Blood testing results ranged from 0.3 micrograms/liter (or ppb, parts per billion) to 1,125.6 micrograms/liter or ppb, and the geometric mean of PFOA in blood among the sampled residents was 10 ppb — five times higher than the geometric mean of PFOA believed to be present in the blood of most Americans (which is 2.1 ppb, a figure likely resulting from our ubiquitous exposure to Teflon chemicals that were present in everyday consumer products: nonstick coated cookware, stain-resistant carpets and upholstery, water-resistant clothing, paper and cardboard food packaging, and fire-fighting foam). The health advisory went on to list the known health effects reported with exposure to PFOA, and requested of my husband: “If you have a patient that you think is experiencing health effects due to PFOA exposure, please call us at 1-800-439-8550.”

In general, the higher the PFOA concentrations in drinking water, the higher the PFOA concentration in blood. Some studies have even shown that PFOA levels in blood serum can be up to 100 times higher than the levels found in drinking water — meaning that if someone has 2,000 ppt (parts per trillion) in their drinking water, the anticipated level of PFOA in their blood might be as high as 200,000 ppt (or 200 ppb), an order of magnitude difference.

Why? Because PFOA is like, well, Teflon… resistant, persistent, hard-to-break-down. The half-life of PFOA is between 2-4 years, which means it takes up residence in the body and accumulates faster than the body can expel it — doing what exactly, we’re still not sure, except perhaps, as suggested by the limited epidemiological evidence compiled so far, wreaking havoc on the thyroid, the kidneys, the intestines, the liver. In other words, a baby born with PFOA in its blood has essentially become a chemical harbor until it grows up to be a toddler, or even a preschooler, before PFOA can be completely evicted from its system. Assuming, of course, that the exposure has been removed.

When my husband was first studying to become a physician, he was required to take a class on the history of medicine. I can remember him showing me a graph of total fatalities mapped over time, and pointing to a distinct drop in the curve — a place where something had caused some miraculous reduction in deaths from infectious disease. What was it? Antibiotics? Vaccines? Nope. It was sanitation. Removal of waste from drinking water resources. According to an article on longevity published in Slate.com, “Clean water may be the biggest lifesaver in history. Some historians attribute one-half of the overall reduction in mortality, two-thirds of the reduction in child mortality, and three-fourths of the reduction in infant mortality to clean water.” The discovery of penicillin appeared to yield but a relative blip on the graph my husband showed me, as did the proliferation of vaccines (not to diminish the importance of either to the improvement of public health), but nothing impacted public health with such magnitude as the removal of waste from water. “The garbage man does more to save lives than I ever will,” my husband said.

In Parkersburg, West Virginia, a place considered by many to be ground zero for PFOA-related contamination and injury, DuPont dumped thousands of tons of PFOA into the Ohio River, unlined ponds and beyond, causing widespread contamination of surface and drinking water resources in Parkersburg and surrounding communities. In Hoosick Falls, New York, mishandling of PFOA at the Saint-Gobain plastics facility around the corner from the water supply well on Water Works Road has resulted in contamination of the community water supply. Investigation of the former ChemFab facility will do doubt yield similar findings about disposal of PFOA materials, and during my latest trip to Pownal, Vermont, I was shocked to see that the proximity of the former Mack Molding plastics site to one of the community’s water supply wells was a mere 1,000 feet.

Contamination of drinking water from industrial waste is not a new issue, but these latest developments with PFOA raise the issue yet again, that in this day of modern medicine and sophisticated cancer treatment technologies, we continue to ignore the basic, most fundamental premise of medicine: that the most significant positive impact on human health is the separation of waste from water.

Of course, the implementation of Superfund laws and clean-up programs, and the cradle-to-grave hazardous waste regulations provide some measure of protection, but the exemptions are plenty and the funding is not. Too many waste disposal sites are left festering due to insufficient funds and political commitment for investigation and remediation, and too many water supplies remain in harm’s way.  I keep wondering, after each new discovery of contaminated drinking water wells, of impacted populations whose ailments will likely be traced back to what they drank — I keep wondering if we are ever going to wake up to this fundamental premise of public health.

The post Public Health Advisory: On Water and Waste appeared first on Mary Heather Noble.

The day is bright, cold spring. Wind gusts around the corners, flapping and twisting municipal door hangers into indecision. Back and forth, back and forth, back and forth they dance. I lean in for a closer look:

Village of Hoosick Falls Water Users 

WATER UPDATE

Information about Temporary Filtration and Flushing: 2/25/16

It’s late March now, months after the news about contamination of the village’s water system with perfuorooctanoic acid (PFOA) went public. The likely culprit, Saint-Gobain Performance Plastics, a manufacturing facility that uses Teflon to make coated plastic film, tape, and insulated wiring — one of the few remaining companies that still employ people in this town.

