Groundwater Disaster in Puerto Rico - The Need for Environmental Education.

The Cultural Matrix of Puerto Rico 

The precise cause and the severity of Puerto Rico's groundwater contamination problem have been the subjects of many arguments. The debate, which has been intense, has spilled into the scientific community. Regardless of who or what caused the problem, groundwater contamination has taken place, and the very people who may be most affected are oblivious to it. Furthermore, without support and pressure from the public, government policies are resistant to change. Thus, it is important that the Puerto Rican people know about the ineffectiveness of actions taken to safeguard the quality of the water supplies that are necessary to life. Ironically, as the quality of the environment rapidly diminishes, so does the public awareness of the dangers. In North America, it has been found that bombarding the public with too much information can create a sense of apathy (1). The issue that once caused fervor and tumult quickly becomes an uneventful part of life.

The Commonwealth of Puerto Rico is a Caribbean island located 1,000 miles southeast of Florida. It became a territory of the United States in 1898, at the end of the Spanish-American War. Thus, residents of Puerto Rico are considered U.S. citizens, although they may not vote in national elections and are not required to pay federal taxes. Population density on the island is high, with about 3.5 million people occupying 8,700 square kilometers (2).

The people of Puerto Rico represent a cultural mix of French, Spanish, Indian, and African descent, with African heritage most prominent on the coasts and Indian heritage most prominent in the mountains. Nevertheless, the predominant culture of Puerto Rico is Latin American, and Spanish is the primary language. Since 1898, language has been a central issue in Puerto Rican education and culture, with everyone fighting over what the official language should be (3). The most important newspapers, El Mundo, El Nuevo Dia, and El Vocero, are published in Spanish. The only English newspaper is the San Juan Star. Although the U.S. Bureau of Census reports that a significant portion of Puerto Ricans do not understand English, it is the second official language on the island and a required subject in Puerto Rico's public schools (2,3).

Regardless of language, Puerto Rico boasts a 90 percent literacy rate among its citizens (2). Education has always been highly valued in the Puerto Rican culture, as can be seen in the dozen or more colleges and universities on the island. The Puerto Rico Department of Education even runs radio and television stations devoted only to educational and cultural concerns (4).

Another important aspect of the Puerto Rican culture is religion. The Roman Catholic Church claims 85 percent of Puerto Ricans as members; most of the remaining 15 percent belong to other Christian churches (5). Catholic traditions and customs prevail. Identity as a Catholic can represent identity with a community (4). Because religion is so deeply imbedded in the culture as a set of folk beliefs and practices, common values provide a sense of solidarity among all classes.

For centuries, the island's society has been divided into two classes. There are a small but relatively well-off upper class and a large, poverty-stricken lower class that has developed its own cultural traits within the restrictions of poverty (3). Dramatically poor in natural resources, Puerto Rico is overpopulated relative to the ability of its economy to support people adequately. Although the life expectancy in Puerto Rico is high (79 years for women and 72 years for men), standards of living are low, with most Puerto Ricans living in rural villages and towns. The unemployment rate is high throughout the island, and the mean income is half that of Mississippi, the poorest state in the United States (6). Only recently has the island begun to diminish the chronic poverty and destitution of its people. This change is most likely due to the relatively new shift in the economy. Long based primarily on agriculture, Puerto Rico's economy now relies on manufacturing operations as its chief source of income (3).

The Industrialization of Puerto Rico

Industrial operations, which account for 55.5 percent of the gross domestic product, are relatively new to Puerto Rico (6). Governmental programs of tax exemption were introduced during the 1950s to change the economic base of the island from agriculture to manufacturing (7). In 1976, encouraged by tremendous tax incentives, known as Section 936 of the tax code created by Congress, dozens of mainland companies began operations in Puerto Rico (8). The tax credits were designed to create jobs, attract capital investments, and further develop the economies of U.S. territories. In 1993, the tax credit was reduced from 100 percent to 60 percent and subsequently to 40 percent (9). Pharmaceutical companies were particularly interested in moving their plants to Puerto Rico because raw materials, cheap manufacturing, and low shipping costs made overseas production extremely profitable. In fact, the General Accounting Office of the federal government reported in 1983 that the pharmaceutical industry had been the largest single beneficiary of the tax credit in Puerto Rico. In 1989, the drug companies received $71,678 in tax credits per employee, while the employees averaged only $33,757 in compensation (4).

