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Impact on Children of the Flint, MI Water Crisis

Photo credit : Brittany Greeson for The Washington Post

By Stephen Lester.

It is well understood how dangerous lead is to everyone especially children who are still growing and thus more susceptible to its toxic effects. Scientists have continued to find adverse effects from exposure to lower and lower levels of lead, leading some people to say that there is no known safe level of exposure to lead, especially for children. This evidence continued to grow this month when researchers from Princeton University, the University of Michigan and from a private research group in Cambridge, MA reported that children exposed to lead during the Flint (MI) lead crisis “suffered significant negative effects” on their academic outcome. They further reported that “we find compelling evidence that the FWC [Flint Water Crisis] reduced student math achievement and increased the rate of social needs classification.” Students (over the age of 5) with low socioeconomic status experienced the largest effects on math achievement, with boys suffering the largest effects on special needs classification.

Numerous studies referenced in this report have documented the adverse health effects of lead on children including increased behavioral problems, decreased executive functioning, decreased academic achievement, decreased brain volume, higher rates of crime offending, decreased social mobility and increased anxiety. This study adds to this knowledge and understanding by providing strong evidence that the relatively short exposure to lead in drinking water – about a year and a half – during the Flint Water Crisis had a significant impact on the educational outcomes of school-aged children in Flint.

The authors also discussed the many ways that a crisis such as the FWC impacts a community  that goes beyond the chemical exposures. Specifically, they discussed persistent psychological distress and trauma referencing the 1995 Oklahoma City bombing, the September 11 terrorist attacks, Hurricane Katrina, the DC sniper attacks among others. They made a convincing argument that “one cannot treat these crises as strictly medical phenomena.” It’s much more complex than that.

Lastly, the authors point out that the societal costs of the Flint Water Crisis which have been estimated to range from 50 to 400 million dollars are based on only the effects of lead exposure. They do not take into effect the impact of the psychological distress and trauma that the community goes through. They conclude that “Our results point toward the broad negative effects of the crisis on children and suggest that existing estimates may substantially underestimate the overall societal cost of the crisis.” They expressed hope that understanding the true costs of events such as Flint Water Crisis might help prevent the kind of thinking that led to the Flint crisis in the first place, a decision to switch the source of the city’s drinking water in order to save money – just 5 to 7 million dollars.


1 A. Reuben, M. L. Elliott, W. C. Abraham, J. Broadbent, R. M. Houts, D. Ireland, A. R. Knodt, R. Poulton, S. Ramrakha, A. R. Hariri, A. Caspi, T. E. Moffitt, Association of childhood lead exposure with MRI measurements of structural brain integrity in midlife. JAMA 324, 1970–1979 (2020).

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Unveiling the Impact: Working with Chemically Impacted Communities

By Jordan Martinez.

Since working with the Center for Health, Environment, and Justice, I have met and worked with Jami Wallace, President of the Unity Council for the East Palestine Train Derailment. I have found working with both Stephen Lester and Jami Wallace rewarding and impactful. As I got to learn about Jami, I also learned more about the tragic derailment and the health and policy issues her and her community have been facing, even a year after the event. I had heard about the EP train derailment in the news when it happened. However, after working with Jami, I’ve quickly realized the gravity of the situation and the prevalence of chemically impacted communities.

My interest in environmental health started from another one of my interests: neuroscience. I’m a student at Tufts University studying biopsychology, and the interactions between the brain and the environment are interesting to me. One week while participating in a journal club, I read a paper on Gulf War Illnesses, which are hypothesized to be caused by chemical exposure to sarin nerve gas on U.S. soldiers during the war. This got me interested in environmental causes of neurological disease. This interest was further fueled by Stephen Lester, after a visit to my university, where he talked about his experience working in Love Canal with Louis Gibbs. It’s a pleasure to now work alongside him.

In my work with Stephen, I create digestible science communication papers for residents in East Palestine, based on scientific research I find online. So far I have written about the environmental and health effects of burning lithium ion electric vehicle batteries, and I am currently writing about the effects of burning semolina, a type of wheat used to make pasta, couscous, and sweet puddings. Lithium batteries and semolina were purported to be in some of the train cars that caught on fire after the derailment, so writing these articles has helped answer questions for the residents of East Palestine about the toxic chemicals involved in their exposure.

