IMPERIAL COUNTY, Calif. -- A dust bowl is coming, and people here are scared.
Aide Munguia-Fulton, a nurse who runs a community program for children with asthma, has been seeing referrals for assistance soar in the last three years as the Salton Sea has begun receding due to water management schemes and a persistent drought.
Receiving 400 referrals last year alone, Munguia-Fulton has funding to enroll no more than 200 kids a year. She's managed to include more children, but she knows the lake is expected to shrivel more quickly starting at the end of 2017, exposing thousands of acres of a dusty, toxin-laced salt bed and exacerbating already high asthma rates.
Munguia-Fulton has worked here for more than two decades, and, three years ago, she too was diagnosed with asthma. Just as she tells her patients, she hides indoors from unrelenting dust on windy days. She carries a dust mask with her at all times.
She doesn't know how the cash-strapped area will cope if air quality continues to deteriorate.
"I am so concerned for our hospitals that are going to suffer the heavy loads," Munguia-Fulton said. "We have to be prepared. And I know we are not."
The recession of California's largest lake (350 square miles) is exposing a lake bed saturated with arsenic, lead, cadmium and other toxins. By the end of 2017, the shrinking will accelerate under terms of state-backed water transfer from this agricultural area to coastal San Diego (Greenwire, June 13).
More than 100 square miles of toxic salt flat could be uncovered in the coming decades. The Pacific Institute, a nonpartisan think tank, estimates that by 2045, the lake bed could be putting 100 tons of dust per day into the air.
That dust -- called coarse particulate matter by regulators -- is by nature dangerous because it can penetrate deeply into the lungs. It will make breathing even more difficult in an area whose air quality already ranks among the nation's worst because of dust from farms and desert.
That pollution is broadcast from this remote corner of southeast California by frequent wind storms whose gusts hit 80 mph.
It's a "really salty dust, it burns your eyes," said Bruce Wilcox of the California Natural Resources Agency. "It only lasts for 15 to 20 minutes. But it's the longest 15 to 20 minutes of your life if you are standing in it."
Winds carry that dust toward some 650,000 people -- a population that's expected to double in the next 30 years.
Hit hardest by prevailing north-to-south winds is the Imperial County near the Mexico border. With the state's highest childhood asthma rates, the county is more than 80 percent Hispanic, suffers a 20 percent unemployment rate and nearly more than 1 in 3 of its children live in poverty.
North of the Salton Sea, asthma rates are also high as shifting winds carry dust there.
And new data suggest asthma rates are rising closer to the lake, local health officials say.
The state has had more than a dozen years to come up with plans to address the area's air pollution under terms of the 2003 water transfer agreement. But it took virtually no action until last year, and while some projects are on the drawing board, public health advocates fear the worst.
The Pacific Institute concluded that the costs to human health could be between $21 billion and $37 billion through 2047. It could drastically affect a $2 billion farm economy south of the lake and the $6 billion resort economy north of it.
California is trying to take steps now toward combatting dust and providing some wildlife habitat, and advocates beyond California are closely watching the Salton Sea out of concern for what could happen to their lakes, including Utah's Great Salt Lake.
But California lags in studying the potential health effects of increased air pollution.
Michael Cohen of the Pacific Institute said some of the most basic questions -- including how much of the lake bed will become exposed and when, what parts will emit dust, and what the composition of the dust will be -- simply haven't been studied, so it's hard to project the public health consequences.
"So much of the basic data doesn't exist," Cohen said. "A lot of this work should have been done a decade ago. It's not like it's a surprise that the Salton Sea is going to shrink, and the playa is going to be emissive."
Dr. Cameron Kaiser, the public health officer for Riverside County north of the lake, agreed: "Hard to get an accurate assessment of what public health impact that would cause."
He added, "No one believes it is going to be good thing."
Munguia-Fulton, 47, was spurred to launch the Imperial Valley Child Asthma Program because she repeatedly found families who knew nothing about what was coming.
"I thought I better do something," the nurse said.
Her program receives grants from local sources and U.S. EPA and enrolls kids ranging from newborns to 15 years old. It also works to educate the public on the signs of asthma, as well as how to treat it. If a child in the county is hospitalized due to asthma, Munguia-Fulton's group goes.
