PFAS contamination in U.S. communities

[00:00:01]

Rick Weiss: Hi, everyone. I’m Rick Weiss, director of SciLine, and before we get started, I just want to take two minutes to introduce you to or remind you who and what SciLine is so that we can continue to help you as journalists covering health, environment and science in the future.

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We’re also producing fact sheets you can see on our website that are specially designed for reporters who are in a hurry and just need to get the facts, ma’am, into their stories on various topics that are in the news now and that are science-related. And we encourage you to go to the website and look at those fact sheets and use them as you work on these topics.

And third is what we’re doing right now, which are media briefings held with experts to talk to you, as reporters, on topics that are in the news and that we anticipate remaining in the news for some time ahead. So these are considered backgrounders. We don’t expect people to, you know, craft stories out on deadline after these things, but you’ll be in much better shape on these topics after having heard from these experts and having a chance to ask some Q&A with them.

So today’s topic, as you know, is on PFAS – P-F-A-S – otherwise known as per- and polyfluoroalkyl substances. And it’s not even only on PFAS, as you’ll hear in a minute, because PFAS really is generally used to mean a family of related chemicals that are being found increasingly in water supplies and elsewhere in various cities across the country and about which we don’t really know as much as we wish we did in terms of environmental and health effects. And we have three really highly qualified experts to talk about this topic today. We’re going to hear first – I’m not going to go through their full bios because those are on the landing page that you can go back to where you registered for this meeting. But we will hear first from Linda Birnbaum, who is the head of the National Institute of Environmental Health Sciences and who will walk you through an introduction on this topic. Second, we’ll hear from Rainer Lohmann, who is an environmental chemist and a professor of oceanography at the University of Rhode Island. And finally, we’ll hear from Jaimie DeWitt, who is an associate professor of pharmacology and toxicology at Eastern Carolina University. Their names will appear a little bit differently on your screen, but all of them are doctors and Ph.D.’s.

And I will just go ahead and turn it over here to Linda to get things started. Thanks.

[00:04:56]

LINDA BIRNBAUM: Well, thank you very much. I’m really pleased to be here today and look forward to being able to answer questions and hopefully help you understand – have a better understanding of the science of PFAS. So if I could have the first slide. I’ll just mention that NIHS, we’re a research organization. We’re part of the National Institutes of Health.

Next slide, please. We are not regulatory in any way. So when we talk about what are PFAS and, you know, I think Rick has just alerted you it’s a very large class of substances. On this slide, I say there are over 3,000 different PFAS, but in fact there are over at least 4,700; in other words, 50 percent more than – than I had on this slide – different PFAS. Many of them, we don’t have standards for.

But we know that they are being made and some of them are being created, I should say, in the environment from more complex products. Some of these are impurities or degradants in other commercial products which are being used. The first two with the structures there, I think it’s just important those are the ones that we know the most about, the PFAS and the PFOA. But they are, as I say, only two of a very large family. All the members of this class are resistant to grease, water and oil. That’s why they’re used. They are persistent and, in many cases, bioaccumulative, which means that what is in your body today is a function of your exposure over the past months or even years. And while there have been, for example, what we call the long-chain PFAS, like the PFOS and the PFOA, there are now – shorter-chain ones are being proposed and are being synthesized and are being used as alternatives.

[00:0:5:46]

Go to the next slide. How are we exposed? These chemicals first started actually being made in the 1940s, I believe – certainly, the 1950s. They are found in various products as stain-resistant things in, for example, carpet and fabric and clothing. They’re also present in certain kinds of food packaging. So certain kinds of food – paper products have them in them that – from which exposure can migrate from food. They’ve been used to provide our – our cooking equipment, the pots and pans. And I think a major use has been in firefighting foams, explicitly for oil and gas fires. So they’ve been heavily used around airports, for example, especially military facilities. And much of our exposure, we believe, comes from drinking water. However, I do want to make the point that there are routes of exposure in addition to drinking water. And in fact, we are now becoming more concerned about potential exposure from inhalation because some of these smaller or shorter-chain PFAS have some volatility associated with them. We go to the next slide. This just gives an indication about where we know that there are point source, which have a higher detection frequencies for PFAS. And you can kind of see the blue areas.

That’s where it’s been detected using the methods that EPA has established. In the areas that are grey, there’s been some looking, but it wasn’t detected. But I should mention that the data that I’m showing here is based upon relatively high analytical detection limits, which in fact can be brought much lower and have been done by others. So you find that instead of approximately 6 million people in the U.S. potentially drinking elevated PFAS in their drinking water, that number may be off by one or two orders of, say, maybe 60 – it may be 100 – if you start measuring the lower levels.

[00:07:58]

Go to the next slide. I think this is an important understanding. I mentioned before that one of the problems with the PFAS is that they are extremely persistent and many of them bioaccumulate in our bodies. And this is actually a way that if, for example, your exposure to PFOA, which is the one that has been probably studied the most, it gives you an indication of what the concentration is in the drinking water and what the concentration would be in blood. And basically, you multiply by a factor of 100 to 200, and that gets you close to the blood concentrations. And so your blood levels will rise whether it’s PFOA or PFOS or many of the others with your level of exposure.