For Jami and the residents of East Palestine, I’ve helped gather chemically impacted communities from around the country for the inaugural Chemically Impacted Communities’ Coalition meeting. I did research on chemically impacted communities worldwide, and from my research and reaching out to affected communities, I realized that two things each of these communities had in common was frustration due to a lack of being heard and exhaustion from the work they’ve been doing. After the first successful meeting, Jami, the Unity Council team and I have been working on a mission statement and getting the impacted communities together for a second meeting. However, while Jami seeks the support of other communities, she also fights a battle at home. She’s fighting a battle against corporate greed, which has influenced the government and politics of her area, minimized the real harm done to her community, and acted as a barrier to the work she’s doing for the community. It’s a challenge getting information out to government officials. When President Biden visited 2 weeks ago, even getting a letter out to him proved to be a challenge. But change is being made, even if it is a long process. And Jami and I have learned a lot from each other along the way.

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From Texas to New Jersey – The perilous transport of Vinyl Chloride that puts us all at risk

Photo source: https://www.post-gazette.com/local/2023/02/07/vinyl-chloride-east-palestine/stories/202302070109

By Leila Waid.

Recently, Toxic Free Future (TFF) released a research report on how much vinyl chloride is transported through the U.S. daily. Vinyl chloride is a carcinogenic chemical used to make PVC plastic products. Over the past year, vinyl chloride has constantly been mentioned in the news, partly due to the train derailment in East Palestine, Ohio, last February. The toxic burn of vinyl chloride and other hazardous material resulted in the immediate evacuation of residents within a one-mile radius and has plagued the community with fears and uncertainties about their health since then.

Notedly, the Norfolk Southern train derailment was not the only time a vinyl chloride contamination occurred due to a train accident. In 2012, Paulsboro, New Jersey, experienced a similar disaster. In that community, residents also faced exposure to vinyl chloride after a train accident occurred.

TFF set out to quantify how many people live in the vicinity of the trains that carry this toxic material every day. How many people live their day-to-day lives not realizing that the disasters that hit East Palestine and Paulsboro are not some far-away tragedy that couldn’t possibly happen to them but are instead closer to home than they could have ever imagined? TFF’s report highlights the shocking reality that many live near these train tracks where this toxic material is constantly being transported. The study analyzed the train route of OxyVinyls – a company that was involved in both of the train derailments discussed above – because they have the furthest distance between the procurement site, in Texas, and the PVC manufacturing plant, in New Jersey.

Shockingly, TFF’s report found that over three million individuals, of which 670,000 are children, live within a one-mile radius of the train routes carrying this extremely toxic chemical. Over one year, 1.5 billion pounds of the toxic chemical are carried across train tracks. And 36 million pounds of the chemical is being transported at any given point across the entirety of the U.S.

Of course, someone might think to argue, “I don’t live near the train tracks, so this doesn’t affect me.” However, even individuals not directly in the vicinity of the train tracks still experience adverse effects from the production and use of vinyl chloride. The first reason this affects everyone is that vinyl chloride production releases air pollution, which can travel great distances and cause various health issues. The second reason this issue should concern everyone is that vinyl chloride and PVC production releases over three metric tons of greenhouse gas, further exacerbating the climate crisis. Even the extraction process necessary for vinyl chloride is harmful to the environment. Hydrofracking has a variety of environmental contamination concerns and also releases methane – a potent greenhouse gas. Even abandoned fracking wells have been found to emit methane.

So, how do we address this issue? First, advocate your policymakers for stronger railroad regulations so that other accidents like those in East Palestine or Paulsboro do not occur. Second, pressure government action and stronger EPA regulation around vinyl chloride production. And third, vote with your wallet. Do not purchase materials made out of PVC plastic and pressure retail stores, such as the Home Depot, to phase out selling PVC products.

Click here for a link to the report.

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One Year Anniversary of the Train Derailment in East Palestine, OH

Photo credit: Abigail Bottar / Ideastream Public Media

By Leila Waid.

