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Environmental Impacts ofHurricane MitchIn 1998, the Caribbean region enduredthe worst hurricane season in modern his-tory. In October Hurricane Mitch, themost devastating storm to strike CentralAmerica, killed an estimated 9,600 peo-ple-more people than any Atlantic tropi-cal cyclone since 1780-and spawned amedical and environmental catastrophe.In the weeks following the storm, healthauthorities were deeply concerned aboutemerging epidemics of infectious diseases.Gastrointestinal and respiratory illnesseswere rampant, especially among children.Thousands lacked access to medical care, 1million people were homeless, and watersupplies were contaminated by floods. Inovercrowded shelters, hygiene was poorand food supplies were low.

Mitch produced enormous downpoursacross the region, in nations includingNicaragua, Guatemala, El Salvador, andBelize. More than two feet of rain fell inthe mountains of Honduras in a singleday, and an estimated six feet of rain overseven days swamped some agriculturalareas, drowning crops. "Six feet of rainfallover such a brief period is unprecedented,"says Paul Epstein, associate director ofHarvard Medical School's Center forHealth and the Global Environment.

Health authorities in Guatemala,Nicaragua, and Honduras have reportedclusters of diseases such as dengue fever,hemorrhagic dengue fever, and malaria,which are spread by mosquitoes; lep-tospirosis, which is linked to contamina-tion by rat urine; and cholera, which canspread through polluted drinking waterand contaminated food. Until recently, itwas very uncommon to see such multipleoutbreaks of infections, Epstein says. Butover the past decade, there has been anincrease in clusters of such illnesses innumerous regions around the world fol-lowing heavy, prolonged rains.

According to a November 30 report ofthe Pan American Health Organization's(PAHO) emergency task force onHurricane Mitch, in Honduras there havebeen 16 confirmed cases of cholera, 1,908cases of malaria, 6 cases of leptospirosis,1,165 cases of dengue fever, and 49 casesof hemorrhagic dengue fever. But inCentral America, the gravest healththreats, especially for children, are acuterespiratory illnesses (including pneumo-nia) and diarrhea. These have alreadyafflicted thousands of victims.

Although respiratory illness can betreated with antibiotics and diarrhealafflictions can be treated with an oralrehydration solution, it has been difficult

Pesticidesand People

For farmers, researchers, and consumers concerned about the pesticides used on food,the next seven years will be momentous. By August 2006, the EPA's Office of PesticidePrograms (OPP) plans to have taken a second look at every limit that has been set for anamount of residual pesticide that can remain in a food product. That means that theOPP will be reviewing some 9,700 tolerances that have been set for 470 pesticides. Thegoal of the reviews is to address the key issues raised in the 1996 Food QualityProtection Act (FQPA): Does the pesticide tolerance allow for possible aggregate expo-sures? Could residues below the tolerable limit be dangerous when combined with expo-sures to other pesticides? Does the tolerance sufficiently protect children? And what arethe effects of the pesti- A United Statescide on the endocrine v|1. Environmental Protection5t _ ~~Agencysystem? Based on the O c of Prreviews, the EPA will set Office of Pesticide Programsnew tolerances, and it is likely that some pesticide uses will be banned altogether.

For the many stakeholders that will want to scrutinize the OPP's decisions over thenext seven years, the EPA has provided the OPP home page, located on the WorldWide Web at http://www.epa.gov/pesticides. For background information on the legis-lation that is shaping most of the OPP's current work, users can select the FQPA linkon the menu bar at the top of the OPP home page. The What's New link on the homepage provides a summary of all the recent actions taken by the OPP. Here, peopleinvolved in agribusiness can see if the OPP is reviewing a pesticide of concern to them,scientists can access the latest research guidelines proposed by the OPP, and consumerscan view the most recent warnings about health effects associated with pesticide con-sumption. Drafts of OPP decisions are posted here while the office seeks public com-ment on them. Information on how to submit comments is provided.

To read about past actions taken by the OPP, users can dick on the links on the leftside of the home page. The Researchers & Scientists link, for example, is connected tothe final report outlining how the EPA will determine if a pesticide affects the endocrinesystem, and a description of how the OPP determines dietary exposure to a pesticide.Links to pesticide databases and information on selected grant programs are also provid-ed here.

Under the Business & Industry link, the EPA provides software that can be down-loaded to use the Pesticide Tolerance Index System, a regularly updated list of all thelimits set on pesticide residues in food. Also linked to the Business & Industry section isa database containing registration information on 89,000 pesticide products. To view aconcise list of the pesticides that have been banned or severely restricted in the UnitedStates, users can select the International Activities link on the OPP home page, andthen choose the FIFRA Section 17(a) Notification of Exports link. Activities specific toone area of the country can be found on the pesticide pages maintained by each EPAregion; these can be accessed by following the Regions, States and Tribes link on thehome page.

For people who are less concerned with the details of regulatory decisions and moreconcerned with how pesticides might affect them, the EPA provides the ConcernedCitizens link on the OPP home page. Induded under this link is advice on how to con-trol pests safely in your home, information about the possibility of pesticides being pre-sent in well water, and a straightforward description of the steps the EPA is taking to

protect people from pesticides.

