Tijuana river pollution crisis: health symptoms and environmental perceptions from the Healthy Water Healthy Air Study.
10 affiliations
- 1Division of Epidemiology and Biostatistics, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA. [email protected].
- 2Division of Epidemiology and Biostatistics, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA.
- 3Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA.
- 4Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
- 5Division of Environmental Health, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA.
- 6Department of Anthropology, College of Arts and Letters, San Diego State University, San Diego, CA, USA.
- 7Community Member, Imperial Beach, CA, USA.
- 8South Bay Urgent Care, San Diego, CA, USA.
- 9Kaiser Permanente, San Diego, CA, USA.
- 10School of Public Health, Imperial Valley Campus, San Diego State University, Imperial Valley, CA, USA.
Abstract
Background
Untreated sewage, industrial waste, and urban runoff carried by the Tijuana River from Mexico into the U.S. has created a longstanding transboundary environmental crisis. This pollution significantly intensified in July 2024, with border community members reporting noxious odors and major health symptoms. In response to these escalating concerns, we launched the Healthy Water Healthy Air Study.Methods
A bilingual (Spanish/English) online survey was conducted to establish a comprehensive community profile characterizing members' environmental perceptions, health burdens, and resilience. Individuals living and/or working within the border communities in southern San Diego County, CA were recruited through a multipronged approach grounded in deep-seated community partnerships. We performed descriptive analyses to summarize the participants' sociodemographic characteristics, major health symptoms, air and water quality perceptions, and precautionary and high-risk behaviors at baseline. We fitted Poisson regressions to estimate the associations of environmental perceptions with health symptoms and precautionary behaviors, controlling for sociodemographic characteristics.Results
Among 409 adult community members who had completed the baseline survey through October 31st, 2025, most self-identified as women, White, and of relatively high socioeconomic status. The majority expressed high levels of concern regarding local ambient air and the water quality of the Tijuana River and its adjacent water bodies. Frequent exposure to strong malodors was common. Community members reported a wide range of health symptoms, most notably upper respiratory symptoms (74%), certain gastrointestinal symptoms such as nausea (50%) and bloating (52%), and several symptoms of psychological distress. Compared to those reporting good or moderate air quality, poorer air quality perceptions were associated with a 35-80% higher prevalence of any upper respiratory symptoms, a 2.02-3.51-fold increase in counts of gastrointestinal symptom scores, a 1.72-2.19-fold increase in psychological distress symptoms and high-risk behaviors, and a 3.39-4.16-fold increase in precautionary behaviors. Similar associations were derived from participants reporting more frequent malodor exposure and experiences with boil water notices.Conclusion
This study is among very few to understand health symptoms and behavioral changes of border communities during the Tijuana River pollution crisis. These findings provide support for immediate public health interventions and binational policy actions aimed at mitigating transboundary sewage pollution.
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BibTeX
@article{ni2026tijuana,
title = {{Tijuana river pollution crisis: health symptoms and environmental perceptions from the Healthy Water Healthy Air Study.}},
author = {Yu Ni and Elizabeth A Mikita and Christine T Loftus and Eyal Oren and Jamie Moody and Savannah Shifflett and Eva Azevedo and Isabel Roji and Jade Roccoforte and Eunha Hoh and Tom Csanadi and Marvel Harrison and Kimberly S Dickson and Matthew Dickson and Vi T Nguyen and Miguel Angel Zavala Perez and Penelope J E Quintana and Paula Stigler Granados},
journal = {BMC public health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28833-9},
url = {https://europepmc.org/article/MED/42958191},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Tijuana river pollution crisis: health symptoms and environmental perceptions from the Healthy Water Healthy Air Study.
AU - Yu Ni
AU - Elizabeth A Mikita
AU - Christine T Loftus
AU - Eyal Oren
AU - Jamie Moody
AU - Savannah Shifflett
AU - Eva Azevedo
AU - Isabel Roji
AU - Jade Roccoforte
AU - Eunha Hoh
AU - Tom Csanadi
AU - Marvel Harrison
AU - Kimberly S Dickson
AU - Matthew Dickson
AU - Vi T Nguyen
AU - Miguel Angel Zavala Perez
AU - Penelope J E Quintana
AU - Paula Stigler Granados
PY - 2026
DA - 2026/08/04
JO - BMC public health
DO - 10.1186/s12889-026-28833-9
UR - https://europepmc.org/article/MED/42958191
AB - Background Untreated sewage, industrial waste, and urban runoff carried by the Tijuana River from Mexico into the U.S. has created a longstanding transboundary environmental crisis. This pollution significantly intensified in July 2024, with border community members reporting noxious odors and major health symptoms. In response to these escalating concerns, we launched the Healthy Water Healthy Air Study.Methods A bilingual (Spanish/English) online survey was conducted to establish a comprehensive community profile characterizing members' environmental perceptions, health burdens, and resilience. Individuals living and/or working within the border communities in southern San Diego County, CA were recruited through a multipronged approach grounded in deep-seated community partnerships. We performed descriptive analyses to summarize the participants' sociodemographic characteristics, major health symptoms, air and water quality perceptions, and precautionary and high-risk behaviors at baseline. We fitted Poisson regressions to estimate the associations of environmental perceptions with health symptoms and precautionary behaviors, controlling for sociodemographic characteristics.Results Among 409 adult community members who had completed the baseline survey through October 31st, 2025, most self-identified as women, White, and of relatively high socioeconomic status. The majority expressed high levels of concern regarding local ambient air and the water quality of the Tijuana River and its adjacent water bodies. Frequent exposure to strong malodors was common. Community members reported a wide range of health symptoms, most notably upper respiratory symptoms (74%), certain gastrointestinal symptoms such as nausea (50%) and bloating (52%), and several symptoms of psychological distress. Compared to those reporting good or moderate air quality, poorer air quality perceptions were associated with a 35-80% higher prevalence of any upper respiratory symptoms, a 2.02-3.51-fold increase in counts of gastrointestinal symptom scores, a 1.72-2.19-fold increase in psychological distress symptoms and high-risk behaviors, and a 3.39-4.16-fold increase in precautionary behaviors. Similar associations were derived from participants reporting more frequent malodor exposure and experiences with boil water notices.Conclusion This study is among very few to understand health symptoms and behavioral changes of border communities during the Tijuana River pollution crisis. These findings provide support for immediate public health interventions and binational policy actions aimed at mitigating transboundary sewage pollution.
SN - 1471-2458
ER -