SAN DIEGO (AP) — The smell of rotten eggs permeates Steve Egger’s Southern California home, especially at night as the nearby Tijuana River foams up with sewage from Mexico before emptying into the Pacific Ocean.

Despite outfitting his home with a hospital-grade air filter, Egger, 72, and his wife suffer frequent headaches and respiratory issues related to the contaminated air. Most nights we breathe in a horrible stench,” he said. “It’s awful.”

Since 2018, over 100 billion gallons of raw sewage and industrial waste have contaminated the Tijuana River, a waterway that has been primarily neglected. Officials state that a collaborative cleanup agreement was signed last year between the U.S. and Mexico to address the issue, but the effects on local communities linger.

The river has been consistently blamed for causing significant health issues—recent studies find that as sewage flows increase, the number of patients suffering from respiratory ailments in the area surges by 130%

Environmental Protection Agency Administrator Lee Zeldin remarked, during a visit to San Diego in February, that resolution of the current health crisis will be a two-year endeavor. This is one of the nation’s worst and longest-running environmental problems, he said.

Scientists have measured dangerously high concentrations of hydrogen sulfide, a toxic gas emitted by sewage, which can cause major health problems. Local physicians have urged residents to consider relocating away from the affected areas.

California state lawmakers are considering prospective regulatory updates to deal with these pollutants, but there is skepticism regarding the speed of implementing effective standards.

When the standards were made, the focus was on nuisance, basically smell, but did not account for the serious health effects that we are now uncovering,” stated Democratic Sen. Steve Padilla.

The consensus is clear: change is vital, and ongoing advocacy from citizens like Egger and environmental groups may be crucial to safeguarding public health and restoring the Tijuana River.