High Lupus Rate Along Border

by Danielle Knight

Often a misunderstood and mis-diagnosed disease, lupus is a chronic illness in which the immune system attacks various parts of the body, primarily the skin, joints, and blood vessels.

Symptoms include kidney problems, chest pain, aching joints, prolonged fatigue and skin rashes. About nine out of ten people diagnosed with disease are women.

Community activists argue that the illness may be linked to environmental contaminants from nearby mines and "maquiladora" assembly plants, which make up an export-processing zone strewn across much of the borderland.

Many of these businesses were set up to take advantage of low wages in Mexico while at the same time enjoying easy access to U.S. infrastructure, transportation routes, and markets. Critics say the plants also exploit lax environmental enforcement and fear a connection to lupus. In the absence of detailed data, however, many health professionals are unable to lay blame with certainty.

"Most of these towns have severe pollution problems," says Caroline Hotaling, program director with the Arizona-based Border Ecology Project. "But we cannot be sure of these links until more studies are done."

Accusations that lupus is linked to industrial pollution have been met with skepticism by some researchers, who argue that Mexican-Americans are genetically predisposed to the disease. That argument, Hotaling counters, is being made in the absence of a baseline, "normal" rate of occurrence for Mexican-Americans, against which specific incidence rates could be compared.

While there is no established 'normal' rate for Mexican-Americans, health professionals in Nogales, Arizona point to a 1994 study which found that the rate there was much higher than in other Arizona locales with similar populations but less industrial development.

Bridget Walsh, a medical doctor at the University of Arizona Health Sciences Center who has been searching for answers, is among scientists to become involved in ongoing lupus studies by the U.S. Centers for Disease Control and Prevention. She has worked to document incidence rates in the region while looking at corresponding environmental factors, and was part of the team responsible for the 1994 survey of Nogales, Arizona, headed up by the state's Department of Health Service.

That study found that lupus struck 94 out of every 100,000 people in Nogales, Arizona, nearly twice the highest rate previously recorded: 50.8 per 100,000 in California.

The study also indicated a correlation between contaminated water wells and the lupus cases, explains Walsh. Confirmed lupus patients were found to have resided in clusters near wells known to have high levels of the industrial solvents Perchloroethylene (PCE, used in chemicals production and dry-cleaning) and Trichloroethylene (TCE), both classified by the U.S. Environmental Protection Agency as probable cancer-causing substances.

The study concluded: "While the role of genetic predisposition is accepted as a component of risk, neither the proportion of Hispanics in Nogales nor the possibility of a higher (lupus) prevalence in Hispanics" could explain the higher incidence of the disease.

"Exposure to chemicals -- be it medication or pollution -- may trigger the immune system to turn against the body," she says, noting that gold, mercury and industrial solvents all can cause auto-immune responses that could start the development of lupus.

However, warns Eleazar Garcia, medical doctor and coordinator of the Southeast Arizona Area Health Education Center, "The data that we have now is incomplete and doesn't show a clear link."

"There is definitely reason for concern because there seem to be more cases of lupus on the border, but it could be related to poverty or malnutrition which also are more common in the border region," he says.

In addition, "there is a lot of misinformation about lupus out there and many people do not even know that they have it," he explains. "Sometimes it is never diagnosed because some people with lupus symptoms avoid seeing a doctor because they fear that the disease may be AIDS and don't want to be stigmatized."

Nevertheless, here in Nogales, Arizona many lupus patients are convinced that their illness can be traced to industrial pollution from across the border.

Ana Acuna, a founding member of "Living Is For Everyone" (LIFE), an association of people with lupus set up to raise awareness of the disease, says she witnessed a growth in number of people with lupus after 1965, when the Mexican government began heavily promoting industrial growth along the border.

"Everyone in the community really welcomed the (maquiladora) plants... no one saw any smoke stacks, so we thought it was clean industry," Acuna recalls. "It was about this same time...when we began to see an upswing in the illness."