all the chemicals produced by the mom.’” So it certainly seemed possible that a pregnant mother's obsessive compulsive social media addiction would have an impact on her baby.
The period of rapid ASD prevalence growth coincided with the period in which internet and social media use took off (in the late 1990s). We know from Pew Research Center data that when it first started tracking social media usage in 2005, the figure was 7%. Ten years previously, there was practically no social media, so the number would have been 0. During that same period, the prevalence of autism doubled.
Since then, internet and media usage have grown exponentially. The Pew study found that between 2005 and 2013, usage by adults increased from 7% to 62%. The increase leveled off after that, and the last reading was 65% in 2015. This survey, however, did not measure frequency or duration of use, which, from observation, appears to have increased significantly.
There’s one more point. The current research focuses on factors impacting ASD development before one is born. It considers no post-birth environmental factors. Yet research has shown that a child’s brain continues significant structural development at least until age 2, with further development continuing through adolescence.
It’s a very common sight these days to see even two- or three-year-olds staring at their little screens, watching a program or game while in their strollers, accompanying their parents at a restaurant, or elsewhere. It’s becoming the new pacifier. I cannot help but think that it will also have an impact on autism prevalence.
There is obviously a coincidence in the timing of the increase in both ASD prevalence and social media use. But to make a definitive statement about causality, more research is needed. Given the ubiquitous nature of obsessive social media use in our society today, I feel that testing this hypothesis is of utmost importance, even urgent, given its potential impact on not just children but our society. If more children are being born with ASD due even partially to this risk factor, then every pregnant woman should be given a health advisory to stay off social media during her pregnancy. This should be treated no differently than advice given to pregnant women to avoid other harmful behavior, whether it’s smoking, taking drugs, or eating fish from contaminated rivers. And the use of devices by toddlers should be restricted.
The CDC, or other appropriate agency, should gather information on the computer/social media habits of mothers during pregnancy. That data needs to include not just how many sites she visits (as was the case with the Pew data), but the frequency and duration of her visits. Since it does not appear that such data would be able to be retrieved through the CDC’s ADDM data gathering system, a survey would most likely have to be employed. Data on toddlers’/young children’s exposure to computer games/programs also needs to be gathered.
I became interested in this issue because a close friend has custody of a grandchild who has ASD. Several years ago, my friend asked me, because I had written the book, Raising a Happy Child, if I had any ideas on what might help his interactions with the child. And so I began my research and analysis. I have also experienced firsthand the impact of ASD on a child, having worked with many children with the disorder as part of my work helping at-risk and special needs kids in elementary schools.
This hypothesis may be unorthodox, but it is no laughing matter.
Ronald L. Hirsch is a teacher, legal aid lawyer, survey researcher, nonprofit executive, consultant, composer, author, and volunteer. He is a graduate of Brown University and the University of Chicago Law School and the author of We Still Hold These Truths. Read more of his writing at www.PreservingAmericanValues.com