This town, like so many other former mill towns in northern New England and upstate New York— a place of 19th and early 20th century prosperity, now faded into a shadow of its former self. You’ve been to a town like this, perhaps even lived in a town like this. Grass-filled, uneven sidewalks between old Victorian homes. The lovingly maintained, brick bungalow library sits around the corner from a house with a crumbling porch. Faded plastic toys accumulated in the yard. Buds emerge on the trees after a long and difficult winter. The sign in front of St. Mark’s Episcopal Church reads, Please pray for our town to get through this water crisis.

The Saint-Gobain facility peeks through the trees from the Little League fields on Waterworks Road, where parents, probably grateful for the work, may gather after their shifts to cheer on the batter poised over home plate. The fields are empty now, except for a father pitching balls to his son. He lifts his head and watches me pass by. I wonder if he’s the kind of dad who would lean against the chain-linked fence and brag about his tough Teflon kid.

This morning, before I left home, my children wanted to know where I was headed. “Hoosick Falls?” my daughter said, “Who’s sick? That’s funny.”  It is, until it isn’t.

Just like all the other towns that have lived through a water crisis, it was the amount of cancer that made people wonder. Michael Hickey, the Hoosick Falls resident whose inquiry set current events into motion, lost both his father and grandmother to kidney cancer. He worries about his son. The water in both of their homes contained concentrations of PFOA well above the initial 0.4 ppb threshold limit set forth by the EPA, and since that testing, the EPA has revised its recommended limit to 0.1 ppb. Meanwhile, public health officials in Vermont, in response to a similar water crisis in nearby North Bennington, have used the same toxicologic studies to justify a 0.02 ppb PFOA standard.

The sluggish, inconsistent response must sting, like a reported case of domestic abuse that won’t be believed. And this is a matter of violence — just ask any cancer survivor about what the body must endure. I can’t help but think: if this crisis had been an act of terror, if someone had knowingly added PFOA to a public water supply, it would have been considered an act of war.

Later, when I am standing in the foyer of the Hoosick Township Historical Society building, studying photos of the community’s fallen soldiers from the Second World War, I will remember that Teflon’s inaugural application was for the Manhattan Project, the atomic bomb. I will remember that Teflon’s commercial utility was born from the science of intentional destruction, much like modern-day pesticides born from military nerve agents, and I will marvel at how intertwined the fingers of commerce and war have always been. I will mourn the dull, persistent echo of their intergenerational casualties.

But now, I wait outside the Armory on Church Street, where officials from the New York Departments of Health and Environmental Conservation stand behind tables with flyers containing information about how little we really know about the health effects of PFOA. A young woman walks by on the sidewalk, pushing a stroller with a little boy, maybe two or three years old. She doesn’t go inside. Is she worried about the water that is dwelling inside his cells? Is she worried about his future? Maybe they’ve already been inside to talk with the experts, given samples of their blood. Maybe she’s just looking ahead, soldiering on, accepting their new normal.

The building is beautiful inside — an old gymnasium with a mile-high ceiling and light brick walls, that appear to have been dressed up for a reception. I am impressed by the art, the optimism of this space. Brightly colored quilts line the front of the gym, and everywhere I turn are hand-painted owls with the slogan “Hoosick Rising” — a redevelopment-focused antonym to the downtrodden Hoosick Falls.

Across the room from the make-shift phlebotomy lab, where citizens may get their blood sampled for PFOA analysis, is a little wishing tree with positive messages from Hoosick Falls residents, about why they love their town. Here is where I find the soul of this place — neighbors expressing love and support for one another in the face of challenging times. You’ll never find a place with friendlier people, one postcard reads. Another card touts the value of the history of Hoosick Falls. The one that makes me pause: I ❤︎ HF because we have a great pool for kids to swim in. Love, Raegan.

When I meet the DEC officials, I tell them that years ago, I used to be an environmental regulator myself. They relax into a comradely stance. We exchange technical details on the contaminant of concern. Yes, PFOA appears to be very soluble in water.  No, they don’t yet know how quickly it’ll break through the activated carbon filters — they will be monitoring them frequently, and there’s a feasibility study being conducted to identify alternative sources of drinking water for the area. No, they don’t believe there are any break-down products, but they’ve heard that several different perfluorinated compounds (PFCs) can degrade into PFOA. They are just now learning about these chemicals, which industries use them, how they behave when they’re released. There are probably multiple sites — Teflon-related manufacturing was the industry du jour. The agency is doing the best it can with the resources that it has.

I can feel the tension against resignation to the absurdity of the situation, how difficult it will be to get their horse to catch up with this runaway cart. It’s really a failure of the Toxic Substances Control Act, we all agree. Teflon has been in commercial use since the 1940s, its toxicologic profile held in secret by DuPont from early as the 1960s, and even now, ten years past an historic $10.25 million settlement between the EPA and DuPont, concerning DuPont’s failure to report the risk of harm that PFOA presents to human health and the environment — even now, the EPA lacks sufficient data to confidently adopt appropriate exposure standards for this ubiquitous synthetic compound.

