WASHINGTON (AP) — The Environmental Protection Agency is warning residents who live near medical sterilizing plants in 13 states and Puerto Rico about potential health risks from emissions of ethylene oxide, a chemical widely used in their operations.

Laredo, Texas; Ardmore, Oklahoma; and Lakewood, Colorado, are among the communities facing the highest risk from ethylene oxide emissions, EPA said.

The agency has notified 23 commercial sterilizers — 19 in the continental U.S. and four in Puerto Rico — that their operations pose an elevated risk of cancer and other ailments. The notice follows a recent survey of emissions data from almost 100 commercial sterilizers nationwide.

Ethylene oxide is used to clean everything from catheters to syringes, pacemakers and plastic surgical gowns.

While short-term or infrequent exposure to ethylene oxide does not appear to pose a health risk, EPA said long-term or lifetime exposure to the chemical could lead to a variety of health impacts, including lymphoma and breast cancer. EPA said it is working with commercial sterilizers to take appropriate steps to reduce emissions.

"Today, EPA is taking action to ensure communities are informed and engaged in our efforts to address ethylene oxide, a potent air toxic posing serious health risks with long-term exposure," EPA Administrator Michael Regan said in a statement Wednesday.

EPA will conduct public outreach campaigns in each of the communities where elevated risks have been found, including an Aug. 10 webinar. More than half the sites on EPA's watch list are in predominantly minority or low-income communities.

Laredo, one of the communities targeted by the EPA notice, is a border city where the vast majority of residents are Latino and more than a quarter live in poverty. Missouri-based Midwest Sterilization Corp. operates a sterilization plant in Laredo. The company also owns a plant in Jackson, Missouri that is on EPA's watch list.

More than 40% of Laredo's nearly 70,000 schoolchildren attend campuses in areas with an elevated risk of cancer due to ethylene oxide emissions from the Midwest plant, according to an analysis.