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DATE: |
October 22, 2024 |
28 |
SUBJECT
Title
RECEIVE UPDATE ON EXPANDING MOBILIZATION AGAINST THE TIJUANA RIVER SEWAGE CRISIS (DISTRICTS: ALL)
Body
OVERVIEW
Over the years, San Diego County has been negatively impacted due to contamination and pollution from the Tijuana River Valley. Untreated sewage, industrial waste, and urban runoff have contaminated beaches and coastlines. These issues have particular impact on the well-being of residents, the environment, and the economy of the cities and unincorporated communities of Imperial Beach, Chula Vista, National City, San Diego, Bonita, and East Otay Mesa (South Region).
Under the leadership of the San Diego County Board of Supervisors (Board), the County of San Diego (County), in partnership with impacted stakeholders across the region, have responded to this issue through various strategies. Recognizing the detrimental impacts to the environment, economy, and property within San Diego County caused by persistent contamination from cross-border sewage pollution and sewage-impacted ocean waters, the Board issued a Proclamation of Emergency on June 27, 2023 (16). Subsequently, the Board found that there is a continuing need for the local emergency and took action to keep the local emergency in effect, with the most recent action on September 11, 2024 (3).
In May 2024, the Tijuana River Pollution Task Force (Task Force) led by the City of Imperial Beach, San Diego State University School of Public Health, University of California San Diego, and local physicians and community members formed to understand the long-term public health impact and call on local, State, and federal agencies to step up efforts to fix this issue. On June 25, 2024 (11), the Board took action to expand the mobilization against the Tijuana River sewage crisis and directed the Chief Administrative Officer to ensure appropriate County staff begin meeting with the Task Force within 45 days to discuss and develop options and recommendations on coordinated strategies for mobilization and to return to the Board within 90 days with updates on activities related to these strategies. Today’s action requests the Board receive the update on efforts related to expanding mobilization against the Tijuana River Valley Sewage Crisis. In addition, prior to the directed progress update scheduled for September, additional response in the Tijuana River Valley was needed to address concerns regarding air quality raised by members of the Task Force. Today’s item also details that response and ongoing work, as well as additional actions recommended to be implemented by the San Diego County Air Pollution Control District. This information is categorized under four areas: Prevention; Surveillance; Investigation and Response; as well as Coordination, Collaboration, and Communication.
Today’s action supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe and thriving communities.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Receive the update on Task Force Options and Recommendations relating to expanding mobilization against the Tijuana River sewage crisis.
EQUITY IMPACT STATEMENT
Communities in the South Region are most impacted by the Tijuana River transboundary pollution, including untreated sewage, sediment, and trash. These communities are in a highly diverse border region with 62.1% of the population identifying by race/ethnicity as Hispanic based on United States Census Bureau data. In 2022, the non-Hispanic or Latino populations of the area identified as 17.2% White, 12.6% Asian, 4.5% Black, and the remainder identified as other race/ethnicity. The area has a large proportion of economically disadvantaged residents with existing racial inequities. On average between 2021 and 2022, some areas in the South Region had some of the highest proportions of adults with income less than 200% Federal Poverty Line compared to all other HHSA Regions in San Diego County.
South Region beach waters have been severely impacted by untreated sewage, which has required the County Department of Environmental Health and Quality (DEHQ) to issue beach water contact closures at numerous beaches. As such, the most southern beach in Imperial Beach was closed for over 1,000 consecutive days. According to International Boundary and Water Commission (IBWC), over 100 billion gallons of sewage has impacted the Tijuana River Valley since 2018. South Region residents have registered concerns about the impacts of the environment and foul smells from the Tijuana River pollution on their communities and well-being, as well as on the quality of life of residents, visitors, and people working in the area. These concerns have also been elevated through various community outreach events, media, and elected community representatives.
The County provides regular public updates including water quality and health data to keep the community informed of the impacts of the Tijuana River transboundary pollution. Educational materials have been developed and are available to the public on a dedicated County webpage which also contains links to other informational resources. In addition, the County fosters open communication with the community through various channels including County news stories and press releases. The County has contributed to a community survey, which is under development by the Task Force. The County is also working in collaboration with the California Department of Public Health (CDPH) and the United States Centers for Disease Control and Prevention (CDC) to ensure comprehensive disease investigation efforts. A collaborative effort between the County, the Task Force, and community, State, and federal partners is essential to addressing the root causes of environmental disparities that impact the South Region.