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to transport medicines to communitiesacross damaged roads and bridges. "Cleanwater has been scarce in many areas, andpeople lack fuel to boil dirty water," saysDaniel Epstein, press officer for PAHO.Many parents aren't aware of the dangerof severe dehydration, which can kill chil-dren quickly, he says. "Chronic dysenterydoesn't grab the headlines, but it isresponsible for far more loss of life [thanother illnesses in the region after thestorm]," says Matthew Chico, regionalspecialist for Latin America and theCaribbean for the American Red Cross.To supply drinking water plants, theagency has already sent 20,000 pounds ofpurifying chemicals, with another 20,000pounds on the way and a third shipmentof 20,000 pounds planned. The AmericanRed Cross has also distributed chlorineand iodine tablets to purify water.

Mitch caused extraordinary crop lossesthroughout the region. Nearly 70% ofHonduran crops were ruined, according tothe U.S. Embassy. Grain fields and theshrimp industry were devastated. Thefourth largest banana producer in theworld, Honduras lost 90% of its banana

crop. In Guatemala,95% of the nation'sbanana crop wasreported destroyed,plus 25-60% of thecorn, bean, coffee,and sugar crops.These effects areespecially harmfulbecause so many inCentral America relyon farming for jobs.For example, inHonduras, about54% of the work-force is employed inagriculture. The sound and the fury.

Extensive logging and on the lives of peopland burning offorests contributed to massive flooding dur-inig Mitch, according to the RainforestAlliance, an international conservationorganization. Central America has lost two-thirds of its forests to logging, agriculture,fires, and development, most of it over thepast 30 years. About 75% of the land inCentral America is hilly or mountainous.Farmers have routinely planted crops along

Federal Food Safety UpdateOn 8 January 1999, Morris E. Potter was named director of the National Food Safety Initiative.As initiative director, Potter will oversee the food safety activities of the Food and DrugAdministration's (FDA) Center for Food Safety and Applied Nutrition, expand and improve theFDA's food-related inspection and surveillance systems, enhance FDA collaborations with othergovernment agencies in responding to foodborne illness outbreaks, institute additional preventioncontrols and strategies, and conduct nationwide public education campaigns.

Potter most recently served as assistant director for foodborne diseases at the Centers forDisease Control and Prevention (CDC), and acted as CDC liaison to the National Food SafetyInitiative. Potter has also served as director of the World Health Organization CollaboratingCenter for Foodborne Disease Surveillance, and has worked in various veterinary epidemiologistpositions in a number of state, federal, and foreign food safety programs, including those of theUnited States Department of Agriculture and the Illinois Department of Public Health. Potterhas served on four National Academy of Sciences panels and on the National AdvisoryCommittee on Microbiological Criteria for Foods.

In support of the National Food Safety Initiative, the FDA recently established a new Website, located at http://www.foodsafety.gov, that offers information and resources for consumers,food industry workers, and educators. The Reporting Illnesses & Product Complaints link leads

consumers to information on whom to contact in the event ofvarious food-related health complaints. The Consumer Advicelink accesses information on special topics in food-related health,such as food safety for expectant mothers and senior citizens, andguidelines for handling specific foods such as eggs and seafood.The Industry Assistance link offers a gateway to numerous regula-tory Web sites, such as the EPA Office of Pesticide Programs andthe CDC's Top 20 Hazardous Substances list. The Kids, Teens,& Educators link brings up educational information gearedtoward young people, as well as lesson plans and other resourcesfor teachers who want to inform their students about food risks.

The Foodborne Pathogens link offers fact sheets on specific illnesses such as listeriosis, and linksto government sites with information on various foodborne organisms. Other links on the homepage access recent safety alerts, background information on the initiative, and Web sites for otherstate and federal government agencies.

Hurricane Mitch wreaked havoc on the environmentfle living in its path in Central America.

open slopes, which do not hold the soil aswell as wooded areas during heavy rains. InNicaragua, a tragic incident illustrated adisastrous use of the land. A volcano calledCasita, or "Little House," was home to sub-sistence farmers settled there by the govern-ment. Farmers had cleared trees to plantcrops on the volcano's slope. But after aweek of rain during Mitch, one side of thevolcano collapsed, burying an estimated2,000 people in mud. In recent years, farm-ers and ranchers have purposely set fires.mistakenly believing that burning willimprove the soil. To compound the prob-lem, in the first half of 1998 a regionwidedrought spread wildfires, burnilng about 3million acres.

Mitch overshadowed another tragic nat-ural disaster in the Caribbean this yearHurricane Georges's rampage across theDominican Republic, Haiti, Cuba, andother nations in September 1998. Georgescrushed important banana plantations, coffee crops, and sugarcane fields. In theDominican Republic, 150,000 people weredisplaced by the storm. In SaintKitts-Nevis, 25% of the homes weredestroyed, and 50% of the sugar harvestlost. "Georges caused comparable crop loss-es to Mitch," says Chico. "The effects ofGeorges were just as great, particularly inthe Dominican Republic. But when Mitchentered the scene, Georges was forgotten."

Despite the devastation in CentralAmerica, national governments and theinternational community are making aconcerted effort to clean up the damageand to plan redevelopment. And on thelocal level "there is a strong communityeffort," says Ann Stingle, internationalpress officer for the American Red Cross,who visited the region in early November."People are working to help themselves."

Volume 07, Number 3 March 999 * Environmental Health Perspectives

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