Clearing the air

February 21, 2012

Traffic at port, border, tied to asthma among kids south of San Diego

By Marty Graham

San Ysidro School District Nurse Anita Gillchrest can tell when the air quality in the area near the U.S. Mexico border is bad: the number of asthma interventions needed for the district’s 5,700 students triples and quadruples.

“Most of our medical orders on file are for rescue inhalers,” Gillchrest says. “My health clerks are swamped with kids having respiratory issues when the wind changes.”

Gillchrest oversees nursing staff at the district’s seven schools in the border community, where the schools are less than three miles from the border – where cars and trucks sit idling while they wait to cross to the U.S. She sees firsthand what the California Office of Statewide Health Planning and Development statistics suggest, that children in the border region suffer more respiratory problems than average for the county.

State statistics show that asthma emergencies send South Bay kids to the hospital between 1.5 and 3 times the county average.

The effects of asthma on kids and their families are profound, says Geraldo Garcia, who works with families at the San Ysidro Health Center. Garcia is a licensed doctor in Mexico and is working towards earning medical accreditation in the U.S.

“Kids with asthma can’t exercise and we find some of the kids have weight problems because they are they are afraid of having another exercise induced asthma attack,” Garcia said. “They can’t eat or sleep well – they eat very slowly or they get tired.”

“These kids have a hard time at school if they can’t sleep well,” he added. “They are not getting enough oxygen and they do not learn very well.”

The Environmental Health Coalition, based in Barrio Logan, has been compiling a list of hotspots for high levels of diesel particulate matter and the group has identified Barrio Logan, San Ysidro and Otay as hotspots for the air pollutants. Not surprisingly, the areas also show very high rates of hospitalizations of children with acute asthma.

While San Diego County reports average particulate matter measures averaging less than 50 micrograms per cubic meter of air – within the Envirnomental Protection Agency standards, measurements by San Diego State University researchers found times of day when there were more than 250 micrograms per cubic meter – five times the safe standard – within a mile of the border crossing and the schools.

“The evidence is mounting that diesel particulate matter causes asthma, but there is plenty of evidence that it exacerbates it,” said Diane Takvorian, executive director of the coalition. “That means kids are missing a lot of school and using steroids early in their lives.”

The neighborhoods have three things in common: high numbers of families below the federal poverty line, high proportion of the residents are Hispanic, and dense industrial use or traffic that causes unusually high levels of air pollutants.

In the border communities of Otay and San Ysidro, the air quality is adversely affected by the two working border crossings, where average wait times to cross the border mean that trucks and cars sit with the engines idling for long periods of time

In 2010, the Port of Entry at San Ysidro reported 13.4 million vehicle crossings, including more than 70,000 bus trips, according to a report by the San Diego Association of Governments. The average wait time to cross was 45 minutes per vehicle, while the vehicles sat idling. In 2004, SANDAG counted more than 1.4 million truck crossings at the Otay Mesa Port of Entry, according to a SANDAG report that found average wait times of two hours.

San Diego County’s Air Pollution Control District does not measure PM 2.5 near the border.

“Our job isn’t to look for the dirtiest spot in the county, it’s to make sure the countywide measurements are in compliance,” said William Brick, senior meteorologist for the district.

Preliminary measurements of pollutants by graduate students at the San Diego State University’s School of Public Health found very high levels of particulate matter within a mile of the San Ysidro border crossing, according to Prof. Jenny Quintana. At some times of day and under certain conditions, the team found concentrations that were nearly eight times the EPA’s maximum of 50 units.

In Barrio Logan, a mix of freeway traffic, local industries that include plating and auto body shops, and diesel truck traffic to the cargo ships at the 10th Avenue Terminal, have contributed to the problems, Takvorian said.

The coalition has been able to make some headway, including persuading the port to adopt a rule that all trucks that serve the cargo ships there have to meet state air quality rules. Many of the trucks are registered in Mexico and are hauling goods across the border, and were not required to prove they meet California air standards until the port changed its policies.

“We’ve achieved 99 percent compliance,” Takvorian said. “It doesn’t mean the trucks are totally clean but they are a lot cleaner than they were three years ago.”

The group also got the city to pass an ordinance requiring trucks to use commercial streets on the boundaries of Barrio Logan rather than driving through the residential streets to get to Interstate 5 – an ordinance Williams says is not being enforced.

In the San Ysidro district, accurate numbers for kids being treated for respiratory problems are particularly elusive because many families are truly cross-border and the children see doctors in Tijuana, which is closer and cheaper than going downtown. But the schools aren’t allowed to accept instructions from doctors in Tijuana, nor are they allowed to use medicine obtained there, Gillchrest said.

Gerardo Garcia, a program supervisor for health education at the San Ysidro Health Center, works to educate kids and their families on asthma and how to treat it, and finds that the expense of the medicines that control asthma is one of the problems families face.

“When the child feels better, families sometimes discontinue use because it is so expensive,” he said. “It takes persistent education to help families manage these conditions.”

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