September 29, 2024 • 29 mins
Robin talks with Amy Schultz - an epidemiology senior data scientist with the Real-World Evidence to Advance Community Health (REACH) Program at the UW School of Medicine and Public Health - about PFAS and how most Wisconsin residents have these ‘forever chemicals’ in their bodies.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Good morning. I'm Robin Culbert and this is Madison Forum.
I guess this morning is Amy Schultz, an epidemiology senior
data scientist with a Reach program at the UW School
of Medicine and Public Health. Amy, thank you so much
for joining me this morning, and we're going to be
talking PIFAs. We hear about PIFAs. Boy, it's really increased
(00:20):
over the past five ten years or so, Amy, if
you want to just walk us through initially, what are PIFAs.
Speaker 2 (00:30):
Yeah, PIFAs are It's an acronym stands for perchloro elko
and polyflorolical substances. They are a group of synthetic human
made chemicals. There's thousands of different types of PIFA. What
makes them unique is that they have a carbon fluorine
bond that is difficult to break. That's why they're called
(00:52):
fever chemicals. They break down slowly. They build up in
humans and the environment. But they're desirable for their chemical properties,
which is they are resistant to heat, oil, water, and
greece and those are properties and products that we often desire,
which is why they came to be so prevalent.
Speaker 1 (01:10):
Yeah, I was just doing a little background brushing up
on PIFAs and it's like, because I been in media
here now over thirty years, but yeah, it's a good
Has it been about ten years that they've really come
to the forefront. I see that the chemistry itself surrounding
PIFAs actually that was discovered like in the late thirties.
Speaker 2 (01:32):
Yeah, that's correct. You're right. Production of PEA boss mostly
the most common would be PFOS and p FOA started
in the nineteen thirties and nineteen forties, and so it
begs the question as to why are we all of
a sudden just hearing about it. Yeah. I mean the
first legal case, even though it's been in production since
(01:55):
nineteen thirties and forties, didn't happen until nineteen ninety nine,
the tenant versus a DuPont's case. There's actually a film
on Netflix about it, and that was a West Virginia farmer,
Wilburt Tenant, that filed a claim against a PFOCE company DuPont,
and that ever since there's been more lawsuits. But part
(02:18):
of the reasons just coming to the forefront is well,
some communities and companies have been aware of these dangers.
They weren't disclosed by companies or they changed manufacturing practices,
So that's part of the reason. And then the other
part of the reason is it's really difficult to study
pfos because there's thousands of pfoce chemicals. They have varying
(02:39):
toxicity levels and effects on human health. It can be
expensive and stetistically challenging to study someone's exposure to thousands
of chemicals that they're exposed to, potentially simultaneously from different
sources and so, and also what types are exposed to
and how often they're exposed can change throughout their life.
So well, these cases have come up and people have
(03:04):
very high levels potentially near contamination sites or in their
occupation if they're working in a facility that is using
for manufacturing p FoST. What we don't know a lot
about is at lower doses of exposure to p fos
through diet, drinking water, consumer products. At that level, what
are the health effects. And that's because it can take
much longer to see health effects at a lower dose.
(03:26):
It might not appear for decades.
Speaker 1 (03:28):
Let us not forget back in the day when doctors
are smoking a cigarette and encouraging you to do it
as well.
Speaker 2 (03:36):
Yeah, exactly, that's right. So it takes time sometimes for
research to really uncover some of these associations and sign
causal associations with an exposure.
Speaker 1 (03:47):
And outcome and just the vast amount and as you mentioned,
different levels and different sort of chemicals and what have you.
I mean, it's always been just kind of mind boggling
to me to think about. I get it when you
think of pifa's contamination with firefighting foam. I know that's
a biggie and it's like, wait a minute, So the
stuff that's used in firefighting foam. Wait, that's what I'm
(04:09):
spraying out of my can of pam, you know.
Speaker 2 (04:13):
No, Yeah, that's a great, great question. Yeah, so that
the properties of pifos. Again, there's many different types, right,
so it might not be the exact same compound of PIFAs,
but those properties are used in all sorts of products. Yeah,
it can be the same in terms of your nonstick cookware,
a dental floss coating, oil collage, Yeah, firefighting foams. It
(04:36):
can be in paint and in carpeting and clothing that
has stain resistant or water resistant properties. So we find
them in the liners of food containers, glossy paper that
doesn't seem to absorb grease can be coated with PIFAs,
So yeah, it can be found in a lot of products.
Speaker 1 (04:52):
Jeez, wow, dental floss.
Speaker 2 (04:53):
I didn't know that.
Speaker 1 (04:55):
And so now you've been part a very fascinating study
that the UW School of Medicine and Public Health conducted.
Was just trying to gauge how Wisconsinites are impacted by
these forever chemicals in our blood. Amy when did this
research began? How long did it run?
Speaker 2 (05:17):
So we started doing this research in twenty twenty, but
actually we used existing data. So we collaborate with the
Stale Health Department and the State Laboratory of Hygiene here
in Wisconsin. We asked the question, what is p FOS
exposure in Wisconsin. We wanted to know generally among a
statewide representative sample of adults, not people that we know
(05:39):
live near known contamination sites. We wanted to know what
their levels of exposure were. And there was a cohort
that existed called the Survey of Health of Wisconsin. Adults
had already provided donated blood and survey data and demographics
diet behaviors. So we went ahead and we analyzed blood
theorem levels of thirty eight piece of compounds on six
(06:01):
hundred and five adults and for just discute levels were
and then we also characterize that by different demographics, behaviors,
dietary factors to see, you know, who has higher levels.