Groundwater Contamination by Pharmaceutical Companies in Puerto Rico

The increase in industrialization, which includes the manufacturing of pharmaceuticals, chemicals, machinery, electronics, apparel, and food products, has also brought environmental consequences. According to the Puerto Rico Water Resources Research Institute, Puerto Rico is among the U.S. states and territories with the highest toxic releases to the environment. The U.S. Environmental Protection Agency (U.S. EPA) Annual Toxic Release Inventory for 1991 cited over 300 toxic chemicals injected into the groundwater or released directly to the air, water, or land. Toxic contamination in groundwater is of special interest because of its direct implications for human health.

Along the north coast of the island, the limestone aquifers that contain groundwater are becoming heavily polluted. Although the region occupies only 20 percent of the land mass of Puerto Rico, it is home to 55 percent of the island's manufacturing plants and 48 percent of the population (10). According to the U.S. Geological Survey of 1987, 41 percent of the public drinking-water wells supplied by the aquifers in the region had been closed because of toxic contamination (11). Since then, there have been more closures. Approximately 73 percent of the public water supply wells are closed in the metropolitan regions, compared with 29 percent in the northern central region and 20 percent in the western sector of the island. Because of these massive closures, only six percent of the drinking water for metropolitan areas comes from groundwater sources; by contrast, the central region of the island depends on groundwater for 92 percent of its water supply because it has not been significantly affected by industrial pollution (10).

One of the most contaminated sites is in Barceloneta, where contaminated groundwater is leaking into the wells that provide drinking water. Those wells have been found to contain chlorinated hydrocarbons that have leaked from buried tanks belonging to pharmaceutical companies (12). According to the U.S. EPA National Priorities List, pharmaceutical companies, in particular, have leaked several toxic chemicals into the soil and groundwater.

Several pharmaceutical companies operating in Puerto Rico were recently named on U.S. EPA's list of the top 10 toxic chemical releasers in Puerto Rico for 1994. They are

* Upjohn Manufacturing Company in Arecibo;

* Abbott Chemicals, Inc., in Barceloneta;

* Schering-Plough Products, Inc., in Las Piedras;

* Merck Sharp & Dohme Quimica in Barceloneta; and

* Schering-Plough Products, Inc., in Manati.

It should be noted that approximately half of the worst toxic polluters in Puerto Rico during 1994 were pharmaceutical companies (13).

Cases of Groundwater Contamination by Pharmaceutical Companies

In 1978, a pharmaceutical company, Technicon, discharged industrial waste containing mercury and the pesticide lindane into the Frontera Creek site in Humacao County. The site includes creeks that pour into the Caribbean Sea, industrial properties adjacent to Frontera Creek, North Frontera and South Frontera lagoons, and the Ciudad Cristiana Housing Development. In 1979, the 500 residents of Ciudad Cristiana, a housing development that had been built along the creek, began to complain about health problems within a year of their arrival. The governor of Puerto Rico ordered an immediate permanent evacuation of the residents (13). Although studies conducted by U.S. EPA and the Agency for Toxic Substances and Disease Registry (ATSDR) concluded that the mercury levels were not high enough to warrant an evacuation, U.S. EPA proceeded with a full investigation of the site because of the known contamination. Apparently local residents used the contaminated lagoons for fishing and recreation. The fish and shellfish, which were an important component of the local diet, probably led to the health problems. Mercury in soil sediments at the Technicon site also presented a risk to people who came into contact with it (13).

In 1982, approximately 15,300 gallons of waste material, including carbon tetrachloride and acetonitrile (methyl cyanide), leaked from an underground tank at the Upjohn facility in the county of Barceloneta (10). The Upjohn facility is located in a sparsely populated area. Two communities, Tiburones and Garrochales, with a combined population of approximately 3,000 people, were directly affected. The island's largest aquifer is underneath the facility and supplies drinking water to more than 12,000 people. Groundwater and soil at the Upjohn facility site were contaminated with carbon tetrachloride and its degradation products in wastes from Upjohn's former manufacturing process. People who touched or drank water from wells that tapped the aquifer were at risk. In addition, the aquifer discharged into a wetlands area that supported large aquatic and bird populations, which were important components of the local diet (14).

The Upjohn Manufacturing Company facility in Barceloneta is on U.S. EPA's current national priority list of Superfund cleanup sites and is slated for ongoing extraction of groundwater contaminated by the 1982 leakage from the underground storage tank. The most hazardous substance released by the spill was carbon tetrachloride, a suspected carcinogen.

Carbon tetrachloride is highly toxic, causing acute injury to the kidneys, liver, central nervous system, and gastrointestinal tract. Chronic exposure is suspected of causing liver cancer. Exposure to high concentrations of tetrachloride may result in acute poisoning and death from respiratory failure (15).

