In June and July of 2021, the Association of State and Territorial Health Officials (ASTHO) and the Environmental Council of the States (ECOS) collaborated with the AAAS EPI Center for a discussion series on per- and polyfluoroalkyl substances (PFAS). The 10 panelists included state regulators, scientists, and community advocates who addressed PFAS in drinking water and underserved communities, risk communication, and toxicology, among other topics.
Evidence and Guidelines
Concern about low levels of PFAS exposure. Although there are many toxicological unknowns, there is consensus that low levels of exposure to PFAS are of concern. In the absence of enforceable federal standards, states are setting their own guidance and/or enforceable standards for a number of PFAS in various environmental media. Guidance may differ based on which PFAS are present, which scientific studies are referenced and when they are accessed, and which toxicological endpoints are used. An increasing number of states are setting these advisory and/or regulatory values in the single-digit parts per trillion (ppt) range, which is far below the U.S. Environmental Protection Agency’s (EPA) current drinking water health advisory of 70 ppt for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS).
Need for more scientific evidence and data collaboration. Our understanding of PFAS toxicology and impact on human health and the environment is constantly evolving. Responding to PFAS requires collaboration among state and federal agencies, researchers, industry, and the public. State environmental and health agencies indicate that they need more toxicological data; more robust testing of small drinking water systems and private wells; and increased information on PFAS fate and transport through non-drinking water media such as soil, wastewater, surface water, biosolids, environmental uptake, and landfills.
Variations of critical endpoints used in risk assessments. States may choose similar or different risk assessment factors based on which PFAS are present and environmental medium is impacted. For example, New Jersey uses increased liver weight and delayed mammary gland development in mice and testicular tumors in rats as the critical endpoints for PFOA in drinking water; decreased immune system response in mice and liver tumors in rats for PFOS; and increased liver weight in mice for perfluorononanoic acid (PFNA). For a more comprehensive list of assessments conducted and factors used in different states, see ECOS’ white paper on state processes and considerations for setting PFAS standards.
The limits of existing analytical methods and treatment options. Practical factors, such as the level at which drinking water laboratories can reliably detect PFAS, as well as the ability of available treatment to remove PFAS, can limit efficient and effective standard setting. The development of analytical methods for more PFAS at lower levels in more environmental media, as well as options to treat more PFAS in the varied media, will help regulators regulate and remediate PFAS contamination. Expertise from in-house toxicologists and assistance from an independent advisory body for standards recommendations. As states develop guidance for a number of PFAS in different environmental media, it may be helpful to consider in-house toxicologists (as resources exist) and advisory bodies to assist in science development and regulation implementation. For example, New Jersey became the first state to establish a maximum contaminant level (MCL) for PFAS in drinking water. The guidance was based on New Jersey’s prior development of a drinking water guidance value for PFOA that was more stringent than that in other states and federal guidance at the time, based on agency research and recommendations.
Usefulness of biomonitoring. Biomonitoring can demonstrate that public health actions and interventions reduce individual exposures to PFAS. Biomonitoring can assure the public that regulators are taking action to assess and reduce exposure, despite the challenge of explaining relative health risks related to PFAS levels measured in the body. Medical guidance and blood testing information should be provided to affected people. Health providers and clinicians will need guidance. There is no treatment for PFAS exposure, and blood testing does not provide a clinical diagnosis or definitively say if a person’s health has been or will be affected.
Implementation of monitoring and tracking. States use monitoring and tracking to collect information on PFAS occurrence in various waterbodies and watersheds, at airports, in solid waste landfills, at chrome plating facilities, from bulk fuel terminals and refineries, at public treatment works, and in public water systems. In California, this is tracked by various programs, such as CalRecycle, which monitors the degradation of compostable plastics and the California Air Resources Board (CARB), which oversees emissions reporting. California is also working to pioneer some new approaches to biomonitoring by developing semi-targeted approaches for PFAS not covered by current standard measurement methods to identify the full range of PFAS that people have in their bodies.
