Many people in the U.S. don’t worry if their water is safe to drink. I grew up in Colorado where the water always tastes fresh even straight out of the tap. I was never introduced to the concept of unsafe tap water until I visited the East Coast shortly after a mainline water break. We had to boil the water before we drank, cooked, or cleaned with it to ensure its safety. For the first time, I experienced what many Americans experience daily: insecurity in their water sources.
Per- and polyfluoroalkyl substances (PFAS) are chemicals used in many household items such as stain repellants, nonstick cookware, canned goods, and cleaning products, as well as in firefighting foam. It can also be found in 98% of Americans’ drinking water and though we’re still unsure of all the health effects of having PFAS in our bodies, there is a rising concern among environmental health professionals about the potential consequences of its presence. Current research reflects that PFAS accumulation in the human body can result in increased cholesterol levels, low infant birth rates, effects on the immune system, cancer, and thyroid hormone disruption.
On October 24, 2019, representatives of environmental and public health organizations and Capitol Hill staffers gathered for a Congressional briefing hosted by the National Environmental Health Association (NEHA) and co-sponsored by the American Public Health Association, National Association of County and City Health Officials, Association of State and Territorial Health Officials, and Association of Public Health Laboratories.
Congressional staffers are one of the most important links between researchers and our elected representatives. Therefore, the briefing aimed to educate staffers on the complexities of PFAS exposure in water so that they can call for stronger regulation for reducing exposures in their communities. Away from Capitol Hill, however, it’s the responsibility of the environmental health workforce to spread awareness and educate their communities about the risks of PFAS and best practices for minimizing risks. This endeavor should consist of a commitment to the strong regulation of main PFAS exposure sites to reduce PFAS consumption, as well as the utilization of multisectoral partnerships to address all segments of communities.
Dr. David Dyjack, NEHA executive director, introduced the three panelists and highlighted the importance of community-level interventions in improving health outcomes. “Public health is profoundly local,” he told the room.
Dr. Patrick Breysse, director of the National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, represented the federal perspective. He discussed water quality as a national security issue: when people are unable to access clean and safe water, the integrity of our societal systems are questioned. He pointed out that even if federal law is able to protect those using public water sources, others are left unprotected.
Dr. Christine Bean of New Hampshire’s Public Health Laboratories spoke on the difficulties of having chemical contaminants in private wells. Federal law protects those on public water sources through the establishment of maximum contaminant levels (i.e., acceptable levels of any given contaminant for human consumption). Private wells, however, are left unregulated, leaving 46% of New Hampshire’s residents vulnerable to PFAS and other contaminants, like arsenic, in their water.
Kent County, Michigan, faces a similar issue. Wolverine Worldwide, a Michigan-based shoe company known for its waterproof boots, spent decades disposing of Scotchgard stain-repellent waste in Kent County. The waste, which contained PFAS, leeched into private well water, remains there today and can expose residents to potential health hazards. Nearly 700 contaminated sites have been found throughout the region, especially in communities reliant on private well water.
Dr. Karla Black, an emergency preparedness coordinator at Kent County Health Department in Grand Rapids, Michigan, discussed the department’s concurrent efforts to both reduce PFAS exposure and study and minimize its health impacts on their residents. “We didn’t know about PFAS,” said Dr. Black. “We didn’t know what Scotchgard would potentially do.”
In order to address PFAS in private water sources, Kent County Health Department implemented a multistep, community partnership-based initiative to test water sources and identify health impacts in their residents. Phase one, an ongoing environmental investigation, looks for PFAS-contaminated sites and tests water sources. Phase two focuses on health, including an exposure assessment with blood draws and water testing. Dr. Black talked about how her department focuses on working directly with the affected population through community outreach. Population-based programs, whether they are testing the water or tracking health outcomes for those exposed, are a great way to help engage and educate community members while gathering data.
Dr. Breysse highlighted that the “burden of protecting small water systems falls on state and local health departments,” many of which are often underequipped to handle it. He used Flint, Michigan, as an example.
In 2014, the city of Flint decided to switch its water source from Detroit Water to the Flint River in an attempt to save money. Aging infrastructure, such as lead pipes and poor filtration systems, left residents without clean water and caused many health issues that residents still deal with today. Dr. Breysse pointed out the legacy of such a crisis: even though Flint’s lead levels in the water today are well below the federal standard, its residents still don’t trust their water. And that will take a long time to overcome.
The problem is similar in Kent County. Dr. Black described how, once residents found out their well water was contaminated with something that could make them sick, it changed the way they look at their situations. From whether or not they will be able to sell their house to what caused a family member’s illness, residents were forced to reevaluate their outcomes with the knowledge that their water could have been the cause.
Regardless of the contaminant, whether it’s lead, arsenic, or PFAS, people deserve access to water that is free of toxins that can make them sick. As members of the environmental health workforce, it is our responsibility to integrate community members in our efforts to reduce environmental exposures to toxins and to encourage political leaders to enforce strong regulation of such toxins. Our communities rely on us to be the voice of emerging research and to protect them, and we cannot do that unless we know about all of the potential threats.
For more information on the briefing, you can also read the American Public Health Association’s Public Health Newswire post by Louise Dettman. Also, NEHA staff member Ayana Jones recently attended the Environmental Health Matters Initiative’s workshop on reducing exposures to PFAS and has posted a blog on her experience. For more information on PFAS, potential sites of exposure, and how you can protect yourself and your communities, check out the U.S. Environmental Protection Agency’s PFAS factsheet and their web page dedicated to the topic.
Julianna Rohn is an intern with NEHA’s Program and Partnership Development team in Washington, DC.
She is a student at the University of Colorado Boulder, pursuing her bachelor’s degree in sociology and political science, with an emphasis in public health.