Healthy People 2010 Focus Area 8 : Environmental Health Progress Review March 19, 2003

Key Components of Environmental Health Source: Department of Health and Human Services. Healthy People nd edition. With understanding and improving health and objectives for improving health. Vol. 1. Washington: U.S. Government Printing Office. November Water Quality Toxics and Waste Outdoor Air Quality Healthy Homes and Healthy Communities Global Environmental Health Infrastructure and Surveillance Health of Individuals & Communities

8-1.Harmful air pollutants 8-2. Alternative modes of transportation 8-3. Cleaner alternative fuels 8-4. Airborne toxins Outdoor Air Quality

8-1a. Persons living in areas that do not meet EPA standards † for ozone Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR. Total American Indian/ Alaska Native only White only, not Hispanic Black only, not Hispanic HispanicAsian only Percent2010 target ‡ = 0% Native Hawaiian/ Other Pacific Islander only † National Ambient Air Quality Standards for ozone. Target set to be consistent with the Clean Air Act (Public Law ). ‡

8-1b. Persons living in areas that do not meet EPA standards † for particulate matter TotalAmerican Indian/ Alaska Native only White only, not Hispanic Black only, not Hispanic HispanicAsian only Percent 2010 target ‡ = 0% Native Hawaiian/ Other Pacific Islander only Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR. † National Ambient Air Quality Standards for particulate matter. Target set to be consistent with the Clean Air Act (Public Law ). ‡

8-1c. Persons living in areas that do not meet EPA standards † for carbon monoxide Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR target ‡ = 0% Percent American Indian/ Alaska Native only White only, not Hispanic Black only, not Hispanic HispanicAsian only Total † National Ambient Air Quality Standards for carbon monoxide. Target set to be consistent with the Clean Air Act (Public Law ). Native Hawaiian/ Other Pacific Islander only ‡

8-1d. Persons living in areas that do not meet EPA standards † for nitrogen dioxide Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR target ‡ = 0% Percent American Indian/ Alaska Native only White only, not Hispanic Black only, not Hispanic Hispanic Asian only Total † National Ambient Air Quality Standards for nitrogen dioxide. Target set to be consistent with the Clean Air Act (Public Law ). Native Hawaiian/ Other Pacific Islander only ‡ 2010 target met * * ***** *

8-1e. Persons living in areas that do not meet EPA standards † for sulfur dioxide Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR target ‡ = 0% Percent American Indian/ Alaska Native only White only, not Hispanic Black only, not Hispanic HispanicAsian only Total † National Ambient Air Quality Standards for sulfur dioxide. Target set to be consistent with the Clean Air Act (Public Law ). Native Hawaiian/ Other Pacific Islander only ‡

8-1a-f. Persons living in areas that do not meet EPA standards † for criteria pollutants, 2001 Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR targets ‡ = 0% Percent OzoneSulfur dioxide Nitrogen dioxide Carbon monoxide Particulate matter 2010 target met * * * Lead Outside MSAWithin MSA Total † National Ambient Air Quality Standards Targets set to be consistent with the Clean Air Act (Public Law ). ‡ MSA: Metropolitan Statistical Area

8-1g. Persons living in areas that do not meet EPA standards † for criteria pollutants, by race/ethnicity Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR. American Indian/ Alaska Native only White only, not Hispanic Black only, not Hispanic Hispanic Asian only Number (thousands) 2010 target = † Persons living in areas that exceed the National Ambient Air Quality Standards for one or more criteria pollutants: ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter, or lead. Native Hawaiian/ Other Pacific Islander only

8-1g. Persons living in areas that do not meet EPA standards † for criteria pollutants, by age and geographic location Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR. Less than 1065 and over10-64 Number (thousands) Age in years.………………. ……………….. WithinOutside....………...………… MSA 2010 target = † Persons living in areas that exceed the National Ambient Air Quality Standards for one or more criteria pollutants: ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter, or lead. MSA: Metropolitan Statistical Area

EPA-designated nonattainment areas, 1990 and 2000 Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR * Criteria pollutants are ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter, and lead. *

EPA-designated nonattainment areas for criteria pollutants †, September 2001 Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR. Criteria pollutants are ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter, and lead. † Alaska Eagle River JuneauAnchorage Fairbanks Puerto Rico Guaynabo County Guam Piti Power Plant Tanguisson Power Plant

8-5.Safe drinking water 8-6. Waterborne disease outbreaks 8-7. Water conservation 8-8. Surface water quality (developmental) 8-9. Beach closings (developmental – proposed baseline data shown) Fish contamination (developmental) Water Quality

Number of beaches in the 2001 National Health Protection Survey of Beaches Source: EPA/OW. BEACH Watch Program: 2001 Swimming Season. May 2002.