In 1997, Warner-Lambert, a pharmaceutical company, was found guilty of falsifying reports on the levels of pollutants released from a wastewater treatment plant in Puerto Rico. The pollutants included fecal coliform, metals, oil, and grease, which can cause adverse health effects in humans and other living organisms. The company was assessed fines amounting to three million dollars and civil penalties of $670,000 for releasing excessive pollutants between 1992 and 1995 (16).

U.S. EPA-Caribbean Division

A special branch of U.S. EPA operates exclusively in the Caribbean sector. Known as the Caribbean Environmental Protection Division (CEPD), this division has the goal of incorporating environmental-justice considerations into all U.S. EPA programs for the region, especially in low-income and minority communities. CEPD works with the community to promote public involvement in the implementation of environmental programs. To that end, the agency disseminates information and provides training on specific environmental protection topics.

One of U.S. EPA's most publicly visible responsibilities is to administer the provisions of the Comprehensive Environmental Response Compensation and Liability Act (CERCLA) of 1980, also known as the "Superfund" act. With this act, Congress earmarked 1.6 billion dollars for the cleanup of toxic waste sites throughout the United States and its territories, including Puerto Rico, and for prosecuting violators of U.S. EPA regulations. Currently, Puerto Rico has nine Superfund sites.

Health Consequences

While human health can be directly influenced by water quality, there has been a lack of epidemiological evidence about the health consequences of groundwater contamination in Puerto Rico (17). Cases of groundwater contamination elsewhere in the world have, however, had detrimental effects on the health of surrounding populations.

Methemoglobinemia, commonly referred to as "blue baby disease" can result when an infant is exposed to nitrate-contaminated water, usually from wells polluted by fertilizer, feedlot runoff, or seepage from septic systems (18). Worldwide, about 3,000 cases of blue baby disease have been documented since 1945, when nitrate-contaminated water was first linked to the disease. Improved monitoring of groundwater supplies has since reduced the incidence of methemoglobinemia, but it is not known whether such monitoring is conducted in Puerto Rico. A study conducted by the LaGrange County (Indiana) Health Department during the early 1990s reported a possible link between the ingestion of nitrate-contaminated well water and spontaneous abortion (19).

Cape Cod, Massachusetts, has had a history of pesticide use that may have contributed to contamination of its groundwater source (20). It has been suggested that Cape Cod's unusually high breast cancer rates are a direct result of the contamination. While the association between chemical contaminants and cancer are unclear, studies at Harvard University suggest that exposure to some chemicals found in pesticides may increase the risk of breast cancer (20).

Several cases of groundwater polluted with industrial wastes have been linked to negative health outcomes. In a small area in Tucson Valley, Arizona, congenital cardiac malformations were found to be significantly associated with maternal exposure to groundwater contaminated with trichloroethylene and, to a lesser extent, with dichloroethylene and chromium. Industrial chemicals had been placed on the ground surface or in unlined earthen holding pits, resulting in percolation into groundwater aquifers over a period of approximately 30 years (21).

In 1992, a class action lawsuit was filed against an aluminum die-casting plant in Muscle Shoals, Alabama, on behalf of neighboring residents who suffered from a variety of neurological symptoms. Shortly thereafter, an investigation was conducted to measure the neurobehavioral performance of a group of survivors. The study showed that neurophysiological impairment, as well as cognitive and psychomotor dysfunction, were associated with the use of wells the industrial plant had contaminated with volatile organic compounds (VOCs), trichloroethylene (TCE), and polychlorinated biphenyls (PCBs) (22).

One of the most extensively studied cases of drinking water contamination is known as the "Woburn cluster." In 1986, researchers first reported an association between groundwater contaminated with VOCs and incidence of childhood leukemia in Woburn, Massachusetts, a town of 37,000 that has been an industrial center since the mid-1800s. Between 1969 and 1986, 21 cases of leukemia were reported in children living in the small New England town, making Woburn the city with the most highly concentrated outbreak of leukemia in the United States (23). Ten years later, a study released by the Massachusetts Department of Public Health found that a combination of organic chemicals had polluted the groundwater and supported the association of ingestion of the contaminated water by a mother with the subsequent development of leukemia by her child (24).

A 1997 report by the National Center for Environmental Health cited multiple studies that had evaluated drinking water contaminants and the risk of lymphatic or hematopoietic cancer. The studies were conducted in a variety of geographical locations, including Massachusetts, New Jersey, and Finland. The investigations found that the incidence of cancer can be linked to many different contaminants, including trichloroethylene, perchloroethylene, tetrachloroethylene, and chlorination by-products (25).

