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California Border Environmental Health

California Border Environmental Health. Kathryn C. Dowling, Ph.D. Border Coordinator. Office of Environmental Health Hazard Assessment California Environmental Protection Agency. Office of Environmental Health Hazard Assessment Border Environmental Health Project. Reduce exposures to: Lead

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California Border Environmental Health

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  1. California Border EnvironmentalHealth Kathryn C. Dowling, Ph.D. Border Coordinator Office of Environmental Health Hazard Assessment California Environmental Protection Agency

  2. Office of Environmental Health Hazard Assessment Border EnvironmentalHealth Project • Reduce exposures to: • Lead • Contaminated Air • Pesticides • Contaminated Water • Provide Training to: • Health promoters • Mexican colleagues • Provide Technical Assistance to: • Local governments • Community-based organizations

  3. Environmental Health at the California-Baja California Border: 2002 Forum • Air Quality and Respiratory Diseases • Water Quality • Food Safety • Emergency Response to Hazardous Materials • Pesticides • Lead • Occupational Health

  4. Environmental Health at the California-Baja California Border: 2002 Forum • 144 participants • 44% - CA; 51% - BC; 5% - other • Bi-state priorities for seven topics were generated • To request a copy of the final report/Para pedir una copia del informe final: ccbres@mail.sdsu.edu

  5. 2002 ForumAir Quality Issues • California Air Resources Board (ARB) operates numerous air monitoring stations throughout the border area • California • Baja California • Many non-attainment areas on both sides of the border for: • PM10 • ozone • Calexico, CA is a non-attainment area for carbon monoxide

  6. 2002 ForumWater Quality Issues • Severe shortages of water exacerbate the use of poor-quality water • Chemical and microbial contamination of drinking water is a problem for the Tijuana, New, and Alamo Rivers • Pathogen contamination of the southern part of San Diego Bay results from discharges of incompletely treated wastewater • Chemicals contaminate fish and sediments in the New River and Salton Sea

  7. 2002 ForumFood Safety Issues • Microbiological contamination of food, especially fresh produce • Pesticide residues in food • Lead contamination of food (especially imported products) • Provides a good example of the political, economic, and health benefits from a common testing system

  8. 2002 ForumEmergency Response to Hazardous Substances • Many other toxicants are used in manufacturing on the border • Binational training and cooperation exercises for emergency response • Need for clean-up of contaminated sites • Need for risk-based prioritization to manage industrial risks

  9. 2002 ForumPesticide Exposure Issues • Intensive agricultural activity in the Imperial County/Municipio de Mexicali area • Farmworker exposure • Family member exposure • Community exposure • An unknown number of border farmworkers seek medical attention in Mexico • Farmworkers delay medical attention until they can cross the border to Mexico

  10. 2002 ForumLead Exposure Issues • Particular concern for children • Cultural exposures • Lead-based glazes on pottery • Home remedies • Lead-contaminated food products • Other metals and cultural exposures (mercury?)

  11. 2002 ForumOccupational Health • Should environmental health include occupational health? • Industries in California are required to report occupational illnesses • California occupational health surveillance is quite comprehensive

  12. Surveillance in California to Date • Via laboratory reports • Since medical laboratory testing is so common in California, many diseases are tracked through testing labs • Laboratories are required to report many test results to California DHS • Via physician reports • Illness is diagnosed by a physician • Laboratory tests may not be involved • Problems with physician compliance can be significant

  13. Surveillance in California to Date • U.S. Centers for Disease Control and Prevention (CDC) requires reporting of many infectious diseases • Food- and Water-borne illnesses • Salmonellosis • Enterohemorrhagic E. coli • Botulism (Clostridium botulinum) • Shigellosis

  14. Surveillance in California to Date • Vector-borne Disease Surveillance • Mosquito-borne encephalitis (recently expanded to include West Nile virus) • Malaria • Plague • Hantavirus • Tick-borne diseases

  15. Surveillance in California to Date • Pesticide-related illness • captured through the Pesticide Illness Reporting database • Voluntary laboratory reporting for cholinesterase results (pilot program) • Since January, all laboratories have been required to report all blood lead results to California DHS • Children’s Blood Lead Registry • Occupational Blood Lead Registry

  16. Planned Surveillance in California • Senate Bill 702 (Escutia, 2001) • Declares the State of California’s intent to establish an environmental health tracking network • Chronic diseases • Environmental exposures • Currently under evaluation with funding from CDC • Asthma is expected to be included, among other environment-related diseases

  17. Indicators Projects in California • Environmental Protection Indicators for California (EPIC) – California EPA, March 2002 • Includes one set of border indicators for air quality as a first start • Particulate matter (PM-10 microns) • Ozone • Carbon monoxide • Nitrogen dioxide

  18. Indicators Projects in California State Standard(50mg/m3)

  19. Indicators Projects in California • California Environmental Health Indicators – California Department of Health Services (DHS), July 2002 • California-Baja California Border Region: Air Quality • PM-10 • Ozone • Imperial County maximum • San Diego County maximum • Source: California ARB

  20. Indicators Projects in California • California-Baja California Border Region: Rate of Diarrheal Morbidity • Environmental Health Investigations Branch • Source: PAHO

  21. Questions for Consideration • Should only disease outcomes be considered (direct)? • Are environmental pollution levels useful indicators for environmental health (indirect)? • Could environmental health outcomes be modeled based on environmental indicators? • What environmental health conditions are monitored? • Which are monitored in both states (CA and B.C.)?

  22. Challenges • Completeness of data gathered • EPIC – three levels: • Type I: adequate data are available for presenting a trend • Type II: further data collection/analysis is needed before a trend can be presented • Type III: conceptual indicators – systematic data collection is not in place

  23. Challenges • Many diseases remain to be tracked • Decisions must be made between direct and indirect measures of environmental health • In some cases (for example, air pollution), an area-wide (binational) approach may make most sense • Can California and Baja California disease surveillance be made to correspond? • What political restrictions exist to data sharing? • FUNDING

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