8-9. Beaches experiencing one or more advisories or closings, Source: National Health Protection Survey of Beaches, EPA/OW. NumberBeaches surveyedBeaches experiencing > 1 advisories/closings 23% 25% 24% 27% Note: This objective is developmental. A 2010 target has not yet been set.

Sources of pollution causing beach advisories and closings, 2001 Source: EPA/OW. BEACH Watch Program: 2001 Swimming Season. May Unknown 52% Storm water runoff 20% Other 3% Wildlife 10% Combined sewer overflow 3% Boat discharge 2% Sanitary sewer overflow 2% Sewer line blockage or break 4% Publicly owned treatment works 1% Septic system 3%

8-11. Elevated blood lead levels in children Risks posed by hazardous sites Health care visits due to pesticide exposure Toxic pollutants generated for energy recovery (developmental) Recycled municipal solid waste Toxics and Waste

8-11. Children ages 1-5 years with elevated blood lead levels † Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Percent % 8.9% 4.4% † Elevated blood lead level is defined as > 10 ug/dL. Data for are statistically unreliable (relative standard error > 30%). ** 2.2% **

Mean blood lead concentration in children ages 1-5 years Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. † Geometric mean Mean † blood lead concentration (ug/dL) I 95% Confidence Interval

Mean blood lead concentration in children ages 1-5 years, by race/ethnicity Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. † Geometric mean Mexican American* White, not Hispanic Mean † blood lead concentration (ug/dL) I 95% Confidence Interval Black, not Hispanic * Can be of any race Total

8-16. Indoor allergens Office building air quality Homes tested for radon Radon-resistant new home construction School policies to protect against hazards Disaster preparedness plans and protocols Lead-based paint testing in pre-1950s homes Substandard housing Healthy Homes and Communities

8-16. Indoor allergens: Dust mite and cockroach allergens in bed dust Source: National Survey of Lead and Allergens in Housing, NIH/NIEHS; and U.S. Department of Housing and Urban Development (HUD). Group 1 dust mite > 2 ug/g Millions of homes level 2010 target Direction desired Group 1 dust mite > 10 ug/g German cockroach > 0.1 unit/g Allergen concentration in bed dust ……………………… ………………………

Homes with group 1 dust mite allergen concentrations at or above threshold, Source: Arbes SJ, Cohn RD, Yin M, et al. House dust mite allergens in US beds: Results from the first National Survey of Lead and Allergens in Housing. Journal of Allergy and Clinical Immunology. February > ug/g Percent of homes > 2.0 ug/g> 10.0 ug/g Allergen concentration in bed dust …………………… …………………… Lower limit of detection Threshold for allergic sensitization Threshold for asthma sensitization I 95% Confidence Interval* of any race. 84.2% 46.2% 24.2%

Mean dust mite concentrations, by housing unit characteristics, Source: Arbes SJ, Cohn RD, Yin M, et al. House dust mite allergens in US beds: Results from the first National Survey of Lead and Allergens in Housing. Journal of Allergy and Clinical Immunology. February Construction Year < census region West Midwest South Northeast Household income < $20,000 $20,000-39,999 $40,000-59,999 > $60,000 Mean concentration (ug/g) I 95% Confidence Interval* of any race.

