Should Duwamish cleanup also focus on improving the health of those nearby?

Living along the Duwamish River is hard on your health.

The more than 38,000 people tucked into South Park, Georgetown and Beacon Hill neighborhoods in the river's Superfund site suffer more illness -- including asthma, diabetes and colorectal cancer -- than elsewhere in King County. Babies born to families along the river are more likely to die and those who survive can expect a shorter life span than people born and raised just a few miles away.

Their obstacles are many. They are often poor. They are frequently overweight. Access to a supermarket, much less to health care, can be tough.

But people here also carry the added burden of the river, a toxic stretch that is the legacy of Seattle's industrial past. And Seattle's industrial future continues to foul the air that residents breathe.

An InvestigateWest examination of county health records show that residents along the Superfund site have the highest hospitalization rates for asthma for children and adults in the county. People in the neighborhood are more likely to say their health is poor than elsewhere in the county.

Their babies are born at lower weights than most other children in the county.

Most stark of all is that the life expectancy of people who live along this five-mile stretch of river is significantly lower than for many other parts of the county.

This little-known piece of public health data could help shape a massive, potentially billion-dollar decision coming down the pike about how best to clean up the Superfund mega-site that squats in the middle of these residential communities.

Data collected by Public Health -- Seattle & King County show that the expected life span of kids growing up in South Park/ Georgetown/Beacon Hill is 79.5 years. Not far away in Ballard or northeast Seattle, life expectancy is 85 years,

The difference is "very significant," says Ali Mokdad, professor of global health in the University of Washington's Institute for Health Metrics and Evaluation. He notes that life expectancy in the U.S. has been increasing steadily, rising by more than seven years for men, and more than six for women between 1960 and 2000.

History leans hard on Seattle's river neighborhoods.

Three miles up from the West Seattle Bridge, the condemned shell of Boeing's old B-52 plant (known as Plant 2) hulks along the banks that divide South Park on one side of the river from Georgetown on the other. The factory that gave the nation "Rosie the Riveter," once stood for the muscle and pride of Seattle's working class. Now it serves as one of the most visible landmarks in one of the nation's nastiest messes.

Over the decades, manufacturing plants, truck depots, and scrap yards metastasized through the tidy, blue-collar neighborhoods of Georgetown and South Park. Freeways ensarled them. Three flight paths took shape overhead.

"They've been seen as the dumping ground because they're so convenient to freeways and railways," said Morgan Barry, a health education consultant for Public Health -- Seattle & King County, who works with the Duwamish communities. According to the latest Census numbers, there are 38,465 people living in those neighborhoods.

While there's been exhaustive analysis of the environmental impact of historical polluters on the river and the health of creatures that live in it, as well as theoretical risk assessments of individual pollutants on human health, relatively little attention has been paid to the actual health status of residents living within the 32-square-mile Superfund site. Nor has there been consideration of the cumulative impact of the many health hazards they face.

Heidi Raykeil, has two kids. She's lived on her tree-lined street a few blocks from the river for eight years. There's a factory at the end of her road. She's known a number of South Park residents who are grappling with cancer, or have died from the disease.

She worries about the combined effects of diesel truck emissions, manufacturing fumes, dioxins in the dirt. Even if any one of those is not enough to raise cancer risk over an acceptable threshold, what about the combined risk?

"Maybe it's not any one thing," said Raykeil. "My big concern is who monitors overall health?"

South Park is a tight-knit community that has already faced down multiple threats, from youth violence to toxic waste. The 2010 Census shows a diverse population. About 43 percent of the residents of South Park, Georgetown and Beacon Hill are Asian, and nearly 17 percent are black. About 26 percent identified as white with the balance distributed between Pacific Islanders, mixed races, American Indian, and Alaska Native people. A little more than 11 percent of the population is of Hispanic origin, and there is a significant refugee population, including some from East Africa.

The river is in some ways a symbol of their resiliency. Despite having been straightened and dredged, poisoned and choked, the river is still a kind of urban oasis -- a working river with a vibrant wildlife and a rich cultural history. Osprey glide its surface. Its waters yield up Dungeness crab and English sole. During salmon runs, its shallow sandbars are lined with eager anglers. "It's a beautiful river," said Rakei. "We've done everything we can to kill it, but it's alive."

Some say that's why they continue to live there, despite nagging concerns about their health.

"What unifies this community is concern for their kids," said Public Health's Barry. "They want to know: What happens if I raise my child here?"

'Black dust everywhere.'

The demographics and location make South Park and its neighbors "environmental justice" communities, said Linn Gould, executive director of Just Health Action, a Seattle-based nonprofit that does outreach, education and advocacy around health-disparity issues.

As such, they are subject to the 1994 executive order by President Clinton that directed federal agencies to address inequities in communities where low-income or minority communities were experiencing health disparities caused by their environment. The same thing is happening in King County, where the County Council in October passed one of the first local laws in the country to mandate equity when making decisions affecting communities that are already experiencing poverty, pollution and discrimination.

Under administrator Lisa Jackson, the Environmental Protection Agency has revived its emphasis on environmental justice. The agency's Duwamish Superfund site cleanup recommendation, which is expected next year, will be among the largest decisions to be made under that new push

At issue: Should the area be held to a higher cleanup threshold because the people living in its midst are already more vulnerable to the health risks posed by the toxic chemicals in their environment?

The cleanup debate has also raised the question of whether some money should be spent to improve the underlying health -- both physical and economic -- of residents so they will be less vulnerable to any effects of remaining Superfund contamination.

The new King County law could make a difference for children like Haruun Egal, now 12, who was born in South Park, but whose family was forced to move to White Center about a year ago because his asthma got so bad he was having attacks five times a week.