Next slide please. So my National Toxicology Program, which is a cross-agency effort whose mission is involved in assessing the toxicity of the hazard of different compounds actually held a – or conducted a systematic review of PFOA and PFAS about two years ago. This was externally peer-reviewed and has been published and has concluded that PFOA and PFAS are immune hazards to the human population based not only on extensive animal studies – some done by Jaimie DeWitt who’s one of our other speakers tonight, but also on human studies as well.

And currently, they’re looking at the evidence of six other, what I would say, are legacy PFAS to determine whether they weaken the antibody response to vaccinations, which has been shown in several different human populations in several different studies. So I think we’re pretty convinced that these chemicals are immune toxicants that we should be – might be concerned about.

[00:09:50]

And if I can have the next slide, which is the last slide – I just wanted to give you a quick update on some of the work that we are currently conducting which I think may be important, where we’re actually doing this with EPA. We’re going to be looking at actually 125 of those 4,700 different PFAS in a number of not only trying to get whatever data exists on them, which in many cases is very limited. We’re going to be conducting computational and cell-based and animal studies on some of these.

The in vitro computational will – results will drive which ones we take into animal studies. We are going to be looking at some high throughput and rapid-screening approaches to look at this large number of chemicals so that we can understand whether we can understand the potential risk from these chemicals as a class because there are way too many of them to ever test every one. And in fact, I think that there’s no way we can test our way out of this class of chemicals. But it will help us to decide whether we can treat them as one or possibly a few classes related to toxic effects. I think some of the important take-home messages – and we’ll hear more from our other two speakers – is that the PFAS are extremely stable. So even those which don’t bioaccumulate in people are present and accumulate in the environment. The carbon-fluorine bond is probably one of the strongest bonds that exists. And it is extremely difficult to break it down. As I said, human exposure is very wide-spread. It’s all continents around the world, and there are many pathways for which we can be exposed. And there are many products that lead to that exposure. So while ingestion is extremely important, ingestion in drinking water, other routes – and as I said, we really need to be paying some attention to inhalation. And again with so many compounds, for example, we can’t test our way out of this. So with that, I’ll turn it back to Rick for our next speaker. Thank you.

[00:12:02]

RAINER LOHMANN: Thank you very much, Rick and SciLine, including me – and Linda Birnbaum for the excellent introduction. So I’m a professor of oceanography. I also direct the Superfund Research Center on PFASs, STEEP, and that will be my first slide. We look at the sources, transport, exposure and effects of PFASs. And I’ve tried to cover some of the environmental chemistry and analyses of PFASs.

So the next slide is a family tree of PFASs. And if it looks hazy and blurry to you, that is perfect because that’s the way it looks to people in the field, too. But there are, as we already said, we think about 5,000 different PFASs. Well analyzed, there are really very few PFOS and PFOA. They are part of the upper two branches, and there – other than a fully fluorinated – they are stable, and they do not break down in the environment naturally. But then there are these precursor compounds that have hydrogen attached to the carbon so they can react. And that can either happen in the atmosphere, in animals or below ground in the aquifers. And different states have different compounds targeted. New Jersey has added PFNA to the regulations, so that has nine carbons. Massachusetts looks like has outlawed about five PFASs. So for now, the compounds targeted are a very small group. But there’s efforts underway to both treat them as a family and then maybe look at – some (unintelligible) impact the total organic fluorines, so everything that is confluent bonds, treat them as one and see if that is a good proxy for our exposure.

On the question of the breakdown, as I said, the perfluorinated ones do not break down. The precursors will break down, and some will then produce smaller persistent compounds again. The exposure is through the release from polymers, which site-change can degrade over time, the evaporation from the treatment of stain repellents and treatments of carpets and food-contact materials.

And then once they’re in the environment – if I could have the next slide, please – the movement in the soil and aquifer groundwater is slow. This is work from Elsie Sunderland on Cape Cod, working together with the U.S. Geological Survey. And they estimated that it took around 15 years for the PFAS stream to move around 800 meters.

[00:14:29]

There’s a similar timeline estimated for the transfer of PFAS waste from the production side to groundwater wells that were a few kilometers downstream. But we’re again talking about two, three decades, so it’s a very slow process. Once, however, they have reached surface waters or soil, the transfer into the food chain is much faster. We’re probably thinking of seasons or a few years. So the enrichment in the top predators is much faster once the exposure happens in the environment.

My next slide is now discussing the analysis and the remediation cost. So the analysis in drinking water has been straightforward at this point. EPA has a method for drinking water where you collect between a half liter and a full liter of water. You filter it through a cartridge where you collect the PFASs on – on an absorbent. You dilute it with a chemical solvent and use that for the analysis by liquid chromatography/mass spectrometry.