SUSTAINABILITY IMPACT STATEMENT
Today’s proposed action supports the County of San Diego Sustainability Goal #4 to protect the health and well-being of everyone in the region; Sustainability Goal #5 to protect water in all forms; Sustainability Goal #6 to develop natural and organic land management policies that protect ecosystems, habitats, biodiversity, and soil health throughout the county while providing opportunities for all residents to access and enjoy the outdoors; and Sustainability Goal #7 to reduce pollution and waste and demonstrate reduction in consumption of resources. This will be accomplished by collaborating with community partners and advocating for environmental justice for communities that have been disproportionately impacted by the Tijuana River Valley sewage crisis. These efforts aim to protect the environment and promote natural resources and diverse habitats, and cultivate a natural environment for residents, visitors, and future generations to enjoy in San Diego County.
FISCAL IMPACT
There is no fiscal impact with today’s recommendation to receive the update on the Task Force options and recommendations. There may be future impacts associated with the implementation of Task Force recommendations for which staff will return to the Board with recommendations for consideration and approval. At this time, there will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
The impact of beach closures has had a devastating impact on coastal communities through decreased visitors and street traffic. A reduction in individuals moving into affected coastal communities may affect real estate and properties.
ADVISORY BOARD STATEMENT
The Health Services Advisory Board recommended to approve this recommendation at its meeting on September 9, 2024, and was provided an update on current actions at their October 1, 2024 meeting.
BACKGROUND
Over the years, San Diego County has been negatively impacted due to contamination and pollution from the Tijuana River Valley. Untreated sewage, industrial waste, and urban runoff have contaminated beaches and coastlines. These issues impact the well-being of residents, the environment, and the economy of the surrounding communities.
Under the leadership of the San Diego County Board of Supervisors (Board), the County of San Diego (County), in partnership with impacted stakeholders across the region, have responded to this issue through various strategies. Recognizing the detrimental impacts to the environment, economy, and property within San Diego County caused by persistent cross-border sewage pollution and sewage-impacted ocean waters, the Board issued a Proclamation of Emergency on June 27, 2023 (16). Subsequently, the Board found that there is a continuing need for the local emergency and took action to keep the local emergency in effect, with the most recent action on September 11, 2024 (3).
On June 25, 2024 (11), the Board took action to expand the mobilization against the Tijuana River Valley Sewage Crisis and directed staff to begin meeting with the Tijuana River Pollution Task Force (Task Force) within 45 days to discuss and develop recommendations on coordinated strategies for mobilization and to return to the Board within 90 days with updates on activities related to these strategies. Today’s action requests the Board receive the update on efforts related to expanding mobilization against the Tijuana River Valley sewage crisis as directed by the Board on June 25, 2024 (11). In addition, prior to the directed progress update scheduled for September, additional response in the Tijuana River Valley was needed to address concerns regarding air quality raised by members of the Task Force. Today’s item also details that response and ongoing work, as well as additional actions recommended to be implemented by the San Diego County Air Pollution Control District (APCD). This information is categorized under four areas: Prevention; Surveillance; Investigation and Response; and Coordination, Collaboration, and Communication.
Update to June 25, 2024 (11) Direction:
Prevention
The County Public Health Services (PHS) established a central email address to capture and respond to concerns from the public. In addition, PHS issued a California Health Alert Network (CAHAN) Health Advisory: Cross-border pollution in the Tijuana River Valley and potential health effects. This information was shared with healthcare providers on September 13, 2024.
Surveillance
In August 2023, PHS began investigating potential health concerns that may have been attributable to sewage exposure. These concerns were centered around increases in gastrointestinal (GI) illnesses, and other reportable diseases, with an initial focus on periods of intense rain and flooding. Considering the severity of health risks that can result from direct exposure to sewage, PHS enhanced surveillance for GI illnesses in the South Region. PHS also added surveillance for asthma and other respiratory symptoms in response to concerns raised around respiratory health impacts.
While expanded surveillance has not identified an increase in GI infections, asthma or chronic obstructive pulmonary disease (COPD) symptoms in the South Region, PHS acknowledges the lived experiences of the residents in the affected areas and the impacts on their quality of life as a result of the sewage issue. Strong odors can impact individuals, especially those who are sensitive to smells or have chronic lung or heart disease. Individuals can experience symptoms including but not limited to headache, nausea, eye and throat irritation, or breathing problems. It is critical to continue to support efforts that focus on addressing the root cause of this issue, which is the failing sewage infrastructure. In addition, PHS supports long-term studies conducted by academic institutions, as such investigations will provide a clearer picture of what residents in South Region are experiencing.