One DEC official shares with me that earlier in the week, he received a request from the Commissioner’s Office, probably for the purpose of briefing a politician in the wake of this water crisis: “They said, ‘Please identify any public water systems in New York that are at risk of becoming polluted by any regulated and/or unregulated contaminants.’” He looks at me, shaking his head. All of them.

The woman from the Department of Health informs me that about 2,500 of the town’s 3,500 residents have requested to have their blood tested for PFOA. I ask her if there is a certain threshold concentration of PFOA in blood, above which residents will be referred for more rigorous medical monitoring. “We aren’t yet sure what the long-term plan for bio-monitoring will be,” she admits. “I guess it depends on what we find.”

But she doesn’t know what they will find. No one does. They can only guess, based upon the epidemiological studies and exposure data they have gathered from previous PFOA contamination cases in Ohio, West Virginia, and New Jersey.  I leave the Armory a little shaken by the sense of bearing witness to another accidental experiment.

On my way out the door, I notice a poster for the Hoosick Has Heart community blood drive. Donate blood. Save a life. Monday, April 11, at the Hoosick Falls Community Alliance Church.  The bright cold and piercing wind send shivers down my spine. I hope they get their sample results before then.

The post A Walk in Hoosick Falls appeared first on Mary Heather Noble.

I guess that’s what makes the recent drinking water catastrophes in Flint, Michigan, and Hoosick Falls, New York so upsetting — because technically, both of those systems appeared to be in compliance with the Safe Drinking Water Act. Technically, water sampled from the City of Flint’s water treatment plant met drinking water standards for lead, even though that same water was corrosive enough to erode lead-bearing private and municipal infrastructure and produce (in some homes) tap water samples high enough in lead to be qualified as hazardous waste. Technically, the Village of Hoosick Falls Water Department appeared to have a flawless performance record, producing water of such quality that the Hoosick Falls Water Treatment Plant was once honored by the New York Rural Water Association as Rural Water Treatment Plant of the Year. In fact, Hoosick Falls’ water was named the best-tasting water in Rensselaer County in 2013, and did well enough in regional competitions to make it to the finals at the New York State Fair. And yet, until recently, water distributed from that perfectly compliant, award-winning plant contained alarming concentrations of perfluorooctanoic acid (PFOA), exposing thousands of unsuspecting residents to a chemical whose toxic health effects are just beginning to be understood.

I’m neither a resident of Flint nor Hoosick Falls, but I can imagine that the betrayal cuts deep, the violation of trust like a swift punch to the gut. It’s as if you asked a trusted friend to babysit your children, but when you got home, you found a stranger with a history of violent criminal behavior watching them instead. How did this even happen? How long has this been going on? What does this mean for the future of my family’s health and well-being?

When water hurts, your understanding of the world gets turned upside-down. The very essence of your cells and those of your children have been violated, their walls trespassed against by chemicals that may or may not hold your bodies hostage, that may or may not, at some time in the coming years ahead, commit some type of unspeakable harm. The anxiety is both tangible and intangible, acute and everlasting. When water hurts, the harm is real — even if the physiologic manifestation of that harm is not diagnosed for many years.

As a former environmental regulator, I have had the unfortunate experience of informing someone that their water has become contaminated — that their private well intersected a petroleum or solvent plume and their water was no longer safe to drink. There is little to say to dull the blow, little that can be offered to calm the fears of what might happen later on. So we focused on the solution. Our course of action always included bottled water as a temporary fix, in-situ treatment systems and monitoring plans as an acceptable long-term solution, but the holy grail for solving a potable water problem in our line of work was to connect them to  public water. Public water was the life boat, the safety net, the thing that delivered you unscathed to the other side.  It was the solution to the problem, not the problem itself.

But it seems this is no longer the case. Or rather, perhaps it never was. The unsettling discovery from the past few months is that the systems designed to safeguard and monitor our public drinking water systems are un-protective, incomplete.  We are vulnerable to a national crisis of antiquated water infrastructure, and we are limited by the narrow scope of authority that our regulatory agencies have.

To that point: the most contaminated public well in the Village of Hoosick Falls is reportedly located a mere 500 yards from the Saint-Gobain facility — a facility that has handled PFOA in the manufacturing of Teflon products since at least the 1960s. Though a clear hazard to a public source of drinking water, plant operators were never required to report releases of PFOA to the EPA, because the chemical wasn’t regulated, and the Village was never required to look for it because it wasn’t on the list. Why? Under existing chemical policy, compounds are considered safe until proven otherwise, and the EPA is granted neither the time nor the resources to adequately study the toxicity of the 85,000 industrial chemicals currently in use. PFOA is just one of those compounds.

The municipal water systems of Flint and Hoosick Falls are not the first public drinking water systems to become contaminated in this country, nor will they be the last. But one would expect our public health and environmental agencies to at least be equipped with the authority to handle the emergencies that arise. As long as chemicals for which human health and environmental impacts are not yet known can be incorporated into consumer products and released into soil, air, and water — as long as these compounds can loiter in our drinking water resources, unmonitored and unaddressed, our current rules are not enough.

The post When Water Hurts appeared first on Mary Heather Noble.