Part of what we do and what other groups are not looking into is trying to find paths to something, approach to get an integrated measure of contamination over a longer period of time to get an integrated measure. And then of course – and that’s why this picture is up – what happens if your drinking water is contaminated? So the town of Barnstable on Cape Cod in Massachusetts faced that problem several years ago. And they installed these big, egg-shaped cylinders or containers full of granular activated carbon. It costs them around three million dollars to install two of these. And you see the size of them next to a roughly 6-foot man, the superintendent for the drinking water supply. At this point, granular activated carbon is a known remedy for cleaning up your drinking water. It is expensive, but at least it works.

[00:16:17]

Alternatives include reverse osmosis, which you could also do in your home, or ion exchange filters. Of course, ideally, you would treat the problem at the source, and that’s the most difficult. At this point, the viable options for a contaminated site include just good, old-fashioned removal and then either burying it in a landfill or incinerating it. You could try to cap it, so you remove the exchange to the environment or add stabilizing agents to keep the PFASs in place, both exploratory options similar to treatments that include thermal desorption or potentially flushing with plenty of water.

Of course, because this is the billion-dollar question, numerous approaches have been tried. It is unclear which one will prevail in the end other than granular activated carbon. With that, I’ll toss it onto the next one. Thank you.

[00:17:09]

RICK WEISS: Well, that’s discouraging, but thank you. And let’s move to Jaimie DeWitt.

JAMIE DEWITT: Well, hi, everybody. Thank you for inviting me to present and to talk to you about health risks associated with PFAS. I’m very honored to be presenting here and alongside Dr. Birnbaum and Dr. Lohmann. So we can move to my first slide.

So I think that a lot of PFAS-impacted communities around the United States are really focusing on controlling people’s exposure through their drinking water. I think that’s a really good place to start given that we know that drinking water is a source of PFAS exposure for many people across the United States. But it’s also important to acknowledge that drinking water isn’t the only pathway that brings PFAS into our bodies. We might also get exposed through food that is grown in contaminated water or that received contaminated biosolids from wastewater treatment plants. We might also eat seafood that contains PFAS. We might also eat food that is contaminated through food contact papers that still contain PFAS. As Dr. Birnbaum mentioned, we might breathe in some PFAS, and we might even absorb some of them through our skin.

[00:18:17]

We really don’t know a lot about how much PFAS we get exposed to along these other pathways partially because we don’t know a lot about what kinds of PFAS and – and how much of these PFASs are in these other types of pathways. It’s challenging to scientists because it provides an analytical challenge. We have to go out and sample and figure out what types of PFASs are in these different sources. And it’s a scientific challenge that scientists are working to address. Once we know about some of these other pathways, we can better predict if drinking, eating, breathing or absorbing PFASs through our skin might pose different health risks than those posed by exposure to drinking water.

So we can’t have a risk of a health effect without exposure. And one of the biggest exposure and health effects study was the C8 Health Project. This was a large-scale study of a community along the Ohio River, which is an area between Ohio and West Virginia. In this particular community, drinking water was contaminated with PFOA from a PFAS production facility. And this study evaluated medical records from nearly 70,000 people, which is a really large number of people, and asked if there was a probable link between certain types of diseases and their exposure to PFOA. About 20 different diseases or health conditions were evaluated by the epidemiologist who conducted the study. And of these different diseases, it was concluded that there were probable links between PFOA exposure and the seven different diseases or conditions that are listed on the slide.

[00:19:59]

That doesn’t mean that everybody who was exposed developed the disease. And it doesn’t mean that everybody who is exposed will develop these diseases. It also doesn’t mean that these are the only diseases or disorders that might be linked to PFOA or other PFASs. What it means is that in this community, the diagnosis of these diseases increased as blood levels of PFOA increased. Therefore, people exposed to PFOA or other PFASs have an increased risk of contracting these diseases or disorders. So if you go to my next slide – sorry. I forgot to advance to the next slide. So there’s the C8 science panel study with the seven different types of diseases that were identified as probable links.

Now if we go to my next slide, we can ask questions about other types of health effects that have been observed from PFASs. So there are people in other communities impacted by PFASs as well as people in the general human population that haven’t been evaluated. Most people in the United States have PFAS in their body. And so we can ask questions about these additional data and ask about the potential for other diseases or disorders aside from the seven that were presented on the previous slide.

So several of these diseases and disorders have been observed in laboratory studies of experimental animals, which increases our confidence in the findings that we observe in humans. So when we see these changes in humans and we see similar changes in experimental animals or at least changes in the same systems of experimental animals, that gives us multiple lines of evidence and increased confidence that increases the biological plausibility that exposure to PFASs leads to adverse health outcomes in exposed humans.

So if you look at the list on this slide, you can see that liver disease, antibody responses to vaccines, an increased risk of asthma diagnosis, increased risk of decreased fertility and small decreases in birth weights are other findings that had been associated with PFASs. And you can see that some of the findings are different than those findings uncovered by the C8 science panel.

