Researchers urge doctors to test patients for PFAS
Chemicals could cause nearly $63B in hidden health costs in US
Physicians should test millions of Americans for toxic forever chemicals, the nation’s leading scientific advisory body urges in a new report that reflects growing concerns about unregulated compounds added to clothing, food packaging and household products.
A panel of researchers organized by the National Academy of Sciences concluded that pregnant women and other sensitive groups should be screened for breast cancer, unhealthy cholesterol levels and high blood pressure when the amount of forever chemicals in their blood exceeds 2 parts per billion — equivalent to a couple of drops of water in a swimming pool.
Every American with more than 20 ppb in their blood should be checked for signs of other diseases as well, including thyroid disorders, kidney and testicular cancer and ulcerative colitis, panel members said Thursday in their recommendations to the Centers for Disease Control and Prevention.
New guidelines for the nation’s doctors came the same week another group of researchers estimated that exposure to forever chemicals — also known as perand polyfluoroalkyl substances or PFAS — could cost the current U.S. population nearly $63 billion in hidden health costs.
There are more than 9,000 PFAS, of which about 600 are in commerce today, according to the U.S. Environmental Protection Agency. The chemicals have been widely used for decades in firefighting foam and to make products such as nonstick cookware, stain-repellent carpets, waterproof jackets and fast-food wrappers that repel oil and grease.
Blood tests are recommended for anyone exposed on the job or who has lived in communities with documented sources of PFAS contamination. Others are advised to get tested if they have lived near airports, military bases, sewage treatment plants or farms where sewage sludge may have been used as fertilizer. Living near a landfill or waste incinerator also increases the risk of exposure to forever chemicals, according to the national academy panel.
Based on the latest human and animal research, “we feel the closer to 2 (parts per billion) that people are the less likely they are to have adverse health effects, and the closer to 20 (ppb) the more likely,” said Ned Calonge, the panel’s chairman and a physician, epidemiologist and associate professor of family medicine at the University of Colorado.
The CDC determined during the late 2000s that forever chemicals are in the blood of virtually every American. But routine testing is still rare. Most people don’t know how much PFAS is coursing through their circulatory system unless they work for chemical manufacturers that routinely monitor employees.
Two of the mostly widely detected forever chemicals — perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) — are so dangerous there is effectively no safe level of exposure in drinking water, the EPA announced in June.
An ongoing Chicago Tribune investigation revealed this month that more than 8 million people in Illinois — 6 out of every 10 people in the state — get their drinking water from a utility where at least one forever chemical has been detected. PFOA and PFOS are in the water of nearly every community where testing by the Illinois EPA found the chemicals.
“The entire U.S. population is likely overexposed to these toxic PFAS,” said David Andrews, a senior scientist at the Environmental Working Group, a nonprofit research organization that has advocated for federal regulations since the early 2000s. “Clinicians should advise their patients to reduce their exposure to these forever chemicals as much as possible — a difficult feat, since they are ubiquitous.”
It almost assuredly will take time and considerable debate before testing people for PFAS becomes commonplace.
Spokespeople for Northwestern Medicine and University of Chicago Medicine said they were unaware of any physicians in their networks who are testing patients for the chemicals. The Chicago-based American Medical Association did not respond to a request for comment.
During public forums the National Academy of Sciences held across the country last year, several participants said physicians scoffed when asked about PFAS testing.
“Clearly they didn’t have any information about environmental components (of disease),” a Pennsylvania woman said at one of the forums. “They made me feel small; they made me feel stupid and embarrassed for even asking the question.”
One of the chief manufacturers of PFAS, Minnesota-based 3M, has known since 1975 that forever chemicals had been detected in blood banks around the United States, according to industry records uncovered during lawsuits.
Regulators and the public were kept in the dark until 1998, when a 3M executive informed the U.S. EPA for the first time that PFAS used to manufacture the company’s Scotchgard coatings, and Teflon made by DuPont, build up in human blood, take years to leave the body and don’t break down in the environment.
PFOA and PFOS no longer are made in the U.S. In a statement, a 3M spokesman said levels of PFAS found in the environment do not pose risks to humans.
Based on what researchers are finding, though, the chemicals 3M, DuPont and other manufacturers released into air, water and land for more than 70 years could endanger public health for decades to come. Some of the replacements for PFOA and PFOS are just as dangerous, if not more so, studies have found.
A team of researchers at New York University estimated the costs of PFOA and PFOS exposure by plugging the most scientifically rigorous disease studies into a computer model that calculates the price of medical care and lost wages due to illness.
They based the low end of their estimates — $5.5 billion — on the strongest links between exposure and disease. When they added research suggesting other health damages caused by forever chemicals, the projected cost swelled to $62.6 billion.
“This is a giant uncontrolled experiment on the public,” Leo Trasande, a researcher at the NYU Grossman School of Medicine and the study’s senior author, said about the spread of PFAS worldwide.
Left unanswered by both of the new studies is who pays for testing, treatment and cleanup.
Cincinnati attorney Rob Bilott already has won PFAS legal settlements against DuPont in Ohio and West Virginia. Now he is among a group of trial lawyers suing 3M, DuPont and other manufacturers in an effort to force the companies to pay for medical monitoring of every American exposed to forever chemicals.
In March, a federal judge limited the case to Ohio residents with a specific amount of the chemicals in their blood, which alone could include up to 11 million people. Chemical companies are appealing the decision.
“The public — those of us exposed to these poisons for decades without our knowledge and consent — should not bear the cost of the public health impacts when we already know exactly which companies caused this problem,” Bilott said in an email. “It is way past time to hold those responsible for the public health disaster they have caused.”