Educating the Public

There is no epidemiological evidence of the effects of groundwater pollution in Puerto Rico because studies have not been conducted (10). For toxic substances delivered in very small quantities over time, as is the case with groundwater contamination, research findings on health effects are limited. Thus, debate continues in the scientific community about the severity of Puerto Rico's groundwater contamination and its precise cause. Nevertheless, the evidence is insurmountable that the groundwater of Puerto Rico has been polluted. Although several of the pharmaceutical companies have been fined for their carelessness, "governmental monitoring and enforcement of standards, in both the public and private industrial sectors, are poorly effective in Puerto Rico because of piecemeal programs and a lack of coordination among the multiplicity of agencies involved with water" (10). Therefore, Puerto Ricans must become aware of the issue. Otherwise, future generations of Puerto Ricans will have to sacrifice their right to clean water.

Informing the public about possible hazards and dangers to their health has always been a challenge in public health education. Risk perception studies show that people may underestimate the significant risk relative to what the risk assessors have determined. Burger et al., for example, reported that when warnings about contaminated water were posted at the Jamaica Bay Wildlife Refuge in New York City, local fishermen ignored them and continued to catch and eat the fish (26). According to this report, the fishermen believed that they could tell if a fish was contaminated by the way it looked or smelled. Perhaps they also reasoned that since they hadn't gotten sick yet, they weren't going to. Despite such obstacles, environmental health educators must find ways to reach and educate the public.

CEPD operates several public education programs in Puerto Rico, but the programs are limited in scope. During 1996, CEPD held three community seminars, in Spanish, on important environmental topics. Two of the seminars were broadcast live on radio. CEPD also has a web site, in both Spanish and English, so that the public can find out where to lodge complaints about environmental hazards and can access basic information during all hours of the day and night. This access, obviously, is limited to people with computers. Because of the extreme poverty in Puerto Rico, it is unlikely that many people have access to computers.

Another CEPD project is a pilot educational program designed to promote awareness of environmental problems in San Juan Bay. This program reaches out to fishermen, high school students, teachers, and parents. CEPD also has led a project that serves 100,000 people who receive drinking water from public water systems in central Puerto Rico. The purpose is to increase public awareness of the need for safe drinking water, increase compliance with water regulations, and improve the quality of drinking water in that region of the island.

Any effort to inform the public about the hazards of toxic spills should, throughout the development and implementation of the awareness program, take into account the cultural beliefs and values, as well as the economic and educational background of the population. Incorporating environmental education into the school curriculum is a good starting point. Students from the many universities on the island could be shown the causes and effects of groundwater contamination. If their protests were publicized, they could certainly cause changes to be made immediately. Even educating primary and secondary school students could make a difference. In the same way that U.S. children were taught the importance of seatbelts and came home to compel compliance by parents, Puerto Rican children can persuade their parents to take note of the importance of clean water.

No matter how education is accomplished, it is imperative that the public learn about its environment. Only then can the necessary actions be taken to salvage and protect that environment. "Possibilities for Public Health Education," a moving article published in a U.S. EPA newsletter, addresses the issue of "environmentally abused" communities (27). The author, Rosa Hilda Ramos, lives in the Catano region of Puerto Rico, one of the poorest and more polluted regions of the territory. Her article charges the environmental watchdog agencies, including U.S. EPA, with neglecting the health and environmental needs of poor communities. According to Ramos, the community leaders, who are housewives or church leaders, lack the skills to be successful environmental advocates for their constituencies. Poor communities don't have funds to hire experts who could scientifically prove their claims of adverse health effects from industrial pollution. Although U.S. EPA does make an effort to hold public hearings and include the public, Ramos claims that people in poor communities do not have the resources, education, or documentation that they need to fully understand what is at stake. This condition leads to a feeling of hopelessness and powerlessness among the members of the community. She concludes her article with a plea to U.S. EPA to right the wrongs done to such communities and fully administer environmental justice.

Media Coverage of Environmental Issues

Today most of what the general public knows about broader issues, such as the environment, comes to us through the media. Newspapers, magazines, television, and film all present images we react to. We may not react consciously, but the very presence of certain topics in the media conditions us to contemplate them. These topics become subjects for discourse. Theoretically, the media does not tell us how to think. Rather, it tells us what to think about. This is known as the "agenda-setting hypothesis" (28). One of the most effective tools the media has is visual stimulus. Whether through photographs or through film and television, pictures seem to say more than words ever could.