Again, if any one person is exposed, it doesn’t mean that he or she will absolutely experience these health effects. But it does mean that as levels of PFAS increase in their bodies, the risk of contracting these diseases also increases.

[00:22:20]

So think about it like this. And I explained it this way when I talked to somebody from the media last week. You just spent the – well, I guess I explained it in a slightly different way. You just spent the holidays with family and friends, and you – some of you may have traveled on a plane. You probably encountered all sorts of people, and you probably encountered a lot more different types of people than what you encounter in your daily life. Some of you probably got sick. I know one of my students got sick flying with kids this weekend.

So diseases from environmental pollutants in some ways are like this, too. Some people will get sick from their increased exposure, whereas others will not. And all people who get – and not all people who get sick will develop the same types of sicknesses. This is one of the reasons that uncovering specific diseases from exposure to pollutants can be somewhat challenging.

[00:23:16]

So if we go to my last slide, I want to emphasize that PFAS are a global problem. They’re not just limited to the United States. They exist all across the globe. And I’m often asked if there is a safe level of exposure to PFAS. I really think the better question is, is there an acceptable level of exposure? These are compounds that were not specifically designed to be put into our bodies. Safe means then that there is absolutely no hazard. And I think that we have enough information on PFASs that when they enter their body – our bodies, they induce a hazard.

At some low level of exposure, the risk of disease – developing a disease or disorder is low, at least at a population level. But the biggest problem, as has been mentioned with PFASs, is that they’re forever-pollutants. They don’t go away, and they’re present across the globe. So we need more information on pathways of exposure. For example, how much PFAS are produced each year. Into what products do they go? How much gets into the environment from production versus disposal of products containing PFASs?

We also need more information about the molecular events that lead to their adverse health effects – in other words, what changes occur in genes or in proteins or metabolic processes that lead to these adverse health effects. This will help us to really develop some pathways from that molecular event to the health outcome so that maybe we can better predict how other PFAS might affect health and develop therapies maybe to alleviate some of these health effects. And thank you for listening.

[00:24:50]

RICK WEISS: Fantastic. Thanks for a great introduction to the health side of this, Jaimie. So I want to remind the reporters now, if you have questions, please type them into the Q&A box that you can see on your screen there. And let us know if there’s a particular speaker who you want us to present that to or if it’s for the group more generally. And of course, for all of the panelists, please feel free to weigh in on anyone else’s question or answer as we go along.

I’m going to start off with a combination of my own question to get things started and one that does come from one of the reporters online here. And I’ll start with you, Dr. Birnbaum. And it has to do with just getting a little bit deeper into the regulatory side. We’ve heard a lot about how – how little we know, in some ways, about how much of these compounds are out there and what the health impacts might be.

Given all those uncertainties, it seems like a hard thing to regulate appropriately. But I wonder if you could spell out in more detail what the current status of the regulatory landscape is for these chemicals, who’s overseeing the regulation of them and what limits or levels are considered safe. Or is there any level of that’s considered inappropriate or illegal at this point?

And then on top of that, more general regulatory question, I’ll add this from Kyle Bagenstose at the Bucks County Courier, who is a little bit deeper into this topic, and wants to know whether collaborative research on some of these subclasses of PFAS could feed into regulations on exposure similar to the total limits that exist for things like haloacetic acids or gross alpha. Has NIEHS had conversations with EPA about this?

[00:26:30]

LINDA BIRNBAUM: Well, as I said before, we’re a research organization not a regulatory. But I think I can answer the regulatory question. And I’ll take the second one first and just say, yes, we are in dialogue not only with EPA, but with other regulatory bodies that have responsibility to look at the levels of contaminants that may exist in drinking water or in products or in, for example, food. So FDA actually treated seven PFAS as a class. These are legacy PFAS they looked at. And by legacy, I mean some of the longer-chain ones, PFAS, PFOA, PFNA, PFHxS, a number of them and are treating them all the same and have a regulatory limit on the level but can be present as contaminants in food. EPA has an advisory level that was set about two years ago for PFOS and PFOA. A combined total or either one alone of 70 parts per trillion in drinking water is basically an advisory limit.

They have not actually come out yet with a reference dose, which is a dose that’s considered kind of virtually safe. They have not done that for PFAS and PFOA. They have just sent out for comment drafts for preparing regulatory levels for PFBS and for GenX. GenX is something that hasn’t been mentioned before, but that is a more novel short-chain – shorter-chain PFAS that was a replacement for PFOA and has led to contamination of the Cape Fear River and the drinking water supply of all of the city of Wilmington, N.C. So EPA, again, does not – has not regulated PFAS to date.

At the congressional briefing – the senatorial briefing that I did along with Peter Grevatt, he said that they were working on developing some regulatory limits. In addition, I should say that many – or quite a number of states have now come up with regulatory levels not only for PFOS and PFOA, but for PFNA and some states have included a couple of – for the legacy. So when I talk about legacy, what I mean are the PFAS that we know a little bit about and that are routinely or relatively routinely looked for in, say, human samples, like human serum samples or human urine or, for example, in water. But the vast majority of PFAS, of the 5,000 or 4,700 different compounds, they are often not even looked for.

