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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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The Rachel Carson Amendment

Our colleague and friend Lou Zeller at the Blue Ridge Environmental League (BREDL) shared an article he wrote a few years back about the great pioneer Rachel Carson who wrote in her epic 1962 classic Silent Spring that “If the Bill of Rights contains no guarantee that a citizen shall be secure against lethal poisons distributed either by private individuals or by public officials, it is surely only because our forefathers despite their considerable wisdom and foresight, could conceive of no such problem.”
Lou continued. “The public outcry created by Silent Spring led to a ban on DDT from agricultural use in 1972. However, today the industrial use of poisonous substances continues almost unabated, based on regulatory risk assessments and legally acceptable death rates. For example, retail shops are still permitted to dry-clean cloths with perchloroethylene, a carcinogenic solvent, even though non-toxic alternatives are available. Household hand cleaners laced with toxic Triclosan contaminate wastewater and sewage sludge deposited on farm fields as fertilizer. Nuclear power plants routinely spew radioactive Tritium into the air and water. And chemical giant Monsanto sells the weed-killer Roundup to farmers and homeowners—components of which are carcinogenic and known to damage the liver, kidney, brain and lungs. The list goes on.
“How can it be that after the passage of two generations we have let this continue?  Worse, a new natural gas extraction industry—cracking underground rock with high-pressure chemicals and water—exempts itself from the few environmental, public health and safety laws still on the books. It is indeed a strange blight creeping over the land.
“The Fifth Amendment to the US Constitution states, ‘No person shall…be deprived of life, liberty, or property, without due process of law.’  The Fourteenth Amendment adds that the States may not, ‘deny to any person within its jurisdiction the equal protection of the laws.’ Rachel Carson’s Fable for Tomorrow painted a grim picture, but it was meant to prompt action.  In part, she succeeded.  But it remains to us to ensure that the next forty years complete the changes necessary so our legacy to future generations is not a silent spring.  Either the fundamental principles established under the Constitution mean what they say, or Rachel Carson’s admonition should become the 28th Amendment to the Constitution.”
I think Lou is onto something. What do you think?

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Trump Administration Narrows Water Protections: Increases Risks of Drinking Water Contamination

The EPA redefined protections of water through its new navigable waters rule on June 22, one that largely cuts out storm water runoff from being regulated by the EPA. This change could have a large detrimental impact on drinking water quality in areas and could therefore result in greater human health risks. Thus far, the new rule went into effect in all states except Colorado, where a federal judge in Colorado was able to block the Trump administration’s narrowing definition of water protections. Read More
Photo by Suhel Nadaf on Unsplash

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New Jersey Increases PFAS Regulations to Help Make Drinking Water Safer

On Monday, June 1st, New Jersey became one of the few states in the US to regulate two specific types of PFAS—Perfluorooctanoic acid (PFOA) and perfluoroalkyl sulfonic acid (PFOS) —that are known to be cancer-causing chemicals that contaminate drinking water. The chemicals are often found in nonstick cookware, waterproof apparel, and firefighting foam and have been tied to cancers and immune system issues. New Hampshire, Vermont, and New Jersey are currently the only states that regulate PFOA and PFOS in drinking water systems. This step to better ensure the environmental safety of drinking water is one that needs to be instituted throughout other states. Read More

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Finding a Safe Replacement for PFAS

PFAS is a forever chemical that is commonly used in flame retardants and fire fighting foams. The toxic chemical is known to cause hormonal changes, decrease fertility, weaken immune systems, and increase risks of cancer. States across the country have worked to ban the use of the chemical that is now found in all major U.S. bodies of water. Companies are working to find suitable replacement for the chemical in fire fighting foams with concern of substituting one hazardous pollutant for another. Read More.

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Staying Home Isn’t Safe When Surrounded by Pollution

I look out my window every day and see that plant putting out black smoke, dark clouds of smoke. And now we’ve got this virus going on. I joke we’ve got a double whammy going on, but this is serious. We were in battle over here. We’ve got a war going on. Keisha Bowns interview with Katherine Webb-Hehn a freelance multimedia journalist in the South.
 

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Equitable and Just Economic Stimulus Spending – Sign on