It’s hard to believe that it has already been one year since the Norfolk Southern train derailed in the small and quiet community of East Palestine, OH. The community members have faced uncertainty and fear of how their health has been impacted by the exposure to toxins, such as vinyl chloride, present at the burn site. Burning vinyl chloride can produce dioxins, a chemical that poses immense danger to human health. Over the year, many residents have spoken out about the health risks they are experiencing, such as increased asthma in their children, skin rashes, bleeding from the ears, and new diagnoses of cancer. Also, residents have pointed out how the train derailment has impacted them financially. One of the residents, Ashley McCollum, talked with ABC News about how she has been displaced from her home for the past year. Unfortunately, Norfolk Southern, who had been paying for her and her family to stay in a hotel, said they would no longer fund her accommodations. Now Ashley and other displaced residents have a hard choice to make – return to the community they believe will make them sick or come up with alternative living arrangements with their own finances.


This harsh abandonment that many residents have experienced feels all the more infuriating when considering how much Norfolk Southern has spent on lobbying. According to Public Citizen, “the company and its subsidiaries spent $2,340,000 lobbying the federal government in 2023 – up 30% from the $1,800,000 it spent the year before.” Interestingly, no new railroad safety legislation was passed by Congress after the Norfolk Southern train derailed. One would imagine that when such a severe accident occurs that threatens the health of thousands of people, the policymakers would immediately work in a bipartisan manner to make sure that such an accident never happens again. Notedly, both the House and the Senate introduced bills to increase railroad safety, but a year later, those bills have not moved forward. House of Representatives member Marcy Kaptur directly connects the lack of action by Congress on the bills to the lobbying being carried out by railroad companies, such as Norfolk Southern.


Without stricter regulation, who knows when and where the next derailment might occur and which American town could be the next East Palestine.

Frustrated by the lack of answers and support, the impacted community in East Palestine created the Unity Council for the East Palestine Train Derailment. One of the most recent actions the Council undertook was a “ceremony of solidarity,” an event held on the first anniversary of the train derailment to raise awareness about the suffering the community is still going through. The Council wanted to showcase to the country that what happened in their community could happen anywhere in the country.


The ceremony was conducted in partnership with We Refuse to Die, an environmental justice campaign utilizing art to communicate the message. Artists and activists have a long history of working together effectively to enact change. By moving people emotionally, artists can tap into the feelings and emotions of individuals that motivate them toward change. In this case, the campaign was focused on showcasing that, just because individuals in East Palestine may have been forgotten about by the railroad industry and politicians, they are still here and will continue to fight until they can rebuild what was stolen from them by the explosion.

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Planetary Health and Environmental Justice

Photo source: https://www.sciencedirect.com/science/article/pii/S2542519621001108

By Leila Waid.

Planetary health is a term used to define how human activity impacts the environment and, in turn, how those environmental changes impact human health. Utilizing a planetary health framework is essential for environmental health organizing because it uses a holistic approach to understanding the world and our place within it. The Planetary Health approach showcases that protecting our environment is not something we should do because it is simply the right thing, but we need to do it for our preservation and well-being. 

The air we breathe is littered with pollution from fossil-fuel industries. Even antibiotic resistance, a major emerging public health threat, has connections to air pollution. For example, a study found that PM2.5 (particulates in the air smaller than a strand of hair) contain antibiotic-resistant bacteria. Shockingly, the study found that “the magnitude of the contribution of PM2.5 to aggregate antibiotic resistance is greater than that of antibiotic use.”

Our waterways are full of plastics and PFAS, a group of forever chemicals that bioaccumulate in the body. The fish we consume are saturated with methylmercury due to humanmade activity, such as coal mining that dumps excess mercury into the waterways. And we keep pumping greenhouse gases into the environment, which causes warming and a disbalance in our delicate climate system. Interestingly, even the knowledge that we are driving the deterioration of the natural world causes stress and other mental health issues – a phenomenon coined “eco-anxiety.” On the other hand, being in nature does wonders for our mental health, such as decreasing anxiety and depression. 

So, what can be done? How can we keep our quality of life, with all our modern conveniences, while understanding that profound changes must be made to preserve the ecological world and our health? Two public health experts, Tong and Bambrick, weigh in on this issue in a peer-reviewed article, in which they provide four suggestions.