She said the effects of worsening air quality are clear. She has one 16-year-old patient who recently moved to the area from San Francisco. Ever since she moved, she's had asthma.
"You can see the difference," Munguia-Fulton said. "She's only been here less than a year and been to the ER eight times."
Less water, more asthma
The air quality surrounding the Salton Sea is among the worst in the state.
Of particular concern are airborne dust particles 10 micrometers in diameter or less -- about a seventh the thickness of a human hair. PM10 particles are classified as a hazardous air pollutant because they are small enough to breathe in and lodge deep in the lungs.
Both Riverside and Imperial counties are in nonattainment of the federal air standard for PM10.
According to the California Air Resources Board (ARB), particulate concentrations in the Salton Sea basin regularly exceed the more stringent state standard. The basin exceeded the state limit of 50 micrograms per cubic meter for 128 days last year and 183 days in 2014.
Particulate concentrations peak in wind storms that create dangerous dust bowls. In 2014, for example, a monitor captured PM10 levels in the basin at 477.6 micrograms per cubic meter -- nine times the state standard and three times over the federal standard.
Over the past several years, the Salton Sea has had more days above the state standard than the Great Basin air district, the site of Owens Lake, which had the worst such pollution in the country before an elaborate network of pollution controls were installed on the dry lake bed (Greenwire, June 6).
Bearing the brunt of that pollution is Imperial County with its large numbers of people suffering from asthma.
Asthma rates are calculated based on the number of hospitalizations or emergency room visits per 10,000 people.
The most recent data from California's Office of Statewide Health Planning and Development in 2014 show the rate of hospitalizations for children from infancy to 17 years old was 17.8 visits per 10,000 residents in the county -- far beyond the state rate of 10.9. The numbers are most striking for kids up to age 4. In Imperial County, the rate is 38.2 visits per 10,000 people, compared to 22 for California, according to 2010 data.
And those figures are improvements. A year earlier, Imperial County's childhood hospitalization rate was the worst in California, doubling the state rate.
Emergency room statistics are bleak. In 2014, Imperial County's rate of ER visits for children because of asthma was 149.6 per 10,000 residents. The state's rate was 80.7.
"The need is enormous," Fulton said.
The science of public health is complicated. It is very difficult to prove linkage or causation between an environmental factor such as air pollution and a health problem. That is especially true in Imperial County, which has a population of about 180,000, so study sample sizes are small.
But Imperial County Health Officer Stephen Munday said the most recent data indicate asthma rates are worsening near the receding Salton Sea.
"Asthma is a problem in our county," he said. "And some of the data suggest that it is enhanced in the area that surrounds the Salton Sea."
Munguia-Fulton sees that in her asthma program.
"We can attribute it to the windy days and playa being exposed," she said. "Parents usually say, my kid was outside in the wind and got sick."
Munguia-Fulton, who grew up near San Diego, also personally experiences the worsening air quality.
"I wheeze when we have a windy day," she said.
'I was really scared'
On the north side of the Salton Sea, 17-year-old Christian Garza has had asthma since he was 5.
Growing up a few miles from the lake in Riverside County, Garza was often kept indoors during dust storms.
"It was really hard dealing with it," Garza said. "If I were to try to play sports, I would pass out or run out of breath after 10 minutes."
His mother, Olivia Gomez, recalled that on many nights, one of Christian's brothers had to carry him from the couch in their living room to his bed.
"We're just used to having a nebulizer at home," said Gomez, 51, a single mother of five. "We spent a lot of time at the ER."
Last September, Gomez rushed her son to the hospital because he was on the verge of passing out at school after a wind storm.
He had a collapsed lung.
"I was really scared because I didn't know what was going on," Garza said. "The doctor said it was normal, so they gave me steroids. But it kept getting worse and worse."
Riverside County is large -- stretching nearly from southern Los Angeles to the Nevada border. It's home to Palm Springs and a rapidly growing area well north of the Salton Sea.
The county's asthma rates can be deceiving. They are close to state averages, but breaking them out by ZIP codes tell a different story.
