Statement Of Dr. Fernando A. Guerra
Environmental Protection Agency
Aging Initiative Public Listening Session
San Antonio, Texas
April 8, 2003
Director of Health
San Antonio Metropolitan Health District
Let me thank all of you for joining us for this very important meeting to exchange information and to pose a few questions for the panelists and personnel from the agencies that have the mandated responsibilities to give all of us the assurance for living, working and playing in a safe environment. This meeting is very important from a public health perspective.
(Message above repeated in Spanish).
The public health perspective is important to all of us, not only in this time of the threat of terrorism and emerging new diseases such as Severe Acute Respiratory Syndrome, last year's West Nile Virus (which I am sure we will encounter again this summer) plus a number of other diseases. It shouldn't surprise us that in the last 20 years we have encountered 30 new diseases, which previously were not recognized and which pose a threat to living beings. Certainly many of those diseases are closely tied to the environment. What we try link the two in public health and what I would share with you initially is that one of the very important responsibilities that we have is to ensure the health and well being of the community. We need to do that by measuring the different conditions that affect individuals. We need to know how individuals are affected by infectious diseases or injuries - accidental or intentional - or environmental exposures from contaminants or something in their indoor or outdoor environments. That information can help determine what are the possible causes for their ill health conditions. However, one develops different scenarios, they are closely tied to many different aspects of the environment. Unfortunately, we have long neglected paying attention to those issues. I can't give you the assurance that we always have had our air attainment levels within the appropriate range and that the amount of certain volatile organic compounds or the particulate matter in the air is not going to pose some threat. We hope that we can air levels at the appropriate range, and for the most part we are able to, do that. When, however, there are certain conditions that affect the environment, ozone, or a combination of heat and high humidity, and/or the overuse of motor vehicles - cars and buses - all of those things change. And they can change very quickly.
Individuals over their lifespans have cumulative exposures to many things going on in their environment whether it is in air, the water that they consume, the food that they eat, or from the soil, that in many instances is contaminated with industrial waste. We certainly are thankful that Mr. Eklund and people from the EPA regularly work with us on issues about contaminants from prior industrial uses and from of the Department of Defense operations here that have affected peoples' environments because of the accumulation of the underground plume, which is quite extensive. People, a very significant number of them, across all age groups have lived with these contaminants for long periods of time. People - because genetic disposition or life style or quirk of nature can be at risk - for several diseases. When you superimpose environmental exposures on their diabetes or asthma or circulatory disease or some inflammatory process, the burden of those diseases can have long term effects on those peoples' health, quality of life and well being. To hear that we have one of the most rapidly growing populations over 50 or 60 years of age is something we really have to pay attention to. The next generation that is coming up - when you look at the population pyramid that Dr. Richardson mentioned - from the studies that they are doing at the Aging Center - will be a predominantly Hispanic and primarily Mexican American population of young people, young families with many women in their child - bearing years. Over time their numbers will increase very significantly. If we can't give them the assurance of quality, indoor air then they are going to be at risk. Or, we are going to see higher rates of many of those conditions I just mentioned.
As has been recommended to the Administration by several agencies, the United States need to have a consistent, well supported system for chronic disease surveillance. It will only be by having that system in place that we will be able to - over time - determine that it was these common exposures that caused us to understand short life expectancy in some individuals and/or a worsening of some conditions or higher prevalence rates of certain types of cancer, which are directly attributable to some long time environmental exposures When you couple those with risky behaviors - smoking or environmental tobacco smoke - the latter of which we now know is aggravating a variety of concerns including a higher risk for heart disease, strokes and a variety of circulatory disorders along with other diseases such as diabetes. All of these things come together and somehow we have to be able to monitor them and to see how they play out in large population groups. I also want to emphasize that we must recognize those conditions that are very much a part of our environment for which we may be able to take preventive measures.
Every year there is excess morbidity and mortality. Disease and death related to influenza and its complications are most related to people like those of us here in this meeting. Every year we must get the influenza vaccine, the vaccine to protect us against the complications of pneumonia. People exposed to some of these infectious agents a