According to Tong and Bambrick, we first need to address the root cause of climate change globally and utilize different approaches based on regional and national contexts. Second, we must address environmental justice at all levels, from international to hyper-local. Third, we must understand that the entire world is interconnected, and we live in a “global village.” Our air and waterways do not have national boundaries, and the air pollution on one side of the world can eventually reach your backyard. Nowhere was this more apparent than the summer of 2023 on the east coast of the U.S. when the Canadian wildfire plume traveled south and made the air unbearably smoggy. The fourth, and final, suggestion states that we must take collective action at an international level. After all, these are not issues that one individual or country can tackle. Instead, we need to reimagine our way of life that is focused on being connected to our environment, respecting our limited natural resources, and protecting human health.

Planetary health lays out the vicious cycle that modern humans face. We have built our way of life not in tandem with the natural world but in its exclusion. And as a result, we face the health consequences of those choices. 

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It’s Time to Do Right by the People in East Palestine, OH – and Elsewhere

Photo credit: CNN

By Stephen Lester.

Nearly 10 months ago, a Norfolk Southern train with more than 150 cars, many of which contained toxic chemicals, derailed in East Palestine, OH. Thirty-eight of the train cars derailed and a decision was made by Norfolk Southern to burn the contents of 5 tanker cars containing vinyl chloride and other toxic chemicals. This unleashed a huge black cloud full of particulates that enveloped the surrounding neighborhoods and farms in both OH and PA.

Immediately after the burn, people in East Palestine began reporting adverse health symptoms including headaches, nose bleeds, skin rashes, central nervous symptoms, thyroid problems and more. These and other adverse health problems have continued to plague the residents of this rural midwestern town.

EPA immediately responded by telling people that everything was alright and there was no cause for alarm. EPA’s testing found no levels of “concern.” But the people in East Palestine could not accept this narrative because they knew things were not right. They knew the health effects they were suffering from were real. They knew that EPA was not telling them the truth.

If EPA were honest with the people at East Palestine, they would have told them that they didn’t understand why people were continuing to report so many illnesses while their data told them otherwise. But if EPA did acknowledge how little is known about the link between adverse health effects and exposures to mixtures of chemicals, the people of East Palestine would demand action in the face of these uncertainties. Actions like paying for relocations so that they can stop being exposed to the toxic chemicals that are still in the air and getting the health care they need to move on with their lives.

The people in East Palestine deserve better. So do hundreds of other communities across this country where people have similarly been exposed to low levels mixtures of toxic chemicals. It is clear from the situation in East Palestine that very little is known about how people respond to chemical exposures, especially to low level mixtures. This is evident when the EPA and other public health agencies who rely on traditional toxicology and risk assessment are telling the people of East Palestine that everything is safe when it clearly is not.

It’s time to acknowledge that the scientific understanding does not exist to explain what is happening to the health of the people in East Palestine. It’s time to recognize that we cannot rely on traditional toxicology to answer the questions people have about their exposures to low level chemical mixtures. It’s time to do the right thing by the people in East Palestine and by hundreds of communities across the U.S. where people are being exposed to low level mixtures of toxic chemicals. It’s time to acknowledge that the tools we have are not able to answer the questions people raise about their exposure to toxic chemicals and give people the relief they are asking for, whether it’s cleanup, relocation, health care or something else.   

It’s what the government did for the Vietnam veterans exposed to Agent Orange; for the atomic bomb victims exposed to radiation fallout; for the 9/11 first responders in New York City; for the soldiers exposed to burn-pit smoke in Iran and Afghanistan and other overseas locations; and for the Marines at Camp Lejeune, North Carolina who drank contaminated water. Do the people of East Palestine deserve anything less than the soldiers and first responders who protect this country?

In each of these instances, the government recognized that the science linking exposure and health outcomes was incomplete and instead of requiring proof of cause and effect, they said, “Enough, we will take care of our own.” They moved to a presumptive scientific approach that allowed veterans and first responders to  health care and other compensation. We should do the same for the people of East Palestine and in hundreds of other communities that have been exposed to low level mixtures of toxic chemicals.

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How Individual Sensitivity Affects Toxicity

Toxic Tuesdays

CHEJ highlights several toxic chemicals and the communities fighting to keep their citizens safe from harm.