The two ZIP codes closest to the Salton Sea's north shore, where Garza lives, and the towns of Mecca, Thermal and Indio have rates of childhood-asthma-caused hospitalizations of 24.7 and 15.1 per 10,000 residents -- well above the state average, about 10 -- according to an analysis of 2008-10 data from the California Office of Statewide Health Planning and Development by the Strategic Health Alliance Pursuing Equity, a community group in Riverside County.
And those numbers, locals say, may underestimate the health problem because there are many undocumented immigrants who may be reluctant to go to hospitals.
Kaiser, the public health officer, said that rising dust levels would be particularly problematic for lakeside communities.
South of the lake, Imperial County's unemployment is above 20 percent. One in 5 live below the poverty line, including nearly 1 in 3 children.
And away from posh resorts in Palm Desert, Garza's area north of the lake isn't better off, Kaiser said.
Health resources are scarce, Kaiser said, making them particularly vulnerable to asthma, lung cancer and other ailments.
"These are communities that cannot tolerate substantial shocks to their well-beings, whether it be economic or public health," Kaiser said.
'They should just act now'
Kaiser is particularly concerned about what toxic substances may be embedded in the Salton Sea's playa. Fed by agricultural runoff, early studies have detected cancer-causing substances like arsenic and selenium, as well as potent neurotoxins like lead.
A major problem, though, is that no one knows how prevalent those substances are in the playa's dust. In fact, no one seems to know much about how the lake's dust will influence air quality in the area and, by extension, public health.
"I don't think anyone ... has said what does this do to public health," Cohen of the Pacific Institute said.
There are multiple aspects to figuring that out. The first is analyzing how much of the playa and which exposed areas will emit dust when the lake recedes.
The Imperial Irrigation District has started studying that.
They have hired the environmental consultants who worked on Owens Lake. They have also begun using a device that is rolled out over the exposed playa in a baby stroller.
The contraption, which looks a little like the "Star Wars" character R2-D2, creates a miniature wind storm under its dome, then measures how much of the dust underneath it comes up.
And the irrigation district is also experimenting with dust control measures, including planting vegetation to reduce dust and plowing ridges in the playa -- techniques similar to those used at Owens Lake.
"That's what we are doing on the actual playa to see what emissions on the playa look like," said Jessica Lovecchio, who leads the district's program.
But she added that the early results have been unclear.
"Right now, some areas are showing really high emissions, but then a parcel right next to it will show none," she said.
Brad Poiriez of the Imperial County Air Pollution Control District added that he has recently secured funding with U.S. EPA to install four toxics monitors to add to the irrigation district's network.
Those monitors will collect dust to be analyzed for what they contain and at what concentrations.
"This is just getting off the ground and being formalized now," Poiriez said.
California has also begun work on a 640-acre conservation project that will also control dust, and it has allotted $80 million in its recent budget to the lake. Additionally, the U.S. Fish and Wildlife Service has broken ground on another effort to cover about 420 acres of exposed playa.
But those projects will control dust on a fraction of the 26,000 acres of playa that is expected to be exposed by 2020.
Cohen emphasized that addressing dust and creating habitat need not be terribly difficult from an engineering standpoint. From 2006 to 2010, he said, the Bureau of Reclamation managed four basic 100-acre ponds on the lake bed, and showed it was relatively easy. Plus, in the coming years, plenty of water that could be used for dust mitigation will continue to flow into the lake from agricultural runoff.
"It's not a complicated structure. It's not a huge engineering project," he said. "It's been done, and we know it's been done, and we know it's not that hard to do."
The hurdles, Cohen said, are obtaining the funding and getting all parties to agree to move forward. The bureau's ponds are a case in point. In 2010, the federal government ended the pilot project and gave California the opportunity to take ownership of it. It didn't, and the ponds dried up.
Garza has lost his patience. The teenager is tall, with dark hair and gets worked up easily describing the issues at the lake. He frequently takes breaks to catch his breath.
He now works with a local environmental group and wants to become a journalist when he grows up.
In the meantime, he's frustrated by authorities moving too slow.
"For them, the biggest worry is money, but if they keep waiting, the costs are going to go higher and higher. If they don't do anything, it's going to get worse," he said.
"They are weighing the cost of money against the cost of human life," he said. "I don't get why. They should just act now before it's too late."
Coming Monday, June 27: The West’s most protected lake in peril.