Improving the Health of Disasters: Protecting the Environment and Communities

Disasters have made it painfully obvious that some aspects of the environmental health system in the US are broken.  What exactly is broken and what lessons might we draw from disasters, such as the recent Gulf Coast hurricanes?  Jason Corburn, author of Street Science: Community Knowledge and Environmental Health Justice, offers some ideas to encourage reflection and, more importantly, action to prevent unnecessary death and disease:

Background monitoring. Our current environmental health system is ill-prepared to respond to crises because we don’t have a good idea of  “normal” or background environmental exposures. For instance, in downtown Manhattan in the weeks following September 11th, 2001, few environmental health professionals could describe what local air quality was like before the World Trade Center collapsed and burned.  One reason was that agencies weren’t monitoring the air in lower Manhattan but more concerning was that almost no street-level air toxics data were being collected anywhere in New York City. Environmental health agencies need to focus on gaining a better understanding of the distribution of pre-disaster environmental health hazards. The more we know about who is at risk from what kinds of exposures, the better we can focus recovery efforts. Local agencies and not-for profit groups can help guide federal agency efforts to ensure monitoring captures local realities of how people are exposed in specific environments.

Hazard Reduction. Another lesson from disasters is that we are not spending enough attention on reducing chemical and other toxic hazards before disaster strikes.  The EPA hasn’t banned the production of a chemical in over two decades. The Precautionary Principle, now widely used in Europe to reduce toxic exposures, is a paradigm that is yet to take hold in the US, but should. The Precautionary Principle demands that those producing or using toxins prove that they are safe and that regulatory agencies take preemptive action, even with uncertain science, if they suspect a compound will be hazardous to human health.  The more we can focus on reducing the existence of environmental health hazards before a disaster, including better management practices for storing and transporting chemicals, the less disaster recovery efforts will have to worry about.

Social Structure matters more.  A third lesson is that it is not enough to focus on chemical or biologic hazards; we need to better understand how and why populations are exposed, not just what level of exposure is safe.  In the Chicago Heat Wave of 1995, hundreds of elderly died, in part, because no one knew about them; they never ventured onto the street and had no family, friends, or social connections.  The infirm elderly were “invisible” even to their neighbors.  Its unclear how many poor, African American, or disabled residents of New Orleans died for similar reasons.  Environmental health agencies might do as well preventing death and disease by investing in building human social networks as much as chemical monitoring ones.  Yet, improving environmental health interventions can never be divorced from other public policies that must address growing economic inequalities, residential segregation, employment discrimination, incarceration rates, and the wholesale disregard for impoverished neighborhoods - - whether in the Gulf region, ghettos in New York City, or slums around the world - - all of which perpetuate inequities in environmental health burdens.

Local knowledge. Finally, all disasters and recovery efforts can learn much from the insights and experience of local people, particularly those with a long tenure in their neighborhood. Local knowledge might help rescuers learn about the location of hard-to-see but hazardous infrastructure, such as underground petroleum tanks, utility lines, and hazardous material storage areas.  Local knowledge can also offer environmental health professionals insights into how people might be exposed.  For example, while fecal coliform, E. coli, and some heavy metals have been found at concentrations deemed hazardous to human health in the flood waters of New Orleans (and surely some of these toxins will remain in sediment as the waters recede) the US EPA, the Louisiana Department of Environmental Quality, and the Centers for Disease Control and Prevention “do not believe that these levels pose a human health threat as ingestion of flood water should not be occurring unless there is inadvertent ingestion (e.g., from splashing).” (EPA web site, www.epa.gov/katrina/testresults/water/). One danger of this assumption is that it will not apply to all local people, such as children who might be playing in and around toxic sediments, and our most vulnerable populations will be harmed even when it seems as if the toxic waters have disappeared.  Listening to local people and how the disaster has uprooted their lives and forced them to adopt new, potential exposure inducing practices, might prevent these potentially dangerous assumptions.

In the rush to rebuild after disasters, we ought to pause for a moment to reflect on whether and how we can do better; by knowing more before disaster strikes, preventing toxics from being used in the first place, addressing social inequities that drive toxic burdens, and listening to the local, lay “experts” that live among us all.