State and Federal Actions to Protect Communities from Toxic PFAS Chemicals

April 10, 2019|4:36 p.m.| ASTHO Staff

John WiesmanPatrick-BreysseIn recent years, the public health community has focused more attention on per- and polyfluoroalkyl substances, or PFAS. After several high-profile lawsuits in Minnesota and West Virginia thrust environmental PFAS contamination and human exposure issues into the national spotlight, the public became understandably concerned, demanding action from elected officials and governmental public health agencies. Environmental PFAS contamination is a complex issue that requires leadership and input from multiple stakeholder groups, including local, state, and federal public health agencies, elected officials, the public, and industry.

PFAS are a group of synthetic compounds that are widely used in many different consumer commodities, including non-stick cookware, stain resistant fabrics, and some firefighting foams. Because they are designed to resist grease, water, and oil, these chemicals persist for long periods of time in the environment—in the soil, water, and air. Lately, national attention to PFAS has centered on contaminated drinking water, but PFAS can also be found in food, including fish. Most people have been exposed to PFAS in the United States, which is cause for concern due to the unhealthy side effects sometimes associated with exposure, including problems during pregnancy, hormonal fluctuations, high cholesterol, immune disorders, behavioral and learning issues among children, and elevated cancer risk.

Given the potential health risks and widespread documented exposures to PFAS, federal public health agencies are moving to address these chemicals through several recent actions, outlined below.

In 2016, the U.S. Environmental Protection Agency (EPA) published its PFOA/PFOS drinking water health advisories to help federal, state, and local officials assess the risks from contaminants in drinking water. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) are two of the most commonly investigated and discussed PFAS. Namely, these health advisories set the combined concentration of PFOA and PFOS in drinking water at which deleterious health effects are not anticipated to occur over a lifetime. More recently, EPA released its action plan for PFAS, which outlines various short- and long-term actions to protect public health from PFAS exposures. Examples include creating toxicity values for perfluorobutane sulfonic acid and GenX, releasing a draft regulatory determination for the creation of a legally enforceable maximum contaminant level for PFOA and PFOS by the end of 2019, and commencing work to list PFOA and PFOS as hazardous substances under the Comprehensive Environmental Response, Compensation, and Liability Act.

State and territorial health departments should also take note of EPA’s plans to create a risk communication toolbox this year. Risk communication concerning PFAS presents unique challenges to health departments. Because there is no legally enforceable federal drinking water standard for PFAS, states often grapple with how to navigate the issues that arise when the public sees a discrepancy between state advisories or regulatory standards and EPA’s health advisories. PFAS risk communication continues to be an important priority for state and territorial health departments.

CDC/ATSDR has also been busy addressing issues related to environmental PFAS contamination and human exposures. ATSDR released a draft toxicological profile for perfluoroalkyls for public comment, and CDC/ATSDR also released the PFAS Exposure Assessment Technical Tools (PEATT), an eight-step protocol for assessing a community’s exposure to specific PFAS compounds through drinking water. In 2018, the Pennsylvania Department of Health and the New York State Department of Health piloted these tools with the goal of improving how states and territories use the PEATT to measure and evaluate community exposures to PFAS in drinking water. These pilot sites provided CDC/ATSDR with practical, actionable feedback to improve the PEATT, and data from these projects will inform CDC/ATSDR’s additional exposure assessments in communities across the United States.

This initiative will deepen our understanding of PFAS as a public health issue, says Patrick Breysse, director of CDC’s National Center for Environmental Health and ATSDR. “The exposure assessments will provide valuable information to determine what is needed to assess PFAS drinking water exposures in communities. They will also help participants and their communities better understand their exposure to PFAS,” he explains. People in each of these communities will be selected randomly to participate in these exposure assessments, which are located near current or former military installations where PFAS-containing products are widespread. According to Breysse, the assessments will also generate information about the pathways of exposure in communities, which can inform future studies evaluating the impact of PFAS on human health.

Breysse elaborated on why the results from these exposure assessments are important to conversations about PFAS drinking water contamination, citing them as one of the first steps ATSDR is taking to address PFAS exposure through drinking water. “The benefits of the exposure assessments will extend beyond the communities identified, as the lessons learned can also be applied to communities facing similar PFAS drinking water exposures and be used by public health professionals across the nation to help communities impacted by PFAS exposure,” says Breysse.

John Wiesman, Washington State Secretary of Health and ASTHO’s Immediate Past President, agrees. A community in Washington state was one of the sites chosen to participate in CDC/ATSDR’s PFAS exposure assessments. “We have several communities in Washington whose drinking water has been contaminated by PFAS,” says Wiesman. “This exposure study is an important first step in helping us understand how high levels of PFAS chemicals in tap water contribute to people’s exposure and health over time.”

CDC/ATSDR plans to fund up to six recipients across the country to investigate how wide-ranging PFAS exposures affect public health, and a funding opportunity announcement for the study was recently released.

Environmental PFAS contamination and the risks associated with human exposures are issues that state and territorial health officials will be facing for years to come. These issues can only be addressed by close coordination between stakeholders at all levels of government, the private sector, and the general public. Contact for more information on CDC/ATSDR’s PEATT or to request a copy of the tools.

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