Two years ago, federal environmental officials visited Salisbury to tell residents about stringent new regulations on a local business.

Trinity Sterile, a company based in the Eastern Shore town, uses a potent but highly carcinogenic chemical to disinfect medical supplies, and U.S. Environmental Protection Agency officials explained plans to crack down on emissions of this gas to protect nearby residents.

But in July, Trinity Sterile got a waiver to keep releasing the same amount of the toxic chemical, ethylene oxide, until at least 2028.

All it took was an email.

That’s thanks to a step announced this spring by President Donald Trump’s EPA. It invites industrial polluters to seek waivers on certain Clean Air Act requirements if technology for compliance isn’t available and exemption is in the country’s “national security interests.”

Trinity Sterile’s request, sent in late March, was one of hundreds to land in what some critics have called “the inbox from hell.”

Others came from a suburban Baltimore spice importer that also uses ethylene oxide, a colorless and odorless gas known as EtO, and a scrap metal recycler with a South Baltimore facility.

EtO is used for sterilization, including for about half of U.S. medical devices. But after the EPA found in 2016 that EtO is far more toxic than previously known, regulators looked for ways to limit releases.

The agency finalized a requirement last year, under former President Joe Biden, mandating that sterilization plants seal off emissions sources completely. EPA officials said the new standards, which take effect in April 2026, would slash EtO emissions by 90% and reduce cancer risks.

The new White House exemptions apply to Clean Air Act restrictions on close to 200 hazardous pollutants, including mercury, arsenic and ethylene oxide. More than 500 coal plants, chemical manufacturers, sterilizers and other operators have applied, according to an Environmental Defense Fund tracker.

Of the Maryland facilities that have asked for waivers, only Trinity Sterile has gotten approval so far. Under the exemption, the Salisbury plant can keep emitting ethylene oxide above the federal limits for two more years.

Located at the north end of Salisbury, Trinity Sterile’s plant released 250 pounds of ethylene oxide in each of the last five years, according to the EPA’s Toxics Release Inventory. While that’s relatively little compared to the country’s largest EtO emitters — a Union Carbide plant in Louisiana’s “Cancer Alley” emitted more than 6,000 pounds in 2023 — the plant is among 23 sterilizers nationwide that the EPA flagged for elevated cancer risk.

Inhaling ethylene oxide over years increases long-term risks of leukemia, lymphoma and breast cancer, and Jane Williams, a clean air advocate focused on ethylene oxide in Southern California, said the 250 pounds of EtO that Trinity Sterile emits annually is about five times above safe levels.

“You don’t want to mess with this chemical. It’s really bad,” said Williams, executive director of the group California Communities Against Toxics.

Williams argues that most medical devices could be sterilized by less hazardous means. State data shows Trinity Sterile has used roughly 20,000 pounds of EtO per year in recent years, a volume that Williams said seems high for a facility of its size.

In a statement, White House spokesperson Taylor Rogers described the exemptions as part of Trump’s promise to “unleash American energy.”

“These exemptions simply allow for more time to abide by environmental standards,” Rogers said.

Releases from Trinity Sterile’s facility have persisted despite strict requirements by the Maryland Department of the Environment.

Under two state air pollution laws, Trinity Sterile must contain emissions to levels deemed safe for public health, and must funnel ethylene oxide through scrubbers that cut the amount released into the atmosphere by 99.998%, according to MDE spokesperson Jay Apperson.

The EPA rule, though, aims to tackle releases from different points in the process. Known as “fugitive emissions,” these releases can escape through vents or outside the sterilization chamber, such as when EtO is transferred from trucks to facility tanks.

Trinity Sterile did not respond to emailed questions about its exemption, but a company attorney laid out their case for the waiver in a letter this spring to the EPA.

In the document, obtained by the Sierra Club in a records request, Trinity Sterile said it wouldn’t be possible to enclose its sterilization facility by the EPA’s April 2026 deadline. Instead, the company would have to shut down operations to get into compliance and outsource sterilization work.

The risk of developing cancer is statistically low, even for those living nearby for decades, and Trinity Sterile is located in an industrialized area. Hazards are greatest for employees.

Trinity Sterile’s waiver isn’t likely to increase ethylene oxide emissions, Apperson pointed out, but delaying requirements prolongs hazards.

“The use of these exemptions to circumvent longstanding clean air requirements will put peoples’ health at risk, in Maryland and around the country,” Apperson said.

Wicomico County Health Officer Matthew McConaughey said in an email that his agency hasn’t received complaints about Trinity Sterile and is unaware of cancer cases linked to the site. Still, he said ongoing exposure to EtO could increase cancer risk for people “who work, live, go to school or daycare near these facilities.”

Environmentalists, meanwhile, have blasted the Trump administration for its exemptions.

The waivers are especially problematic in the case of coal plants elsewhere in the country, said Sanjay Narayan, chief appellate counsel for the Sierra Club, since the administration has granted exemptions from pollution controls that are already in place at many of those facilities.

Claiming this is needed for national security is a “fig leaf” at best, Narayan said.

“The clear implication is: ‘Just ask, and we’ll give this to you,’” he said.

Other Maryland companies that appealed for waivers haven’t gotten them yet.

One is Elite Spice, a Jessup-based spice importer that requested exemptions for its Jessup and Hanover facilities, both of which use ethylene oxide to eliminate pathogens. In recent years, the two facilities combined released between 240 and 320 pounds of EtO emissions annually, according to EPA reporting.

A third Maryland request came from Smith Industries, a scrap metal processor, which asked for waivers on chemical emissions from its facilities in South Baltimore and Prince George’s County, calling its work “vital for national security.”

In Southern California, where Williams lives, local regulators have imposed some of the country’s strongest restrictions on ethylene oxide. Air monitors track toxic releases from sterilizers there, and when concentrations exceed strict local limits, operators have to stop work.

Under the EPA’s laxer standards, Maryland regulators must inspect Trinity Sterile only once every five years, though its permit requires indoor monitors and quarterly emissions reports. Apperson said MDE last visited the site in March 2024.

To Williams, that’s not enough to know how the company is handling its dangerous chemical. Without tighter oversight, she said, “they’ve got carte blanche.”