His mother doesn't have scientific proof for her son's illness, but she does have a theory.

"There are so many trucks," said his mother, Libin Egal, who came here from Somalia. "Haruun was coughing and coughing. I couldn't sleep. He had eczema and bad allergies. Wheezing." she said. Many of the kids in her son's earlier grades carried inhalers because of respiratory issues. She frequently wound up in the emergency room with her gasping son, she said. "I was scared."

Air quality has been an ongoing concern in South Park and Georgetown because they are sunk into a river valley, and strangled in a spider web of high-traffic freeways. Barge traffic on the river, rail traffic, and ships and vehicles bound for the Port of Seattle also spew particulates into the air.

"There is always black dust everywhere," said Bill Pease, who has lived in South Park for a dozen years.

A Washington State Department of Health report noted there were more than a dozen childcare centers and schools within 500 feet of highways in the Duwamish area, putting kids in proximity to the highest levels of diesel emissions. Some states, including California, have already banned construction of new schools within that zone. Washington has not.

Residents and researchers are particularly worried about the potential health effects of the ultra-fine particles thrown off by diesel trucks. These particles, which are so small that the lung can't filter them out, can concentrate in "hot spots," creating microenvironments -- super-localized areas such as a particular street --where the air quality is worse, said internist and epidemiologist Dr. Joel Kaufman, professor of environmental and occupational health sciences at the University of Washington. The university is seeking funding to look at air microclimates in Georgetown and South Park.

Public health experts are concerned that the environmental risks of living near the Duwamish are being disproportionately borne by minority and low-income residents whose health is already compromised by multiple stressors.

In 2010, about 80 percent of children enrolled at South Park's Concord Elementary qualified for reduced or free lunches, according to the Office of the Superintendent of Public Instruction.

The effects of living in poverty can harm health, creating an especially vulnerable population along the Duwamish.

Vulnerability factors

To date, no one has taken a comprehensive look at the cumulative impact of the social and environmental stressors associated with living in the Duwamish area on people's health. Just Health Action and the Duwamish River Cleanup Coalition are seeking funding for a study of cumulative risk. The coalition represents environmentalists, neighborhood groups, local businesses and Duwamish tribal members.

When the EPA did its risk assessment for the Duwamish Superfund site, it used a conventional approach that addressed chemicals from the contaminated river sediments without consideration of other pollutant sources or community health issues that might increase sensitivity to pollutants in their environment, said Gould.

But researchers are starting to look more holistically at how various environmental factors work together on a population.

Take lead exposure, for example. Children who are iron-deficient absorb lead more readily, said Dr. Catherine Karr, pediatric environmental health specialist at Seattle's Children's Hospital and Regional Medical Center. "There are vulnerability factors."

Stress, too, has an impact on development of chronic diseases.

For some residents in environmental justice communities, such as South Park and Georgetown, basic survival concerns -- fear of violence, discrimination, meager incomes and loss of jobs or housing -- are major stressors. According to Communities Count, a report produced by a coalition of public and private organizations, the low-income residents in South King County, where the Duwamish communities are, experienced higher levels of stress than those who lived elsewhere.

Stress has a physiological effect on people -- raising the levels of cortisol, a stress hormone, which in turn contributes to a host of chronic diseases and conditions, including low birth weight babies and heart disease, said Karr.

Data show residents of communities near the Duwamish have higher rates of heart disease than many other parts of the county, as well as babies with lower birth weights.

These health consequences likely have multiple origins, said Karr. "The more stressors you have, the more likely you are to have adverse health problems."

Just how much and where pollution and the river's toxic legacy hurt people's health and not their poverty and other difficulties can't be parsed.

Still activists and residents are convinced that the river plays a mighty role in the neighborhoods' poor health.

They want the EPA to accept that and force the river to be cleaned to a tough standard.

"What is irrefutable is, if you have already showed health effects (are occurring), the last thing you should be doing adding some risk factors," said BJ Cummings, policy adviser to the Duwamish River Cleanup Coalition. The coalition represents environmentalists, neighborhood groups, local businesses and Duwamish tribe members.

California is one of the few states already tackling this issue. The California Environmental Protection Agency has begun work on new guidelines to help communities evaluate cumulative exposures, a move being closely watched by other regions, including Seattle.

"There hasn't been a major cleanup decision under that renewed emphasis on environmental justice," Cummings said. "This is potentially a test of that new policy."

'Precautionary principle'

The kind of health data coming out the Duwamish neighborhoods, as well as other communities like it around the country, has spurred new thinking in the public health practitioner community, said Dr. Ngozi Oleru, chief of Environmental Health at Public Health -- Seattle & King County.

"We know people who are poor are sicker. Why? It's not because they're poor. It's the web of (events) that got people to be poor."

Tackling illness means tackling the underlying ways that living in the community is making it difficult to stay well, said Oleru. Public Health officials are shifting their thinking toward the "Precautionary Principle" -- taking steps to address a problem even if all the scientific questions aren't answered.

Data drive federal rule-making, but data aren't always available in time, she said. "We shouldn't have to study people (after they get sick,)" she said." We should just not let it happen in the first place."

Public comment period

The Boeing Plant 2 Resource Conservation and Recovery Act (RCRA) sediment cleanups alternative Statement of Basis will be available for public comment March 29-May 28.

To allow for the public to hear first hand about the sediment cleanup options available, EPA is hosting a public meeting at the South Park Community Center on Wednesday, April 27 from 6-9 pm. During the meeting people will have the opportunity to hear what the cleanup alternatives are, ask questions, and provide any comments or feedback that they may have about the cleanup options.