Unfortunately, visual images are not without limitations. First, pictures fail to pinpoint the exact source of contamination. They can only show that the contamination exists. Without knowing the source or cause, people may feel hopeless about fighting it. The same images could be more effective if they showed how and why the groundwater became contaminated, the extent of contamination, and its effects on health. Visual images are also limited in that one picture can conjure up different meanings for different people. Only through words, music, or other signifiers associated with the images can the audience understand their meaning. In fact, all forms of media are somewhat handicapped by the use of images that can have several connotations. As a result, environmental images in the media, like almost every environmental discussion, need to be anchored in a context to help audiences understand their message.

The general-interest media are often looked upon as government watchdogs, cracking down on political conspiracies and the like. Frequently, it is assumed that the media will be highly critical of governmental or industrial practices with respect to the environment. The general-interest media - especially the print media - seem, however, to have abandoned the watchdog role when it comes to matters of the environment. Conceptually, environmental conditions link the past and the present. We have, however, been conditioned to expect representations of what is going on now from the news and general-interest media. Because of its tendency toward "nowness," the media does a poor job of presenting images that reflect long-term problems such as environmental problems.

Only in advocacy journalism, usually undertaken by special interest groups, do we find such problems elucidated. Unfortunately, advocacy journalism often relies on irony, sarcasm, or cynicism to deliver its messages. By speaking in a special voice to those most likely to listen, the special interest groups or pressure groups are failing to convert the undecided. To compound the problem, environmental risks frequently are exaggerated, which creates a sense of numbness or apathy in the audience.

Nevertheless, most researchers agree that the media have played a major role in the widespread dissemination of environmental concern (29-31). The amount and type of media coverage of environmental disasters and conflicts has helped transform many specific problems into a major public issue. Journalistic preference for the negative and the dramatic, combined with the conflictual nature of debate between environmentalists and nonenvironmentalists, shapes the overall message delivered to the public. It also has been pointed out that stories about environmental problems carry with them powerful cultural symbols related to nature, as well as a strong emotive and moralistic appeal (30, 32).

Despite obstacles, most environmental groups still find national newspapers to be the best vehicle for influencing public opinion and governmental policy (33). The challenge, then, is for scientists to learn the language of the media or for a "translator" to mediate communication between scientists, the media, and the public. It is also important for the media to recover its sense of social responsibility. Public pressure has proved to be an effective tool in persuading companies to follow regulations and clean up any polluting they may have committed, but unless typical media coverage of these issues somehow changes, the public will be ill-prepared to demand environmental changes.

As previously mentioned, increased media exposure results in additional information about the nature of environmental problems - and does so in a way that encourages greater concern. The degree of exposure of individuals to media coverage of a given issue is difficult to measure. In the literature, instead of direct measures, one generally finds that individuals' knowledge of environmental problems is measured and then attributed to a corresponding degree of media exposure (34).

Public Awareness

How then, can the public learn about environmental issues, if the dominant media sources are not providing the needed information? Historically the government has served as the major source of environmental news (35). This is true despite the fact that only the most extreme cases of environmental irresponsibility are publicized, and then only after the damage has been done and all attempts at negotiation have failed (36).

One of the ways in which U.S. EPA is already using the media for environmental education is through news releases that are published in major newspapers. Under U.S. EPA's Right-to-Know Program, which was mandated by the 1986 Emergency Planning and Community Right to Know Act (EPCRA), the public has access to the annual Toxic Release Inventory (TRI). This is a comprehensive database, providing information on the release and transfer of toxic chemicals by manufacturers and other facilities. Pharmaceutical companies are among the almost 30,000 facilities that are required to report their toxic chemical releases and transfers to the TRI. According to U.S. EPA Administrator Carol M. Browner, reported pollution releases to the environment have decreased by 46 percent since the TRI program began (13). This significant reduction is a strong indication of the value of informing the public about the real levels of pollution in the environment.

Another program administered by U.S. EPA is an environmental-education grant program designed to provide financial support for projects that educate citizens about their environment. In 1995, this program awarded $148,000 to the Citizen's Committee for New York City, an environmental education and leadership program focusing on residents of the city's Latino, African-American, and Asian neighborhoods. The specific purpose of the grant was to fund the committee's efforts to provide citizens in grassroots community groups with the knowledge and skills to become environmental leaders in their neighborhoods (37). Clearly, U.S. EPA could fund a similar program in Puerto Rico. Perhaps U.S. EPA could use media resources to market a contest for grant funds.