[00:29:34]

RICK WEISS: Great. Does anyone, Rainer or Jaimie, want to add to this question generally looking at the regulatory landscape? Great. OK. So we have a question here from Cheryl Hogue at Chemical and Engineering News. This, again, directed to Dr. Birnbaum, but anyone else should feel free to chime in after. Can you talk more about the growing concern about exposure to PFAS via inhalation? Is this primarily about point sources, like factories, or generally from consumer products?

[00:30:07]

LINDA BIRNBAUM: Well, Cheryl, it’s a very good question because we know so little. It certainly is a concern around point sources, where some of the PFAS are being produced or they’re being heavily used in the construction of a certain product.

However, I think we know almost nothing about many of the shorter-chain PFAS or even some of the longer ones. We know very limited – have limited information on the volatility. So we don’t know if there’s an issue, for example, with bathing and showering, which would be not only inhalation, but could also be dermal as well. I think it’s one of the big unknowns.

[00:30:49]

RICK WEISS: Another question here. This is from – oh, go ahead, Jaimie, yeah.

JAMIE DEWITT: I just wanted to add that – that I’m part of a group here in North Carolina that’s going to be looking at the atmospheric transport of some of the shorter-chain PFASs, the ones that have been found in the Cape Fear River. So there’s some findings from UNC, Chapel Hill and UNC, Wilmington who are doing some environmental sampling that will help us to understand rainwater concentrations as well as atmospheric concentrations. My house is actually one of the sampling sites here in Greenville.

[00:31:23]

RICK WEISS: Great. OK.

Rainer Lohmann: I just want to say, I think there’s some evidence to suggest that indoor concentrations of PFAS correlate with blood level, suggesting there’s indeed exposure at home. That is also relevant for the general public.

RICK WEISS: And those home exposures may be from – any idea what the major source is maybe indoors?

[00:31:54]

LINDA BIRNBAUM: I’d like to say a lot of that is probably there are elevated levels of PFAS in house dust. And so there may be some inhalation of the particle from the house dust, and then you end up swallowing it. And some of it is children, and lots of people put their hands in their mouths all the time.

RICK WEISS: Great. One more health question here. This is from Dana Bate at WHYY in Philadelphia. Do we know whether some classes of PFAS are generally more harmful than others – in other words, for example, long-chain versus short-chain? Are there general structure correlations with suspected health impacts, or is it going to be more complicated than that?

LINDA BIRNBAUM: Well, I think the simple answer is it’s more complicated, even considering things long- and short-chain doesn’t – is not very definitive when you’re talking. We have such limited data on some of the shorter-chains ones. And then we have ones that may have lots of fluorines on them, but also have other molecules in their structure like ether links, oxygen bridging some of the carbons that we know literally nothing about. But to date, some of the shorter-chain ones, some of the newer ones, appear to be less toxic because they don’t bioaccumulate. But I think we all need to remember that because something doesn’t bioaccumulate doesn’t mean it won’t be a problem if you’re exposed to it, say, in your drinking water every day.

[00:33:14]

JAMIE DEWITT: Could I also add that some work done by a laboratory out of Sweden has demonstrated that when we look at accumulation of the shorter-chain compounds in specific organs, they may accumulate differently in different organs, which gives them more time to elicit toxicity in specific organs, even though, overall, they’re getting out of our body more rapidly. So there might be some specific differences related to how much these shorter-chain compounds accumulate in organs like the liver.

RICK WEISS: Interesting.

[00:33:55]

RAINER LOHMANN: …Then the exposure pathways may also differ from food. Seafood, for example, we expect to be more exposed to the long-chains, as Linda mentioned. If we have vegetation that was grown with sewage slush that contained PFAS, we have more of a short-chain ones in the vegetation. So we have different exposure pathways, and neither of them is very helpful to us.

[00:34:17]

RICK WEISS: From Julia Rosen at the LA Times, is there any research on how PFAS are affecting ecosystems? Rainer, maybe you could take that first.

RAINER LOHAMANN: That’s another good question. I don’t think at the background exposure we’re talking about. There are probably some indications. Still no one’s looking at PFASs and (unintelligible) and that’s something we need lots of. The data that she has collected from the Cape Fear watershed presents a very unusual high-end exposure. So I assume there’s nothing I know of the background exposure at this point.

RICK WEISS: Anyone else want to weigh in on – yeah.

LINDA BIRNBAUM: Not a lot is known, but again, since these chemicals essentially never go away, they’re going to be in the environment. And there is some data for marine mammals indicating the possibility – I mean, it’s not definitive yet – but that there are some immune suppression going on and some other effects in some of our marine mammals, for example, which are, you know, animals high on the food chain.

