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CDC determining ways to help address sewage crisis impacts on public health

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The Centers for Disease Control and Prevention says it is determining what kind of immediate help it can offer to address the cross-border sewage crisis affecting South County communities.

Aaron Bernstein, director of the CDC’s National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR), said in a Friday letter to county Chairperson Nora Vargas that discussions for epidemiological assistance, or Epi-Aid, were underway between his departments and the county and state public health agencies.

He also announced that the ATSDR is looking into whether it could conduct a similar but longer-term environmental health investigation.

Bernstein’s response comes after a joint effort between the state and county to formally enlist the help of the CDC. Communities that include Imperial Beach, San Ysidro, Nestor and Otay Mesa West are exposed to sewage and toxic chemicals because of their proximity to untreated wastewater that flows into the U.S. from Mexico.

While both countries work on repairing treatment plants, concerns have grown in recent years about the short- and long-term effects of living and working near pollution. Besides beach closures and economic downturns, people have reported symptoms such as chronic coughs, headaches, nausea, vomiting and diarrhea.

“Despite multiple efforts, the reality is that our communities continue to be exposed to elevated levels of hydrogen sulfide and other gases that contribute to a diminished quality of life, and that could potentially translate into health impacts,” Vargas wrote to the CDC in late May.

Dr. Seema Shah, medical director of the county’s epidemiology and immunization services branch, had specifically asked the NCEH’s Emerging Environmental Hazards and Health Effects division for help. The department is one of NCEH’s five branches, with expertise in epidemiology and medical toxicology to investigate outbreaks.

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“NCEH’s expertise in investigation and responding to environmental public health events, including air quality impacts, is requested to review the actions taken by the county and assist in planning next steps to meet the needs of San Diego County residents,” Shah had written.

An Epi-Aid is a study of “an urgent public health problem, such as infectious or noninfectious disease outbreaks, unexplained illnesses, or natural or manmade disasters,” according to the CDC’s website. Such investigations typically last one to three weeks and are generally conducted onsite.

Per its guidelines on epidemiological help, the CDC first determines the technical assistance needed and then decides if it can support the Epi-Aid.

“Once that has been established, CDC will respond accordingly,” a spokesperson said via email.

Meanwhile, ATSDR will consider investigating health concerns related to chemicals and contaminants in the water, soil and air, said Bernstein. The agency will begin by requesting environmental sampling data from multiple government and non-governmental organizations, which includes public complaints. Federal and local agencies have received dozens of complaints about sewage-related foul odors, for example.

“Once compiled, ATSDR will determine if sufficient data are available to support an analysis that can address the question raised in a petition,” said Bernstein, adding that the review process depends on when the agency receives information. The typical timeframe can take up to one year, according to its website.

If a petition is accepted, the investigation will determine if there has been exposure to a hazardous substance and if public health is at risk. The non-regulatory agency says that it can recommend ways to “reduce, stop, or prevent exposure to the substance,” but it cannot diagnose health conditions, clean up chemicals or direct facilities to stop polluting.

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