Partnerships and Community Engagement
Partnerships to support multi-agency PFAS response. PFAS responses require extensive collaboration and planning among federal, state, and local agencies on environment, health, agriculture, etc. Environmental and health agencies often coordinate across other programs within the state to regulate PFAS in different media, and implement legislative bans and/or bills relating to firefighting foam, PFAS in food packaging, etc. Residents need to see evidence that their governments are working together.
Efficiency of county and local health departments to reach impacted communities. County and local health departments are often the lead on delivering health services. When communicating about PFAS contamination, the public may expect those officials to inform them about what levels are considered “safe.” More transparency on what departments know and do not know builds a higher level of trust among constituents. Emphasis on environmental justice. There is a need for research and policy that amplifies the voices and experiences of those impacted by PFAS contamination. Officials should proactively target testing in low-income and black, indigenous, people of color (BIPOC) communities; prioritize these communities for remediation; offer financial support for expensive remediation needs; and stop new manufacturing, uses, and emissions of PFAS for all non-essential uses. Community engagement. Directly engage communities to involve them in PFAS response. It is important to explore different communication avenues for sharing information to reach more people.
Principles of effective risk communication. Effective risk communication on PFAS should:
- Establish dialogues early and continue through resolution.
- Include communities in the decision-making process.
- Present accessible and clear information.
- Communicate both the knowns and the uncertainties. Be transparent, particularly about human health concerns.
- Listen, acknowledge, and follow up on specific concerns.
- Communicate the context for the risks.
Examples of suggested messages are included in the Risk Communications session summary (PDF).
Assess community concerns and knowledge. Check social and news media, reach out to municipal representatives to hear their concerns, and identify the community’s risk perception factors. Integrate the findings from the community assessment into your communications and use key messages to directly answer the concerns.
PFAS Central, Green Science Policy Institute
PFAS Project Lab, Northeastern University
PFAS-Exchange, Silent Spring Institute
Addressing Per- and Polyfluoroalkyl Substances (PFAS) in Drinking Water: Guides for Local and State Leaders, AAAS EPI Center, January 2021
PFAS Risk Communications Hub, ASTHO and ECOS
Risk Communication, IRTC, September 20, 2020
Processes and Considerations for Setting State PFAS Standards, ECOS, February 13, 2020
Perfluoroalkyl Substances (PFAS), Minnesota Department of Health
New Jersey MCL Development Process, NJ Department of Environmental Protection (NJDEP)
New Jersey Drinking Water Quality MCL Recommendation Documents, New Jersey Drinking Water Quality Institute, August 5, 2021
Approaches for Addressing Drinking Water and Wastewater Contaminants of Emerging Concern (CECs) in a Broader Context: Identification, Ranking and Treatment Removal, NJDEP Science Advisory Board, April 20, 2020
Public Health Goals: First Public Review Draft – Perfluorooctanoic Acid and Perfluorooctane Sulfonic Acid in Drinking Water, CA Environmental Protection Agency, Office of Environmental Health Hazard Assessment, July 2021
Session 1: How does PFAS in drinking water impact communities? What are the environmental justice issues?
June 16, 2021
- Michael Scott, Director for the Division of Waste Management, North Carolina Department of Environmental Quality
- Michael Abbott, Associate Director, Division of Environmental and Community Health, Maine Department of Health and Human Services’ Center for Disease Control and Prevention
- Phil Brown, Ph.D., Distinguished Professor, Northeastern University
- Alissa Cordner, Ph.D., Associate Professor of Sociology and Paul Garrett Fellow, Whitman College
Session 2: PFAS Risk Communication and Dialogue
June 23, 2021
- Melissa A. Harclerode, Ph.D., BCES, CDM Smith and Interstate Technology Regulatory Council (ITRC) PFAS Risk Communication Team Leader
- James Kelly, Manager, Minnesota Department of Health
- Laurene Allen, Merrimack Citizens for Clean Water and National PFAS Contamination Coalition
How does scientific evidence inform state policies for PFAS in drinking water?
July 20, 2021
- Katrina Angarone, Associate Commissioner for Science and Policy, New Jersey Department of Environmental Protection
- Lauren Zeise, Ph.D., Director, California EPA Office of Environmental Health Hazard Assessment
Last updated October 27, 2021