[00:35:21]

RICK WEISS: From Karen Usher at Cadillac News in Michigan, a sort of a personal health angle here – is there a way to find out how much PFAS is in one’s own body. And if the levels appear to be high, are there treatment options to remove these chemicals and are there treatment considerations if the PFAS has affected fertility, asthma etc. or has expected to be involved in health effects already.

JAMIE DEWITT: I can try to answer that one.

LINDA BIRNBAUM: Go ahead, dear. You go first.

JAMIE DEWITT: So I think this is a challenge is that people in the general public are experiencing. There’s not a lot commercial testing labs that can actually test PFASs in our blood and our urine, etc., so that the average person can figure out what’s in his or her own body. The best right now you can probably do get involved in sort of an exposure study, which would give you the opportunity to have somebody measure the compounds in your body. In terms of helping to facilitate their removal from your body, I don’t know of any empirically tested technology that has been doing that. Maybe Dr. Birnbaum has heard about some technologies that I’m not aware of.

[00:36:37]

LINDA BIRNBAUM: So in the C8 study that Jaimie talked about earlier, there was the observation that people who took cholestyramine had – were among the lowest people – had the lowest levels of PFOA in their blood compared to everybody else. And there has been some work that’s going on now where people are actualzly – cholestyramine is a drug that used to be used to keep your cholesterol levels down. Now most people take statins. But it is a medically approved drug, and there are people who are actually proposing conducting some studies where you would give people cholestyramine over time and see whether that brings their level down. But that really hasn’t been tried. It’s an observation in a large study. We need to find out whether it actually will help, but that’s one of the only things that has been proposed.

RAINER LOHMANN: If I may add, I think there’s two other pathways, both of which are troublesome. You can donate blood. That will lower your personal level but of course might increase it for somebody else – and presumably through lactation. So women can potentially pass it on. For men, that’s not really an option.

LINDA BIRNBAUM: Lactation is a significant route of exposure, at least for some of the PFAS, but again, we know so little about most of them.

[00:38:03]

RICK WEISS: So I take it there are no particular recommendations right now in terms of whether women should or should not breastfeed if they’re found to have elevated levels of these chemicals.

LINDA BIRNBAUM: There is – the recommendation is still that breast is best.

RICK WEISS: Interesting. A question from the PBS NewsHour for Rainer. I think, for starters, did the town of Barnstable install those filters to tackle PFAS filtration specifically, and if so, why that town specifically? What was going on, on the cape there?

RAINER LOHMANN: Yes, they were aware that they had PFAS contamination in their drinking water several years ago, and they thought it was not safe for the citizens to be exposed even though there was no drinking water guideline established. So they put it in place to be cautious. They are now fighting over cost recovery with the people who caused the problem – or the institution that caused the problem, but that’s a different story. And why they are part of the plume of the groundwater is from fire-training activities on a military base. And there’s also waste where the people with effluent used to recharge the groundwater. So there’s a couple of (unintelligible) points off.

[00:39:17]

RICK WEISS: Great. From Marco Lauld (ph) from the Center for Public Integrity, has there been much engagement – I think this might be first for you, Dr. Birnbaum – has there been much engagement with PFAS producers, the business-side of the topic, regarding studying the compounds at the source and minimizing their use?

LINDA BIRNBAUM: So there has been some good going on. I can say that as far as EPA clearly works with the producers. Our scientists and our funded scientists – who you’re looking at some of them – actually also would talk to some of the producers. There have been a lot of scientific meetings that have been held that have involved, for example, the fluoropolymer council, of which, for example, the chemicals that make PFAS are members. And they believe that by moving to shorter-chain PFAS, they are reducing the potential for risk in humans. My question would be is, why are we making chemicals that will never go away?

[00:40:32]

RICK WEISS: Anyone else to address the business side here, the industry angle?

JAMIE DEWITT: So here in North Carolina, I think one of the producers has been very helpful in sharing purified standards with some of the academic scientists so that we can conduct laboratory studies and have standard – analytical standards for evaluating environmental samples. So they’ve been very, very helpful in providing those standards, which can be sometimes expensive to get synthesized by commercial laboratories. We also interact with scientists from various industries in terms of scientific meetings and sharing information at scientific meetings. So we do talk to one another. We’re not – we’re not exclusively in our little bubble.

[00:41:23]

RICK WEISS: Question from Tim Wheeler at the Chesapeake Bay Journal. You’ve mentioned that some states are doing some of their own thing regarding regulations. Can someone spell out which states have taken the most aggressive steps so far or name a few states that might be exemplary and worth paying particular attention to?

LINDA BIRNBAUM: New Jersey, Vermont, Minnesota. I believe Washington – state of Washington. Jaimie, others that you want to mention?

JAMIE DEWITT: I think you hit the main ones. I know there’s been a lot of ongoing work in Colorado in terms of understanding contamination from military bases. And California has been proactive in trying to understand PFAS in textiles. I think – I think some other states – Connecticut, I think, also, too – I think they have standards for 11 different PFASs. Or maybe – maybe Dr. Lohmann could correct me on that. But I think Connecticut has been fairly proactive as well. But yeah, I would like to also add that New Jersey has been especially proactive, largely due to some of the scientists who work with our water quality institute.

