Nurse practitioner Maria Villanueva, far left, instructs Bridgette Rodriguez, 12, from San Jose, on how to use her inhaler as her mom Maria, far right, watches on, during their meeting for the Pediatric Asthma Disease Management Program at the Santa Clara Valley Medical Center in San Jose, Calif., on Wednesday, April 29, 2015. (Nhat V. Meyer/Bay Area News Group)
Children in some California counties visited emergency rooms for asthma at nearly twice the statewide rate, according to the latest data — a phenomenon that experts blame largely on dangerous air pollution.
While children in some of these counties struggle with consistent, long-term exposure to bad air, experts also point to the effects of environmental disasters, such as wildfires and the spread of toxic dust from a dying lake.
California children made 69,375 visits to emergency rooms for asthma in 2016, the data from the state Department of Public Health show. That translates to an annual rate of about 75 visits per 10,000 children.
Counties in the state’s San Joaquin Valley, its agricultural heartland, consistently have some of the worst rates in the state. Fresno County topped the list in 2016, with 143 ER visits per 10,000 kids. It also had the worst rate in 2015.
Merced and Madera counties, also in the valley, ranked in the top five both years.
San Joaquin Valley residents breathe some of the nation’s dirtiest air, and about 1 in 4 children there have asthma — making it the region with the highest proportion in the state, according to California Health Interview Survey.
Because the region is surrounded on three sides by mountain ranges, pollutants get trapped in the valley. Wildfires — such as the blazes that have dirtied the valley’s air this summer — exacerbate asthma symptoms and send more kids to the emergency room.
Wildfires likely contributed to the high rate of childhood ER visits for asthma in Del Norte County in 2016 — 121 visits per 10,000 children — which represents an increase of more than 40 percent from the previous year. Del Norte, which sits along the Oregon border, had the fifth-highest rate in the state in 2016.
David Esteves, who owns land in the county and has been a firefighter for 38 years, confirmed that the fires — and air quality — have been getting progressively worse since 2015. Wind blows smoke from raging blazes in southern Oregon and Northern California toward coastal towns like Crescent City, he said.
“You work in the fires, and then come home to live in smoke,” he said.
At the state’s southern border, Imperial County had the third-worst rate in the state in 2015 and in 2016. It is battling a rapidly worsening environmental disaster as the Salton Sea dries up, leaving behind dust contaminated with decades of polluted runoff. The wind blows the toxic dust into the air — and into the lungs of local children.
“There’s going to be more dust,” said Jill Johnston, an assistant professor of preventive medicine at the University of Southern California. Johnston fears that as more land is exposed, it “could have more toxic effects and more adverse impacts on people living in the area,” she said.
The quickly receding Salton Sea contains heavy metals, such as arsenic and selenium, and pesticides from agricultural and industrial runoff. Fish are dying en masse; on a single day in 1999, nearly 8 million tilapia died of oxygen depletion.
A water-use deal implemented in January 2018 between California and neighboring states will speed up the lake’s disappearance, exposing yet more toxic dust, Johnston said.
Locals are trying to address the problem, including taking action at schools. School officials fly yellow flags when at-risk children should stay indoors, and red flags when all children must have recess indoors, she said.
Harriet Rowan: hrowan@kff.org, @HattieRowan
