Cassandra Sutcliffe has been using her inhaler more often to treat her chronic bronchitis.
She lives on an oceanfront property in Imperial Beach, one of the southernmost communities impacted by sewage and toxic chemicals that spill over the U.S.-Mexico border.
“The smell makes your eyes water and your throat close up,” said Sutcliffe, one of many residents who have reported having similar symptoms and who say they find relief when they leave town. “I was told by (my doctor) that the environment could be the contributing factor (to) my failing health.”
But it’s been difficult to correlate symptoms of bacterial illness with nearby wastewater releases. There have not been any deep investigations into the issue by private or public health and environmental entities.
A newly formed task force, spearheaded by Imperial Beach Mayor Paloma Aguirre and comprised of San Diego researchers and physicians, aims to change that. The group has yet to decide on its formal name, but it does have an end game.
“The community is screaming at the top of their lungs that there’s a problem,” said SDSU environmental health professor Paula Stigler Granados, a task force member. “So, our job as academics is to listen and to try to address it.”
They hope to answer some simple questions: What is the link between water quality and air quality? What are people breathing in South County? How many people are exposed and what is that doing to human health?
There is a lot of data showing that ocean water quality is poor. And that there are sewage-linked bacteria in sea-spray aerosols at Imperial Beach, according to a 2023 study from UC San Diego’s Scripps Institution of Oceanography.
Still, not much is known about the water-to-air transfer of those pathogens, including chemicals, and how they affect people’s health.
“You inhale 11,000 liters of air a day, versus two liters of water that you drink,” said UC San Diego biochemist Kim Prather, another task force member and principal investigator on the aerosols study. “So, your main exposure route is the air. Our thinking is that a lot of the exposure and a lot of the illness is coming from what people are breathing.”
People who live and work in communities such as Imperial Beach, Nestor, San Ysidro and the Tijuana River Valley, have reported headaches, chronic coughs, diarrhea, vomiting and other symptoms, particularly after heavy rains when more sewage hits the riverbed and when odors seem stronger during hotter and drier days.
But local public health experts have repeatedly said they have not seen an increase in reported infections that would be expected from exposure to polluted water.
The public health system does not track every infection, however. Not all infections are required to be reported to said agencies. Additionally, many with gastrointestinal symptoms don’t always go to emergency departments, meaning their illnesses won’t appear on reports. And infections that are not confirmed with testing cannot be reported to public health departments.
Drs. Kimberly and Matt Dickson of South Bay Urgent Care, also task force members, have seen an uptick in gastrointestinal illness that appear to coincide with heavy rain. They fear that the true severity of the sewage-linked illnesses will remain unknown if the local public health system does not step in to do more.
Aguirre and San Diego congressional members have instead asked the Centers for Disease Control and Prevention to investigate the impact wastewater pollution has had on people’s health. The federal agency recently told Aguirre that it can only intervene with a direct request from the county and state.
Without hard data, the county has limited its intervention to surveillance and meetings with other agencies. In March, it launched a “surveillance bulletin” to show a weekly prevalence of gastrointestinal symptoms observed in emergency department patients. It’s also met with the state public health department and the Environmental Protection Agency “about the local concerns raised and continue(s) to provide updates,” according to a March 27 letter from Eric McDonald, the Health and Human Services Agency’s interim agency director, to Aguirre. It’s unclear what has come of those meetings.
“A non-traditional approach is what it takes,” said Stigler Granados.
A ‘huge undertaking’
The task force’s “non-traditional” work will be no easy feat.
“Collecting environmental health risk data is probably one of the hardest things to do because all of us are exposed to so many things in the world on a daily basis, through our work and activities in our homelife,” said Stigler Granados.
The group also does not have enough funding to conduct a large-scale epidemiological study that could follow people for years, which could cost “millions and millions of dollars that would be better spent toward the (wastewater infrastructure) repairs,” she added. They are working with funding that was previously granted by San Diego’s Conrad Prebys Foundation to conduct a now-published report about the Tijuana River’s unhealthy conditions due to untreated wastewater and industrial waste.
What they also have: epidemiology and environmental health graduate students who “are equipped to ask the right questions and the expertise to do good, independent analysis,” said Stigler Granados.
The task force’s expected yearlong work will start as early as next month with the launch of a community health survey in South County that asks people to report any symptoms and exposures they had in recent weeks. They would then recruit people with reported illnesses and study their cases closely to identify what got them sick.
They envision using various technologies, such as giving residents silicone wristbands capable of absorbing chemicals from the environment to help researchers find out if people are exposed to airborne pathogens and chemicals in their homes. They also plan to deploy an electric vehicle that can map the air quality across South Bay. Additionally, they want to collect dust samples from people’s homes because, “believe it or not, it’s like a magical world of all the microbes and everything they’re exposed to collected in one little spot,” said Prather.
Ideally, the task force hopes to link human samples of viruses or bacteria with that of samples coming out of contaminated water-to-air transfers.
“You can think of it like contact tracing, kind of what they do whenever you have outbreaks on lettuce or spinach,” said Stigler Granados.
Task force members are already connecting with Mexican universities, who have expressed interest in collecting similar data in Tijuana. And because many people in San Diego County, particularly low-income communities in South County, travel to Baja California for cheaper health care, researchers will ask clinics there about any similar illnesses or related symptoms.
Additionally, the task force hopes to work with a new, White House interagency working group created to keep federal agencies up to speed on efforts addressing the sewage crisis.
‘Our job as government’
Officials said their work will only scratch the surface of the issue.
It can only be successful with the participation of those affected by cross-border pollution, they said.
Their biggest hope is that their data will teach people how to protect themselves and equip policymakers with data-driven information so that they can expedite solutions to stop pollution.
“We want the county and the state to better monitor environmental and public health,” said Aguirre. “We need to make sure that our communities, which are the most vulnerable, are protected. That’s our job as government: health, safety and welfare.”
This story originally appeared in San Diego Union-Tribune.
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