Recommendations for Equitable and Just Economic Stimulus Spending in Response to the COVID-19 Pandemic
As Congress considers legislation to address the growing public health and economic crises caused by the COVID-19 pandemic, the principles of justice and equity must be centered in the response. Environmental justice communities, Tribal communities, low income communities and communities of color are hit hardest by economic downturns and must be prioritized. Members of these communities are particularly vulnerable to COVID-19 because they are often exposed to disproportionately high levels of pollution and have underlying health conditions, such as asthma, diabetes and cancer.
Congress must also ensure that the pathway for economic recovery works for everyone and that the benefits of a stimulus package are distributed equitably and justly. In addition, stimulus legislation must include safeguards to ensure that stimulus dollars are spent in ways that comply with environmental regulations to avoid increasing public health and safety risks. Projects supported by stimulus legislation should reduce locally harmful air pollution in communities coping with the cumulative impacts of multiple pollution sources. Companies receiving stimulus support with facilities located in or near low-income neighborhoods, tribal communities and communities must significantly reduce locally harmful pollution, such as airborne particulate matter, in these communities.
To safeguard environmental justice communities, Tribal communities, low-income communities, and communities of color, Congress must include in economic stimulus legislation the spending priorities recommended below.
WATER
Access to affordable clean water is critical, especially as households nationwide respond to the COVID-19 pandemic. We recommend the following specific actions and funding:
Immediately implement a national moratorium on water shutoffs for all households. Fund $100 million for the immediate restoration of all residential water services.
Include $25 million for immediate potable water distribution, filter installation and sanitation systems for homes without access to these necessities. Spending should prioritize urban, rural, and Tribal communities who currently lack access to safe drinking water and adequate water and sanitation systems.
Include $45 million in grants and technical assistance dollars for the replacement of both household plumbing and lead services lines. Spending should prioritize households’ whose plumbing systems have been corroded by municipal drinking water systems, such as in Flint, Michigan. This should also allow for home waters filters for contaminants including but not limited to lead and PFAS. Trust in municipal water systems must be rebuilt.
Include $150 million to establish three Community Water and Energy Resource Centers (CWERCs) in Michigan. CWERCs will resolve many ratepayer, infrastructure, and environmental issues to improve Michigan’s essential freshwater resources through a decentralized approach to water treatment and infrastructure.
Fund $30 billion for the Drinking Water State Revolving Fund and the Clean Water State Revolving Fund. These funds support investments in infrastructure and programs that are essential to providing safe and affordable drinking water to communities, protecting water systems, managing waste- and stormwater, building climate resilience and expanding economic opportunities for low-income communities and communities of color. The American Society of Civil Engineers gave U.S. drinking water and wastewater infrastructure “D” and “D+” grades, respectively, and estimates that the investment gap for these critical systems will reach $105 billion by 2025.
ENERGY
Households must have access to affordable, reliable and sustainable electricity to ensure public health and safety and to support an inclusive, just and pollution-free energy economy with high-quality jobs. We recommend funding for the following programs:
Fund $3.2 billion for the Energy Efficiency and Conservation Block Grant (EECBG) Program. According to DOE’s Office of Energy Efficiency and Renewable Energy, “Through the 2009 American Recovery and Reinvestment Act (Recovery Act), the U.S. Department of Energy’s (DOE’s) Energy Efficiency and Conservation Block Grant (EECBG) Program provided $3.2 billion in block grants to cities, communities, states, U.S. territories, and Indian tribes to develop, promote, implement, and manage energy efficiency and conservation projects that ultimately created jobs.” Economic stimulus legislation should provide $3.2 billion to the EECBG program. The EECBG program should prioritize spending in communities left behind by past and ongoing energy efficiency programs.
Fund $7 billion for the Low Income Home Energy Assistance Program. LIHEAP assists families with energy costs related to energy bills and weatherization and energy-related home minor repairs. Stimulus legislation should include $7 billion for LIHEAP.
Fund $7 billion for the Weatherization Assistance Program (WAP). WAP provides weatherization for low-income households, leading to $238 or more in average savings on energy costs. WAP lowers energy bills for mid- and low-income families by supporting home energy efficiency improvements and supports clean energy jobs. Every year the requests for WAP support far exceed the funds available, leaving many households without the support they need to improve their energy efficiency and reduce energy costs. Congress should include $7 billion for WAP in stimulus legislation and strengthen the program to better reach and serve low-income families.
POLLUTION FREE TRANSPORTATION AND GOODS MOVEMENT
Existing federal programs, with adequate funding, can substantially reduce air pollution from transportation and goods movement. These programs provide critical funds to shift fleets and equipment from diesel to zero emissions, while improving air quality and public health. We recommend that Congress supporting the following programs:
Fund $500 million annually for Federal Transit Administration’s Low or No Emissions Vehicle Program.
Fund $500 million annually for the Diesel Emissions Reductions Act (DERA) and prioritize zero emissions replacement equipment.
Prioritize programs for communities confronted with the cumulative impacts of disproportionately high levels of pollution.
SAFE, HEALTHY AND POLLUTION-FREE COMMUNITIES
To build safe and healthy communities and infrastructure, we recommend that Congress fund the following programs:
Fund $100 million for the National Institute of Environmental Health Science (NIEHS) Environmental Career Worker Training. The NIEHS Environmental Career Worker Training Program (ECWTP) provides job and safety training for disadvantaged and underrepresented members of communities of color and low-income communities to secure jobs in environmental restoration, construction, handling hazardous materials and waste, and emergency response. A 2015 report assessing the program found that “an annual federal investment of $3.5 million in the ECWTP generates a $100 million return.” The report found that the program increases the earning potential of those trained, increases tax revenue, lowers workplace injury and hiring costs, and reduces crime..
Fund $6 billion for the EPA Environmental Justice Small Grants (EJSG) Program. This program provides small grants to communities to address environmental risks associated with high concentrations of pollution, to prepare for climate change effects, and to improve public health. In 2019, the EJSG program provided roughly $1.5 million for one-year grants of up to $30,000 each. Given the disproportionate exposure to high levels of pollution, climate change effects and other impacts of historic economic and racial inequality, these grants provide critical resources to low-income communities, tribal communities and communities of color to improve community health and support job creation. Congress should increase the annual funding for the EJSG program to $6 billion, increase the grant size to up to $500,000, and increase the grant period from one to two years.
Fund $20 billion for Superfund Site Cleanup to protect communities from toxic pollution. Hurricanes Harvey, Florence, and Maria spotlighted the elevated public health and safety risks that Superfund sites pose to communities. Superfund cleanup spending is crucial to protect the 53 million people living within three miles of the existing 1,836 Superfund sites. Stimulus legislation should increase Superfund site cleanup funding to $20 billion.
Fund $560 million for EPA to enforce environmental regulations. Industrial facilities and other companies must continue to comply with environmental regulations to avoid increasing public health and safety risks at a time when public health is already threatened by the corona virus pandemic. To protect public health and safety and hold companies accountable when they violate environmental regulations, Congress should provide $560 million for EPA to ensure compliance and enforcement with environmental regulations.
Fund $30 billion for Community Development Block Grants (CDBG). The CDBG program provides grants to states to support community development and address economic and public health challenges created by historic racial and economic inequality. CDBG grants support construction of affordable housing, programs to create economic opportunities and jobs, services for those in need, job creation, and improvement of community living conditions and quality of life. In light of current public health and safety risks, Congress should provide $30 billion for CDBG to support equitable and just community development and access to safe, affordable, resilient and energy efficient housing.
Fund $2 billion for Brownfields Redevelopment. EPA’s Brownfields Program supports economic redevelopment by helping states and communities safely clean up and sustainably reuse former industrial and contaminated sites. Congress should increase the FY 2019 annual appropriation of $250 million for EPA’s Brownfields redevelopment program to $2 billion to support economic development and sustainable approaches to local land use. This program should be implemented through community-driven planning that protects against community displacement.
CUMULATIVE IMPACTS
Environmental regulation does not necessarily mean healthy environments for all communities. Many communities suffer from the cumulative effects of multiple pollution sources. National climate legislation must not abandon or diminish the important goal of reducing toxic pollution in all its forms. The stimulus is an important opportunity for an innovative and comprehensive approach to reducing legacy environmental and economic impacts on communities and be designed intentionally to ensure that it does not impose further risks. Therefore all the items noted above, should integrate criteria and mechanisms for prioritizing those communities which are the most vulnerable economically and environmentally.
 