How Individual Sensitivity Affects Toxicity

We previously addressed individual variability and how it affects a person’s response to toxic chemicals. Another important factor in toxicology is a person’s individual sensitivity to chemicals. How sensitive a person is to chemical exposure helps determine how susceptible or vulnerable they are to toxic chemicals. Several factors determine how sensitive a person is including age, sex, health, genetics, diet, lifestyle, preexisting conditions and previous environmental exposures. While some people are more sensitive to chemical exposures than others, there is no clear definition of what sensitivity is or what it means. This is partially since so little is understood about the human response to toxic chemicals, especially to low level mixtures of chemicals.

Because of this uncertainty, there is no generally accepted definition of sensitivity. Nicholas Ashford and Claudia Miller describe the various meanings of the term. In traditional toxicology, sensitivity has been defined as individuals who require relatively lower doses to induce a particular response. These individuals are considered more sensitive than people who require relatively higher doses to experience the same response. The distribution of this population is described by the classic bell curve where the sensitive and resilient populations are found in the tails of the curve. Most people fall into this response category. In traditional medicine, sensitivity has been defined as individuals who have a significant and rapid immune-mediated response to an allergen or agent. In this population, some individuals, described as chemically sensitive, have a striking immune response to an allergen or agent, while non-allergic individuals do not, even at high doses. Classic allergens include ragweed or bee venom, but also include chemicals such as nickel or toluene diisocyanate (TDI).

In recent years, a growing population of people have expressed an entirely different sensitivity response. These are people who have developed multiple chemical sensitivities. Ashford and Miller found that people who have developed multiple chemical sensitivities may exhibit a third and entirely different type of sensitivity. These authors stated this about people with multiple chemical sensitivities (MCS): “Their health problems often (but not always) appear to originate with some acute or traumatic exposure, after which the triggering of symptoms and observed sensitivities occur at very low levels of chemical exposure. The inducing chemical or substances may or may not be the same as the substances that thereafter provoke or ‘trigger’ responses.” Unlike classical toxicological or immune mediated responses, people with MCS sensitivity respond in a two-step process of an initial exposure event followed by a second triggering exposure. Much still needs to be understood about this third wave of sensitivity.  

Another factor that influences a person’s sensitivity is the body’s reserve capacity. Researchers have speculated that a chemical exposure may affect the reserve capacity of the body without causing an immediate adverse effect. However, when there are subsequent exposures, the body becomes unable to compensate for the additional stress and toxicity develops.

The science behind what is known about how people respond to chemical exposures, especially to low level mixtures of chemicals, is highly complex and not well understood. We know that people exposed to low level mixtures of toxic chemicals, like the people in East Palestine, OH, the site of that horrific train derailment and subsequent intentional burn of vinyl chloride, continue to suffer adverse health effects despite reassurances from EPA and public health agencies who are relying on traditional toxicology and risk assessments. Perhaps the people in East Palestine have developed a unique chemical sensitivity much like the third wave described by Ashford and Miller. So as their exposures continue during the ongoing cleanup, their chemical sensitivity and the subsequent adverse health responses are not what would be predicted by traditional toxicology or medical models. 

This is an important consideration to consider in East Palestine because it is clear that we do not understand what is happening to the health of the people there. It’s time to recognize that we cannot rely solely on traditional toxicology to address the questions people have about exposures to low level chemical mixtures.

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How AI Can Help Strengthen Grassroots Organizing

Image Credit: Tensorspark

By Gregory Kolen II.

Environmental justice is an issue that affects everyone, but those who bear the brunt of it are often the most vulnerable members of society. Disadvantaged communities, specifically, are often the ones living in areas with poor air quality, contaminated water sources, and unregulated disposal of waste. These challenges have been longstanding and difficult to overcome, as they require significant resources and political will. Yet, in recent years, emerging technologies such as Artificial Intelligence (AI) have emerged to support community leaders and organizations working towards environmental justice.

Boosting activism through data: AI can assess and analyze vast amounts of data to help grassroots organizers tailor their messaging based on the demographics, behavior, and attitudes of their target audience. By better understanding the needs of the communities they serve, organizers can create more effective and convincing campaigns that are more likely to drive action.

Streamlining operations: Organizers can improve the efficiency of their operations and decision-making processes, allowing them to work more effectively and achieve their goals more quickly. AI can help organizers automate routine tasks, which saves time and energy, allowing them to focus on more complicated tasks that require human expertise.

