Congressman José E. Serrano

Representing the 15th District of New York

Congressman Serrano Leads Letter on Alarming Rise in Asthma Cases in Puerto Rico

Aug 9, 2018
Press Release
Doctors in Puerto Rico See Increase in Cases and Worsening Symptoms Following Devastating Hurricanes

Washington, D.C. – Today, Congressman José E. Serrano (D-NY) led a letter with 29 members of Congress to U.S. Health and Human Services Secretary Alex Acosta and U.S. Environmental Protection Agency Acting Administrator Andrew Wheeler on recent reports of skyrocketing asthma cases and worsening asthma symptoms in Puerto Rico following the aftermath of Hurricanes Irma and Maria more than 10 months ago. The letter is a request for information on the federal government’s response to the growing threat of an asthma crisis on the island in order to take appropriate Congressional action.

“Puerto Rico is not new to the threat of asthma. More than 415,000 Puerto Ricans on the island live with the chronic disease. However, what we are hearing from doctors on the island is a cause for great concern,” said Congressman Serrano. “Damaged homes and buildings still in need of repair are a breeding ground for mold spores and other pests that trigger asthma symptoms. The prolonged use of gas- and diesel-powered generators that power many buildings as the island continues to cope with an unstable electrical grid are spewing toxins that make the air difficult to breathe. Meanwhile, the number of doctors on the island is shrinking and access to quality health care is more limited every day. The pace of recovery has been unacceptably slow, and we fear that it may be leading to another public health crisis. Congress needs to know what the federal government is doing, or plans to do, to address this matter in a timely manner.”

A recent article in the Associated Press, Puerto Rico struggles with jump in asthma cases post-Maria, reported that many doctors are seeing an alarming number of new asthma cases and individuals are experiencing more severe symptoms since the hurricanes devastated the island last September. The article highlights the many side effects of the storm’s lasting damage and slow pace of recovery as potential reasons for the increasing cases. The federal government must continue being responsive to the needs of Puerto Ricans as they continue on the long road to full recovery.  

Members of Congress joining Congressman Serrano’s letter include: Joseph Crowley (NY-14), Adriano Espaillat (NY-13), Nanette Diaz Barragán (CA-44), Kathy Castor (FL-14), Nydia M. Velázquez (NY-07), Eleanor Holmes Norton (DC-At Large), Yvette D. Clarke (NY-09), Raúl M. Grijalva (AZ-03), Luis V. Gutiérrez (IL-04), Pramila Jayapal, Lucille Roybal-Allard (CA-40), Sean Patrick Maloney (NY-18), Al Green (TX-09), Carolyn B. Maloney (NY-12), Janice D. Schakowsky (IL-09), Dwight Evans (PA-02), Donald M. Payne, Jr. (NJ-10), James P. McGovern, Eliot L. Engel (NY-16), Richard E. Neal (MA-01), Brian Higgins (NY-26), Jacky Rosen (NY-03), Debbie Wasserman Schultz (FL-23), Barbara Lee (CA-13), Colleen Hanabusa (HI-01), Madeleine Z. Bordallo (GU-At Large), Donald Norcross (NJ-01), Alcee L. Hastings (FL-20), and Grace Meng (NY-06).

Full text of the letter below and attached:

August 6, 2018

The Honorable Alex M. Azar II


U.S. Department of Health and Human Services

200 Independence Avenue, SW

Washington, D.C. 20201

The Honorable Andrew Wheeler

Acting Administrator

U.S. Environmental Protection Agency

1200 Pennsylvania Avenue, NW

Washington, D.C. 20460

Dear Secretary Azar and Acting Administrator Wheeler:

We write to you regarding the federal response to the alarming increase in asthma cases in Puerto Rico in the aftermath of Hurricanes Maria and Irma recently detailed in media reports.[1] Doctors have also indicated that symptoms have become more severe for those already living with this chronic disease.[2

As you know, asthma rates on the island have been disproportionately high for some time. The Puerto Rican Department of Health estimates that more than 415,000 people on the island live with asthma.[3] However, while the disease may be manageable for most individuals, we fear that many of the persistent problems the island faces as it continues in its recovery efforts have created an environment that is making matters worse for those affected by asthma and other chronic upper respiratory illnesses.

Many parts of Puerto Rico, including the surrounding islands of Culebra and Vieques, continue using gas- and diesel-powered generators as a main source of energy while power remains unstable.[4] In many parts of the island, power is still not available since Hurricane Maria hit nearly 10 months ago.[5] The fumes from generators clustered around sensitive locations like churches, hospitals, apartment buildings, homes, and schools are exposing children and families to toxins that can affect breathing and induce asthma attacks. [6]

In addition, reports also indicate that many families live in homes or near buildings damaged by the storms, where mold spores continue growing because of the lack of proper treatment and slow pace of repair.[7] Debris and waste that remains piled near vacant buildings and along many roadsides have become home to vermin and other pests that trigger asthma symptoms.

Overall, many factors, including the island’s tropical climate, have made this crisis much worse for tens of thousands of Puerto Ricans. Therefore, we request more information about the federal government’s efforts to address these valid health concerns during continued recovery efforts.

To better understand the state of the current situation in Puerto Rico and take Congressional action accordingly, we ask for a thorough response to the following questions as soon as possible:

  1. What disaster aid dollars from FEMA, HHS, or elsewhere have you dedicated to mitigating the effect of the 2017 hurricane season and its aftermath on chronic diseases, including asthma? Please provide a list of agency programs and funding dedicated to this issue.
  2. What actions have you taken to date to address these issues?
  3. Has the EPA or CDC, in consultation with Puerto Rican health officials, conducted air quality assessments in the aftermath of the storm? If so, what were the results? How often have those assessments taken place?
  4. Has FEMA or HHS conducted mold, mildew, and pest mitigation in homes or other structures to minimize the growth of mold spores and other irritants that spur asthma attacks and symptoms?
  5. How widespread is generator-use in Puerto Rico currently? Have these generators met all safety and environmental standards? Please provide any agency data demonstrating generators are in compliance with all applicable standards.
  6. What information have citizens received to help control and minimize the severity of asthma symptoms?
  7. What, if any, barriers are you facing in addressing these concerns?
  8. What current programs are in place to mitigate the causes of increased asthma rates and attack severity going forward?  Please provide a list of programs and the number of agency FTEs working on these programs.

As members of Congress, we have a responsibility to make sure the federal government does not forget about our fellow Americans in Puerto Rico as they continue to recover. We ask that, in addition to responding to the stated questions above, you continue to keep our offices fully informed of continued recovery efforts.

Thank you for your attention to this request, and we look forward to your prompt response.



Congressman José E. Serrano has represented The Bronx in Congress since 1990.  He is a Senior member of the House Appropriations Committee. 

[1]  Associated Press. “Puerto Rico struggles with jump in asthma cases post-Maria.” June 18, 2018.

[2] The Weather Channel. Asthma Cases Spike in Puerto Rico Post-Hurricane Maria. June 20, 2018.

[3] Puerto Rico Department of Health. Asthma Burden Report: Puerto Rico Asthma Program. 2014.

[4] U.S. News and World Report. “Puerto Ricans Regain Power, but Fear for Long Term.” Associated Press. July 16, 2018.

[5] Id.

[6] NPR. “In Puerto Rico, Generators Divide Those With and Those Without. October 15, 2017.

[7] McCabe, Coco. “In Puerto Rico, a shortage of tarps and electricity means the misery continues for storm-weary people. Oxfam. October 18, 2018.