In 1986, Congress passed the Superfund Amendments and Reauthorization Act (SARA), otherwise known as the Community Right-to-Know Act. This amendment requires industries to report on the specific amounts of hazardous chemicals stored on site and released into the environment. Four years later, SARA was amended by the Federal Pollution Prevention Act, encouraging the prevention or reduction of pollution at the source, whenever possible. This evolution of the government's protective role from toxic waste management to toxic waste prevention mirrors the development of public health efforts. Once health care providers primarily sought to treat disease; now their focus has shifted to prevention efforts (38). Public health education plays a crucial role in health promotion and disease prevention and certainly can encompass the broad scope of environmental health education.

Public access to toxic waste discharge information has created fertile ground for environmental activism. In response to growing public pressure, many industries have entered into "Good Neighbor" agreements in which they pledge to reduce the level of pollutants released into the environment. Thus, in response to protests staged by fishermen in Texas, the Aluminum Company of America (ALCOA) signed a pledge in 1995 to work toward zero discharge of wastewater pollutants, including the highly toxic methyl mercury. The following year, a similar agreement was signed by Formosa Plastics, a producer of polyvinyl chloride. In return for these pledges, the protesters agreed not to file a citizen's Clean Water Act lawsuit against the companies (39).

Labor unions are frequently involved with community members in the negotiation of good-neighbor agreements with industries. Factory workers are at considerable risk for developing health problems as a result of exposure to toxic chemicals and thus have an important stake in the reduction or elimination of toxic waste. Negotiations involving workers' unions have been underway in several major industries across the United States, including Chevron, General Motors, and Sun Oil (40).

These resources could also be used to launch a media campaign in Puerto Rico that would use the skills and enthusiasm of community activists, professional health educators, and other identified stakeholders. Since the literacy rate in Puerto Rico is particularly high (90 percent), the print media could be used effectively to educate the public. Readers would be empowered by more newspaper and magazine articles written with the purpose of informing communities about health hazards from groundwater pollution and about how individuals can protect themselves against those hazards. Advertising agencies could plan clever billboard campaigns to grab attention and inform the public about the danger groundwater pollution poses to drinking water.

Of special interest are the Puerto Rico Department of Education radio and television stations devoted to educational matters. The broadcasting of programs showing the effects of water contamination not only on the land and on agriculture, but also on disease and illness, may pique the interest of the public. Television news programs could air special features about groundwater contamination seeping into the drinking-water supplies in specific communities, as well as what those communities have or have not done to respond to the problem. All forms of news media could help educate the public by covering events, such as community forums or protests by environmental activists, that specifically target the issues of environmental pollution. Commercials that aim at the growing middle class, letting this group know the consequences pollutants may have for their children's health - and, in turn, for the children's schoolwork and eventually for their future - could also be effective.

Enlightening the poverty-stricken class probably will require the help of the Church. Because the Church may be stronger than any other force for this group of people, it is important that the priests and nuns inform the affected communities of the groundwater pollution and the effects of the pollutants on their daily life. Together with the media, church leaders can have a powerful and positive impact on the environmental crusade.

Environmental activism is a growing movement within a number of churches and synagogues in the United States. Roman Catholics, Protestants, Evangelicals, and Jews have collaborated in an interfaith effort to develop a theologically informed environmentalism and to promote environmental protection. Known as the National Religious Partnership for the Environment (NRPE), the group is relatively small, but it represents a large socioeconomic range. Some member congregations lie in poor industrial areas that are more greatly affected by environmental degradation than are the wealthier neighborhoods. In February of 1997, 20 members of NRPE traveled to Washington to impress upon the nation's leaders that protection of the environment is particularly important to the poor and vulnerable. The Reverend James Parks Morton, founder of NRPE, described the mission: "The moral integrity of environmental protection is at stake here. It's hard to be poor in America without bearing disproportionate burdens of poisons and pollution" (41). One could substitute "Puerto Rico" for "America" and still be right on target.

In 1994, more than 53,000 congregations joined forces to prepare and distribute environmental awareness kits in commemoration of Earth Day The kits were designed to reflect each religious group's system of beliefs. The Catholic church was especially active in this environmental education campaign, developing and distributing an awareness kit to every parish in the United States. Their product, "Renewing the Face of the Earth: A Resource for Parishes," reflects the tradition of social activism that has long been associated with the Roman Catholic Church both in the United States and abroad (42).