The County remains vigilant in conducting surveillance and collaborating with local, State, and federal partners on health and environmental concerns for residents in South Region.
Expanding Mobilization Against the Tijuana River Sewage Crisis
In May 2024, the Task Force led by the City of Imperial Beach, SDSU School of Public Health, University of California San Diego (UCSD), and local physicians formed to understand the long-term public health impacts and call on local, State, and federal agencies to step up efforts to fix this issue.
Today’s update includes progress made in response to this action through the beginning of September, specifically across seven priority areas of work:
a) Support the Task Force in launching a Community Health Survey to examine environmental health impacts on the community from the Tijuana River Sewage Crisis
The County engaged with the Task Force at their July 23, 2024, and September 5, 2024, meetings and with various task force members by email. As part of this convening, the County provided formal feedback on the Healthy Water Healthy Air Pilot Survey developed by the SDSU School of Public Health. CDPH also provided survey feedback directly to the task force. It is anticipated the survey will be administered to impacted South Region residents in 2024.
b) Develop a Tijuana River Public Health Risk Dashboard
During the Task Force meeting, the County recommended development of a public health risk dashboard. Task Force members agreed that development of a more informationally encompassing public landing page hosted by an academic institution was recommended. At this time, SDSU is exploring this further. In the interim, PHS will continue to produce the Surveillance Bulletin: South Region Illness Concerns with weekly data updates and have expanded the County South Region Health Concerns website with additional information. This resource summarizes trends in GI illness, asthma, and COPD data among residents in the South Region using syndromic surveillance and communicable disease data. PHS will maintain the South Region Health Concerns webpage to provide updates, an explanation of illnesses, surveillance data and resources.
c) Develop local decontamination protocols for sewage contaminated floodwaters in parks, roadways, and other public spaces
The County Department of Environmental Health and Quality (DEHQ) finalized a decontamination reference guidance for local agencies. It includes information about disinfectants and preferred signage to adapt local protocols. The decontamination guidance is included as a resource on the DEHQ website and has been distributed regionally to City Managers and wastewater agencies.
In addition, resources were also developed by PHS to address community concerns including Frequently Asked Questions webpage which addresses topics related to Tijuana River Valley Sewage, as well as Sewage Safety and Exposure flyers. The flyers were distributed along with 414 air purifiers to individuals in South Region in August 2024. These resources are also available online through the County South Region Illness Concerns webpage, in English and Spanish. Additional guidance and flyers for schools and on environmental odors have been developed and distributed to South Region schools and residents.
d) Collaborate with the Task Force to develop a list of data sources that can support tracking sewage-associated, non-reportable diseases
The County continues to identify new data sources to utilize in complement to other data sources identified by the members of the Task Force to enhance existing information. PHS will continue to monitor GI and respiratory syndromic surveillance of the South Region, which is updated on a weekly basis, and assess and investigate cases of reportable communicable diseases.
In addition, the County will collaborate with the Air Pollution Control District (APCD) and the Task Force to review and assess environmental data from APCD, such as air monitoring, as well as the information yielded through the Community Health Survey. Lastly, additional data is anticipated to become available upon completion of the upcoming Epidemic Intelligence Service for Epidemiologic Assistance (Epi-Aid) investigation led by the Centers for Disease Control and Prevention (CDC), including the Community Assessment for Public Health Emergency Response (CASPER), scheduled from October 17 to October 19. It is anticipated that this effort will capture population level health concerns, resource needs, and communication preferences.
e) Request zip-code level asthma and respiratory illness data from California Breathing Program
The County engaged the CDPH California Breathing Program and received the most current zip-code level data, available through 2022. Additional assessment by PHS determined that the California Breathing data was consistent with the County real-time, syndromic surveillance data which can be used as a timelier source of data for monitoring asthma in the region.
f) Request enhanced water quality testing and enhanced communication from other agencies, including the San Diego Regional Water Control Board
The County Beach and Bay Water Quality Monitoring Program conducts beach water quality monitoring using digital polymerase chain reaction (ddPCR) testing method and issues public notifications posted online on the program website. In addition, the water quality at all south county beaches is monitored daily through the South County Enhances Beach Water Monitoring Program.
