Why Emergency Physicians Should Care About the Salton Sea

The deterioration of the ecosystem surrounding the Salton Sea, a 376-square mile lake located between Imperial and Riverside Counties in Southern California1 has an important effect on the health of the surrounding impoverished population. The greater Salton Sea area comprises 177,000 people demographically divided into 80.9% Latino, 13.7% White/NonHispanic, and 10.5% African American.2 Median income and poverty percentiles in the area are 23.02% and $35,000 compared to the rest of California at 15.28% and $61,400 respectively.3,4 This area is also disproportionately affected by pediatric asthma with 20% of its pediatric population diagnosed with asthma compared to 8% nationally.5 Currently, emergency departments in Imperial County treat three times more pediatric asthma visits than elsewhere in California.5,6 Recently, there has been new governmental, academic, and community interest in this issue, and as emergency physicians we have a unique opportunity to become involved in the health of the Salton Sea as well as the surrounding community. The Salton Sea is a terminal body of water without outflow and relies on agricultural runoff, and the New, Whitewater, and Alamo rivers to maintain its water level. The last filling of the lake occurred in 1904 when the Colorado River flooded, and the surrounding area has since become heavily populated and a vital part of the Coachella Valley economy and integral part of the Southern California ecosystem.7 Over the last decade, the lake has been decreasing in size due to evaporation, increasing its salinity. Without efforts to sustain the sea, it is projected to decrease to 1/3 its size in the next 50 years, potentially crippling the local economy, with catastrophic effects on the health of the impoverished surrounding population, and adversely affecting air quality in Southern California.8 Approximately 1,300,000 acre-feet of water each year evaporate from the Salton Sea (one acre-foot = 326,000 gallons).1 Without outflow, it is dependent on river water diversion as well as runoff from agricultural irrigation to equal its evaporative rate. In recent years, water levels have dropped drastically due to the 2003 Quantification Settlement Agreement, which diverted large amounts of river water to urban San Diego.9 This uncompensated evaporation causes salinity levels of the lake to increase. If there is no intervention to address these rising salinity levels, life in the University of California, Irvine, Department of Emergency Medicine, Irvine, California