The Church also can exercise great influence in Puerto Rico because of people's attitudes toward power, which differs greatly from the American view of power (4). The Anglo-American notion of a leader involves someone chosen by the people to delegate responsibility in working toward a goal that everyone, or at least the majority, has agreed upon. The traditional Puerto Rican understanding of a leader involves someone who defines the goals of the group, makes its decisions for it, and sees to it that they are carried out. Thus, it is logical that the people often turn toward the Church hierarchy to lead them in more than just spiritual ways.

It might also be effective to specifically target the people who work in pharmaceutical plants. A mandatory educational program provided by U.S. EPA might be attractive both to the workers and to company management. The program would inform workers of the health hazards that contaminated groundwater poses for everyone in the community, including themselves and their families. Explicit instructions would be provided for preventing hazardous spills, leaks, and so forth. The educational program could be funded by way of a reduction in the amount of the fine that would otherwise be imposed on the company. A 10 percent reduction might be very attractive to a company that has been ordered to pay a fine of three million dollars.

Conclusion

Around the world, thousands of pressing environmental concerns are plaguing every nation. Sadly, most will go unanswered because of lack of interest or resources. In Puerto Rico, however, all the ingredients are present for a successful public health education campaign that targets the prevention of health problems from groundwater pollution. Accomplishing this goal will require commitment and cooperation from all stakeholders. U.S. EPA, the pharmaceutical industry, citizen groups, scientists, epidemiologists, the media, and public health educators need to work together toward true environmental justice. Only then can we reverse the trend of environmental deterioration.

REFERENCES

1. Karlberg, M. (1997), "News and Conflict: How Adversarial News Frames Limit Public Understanding of Environmental Issues," Alternatives Journal, 23(1):22-28.

2. Bureau of Census (1992), 1990 Population Census, General Population Characteristics: Puerto Rico, Vol. 1, Washington, D.C.: U.S. Department of Commerce.

3. Fitzpatrick, J.P. (1971), Puerto Rico Americans: The Meeting of Migration to the Mainland, Englewood Cliffs, N.J.: Prentice-Hall, Inc., pp. 157-158.

4. Wells, H. (1969), The Modernization of Puerto Rico: A Political Study of Changing Values and Institutions, Cambridge, Mass.: Harvard University Press, p. 272.

5. "Puerto Rico (Summary of Facts)" (1997), Information Please[TM] Almanac, p.783.

6. Bureau of Census (1992), 1990 Census of Population, Social and Economic Characteristics: Puerto Rico, Washington, D.C.: U.S. Department of Commerce.

7. Heffler, S. (1995), "Drags-Manufacturing Jobs in Puerto Rico," Monthly Labor Review, 118(3):12-23.

8. Breiner, J. (1995), "Puerto Ricans Fear Loss of Tax Break," Business First-Columbus, 11 (29):18.

9. Schneider, A.J. (1996), "Larger Income Tax Bill Looms Ahead for Lilly," Indianapolis Business Journal, 17(29):32A.

10. Hunter, J.M., and L.I. Arbona (1995), "Paradise Lost: An introduction to the Geography of Water Pollution in Puerto Rico," Social Science and Medicine, 40(10): 1331-1355.

11. Zack, A., T. Roddrigues-Alonso, and A. Roman-Mas (1987), Puerto Rico Groundwater Quality, Open File Report 87-0749, U.S. Geological Survey.

12. Puerto Rico Water Resources Research Institute (PRWRRI) (1997), "Research Projects," <http://mayaweb.upr.clu.edu/rumhp/prwrri/water3.htm>.

13. "EPA Reports on Level of Toxic Releases to Air, Water and Land in Puerto Rico" (May 20, 1997), U.S. EPA Region 2 News Release, <http//www.epa.gov/rO2earth/epd/97085.htm>.

14. "US EPA Region 2 Superfund Site, Upjohn facility" (June 2, 1997), U.S. EPA National Priorities List, <http://www.epa.gov/region02/superfnd/site-sum/0202480c.htm>.

15. Sax, N.I. (1979), Dangerous Properties of Industrial Materials, 5th ed., New York: Van Nostrand Reinhold Company, p. 471.

16. New York Times (Saturday, September 20, 1997), Section D, 447(5):921.

17. Greenberg, M.R. (1987), "Health and Risk in Urban-Industrial Society: An Introduction," In Public Health and the Environment, Guilford, N.Y.:, pp. 3-24.

18. Nadakavukaren, A. (1995), Our Global Environment, A Health Perspective, Prospect Heights, Ill.: Waveland Press, Inc., pp. 619-620.

19. Nadakavukaren, A. (1996), "Spontaneous Abortions Possibly Related to Ingestion of Nitrate-Contaminated Well Water - LaGrange County, Indiana, 1991-94," Morbidity and Mortality Weekly Report, 45(26):569-573.