The County met with the State Water Resource Control Board (SWRCB), Division of Drinking Water on August 21, 2024, to discuss regulatory drinking water requirements. SWRCB volunteered to participate in an advisory role for the Task Force, particularly to assist in providing information on drinking water, regulations, and communications with local water agencies. The County met with the SWRCB on September 4, 2024, to advocate for and discuss sampling and analysis of fish for pollution impacts in the Imperial Beach area. The County provided an update to the Task Force at the September 5, 2024, meeting and offered to coordinate for the SWRCB to attend a future Task Force meeting. A follow up meeting was held on September 17, 2024 with SWRCB, CDPH, Office of Environmental Health Hazard Assessment, Regional Water Quality Control Board, and CA Department of Fish and Wildlife to continue collaborating on this issue.
g) Identify options for additional funding to assess the economic and health impacts of the Tijuana River Sewage Crisis and secure the necessary infrastructure repairs to permanently fix the problem
Notwithstanding the CDC Epi-Aid request, collaboration with local universities through the Task Force, and grant funding approved for the purchase and distribution of air purifiers, no dedicated funding sources have been identified. APCD’s Board has authorized a transfer of funds to the County to distribute additional air purifiers, which the Board approved on October 8, 2024 (12). The County will continue to explore funding opportunities in collaboration with the Task Force and other partners. Federal action, legislative support, funding, and bi-national collaboration is required to support decontamination efforts, as well as address the failing infrastructure which is at the root of the issue.
Investigation and Response Efforts:
On June 25, 2024, with support from CDPH, the County made a formal request to the CDC for Epi-Aid. The focus of an Epi-Aid investigation is to assist partners in making rapid, practical decisions for actions to control and prevent public health problems in the community.
The County, in partnership with the CDC National Center for Environment Health (NCEH), conducted an assessment from October 17 to 19, 2024 in the South Region of San Diego County using a CASPER. This method of assessment is a type of household survey designed by the CDC to provide information about a community, allowing public health and emergency managers to make informed decisions. This method is designed to assess household-level impacts related to air and sewage exposure from the Tijuana River Valley, including health concerns, impact on quality of life, resource needs, and communication preferences. Over 30 CDC staff in addition to 60 County staff and SDSU student volunteers conducted the household assessments. The CASPER methodology is a validated sampling method. A total of 210 interviews of randomly selected households will be conducted and the CDC will analyze and provide results back to the County.
On October 3, 2024, two weeks prior to the arrival of the CDC for the CASPER interviews, over 40 County staff and UCSD Preventive Medicine residents conducted door to door informational papering in the South Region to over 6,500 households. In addition, the County developed a CASPER informational website, informational videos, and a social media education campaign to help inform South Region residents of the upcoming CASPER. <https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/south-region-health-concerns/casper-study.html>.
Role of APCD and Addressing Air Quality Concerns
California Assembly Bill 423 (Gloria) (2019) restructured and expanded the governing board of APCD, which was previously governed by the County Board of Supervisors, to be governed by a separate and independent 11-member board consisting of two county supervisors, six council members or mayors from across the county, and three public members. While APCD and the County work closely, APCD is no longer under the purview of the County.
APCD has jurisdiction over air quality and monitoring on behalf of the region. The County tracks and analyzes infectious diseases through Public Health and water quality through Environmental Health and Quality. The County does not possess the equipment or scientific staff expertise in meteorology to be able to find the source or analyze the safety of the data around air quality. As we do not monitor or analyze air quality data, we rely on the information and data analysis from APCD in order to determine if there is a health impact.
As the region’s lead agency responsible for monitoring and improving air quality to attain all state and federal air quality standards, APCD reported receiving approximately 2,000 odor complaints for the time period between the end of July and beginning of September 2024. This statistic reflects a significant increase from previous time periods. On September 10, 2024, the County’s Interim Public Health Officer sent a letter requesting APCD to take the following action:
• Contract and/or request support and expertise from outside partner agencies (i.e., South Coast Air Quality Management District, State and federal resources) to implement or improve current testing modalities, analysis and interpretation of APCD sensor data, and emergency air monitoring.
• Hire an environmental toxicologist (i.e., Medical Director with Subject Matter Expertise and/or toxicologist) to assist with interpretation of air pollutants from sensor data and regularly liaise with PHS.
