Greener Guidance: PFAS

Note: This is the sixth edition of NACCHO’s Greener Guidance environmental health advice column. See past columns here. Submit a question here.

January 2019

Dear Greener Guidance,

What exactly are PFAS, and what should we be doing as a local health department to keep our community safe from any health risks associated with PFAS?

– PFAS Patrol

Dear PFAS Patrol,

Let’s start with your first question — what exactly are PFAS? Well, PFAS actually stands for per- and polyfluoroalkyl substances, which encompass a range of man-made chemicals most commonly found in products that resist grease, water, and oil.

During the manufacturing and use of PFAS and related products, the chemicals can seep into surrounding environments, contaminating food and water sources. PFAS do not break down, so they accumulate in our bodies over time.

Research on the health effects of PFAS is ongoing, but studies indicate that PFAS exposure can lead to increased cholesterol levels, and more limited findings point to cancer, thyroid problems, immune system problems, and low infant birth weight. Both chemicals have also caused reproductive and developmental, liver and kidney, and immunological effects in laboratory animals.

Learn more from the Agency for Toxic Substances and Disease Registry and the Environmental Protection Agency (EPA).

Now, on to your next question on what local health departments should be doing about PFAS.

The Environmental Council of the States (ECOS) recommends that local health departments work collaboratively with their state health departments, which are often the lead on PFAS monitoring and response. Three state health departments offered guidance on how local health departments can engage:

Colorado Department of Public Health & Environment

In Colorado, each PFAS issue has been very different and resulted in very different responses. For Colorado, the commonality for locals has been the need to address issues around private wells (which are not regulated at the state level in Colorado). Some of the challenges around this issue has been that (1) there are no great databases to identify the locations and owners of private wells, (2) there is usually difficulty in identifying funding for testing of private wells, and (3) sometimes the manpower (or womanpower) to do the door-to-door grunt work and sampling is difficult to find given everyone’s stretched priorities.

I would say the other role that locals have consistently played is acting as the conveners in their local communities both for local government and citizens. I think it is vital for locals to be able to do community outreach and plan events for citizens to receive relevant risk communication.

From a more preparation standpoint, I would urge locals to gather as much information as possible on potential sources of PFAS in their communities, including the potential for ground or surface water contamination that each of these sources presents.

– Mike Van Dyke, Ph.D., CIH, Chief, Environmental Epidemiology, Occupational Health, and Toxicology Branch, Disease Control & Environmental Epidemiology Division, Colorado Department of Public Health & Environment

Minnesota Department of Health

Because exposures to PFAS through drinking water continue to be of most concern, my best advice for local health departments at this point would be to consult with their state level counterparts, be aware of any PFAS water testing data for community water systems in their jurisdiction, and work with their local water system operators to help educate them and connect them with state and national resources as needed. More broadly, there are lots of resources out there about PFAS that could be of use/interest. Our general information sheet on PFAS has lots of good information.

– James Kelly, M.S., Manager, Environmental Surveillance & Assessment, Minnesota Department of Health

New York State Department of Health

“Local health agencies in New York are the ‘boots on the ground’ in working with the New York State Department of Health to respond to community drinking water concerns associated with PFAS and other emerging contaminants. We have been addressing contamination in New York in multiple municipalities where PFAS has been found in public drinking water supplies and private wells. Our experience has shown that community residents are not only eager for a rapid response to address exposures; they want to learn more about possible health impacts that resulted from their exposures. Local health agencies have close ties to the communities they serve, including drinking water plant operators, regulated businesses, local officials and community residents. These relationships, as well as their familiarity with the communities they serve, assist greatly with many aspects of responses. Here are just a few examples of the key role they play:

  • Assisting with planning community events.
  • Working with local officials and area partners to get information out at local meetings, libraries, and other public distribution points.
  • Helping identify local resources such as laboratories for blood testing.
  • Identifying major area health care clinics and providers for academic detailing.
  • Coordinating logistics and transport of water samples between area water operators and New York State’s Wadsworth Lab.

– Gena Gallinger, Outreach and Education Group, Center for Environmental Health, New York State Department of Health

Learn more about these and other states’ PFAS responses in case studies developed by ASTHO and ECOS:

To best answer your question, we also spoke to a local health department that has already faced a PFAS contamination emergency, the Health & Community Services Department (HCS) in Kalamazoo County, Michigan.

In July 2018, the Michigan Department of Health & Human Services alerted the HCS that the entire municipal water supply system of the City of Parchment, serving 3,000 residents, tested with elevated PFAS levels over 1,500 parts per trillion, well above the 70 parts per trillion deemed safe by the EPA.

HCS responded immediately, activating an emergency operations center (EOC) and implementing a “do not drink” advisory within a few hours. Over the next few weeks, HCS updated community members on progress and answered questions at daily briefings. One month later, after flushing the City of Parchment water system and connecting to the City of Kalamazoo’s water system, the advisory was lifted.

HCS Environmental Health Chief Vern Johnson attributes to following to their swift and effective response:

Prior to establishing our EOC, we had developed relationships with all stakeholders that made up the EOC. We were able to quickly respond to the situation due to our established relationships with responders as well as our knowledge of the Incident Command System.

From the very onset, we were transparent with our community, beginning with a press conference on the very day we were informed of the PFAS contamination, numerous interviews during our initial response, and daily and now weekly press releases. We also held a town hall meeting with the impacted community to answer all their questions, present findings, and communicate our future mitigation plans. This meeting had representation from the City of Parchment, Cooper Township, Governor’s Office, elected officials, City of Kalamazoo, Kalamazoo Township, Kalamazoo County, Michigan Department of Environmental Quality and the Michigan Department of Health & Human Services.

From law enforcement, fire departments, and state/local governments, we utilized our specialized trainings effectively to manage the PFAS contamination and formulate a response plan that met the needs of the community.

For more details on technologies to reduce PFAS in drinking water, take a look at this blog post the EPA guest authored earlier this year.

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