110 Million Americans May Be Drinking PFAS-Contaminated Water
More than 1,500 drinking water systems across the country may be contaminated with the nonstick chemicals PFOA and PFOS, and similar fluorine-based chemicals, a new EWG analysis shows. This groundbreaking finding comes the same day the U.S. Environmental Protection Agency (EPA) is convening a summit to address PFAS chemicals—a class of toxic chemicals that includes PFOA and PFOS, and that are linked to cancer, thyroid disease, weakened immunity and other health problems.
From 2013 to 2015, the EPA mandated national testing for PFAS chemicals in public water systems, yet the full results of this testing, funded by taxpayers, were never made public. Water utilities with the highest concentrations of PFAS chemicals have been publicly identified. But the names of utilities with detectable PFAS contamination below the so-called reporting levels of 10 to 90 parts per trillion, or ppt, were not released. Millions of people were not informed that their water supply is contaminated with these chemicals.
The additional water systems with PFAS contamination likely serve tens of millions of people, and it is essential for people in those communities to be informed of this hazard. Eurofins Eaton Analytical, which analyzed a third of the nationwide water samples, found that 28 percent of the water utilities it tested contained PFAS chemicals at concentrations at or above 5 ppt. The percentage of samples with PFAS detections nearly doubled when the laboratory analyzed down to 2.5 ppt. Based on this data, EWG's analysis suggests that up to 110 million Americans could have PFAS in their water.
Independent scientific assessments find that the safe level of exposure to PFAS chemicals is about 1 ppt—significantly below the reporting level set by the EPA.
Just over a week ago, InsideEPA and Politico broke news that the White House and the EPA attempted to bury a proposal from the Agency for Toxic Substances and Disease Registry that suggested exposure to Teflon and Scotchgard chemicals may be harmful at levels 10 times lower than what the EPA has publicly called safe. The full ATSDR proposal has not been made public, but the available information indicates the lower level was proposed because ATSDR accounted for harm to the immune system. This mirrors the more health protective approach New Jersey took in drafting its drinking water limits of 13 ppt for PFOS and 14 ppt for PFOA.
The full implications a lower safe exposure level would have are uncertain because the extent of national drinking water contamination is unknown. The uncertainty is largely due to the reporting value the EPA has previously used. PFAS detections below the reporting limits were kept secret, and may have never been recorded.
Today's EPA summit on the PFAS contamination crisis carries no indication that the agency will take action. In fact, the public might expect the opposite result, given internal EPA emails showing that top aides to Administrator Scott Pruitt and White House officials attempted to suppress the ATSDR proposal, worrying that release of the study would be "a public relations nightmare" for the Trump administration.
EWG calls on the EPA, testing laboratories and drinking water utilities across that country that have PFAS testing results to make the information public immediately. Knowing the locations and extent of contamination is critical for cleaning up water supplies and making the case for regulation.
Secret PFAS Contamination Data
In the water testing mandated by the EPA under the third Unregulated Contaminant Monitoring Rule, or UCMR, 198 different water utilities had recorded detections of PFAS chemicals in amounts above the EPA reporting limit. But the reporting limits were very high, using 40 ppt for PFOS and 20 ppt for PFOA, though many labs have much more sensitive detection limits. Some analytical labs are able to detect amounts as small 2 ppt of PFAS chemicals in water.
Based on a reanalysis of the national dataset by Eurofins Eaton Analytical, a water testing lab that processed more than 30 percent of nationwide water samples, EWG estimated how many utilities would likely have contaminated water if the reporting values had been set lower. At a reporting limit of 5 ppt, an estimated 1,046 utilities could have tested positive. If all results down to 2.5 ppt were reported, we estimate that over 1,900 of the 4,920 water utilities tested in the U.S. would have reported contamination.
Using maps generated by Eurofins Eaton Analytical and the public UCMR results, we calculated the number of water utilities that the lab identified as having PFOA or PFOS in their water, without results being reported to the EPA. Some states such as New Jersey have done additional water testing and have likely identified some, if not all, of the utilities that have PFAS chemicals in their water.
The PFAS water contamination issue is not going away and the EPA needs to take immediate action to both understand the full extent of contamination and ensure Americans have safe drinking water.
EWG Methodology for Estimating Number of Public Water Systems With Possible PFAS Contamination
In Eurofins Eaton Analytical presentations in 2017, the laboratory indicated that it had analyzed water samples from 1,800 water utilities and had measured PFAS concentrations that were much lower than those reported by the EPA. The lab reported 5.3 percent of water samples tested positive for PFAS chemicals at the UCMR limits, compared to 4.02 percent of samples from all laboratories that analyzed UCMR samples. Eurofins Eaton Analytical also found that 28 percent of all water systems had PFAS levels above 5 ppt, and 42 percent of all water samples had PFAS chemical concentrations at or above 2.5 ppt.
Based on the sensitive results from Eurofins Eaton Analytical, we estimated the number of American water systems with PFAS levels at or above 2.5 and 5 ppt. To calculate the number of utilities estimated to have detections at 5 ppt, we used the ratio of detections between Eurofins lab at UCMR levels and at 5 ppt compared with the overall detection ratio for all labs at UCMR levels. We estimate that 21.3 percent of water utilities in the UCMR program would likely have PFAS detections at 5 ppt or higher, and the detection frequency approximately doubles when comparing levels of 5 ppt and 2.5 ppt.
If 39 percent of the U.S. population was exposed to PFAS chemicals, this would represent approximately 127 million people, and 39 percent of the population served by water systems tested in the UCMR program would represent approximately 90 million people.
An alternative way to estimate the number of people affected by PFAS contamination is to compare the ratio of the 4 percent of utilities that tested positive in the UCMR program, representing 16 million people, to our estimate of 39 percent of water systems that have PFAS levels of 2.5 ppt or greater. This yields an estimate of 117 million people with PFAS in their water at levels at or above 2.5 ppt.
On average, these three estimates indicate that 110 million people could have PFAS chemicals in their water at levels of 2.5 ppt or higher.
Interactive Map Shows If Your Tap Water Is Contaminated With PFCs https://t.co/y3g8rOP29K @ewg @foodandwater @Water @charitywater— EcoWatch (@EcoWatch)1497540443.0
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By Ana Maldonado-Contreras
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
How Do Resident Bacteria Keep You Healthy?<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>
Chronic Disease and Microbes<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>
Discovering Microbes That Predict COVID-19 Severity<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>
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