SIGN ON TO THIS LETTER URGING CONGRESS TO SUPPORT COMMUNITIES at this link.

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EPA suspends enforcement of environmental laws amid coronavirus

This is essentially a nationwide waiver of environmental rules. Communities around these chemical plants and refineries now have one more threat to their health and well-being. If no one is watching and there is no financial or legal consequences for dumping toxic chemicals into the air, water and land this country has another crisis lurking in the near future.
Houston, Texas has at least six major chemical fires since last March, incidents that killed three workers, injured dozens, exposed thousands to pollutants and, in the case of the Watson Grinding blast, may cost dozens of residents their homes. That was when the industries were monitored and had to abide by the laws.   Read more.

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Military bases contaminated by “forever chemicals”

The Environmental Working Group (EWG) analyzed the presence of “forever chemicals” in the drinking water on military bases. In a report released in February, the Pentagon revealed that over 600 military sites and surround communities could have drinking water contaminated by a “forever chemical,” including PFAS. As a part of the worst sites, the EWG examined the contamination at Fort Bragg in North Carolina, West Point Military Academy in New York and Yuma Proving Ground in Arizona.
Although none of the sites exceed the EPA’s health advisory level for PFAS at 70 parts per trillion, some sites do exceed the lower levels set for “forever chemical” by certain states. Read More.

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Juliette, Georgia Gets Answers on Water Contamination

Residents of Juliette, Georgia have received answers to what has been contaminating their drinking water. A coal ash pond at the Georgia Power’s Plant Scherer is contaminated with hexavalent chromium, a cancer causing heavy metal. The pond is partially connected to an aquifer that supplies some of the community’s drinking water.
Water testing revealed levels of hexavalent chromium in Juliette that is 500 times the health advisory limit in California and 150 times the limit in North Carolina. Georgia does not have limit and the EPA has not yet determined a guideline for the human toxicity limit for hexavalent chromium. Therefore, the contamination and poisoning of Georgia residents from this cancerous metal is currently considered legal. Read More.