RAINER LOHMANN: And maybe in Massachusetts, they regulate five PFAS, so there are a few moving ahead.

[00:42:43]

RICK WEISS: From a freelance reporter based in the Boston area, for Rainer, just a little more follow up on the Cape Cod question. Is the understanding that the PFAS contamination there has come from the local military base, and if so, is the military participating in Barnstable’s efforts through funding or help with the cleanup?

RAINER LOHMANN: The military was thought to be the main fault. It’s probably still the dominant one. They are working with USGS and us and the town of testing and trying to understand how far the plume has moved. The cost recovery is a political question that I’m not really well positioned to say much about. But as long as PFASs aren’t officially regulated by EPA as priority pollutants, I don’t think the town will get any money back. That’s my understanding, but Dr. Birnbaum probably knows this better.

LINDA BIRNBAUM: So I’ll just mention that I think the military is very aware of this issue and is addressing it in several ways. One is that in their appropriation last year and this year and then will next year, they are – were given an additional $10 million for three years to conduct – to work with the Agency for Toxic Substances and Disease Registry to conduct studies on exposure and health effects around eight military sites. And those studies, with kind of advice and consultation with NIEHS – and those studies are being designed. Protocols are going through the works. And so they’re looking at that. The other thing the military is doing right now is they have required that fluorine be present in their firefighting material that they use for oil and gas fires. And they are looking about whether there are non-fluorinated alternatives that may work. For example, in Sweden and in other parts of the EU, they no longer use the AFFF that has fluorine-containing materials in it.

[00:44:55]

RICK WEISS: So you’ve partially answered a question I was going to follow up with, which was why the military would have particular amounts of exposure here. And so a lot of this, as I understand it, is for firefighting and flame retardants. And that raises the question for me, if I may, about whether this is the same sort of stuff that’s used in wildfire suppression. And if so, is PFAS a looming future problem out West, where so much fire retardant has been dumped of late on the wildfires out there?

LINDA BIRNBAUM: Well, my understanding is that the firefighting material that’s dumped from planes to put out wildfires does not contain fluorinated – the PFAS chemical. Now, what it does contain, I’m not really sure.

[00:45:45]

RICK WEISS: (Laughter) OK. Let’s see. I have a couple of questions here that are similar. One of them is from the New Hampshire Public Radio reporter Annie Ropeik, who wants to know, as do some others, what can we tell our readers and listeners about how to protect themselves from PFAS exposure and how to talk to their doctors about potential exposures? Is there anything practical that people can do or say with their health providers at this point?

JAMIE DEWITT: So I think one of the most important things that is – that – that somebody can do is to know where his or her water comes from. So know whether you’re on a private well or on a public utility, and then go to your public utility’s website and get information on the contaminants that they report and measure. Through the unregulated contaminant monitoring rule, you can find out about PFASs than your community. And then once you know what PFASs are in your water, then you can make a decision about your own risk factors and how you can avoid or reduce those risk factors.

So do you want to put in a reverse osmosis system? Do you want to drink bottled water? Do you have children in your house? Are you planning on getting pregnant, or are you pregnant? Or do you have particular disease risks that may increase with your increase in exposure, and then you can talk about those management plans with your health care providers.

[00:47:10]

RICK WEISS: Anyone else on personal health here?

LINDA BIRNBAUM: I think there’s very little we can do as an individual. I think if you are – if you know that your drinking water has elevated levels, as Jaimie said, you may choose to use bottled water more. I think you might choose to do a filtration system. Although, that I would mention that while the granular activated charcoal works very well for our legacy PFAS, it is unclear whether it works well for some of the newer – some of the other 5,000 chemicals. I think we really don’t know – don’t know that.

And then the other point is, is if you filtered out stuff and you’ve now got it on the charcoal, what do you do with it? I think Rainer brought that up. And the issue is, is we know that you can’t by incinerating the PFAS, which is very expensive, for example, if it’s in waste or if it’s in sewage waste, for example. You have to go to incredibly high temperatures and actually – to break the carbon-fluorine bond. So it’s really not the best way to get rid of it. But we don’t know what is.

[00:48:27]

RICK WEISS: All right now here is a question that I dare someone to take on. It’s from Tony Davis the Arizona Daily Star. So here’s a specific situation. Some of the drinking water in Tucson has been found to be at about 30 parts per trillion PFAS and PFOA combined. The water utility there said the water was safe to drink because of EPA’s 70 parts per trillion standard.

Given that the CDC agency ATSDR recommends a lower limit than EPA, down to 18 PFAS and PFOA combined, do you agree that 30 parts per trillion is safe to eat – or drink I should say? Does anyone want to address something that specific? Or at least what does the question raise as a problem?