Amplifying voices: Magnify the voices of marginalized communities with AI-powered chatbots. Amplify the stories and experiences of those most affected by environmental injustices. This can help grassroots organizers build empathy and support for their causes among those in power, as well as among the broader public.

Improving outreach: Organizers can reach out to a more extensive and precisley targeted diverse audience. AI-powered tools can help create more targeted promotional materials and reach out to individuals who might not have been reached through traditional methods. This can help organizers increase the reach of their initiatives and attract more support.

Identifying environmental issues in communities: AI tools can help communities identify and monitor environmental hazards in their surroundings. For instance, using machine learning and remote sensing technologies, it is possible to map and classify toxic hotspots or areas with high pollution levels. Real-time air and water quality monitoring sensors can also provide early warning systems that allow communities to take the necessary precautions.

Empower communities through data and citizen science: Citizen science is an approach that empowers communities to gather data, conduct research, and create solutions. AI tools can help democratize scientific research by enabling communities to communicate their findings and analyses. Collectively, high-quality data can be used to ascertain environmental health disparities. For instance, EarthAI, a nonprofit organization, aims to provide equal access to AI-assisted satellite imagery, which can be used to map and track environmental health indicators.

Influencing Policies: AI tools can be used to predict the impact of policies on marginalized communities. For instance, researchers can use machine learning models to identify areas where environmental policy interventions are most needed, based on critical community characteristics and environmental hazards. Such data and insights can be shared with policymakers to develop effective policies that prioritize environmental justice.

There are numerous ways that emerging AI technology can be used to help strengthen grassroots organizing efforts for environmental justice. From boosting activism through data analysis to amplifying voices and improving outreach, AI has the potential to help empower grassroots organizers and create more profound change by identifying environmental hazards, empowering communities through data and citizen science, influencing policies, raising advocacy and awareness, and reducing disparities. While AI is not a magic solution, it has the potential to create a pathway towards a more just future and better outcomes for all communities.

Additional information:

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Health Effects of PFAS in Drinking Water

The glass is always... we're screwed comic.
Image credit: Jim Morissey

By Leila Waid.

As a research project for a university course, I conducted a literature review and systematic analysis of the health effects of PFAS in drinking water. This blog post contains a highlight and broad overview of the health effects discovered.

The systematic analysis included 44 observational epidemiological studies focused on PFAS-contaminated water as the exposure and adverse health effects as the outcome of interest. (For inquiries, references to individual studies, or any other information about the information about the systematic review study, email info@chej.org).

The results:

PFAS in drinking water is associated with a variety of different health effects. However, it is important to note that the results included here do not prove causation. In other words, the studies cannot prove that PFAS caused these health issues, only that an increase in PFAS exposure is associated with these health effects.

  • Cardiovascular health: increase in “bad” cholesterol, triglyceride lipids, blood pressure, hypertensive pregnancy disorder.
  • Hormonal health (endocrine system): impaired thyroid function, disruption in the growth hormone IGF-1 in children, lower levels of estradiol and testosterone, increase in Poly-Cystic Ovary Syndrome, fibroids, and testicular cancer.
  • Immune health: increase in adverse health effects from COVID-19, disruption in inflammation production, lower immune cell count and production, increase in ulcerative colitis (stomach ulcers).
  • Urinary system health: kidney function impairment, kidney cancer, bladder cancer
  • Digestive system: esophageal cancer.
  • Neonatal (infant) health: lower birthweight and small for gestational age.
  • PFAS has also been found to cause epigenetic changes, which is a process through which our environment impacts how our genes are expressed. In other words, it does not change the actual DNA structure, but how the body reads the DNA sequence. Specifically, PFAS is associated with DNA methylation (a process through which chemicals attach to a DNA chain and turn a specific gene on or off. This process affects how the gene is read).
  • Mortality: exposure to PFAS associated with all-cause mortality, as well as mortalities from liver cancer, cerebrovascular disease, diabetes, myocardial infarction, kidney cancer, breast cancer, and Alzheimer’s disease.
  • Neurological system: developmental language disorder.
  • Skeletal system: increase in bone fractures (hip, proximal humeral, and distal forearm fractures).
  • Non-regional specific: mesothelioma cancer (affects tissues around organs), increase in multi-morbidity (multiple chronic morbidities occurring at the same time).
  • Mental health: increased anxiety, financial stress around health issues, emotional distress due to worrying about living in PFAS-contaminated region. Also, PFAS was associated with an increase in behavioral problems among children. 