• Develop a Public Notification Plan, which should include messaging on warning levels when certain thresholds are met. Communicate this publicly via text and other methods and in multiple languages.
• Distribute air purifiers to areas needed based on sensor or other appropriate data, including individual households, schools, and other areas with vulnerable populations.
Since September 16, 2024, the County has implemented routine meetings with APCD multiple times per week, also attended by CDPH’s medical toxicologist. In addition, the County is also utilizing a medical toxicologist to provide subject matter expertise, made initial mutual aid requests on APCD’s behalf to South Coast Air Quality Management District, and provided APCD with public health recommendations for a Hydrogen Sulfide (H2S) warning system. The County continues to provide public health and communication guidance and coordinate with APCD on matters like engaging partners to explore potential mitigation of a site where increased detections have been identified.
Additionally, as an abundance of caution and in response to researchers’ concerns regarding H2S and hydrogen cyanide (HCN), the County’s Hazardous Incident Response Team (HIRT) was deployed on September 9, 2024 and September 16, 2024. HIRT is responsible for investigating and mitigating chemically-related emergencies or complaints, including evaluating threats to the local populations and the environment.
On September 18, 2024, CDC’s Agency for Toxic Substances and Disease Registry (ATSDR) provided a final report on interpretation of County emergency air testing data, which found the County’s readings did not demonstrate measurable HCN in the ambient air at the locations monitored, except for one site which was likely due to cross sensitivity with the type of sensor used by researchers. Additionally, on September 24, 2024, further analysis conducted by the United States Environmental Protection Agency (EPA) confirmed that the HIRT team’s interpretation of HCN was accurate and that it was indeed a false positive.
County’s Response Structure
On September 14, 2024, County began an Incident Command Structure (ICS) to further organize County operations and response to the local emergency. On September 16, 2024, PHS also requested that the Public Health Preparedness and Response Branch (PHPR) open the Medical Operation Center to support in the CASPER survey. A weekly Emergency Manager’s meeting, All Agency meeting, and state and federal legislative staff meetings have been established and are ongoing.
On September 10, 2024, the Interim Public Health Officer requested assistance from CDC’s ATSDR Region 9 for involvement with interpretation, cross sensitivity assessment and independent air testing if needed, and communications to the public, including distinguishing potential cross sensitivity of gases. This request included the provision of independent air testing resources. If it is not within CDC’s scope to directly test, PHS requested CDC engage with partners to facilitate testing.
Coordination, Collaboration, and Communication
Responding effectively to the Tijuana River Valley sewage emergency requires a well-coordinated, collaborative, and communicative approach. These elements are important given the complex, multifaceted aspects of this issue. As noted, the County has engaged the Task Force and requested meetings with the researchers to deepen collaboration and data sharing in the response to the local emergency. Since then, the County has met with the researchers on September 19 and September 20.
In addition to close coordination and collaboration with multiple local, State, and federal agencies, the County has engaged South Bay Clinics and South Bay School District Leaders in frequent meetings. The County continues to meet and communicate with impacted stakeholders such as the San Diego River Conservancy Board, APCD, CDPH, CDC, EPA, and other local, State, and federal partners.
On October 4, 2024, PHS and DEHQ participated in a call with APCD and the City of San Diego, United States military, and others to discuss possible mitigation solutions at one site along the river valley with increased H2S detections.
Special attention has been directed to the County’s communication efforts. The County frequently updates the South Region Health Concerns website. To ensure accessibility of information, the County has made several enhancements to the County’s South Region Health Concerns website to include additional information and resources on the health concerns and impacts from sewage and pollution in the Tijuana River Valley and surrounding communities, specifically information on the County response, Public Health Data, CDC Health Survey, Environmental Odors, Contaminated Water, Schools, Beach and Bay Water, and Air Quality information. In addition, multiple County News Stories and educational information were developed to keep the community informed.
The County shares with the community the deep concern for the health and quality of life of individuals living in South Bay, who have been severely impacted by the decades of raw sewage flow through the Tijuana River Valley. The County is dedicated to working with all stakeholders to advocate for solutions and repairs of the failing federal infrastructure in this binational issue.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s action aligns with the County of San Diego 2024-2029 Strategic Plan initiatives of Equity (Health) and Community (Quality of Life) as well as the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by working collaboratively to address the longstanding transboundary pollution that impacts environmental justice, health, and the economy in the South Region.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
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