LINDA BIRNBAUM: Yes, I think – I think the point that Jaimie made was very, very important, is we all have differential susceptibility. So if there’s a reason to think that you are uniquely – or very susceptible, you might want to control your exposure as much as you can. But the level of, say, 30 for combined PFOS plus PFAS – PFOA is in fact higher than the levels that are being recommended by several of our states. So if it’s a concern for you, you might want to switch to bottled water.

[00:49:46]

RICK WEISS: And taking it us to an international level – oh, go ahead. Was that Jaimie?

JAMIE DEWITT: I was just going to echo what Dr. Birnbaum said that, remember what I said. Not everybody who’s exposed will develop a disease, and not everybody who is exposed will develop one of the diseases or disorders that have been identified. We are variable.

So my risk might be very, very different from somebody else’s risk. I think what’s important is that you educate yourself about your risks and your water levels and then make that decision that is best for you and your family and your household.

[00:50:22]

RICK WEISS: Although, I haven’t heard anyone speak about a test that someone could take, such as if you’re a slower or faster acetylator or something that would tell you whether you happen to be particularly at risk of these kinds of chemicals. Is that right?

JAMIE DEWITT: I don’t think there…

LINDA BIRNBAUM: That’s correct.

JAMIE DEWITT: Yeah, so specific tests haven’t been identified. But if you look at that the probable links that were established by the C8 science panel, if you look at the other health effects that were identified in the ATSDR toxicological profile, you can look at that and go, OK, where do I it? Do I have a suppressed immune system already from an existing disease?

If I have a suppressed immune system and one of the health effects is suppression of my immune system’s ability to make antibodies, then perhaps you should consider an alternative source. If you’re somebody like me who doesn’t have any – as far as I know – major health issues and is not planning on getting pregnant is not – does not have a child, then I may make a different decision because my risk profile is different.

[00:51:24]

RICK WEISS: That’s really helpful. Rossie Izlar at UN-CTV – are there other countries regulating these chemicals? What can we learn from how other countries are dealing with this?

LINDA BIRNBAUM: Most are not. I think would be – and again, not being a regulator, I’m not familiar – terribly familiar. We know these chemicals all over the place, are all over the world. We know that there’s a lot of research going on in many other parts of the world, studying the fate and transports, studying the exposure, studying the health effects of these compounds. But I don’t know, offhand, what the regulatory status is, for example, in the EU. Although, I do know that the EU is moving, for example, because of concern, as I said, is no longer using the fluorine-containing firefighting foam.

[00:52:22]

RICK WEISS: From Catherine Shaffer at Michigan Radio – do any of you take precautions to prevent personal exposure such as avoiding seafood or using a home water filtration system? Anyone want to speak to that?

JAMIE DEWITT: Yeah – so this is Jaimie. One of the – one of the issues I have personally is that my home is in desperate need of new carpeting. And I’m going to have to make special arrangements to purchase carpeting that does not have surface protection in it. So I try to avoid products that have surface protectant. It does mean that I use more cleaning products because I have three cats and a dog.

But I – but I do make efforts to avoid purchasing products that I know contain PFAS. Here in Greenville, we do have some very low detectable levels of some PFAS in our public water. But I have a home filter, and so I comfortably drink the water here in Greenville. But mostly, I make decisions based on purchases that I’m going to make that would increase my exposure.

RAINER LOHMANN: Yeah, I think it’s – for me, I bought a rain jacket that is PFAS-free, at least that’s what it tells me. I try to shy away from food contact paper, so I kind of take out stuff that might have the coating. And try to limit, yes, the carpet to make sure it’s free of it. Beyond that, I’m on town water, and town water is clean as far as I know. And we tested it. So, yes, we know it’s clean.

LINDA BIRNBAUM: So I’ve had my drinking water actually tested, and the sum of 11 different PFAS which were monitored in the study, the total of them – I added them all up – was about 50 – about 50 parts per trillion, while the level of PFOS and PFOA were in the neighborhood of 13 to 15 each. There was another PFAS that was at much higher concentrations.

I haven’t changed my drinking water habits, but I agree with both Jaimie and Rainier – Rainer, excuse me – that I look, when I purchase things, for things that don’t have the – the water repellency or the stain repellency, for example, on them.

[00:54:42]

RICK WEISS: Great. Well, it is 4 o’clock here on the East Coast. And so we promised our participants they’d be able to get back to work now. So I’m going to wrap things up here, even though we have a number of questions left. This is obviously a topic of great concern in just about every state in the country. We have amazing coverage in our – in our briefing today.

I want everyone who’s on this briefing to know that we will, within the next 24 to 48 hours, be posting the video of this. So you can go through it and pick up on details you might have missed. That will be accompanied by a time-stamped transcript. So if you want to search through the transcript very quickly to find words or topics that you were most interested in, it’ll tell you where in the video you should jump to, to get the full visuals for that as well.

I want to thank our participants tremendously for a really, really interesting and informative briefing. Thank you so much. Thanks to the reporters for being on. Get in touch with us if we can help you further on this topic or other efforts to get more scientific evidence into your news stories. Thanks, and we’ll see you next time.