It is important to note that all the adverse health effects discussed above were found from observational studies on human health, not animal or in vitro (cell) studies. Although the findings cannot prove causation, they still paint an alarming picture for human health. The results showcase that urgent and robust policy action is needed at the federal and state levels to protect our waterways from PFAS contamination. This situation is critical because almost half (45%) of all tap water systems in the U.S. have PFAS contamination. And one study found that an estimated 97% of all Americans have PFAS in their blood streams.

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Metals & Preterm Births

Toxic Tuesdays

CHEJ highlights several toxic chemicals and the communities fighting to keep their citizens safe from harm.

Metals & Preterm Births

Over 10% of births worldwide are preterm, meaning delivery occurs earlier than 37 weeks of pregnancy. It is a leading cause of neonatal mortality, and evidence suggests that exposure to heavy metals from the environment could be a risk factor. In the US, a major source of exposure to metals is private well water. The Environmental Protection Agency (EPA) sets standards and regulates levels of contaminants in public drinking water, but private well water isn’t regulated. This means private well water – which 13% of the US population receives drinking water from – is vulnerable to contamination. Indeed, studies have found metal contamination in private wells and that people who receive drinking water from private wells have more of these metals in their systems.

A recently published study set out to evaluate if exposure to toxic metals from private well water increased the risk of preterm birth. Because North Carolina (NC) has the largest state population using private well water, the researchers studied live births in NC that occurred from 2003-2015. From birth certificates, they could collect each pregnant person’s address at the time they delivered their babies. The researchers also used the NC-WELL database, which is a database of over 100,000 geocoded well water tests conducted from 1998-2019 from almost all census tracts in North Carolina. These tests include measurements of the concentrations of metals. The NC-WELL database allowed the researchers to assign each pregnant person’s address an estimate of their exposure to private well water and the concentrations of metals measured in that well water. Ultimately, the study included over 1.3 million births. This large sample size allowed the researchers to determine if increased metals in well water was associated with preterm birth.

The study found that people living in census tracts where over 25% of NC-WELL water tests exceeded EPA’s safe standard for cadmium had 11% higher odds of preterm birth than people who did not. People living in census tracts where over 25% of NC-WELL water tests exceeded EPA’s safe standard for lead had 10% higher odds of preterm birth than people who did not. These results indicate that cadmium and lead in private well water were each associated with preterm birth.

The study then modeled how the exposure to mixtures of metals was associated with preterm birth. This is particularly important because few studies assess the risks of multiple chemical exposures, even though it is highly likely people are exposed to more than one chemical at a time. When considering exposure to a mixture of seven metals present in private well water, the researchers found that exposure to the combination of cadmium and lead was associated with preterm birth.

In the US and NC, Black and Native American people have much higher rates of preterm birth than white people. Racial disparities in exposure to toxic chemicals could influence racial disparities in birth outcomes. As the study states plainly, “This is especially pertinent to consider when evaluating private well water-based exposure in NC, as structural environmental racism has led to poor and minority communities being more likely to rely on private well water.” This study found that when considering exposure to a mixture of seven metals present in private well water, the effect on preterm birth was most extreme for Native American people. It was associated with 20% higher odds of preterm birth for Native American people. The researchers say this disproportionate effect of metal exposure on preterm birth reflects the multiple environmental hazards and contaminants disproportionately forced on Native American people over several centuries. They also note that other studies have found that Native American pregnant people have higher levels of toxic metals in their systems than the national average.

This study used publicly available birth information and private well water testing to create a large cohort to study the effects of metals in private well water on preterm birth. The results make clear that private well water needs more regulation in order to ensure the levels of dangerous metals like cadmium and lead do not put people at risk. The results also make clear that not all people bear the same risks of exposure or health effects of exposure. People of color bear a disproportionate burden because they are more likely to receive private well water, which may contribute to disproportionate rates of preterm births.

For more information, CHEJ has previously written about the health effects of leadcadmium, and the importance of considering the health effects of exposure to mixtures of chemicals.

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