8-24. Exposure to pesticides Exposure to heavy metals and other toxic chemicals (developmental – proposed baseline data shown) Information systems used for environmental health Monitoring environmentally related diseases Local agencies using surveillance for vector control Infrastructure and Surveillance

8-24a-d. Pesticide metabolites in the urine, persons ages 6 and over Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). 1-Napthol (carbaryl) Paranitrophenol (methyl parathion/ parathions) 3,5,6-Trichloro-2-pyridinol (chlorpyfifos) Metabolite (pesticide) Isopropoxyphenol (propoxur) Note: data are for persons ages 6 and over data are for persons ages 6-59 years. < LOD † 95 th percentile I 95% Confidence Interval LOD: Limit of detection Urine concentration (ug/g creatinine) † target 2010 target met * *

8-24a-c. Pesticide metabolites in the urine, persons ages 6-59 years, by race, Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). 1-Napthol (carbaryl) Paranitrophenol (methyl parathion/ parathions) 3,5,6-Trichloro-2-pyridinol (chlorpyfifos) Metabolite (pesticide) † 95 th percentile ** Can be of any race. Urine concentration (ug/g creatinine) † Mexican American** Black, not Hispanic 2010 target White, not Hispanic 2010 target met * *

8-24a-c. Pesticide metabolites in the urine, persons ages 6-59 years, by age, Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). 1-Napthol (carbaryl) Paranitrophenol (methyl parathion/ parathions) 3,5,6-Trichloro-2-pyridinol (chlorpyfifos) Metabolite (pesticide) † 95 th percentile Urine concentration (ug/g creatinine) † 6-11 years12-19 years 2010 target years * 2010 target met *

8-25b,c,e. Heavy metals in the blood, persons ages 1 year and over, Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). Note: This objective is developmental. A 2010 target has not yet been set. † 95 th percentile I 95% Confidence Interval Cadmium Lead Blood concentration (ug/dL) † Females & Males 1-5 years Females years ………. Mercury

8-25c. Mean blood lead concentrations, persons ages 1 year and over, Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). Total 1-5 years Mexican American* Male Female Black, not Hispanic White, not Hispanic 6-11 years years 20 years and over * Can be of any race I 95% Confidence Interval* Mean blood lead concentration (ug/dL) Note: This objective is developmental. A 2010 target has not yet been set.

8-25f,g,i. Pesticide metabolites in the urine, persons ages 6-59 years, Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). LOD: Limit of detection. Note: This objective is developmental. A 2010 target has not yet been set. 2,4-Dichlorophenoxyacetic acid ortho -Phenlyphenol 2-Isopropyl-4-methyl- 6-hydroxypyrimidine (Diazinon) Metabolite (pesticide) Urine concentration (ug/g creatinine) † < LOD † 95 th percentile

8-25m,o,p. Organochlorine compounds in the blood serum, persons ages 12 years and over, Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). Note: This objective is developmental. A 2010 target has not yet been set. Oxychlordane Dichlorodiphenyltrichloroethane (DDE) Beta-hexachlorocyclohexane Organochlorine compound Serum concentration (ng/g lipid) † † I 95 th percentile 95% Confidence Interval*

8-25o. Dichlorodiphenyltrichloroethane (DDE) in the blood serum, persons ages 12 and over, Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Data reported in the Second National Report on Human Exposure to Environmental Chemicals, CDC/NCEH (January 2003). Total years Mexican American* Serum concentration (ng/g lipid) † 20+ years MalesFemalesBlack, not Hispanic White, not Hispanic 95% Confidence Interval* 95 th percentile † I * Can be of any race Note: This objective is developmental. A 2010 target has not yet been set.

8-29. Global burden of disease due to poor water quality, sanitation, and hygiene Water quality in the U.S.-Mexico border region Global Environmental Health

U.S.-Mexico border region Source: U.S.-Mexico Border Health Commission

8-30a-f. Wastewater sewer service in selected U.S.-Mexico border communities Sources: EPA; Mexico’s Comision Nacional de Agua; State and local health departments; American Water Works Association; Rural Water Association; U.S.-Mexico Border Health Association. Ciudad Acuna Percent target MexicaliPiedras Negras Matamoros Nogales, Sonora Reynosa NA NA: Data not available. * * * 2010 target met *

8-30g-l. Wastewater receiving treatment in selected U.S.-Mexico border communities Sources: EPA; Mexico’s Comision Nacional de Agua; State and local health departments; American Water Works Association; Rural Water Association; U.S.-Mexico Border Health Association. Ciudad Acuna Percent target MexicaliPiedras Negras Matamoros Nogales, Sonora Reynosa NA NA: Data not available. NA * * * 2010 target met *

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