20. O'Conner, A. (1997), "The Link Between Chemicals and Breast Cancer," Vegetarian Times, 236:20.

21. Gorger, S.J., E.J. Graver, and S. Hicks (1990), "An Association of Human Congenital Cardiac Malformation and Drinking Water Contaminants," Journal of the American College of Cardiology, 16(1): 155-164.

22. Kilburn, K.H., and R.H. Warshw (1993), "Neurobehavioral Testing of Subjects Exposed Residentially to Groundwater Contaminated from an Aluminum Die-Casting Plant and Local Referents," Journal of Toxicology and Environmental Health, 39:483-496.

23. Lagakos, S.J., B.J. Wessen, and M. Zelen (1986), "An Analysis of Contaminated Well Water and Health Effects in Woburn, Massachusetts," Journal of the American Statistical Association, 81 (395):583-596.

24. Posner, M. (1996), "Study Uncovers Source of Leukemia Outbreaks," Reuters, March 10.

25. Blair, A., K.P. Cantor, M.H. Ward, and S.H. Zahm (1997), "Occupational and Environmental Risk Factors for Chronic Lymphocytic Leukemia and Non-Hodgkin's Lymphoma," 1997 USPHS Workshop Proceedings, Washington, D.C.: Centers for Disease Control and Prevention, National Center for Environmental Health, <http://www.cdc/gov/nceh/programs/lab/flowcyto/pub/1997/html/doc16.htm.

26. Burger, J., M. Gochfeld, and K. Staine (1993), "Fishing in Contaminated Waters: Knowledge and Risk Perception of Hazards by Fishermen in New York City," Journal of Toxicology and Environmental Health, 39(1):95-105.

27. Ramos, R.H. (1995), "Views of a Citizen Activist," Highlights (EPA Region 2 External Newsletter), April:5.

28. Skanavis, C., and J. Hanson (1995), "The Environment in the Media - Fair Coverage?" European Environmental Management Association Review, 1(1):22-24.

29. Lowe, P.D., and W. Rudig (1987), "Review Article: Political Ecology and the Social Sciences - The State of the Art," British Journal of Political Science, 16:514-550.

30. Lowe, P., and D. Morrison (1984), "Bad News or Good News: Environmental Politics and the Mass Media," Sociological Review, 32:75-90.

31. Mitchell, R.C. (1990), "Public Opinion and the Green Lobby: Poised for the 1990s?" In N.J. Vig and M.E. Kraft, eds., Environmental Policy in the 1990s: Toward a New Agenda, Washington, D.C.: Congressional Quarterly Press, pp. 81-99.

32. Hays, S.P. (1987), Beauty, Health and Permanence: Environmental Politics in the United States, 1955-1985, Cambridge Mass.: Harvard University Press.

33. Anderson, A. (1991), "Sources, Strategies, and the Communication of Environmental Affairs," Media, Culture, and Society, 13:459-476.

34. Wall, G. (1995), "Barriers to Individual Environmental Action: The Influence of Attitudes and Social Experiences," Canadian Review of Sociology & Anthropology, 32(4):465-493.

35. Ehrlich, P.R., and A.H. Ehrlich (1996), Betrayal of Science and Reason: How Anti-Environmental Rhetoric Threatens Our Future, Washington, D.C.: Island Press.

36. Sandman, P.M., M. Gochfeld, M.R. Greenburg, and D.B. Sachman (1987), Environmental Risk and the Press: An Exploratory Assessment, New Brunswick, N.J.: Transaction Books.

37. U.S. EPA Region 2 News Release (October 23, 1995), <http://www.epa.gov/9600.htm>.

38. U.S. Department of Health and Human Services (1990), Healthy People 2000, Washington, D.C.: Government Printing Office.

39. Mongks, V. (1996), "Environmental Regulations: Who Needs Them?" National Wildlife, 34(2):24-32.

40. Heiman, M.K. (1997), "Community Attempts at Sustainable Development Through Corporate Accountability," Journal of Environmental Planning & Management, 40(5):631-644.

41. Knickerbocker, B. (1997), "Bully Pulpit Clergy Preach Conservation," Christian Science Monitor, 89(47):1.

42. Knickerbocker, B. (1994), "Parish Environmentalism," Christian Century, 3(15):462-463.

Corresponding Author: Constantina Skanavis, Ph.D., Associate Professor, California State Univ., Los Angeles, Dept. of Health and Nutritional Sciences, 5151 State University Dr, Los Angeles, CA 90032.