The Centers for Disease Control and Prevention (CDC) will conduct an investigation into the transborder sewage crisis, measuring potential health impacts on people who live and work near where millions of gallons of sewage are spilling over the U.S.-Mexico border from Tijuana, county officials said Thursday.
In cooperation with the county, state and San Diego State University, the federal public health agency’s survey will include door-to-door interviews with several hundred households in South County to assess the impact of exposure to polluted water and air in the area on residents’ health. It will also examine occupational and environmental exposures and concerns of at-risk populations.
The process is officially known as the Community Assessment for Public Health Emergency Response, or CASPER. These assessments are typically quick and produce data on a community’s needs “so that public health officials and emergency managers can make informed decisions,” according to the CDC’s website.
It’s unclear how the CDC, which did not immediately respond to a request for comment, will select households and when it plans to launch the effort.
The effort is the most comprehensive study to date by government agencies of the health impacts of sewage discharges and lingering odors on people in the southwest region of the county.
The move also follows repeated calls from the public and local officials to investigate health problems related to pollution. As both countries work to repair sewage plants, concerns have grown in recent years about the short- and long-term effects of living and working near polluted areas. In addition to beach closures and economic downturns, residents have reported symptoms such as chronic coughs, headaches, nausea, vomiting and diarrhea.
“Raw sewage flows, and the associated odors and potential for illness, should not be anyone’s daily worry,” Ankita Kadakia, the county’s acting public health officer, said in a statement.
Officials said the CDC and the county are finalizing an agreement for the community assessment, but have already verbally agreed to conduct an epidemiological investigation, also known as Epi-Aid.
According to the CDC website, an outbreak investigation is a study of “an urgent public health problem, such as an outbreak of infectious or noninfectious disease, an unexplained illness, or a natural or man-made disaster.” These investigations typically last one to three weeks and are usually conducted on-site.
After formally requesting Epi-Aid assistance this summer, the county and the federal health agency have been working to determine what kind of immediate assistance they can offer to help impacted communities.
A similar study was conducted in Flint, Michigan, in 2016 to investigate a water crisis in that city. When the city switched its municipal water supply from Detroit’s Lake Huron to the Flint River, the pipes corroded and contaminated the drinking water with lead. The CASPER study found that many local households experienced a decline in their mental health, including signs of depression, anxiety, or stress.
“(CASPERs are) really a great way to assess the public health needs of a community and a great way to get representative data,” said Dr. Seema Shah, medical director of the county’s epidemiology and immunization services branch.
The move also follows a two-week investigation by the county in February that found no evidence of an increase in gastrointestinal illnesses at a South Bay health clinic that claimed its patients were suffering such symptoms. Some researchers and San Diego elected officials have dismissed the county’s findings, questioning whether the data collected was sufficient to conclude that people who don’t come into direct contact with polluted water can’t get sick.
County officials acknowledged that symptoms are not always reported in traditional ways and that there are information gaps.
“That’s the main goal of CASPER,” Kadakia said. “It’s going to give us the data that we’re looking for to capture things that we may not see in reportable diseases. But it’s also going to allow us to validate the concerns that the community has expressed and try to develop action plans.”
The county also announced it is expanding its public reporting on health issues in the South Bay. Earlier this year, it launched a “surveillance bulletin” that tracks the prevalence of gastrointestinal symptoms seen in recently admitted emergency room patients, such as diarrhea and vomiting. Starting this week and updated every Wednesday, the website will include respiratory disease surveillance, tracking symptoms of asthma or chronic obstructive pulmonary disease, including reactive airway disease, wheezing and bronchospasm.
Reporter Paul Sisson contributed to this report.
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