Can we distinguish if there's different types of subpopulations that
are being exposed to higher levels.
Speaker 1 (06:20):
And so and what you found very interesting, I guess
I'll start with some of the more positive news. As
far as Wisconsin's concentration levels of PIFAs nationwide were below
the national average correct correct.
Speaker 2 (06:37):
We compared our state representative adult sample serm levels of
pithos to those that were measured in a national study
as well. It was called ENHANES. It's the National Health
and Nutrition Examination Survey, and on average, PITHA serm levels
among Wisconsin adults were lower than those in the national study.
Speaker 1 (06:57):
And any attribution to that, any thinking is that the
findings as well in this region like the Upper Midwest,
or is it just it's hard to know.
Speaker 2 (07:10):
It is challenging to know. You know, there's certainly pockets
in Wisconsin where there are higher levels detected in groundwater
and in people near Maryett, for instance, where there's plants
there's old mills that biosloves are brains spread on agricultural fields,
and private wells are having very high levels. So we've
(07:32):
seen that in a couple areas, actually more than a
couple areas in Wisconsin and throughout the United States. That's
not uncommon. I think what we knew less about prior
to this study was what are levels among a general
population that doesn't have necessarily high exposure that we know
of based on where they live or their occupation. Because
(07:54):
I mentioned it's in so many different products, we wanted
to see. You know, something that's great about doing research
is that it can uncover other subpopulations that might be
at higher risk that we didn't already know about and
we could maybe identify that. So that was one of
the reasons for doing this. So there are other regions
in the state, specific locations that have higher levels. We
(08:17):
didn't detect that with our statewide sample. We didn't have
enough people in an area of known high contamination to
uncover that.
Speaker 1 (08:28):
But I'm guessing I feel very comfortable in saying this
is not a one and done sort of study. I mean,
the piphas are with us now very much a part
of the scientific community and what have you. I mean,
there's constantly different studies and reviews going on.
Speaker 2 (08:45):
Correct, correct, There's a lot of research to be done still,
and I should say that, you know, this was a
first look at what's going on in Wisconsin. It's a
cross sectional studies, meaning we only measured and looked at
levels at one point in time, and as I mentioned,
they can change over time. Cross exmo studies can't really
good at causality. You know, it is some of these
(09:09):
characteristics we look at causing p FOSS we can't say
for sure. So in our study, you know, we found
more than ninety six percent of Wisconsin adults head serum
levels above the lower limit of detection for six p fosts,
so a majority of people have p FOS in their blood.
It's worth noting that eight of the p FOS compounds
we looked at, no one had detectable levels of. So
(09:30):
just because there are thousands of PFOS chemicals doesn't mean
we're exposed to all thousands you know of them. And
we did find associations in our models older people, male sex,
white race, higher household income, eating locally caught fish. We're
all positively associated with having a higher theoerreum p FoST
level in our study. However, you know, we know howsehold income,
(09:54):
for instance, doesn't cost pfos, right, so the next step
in the next step in the research would really be
too Okay, Well, let's collect more information about people, collect
more data to understand what is it about those in
our study sample who had higher income, What is it
about their characteristics, their behaviors or diet that could be
(10:15):
explaining that association. Because again, we used existing data. So
you know, we found locally caught fish consumption, for instance,
was associated with higher levels of p fos. But you know,
we didn't capture data on how many fish they eat
per year, or what type of fish, or what water bodies.
We didn't capture information on nonstick cookware, so there could
(10:35):
be other factors explain the association that we weren't able
to on comer.
Speaker 1 (10:39):
Okay, but but yeah, that's just a link that stood out.
And I mean, if you think about it, you know,
back back in the day, fish used to be uh oh,
of course if you catch it yourself, it's cheap. But
it fish used to be relatively cheap, but nowadays it's
it is more of a a pricier option for some.
Speaker 2 (10:57):
Yeah, that's true, but it's not like it's.
Speaker 1 (11:01):
Not like you know of New York strip or something
like that, but.
Speaker 2 (11:07):
Right, correct, Yeah, so yeah, I mean, and part of
the reason fish consumption particularly we looked at local fish
consumption is Wisconsin has historically been a paper mill production state,
and so we already knew of other forever chemicals and
(11:28):
prior years that have been found in fish and fist
waters and ground water. And so because pi fos can
get into rivers, streams, lakes from reas water treatment facilities,
from polluters, dumping from just byproducts from landfills and airports,
and stuff running off into water, we knew that fish
(11:50):
is always going to be a a source or a
diapary source of potential contamination.
Speaker 1 (11:56):
Yeah, yeah, yeah, that makes sense. And also I guess
I'm surprised as far as as just according to this
uh this study, but our concentrations below the national because
we are are used to be a lot more a
heavy manufacturing state.
Speaker 2 (12:11):
Yes, it definitely was, and it isn't as much. But
again p fos can stick around in the environment for
many years. Yeah, so some historical uses still we might
be seeing health impacts and exposures from and there still
are plants that are in Wisconsin still, so yeah, it
(12:34):
might have reduced, but we're still dealing with some of
the consequences and.
Speaker 1 (12:39):
Of sor you know, like, oh my god. Okay, so
they're out there, and we have some in our blood stream,
although below the national average, not always detected, but oh
my god, are we going to get cancer? Or what
what is this gonna what is this going to mean?
And I guess that that's also kind of a hard
to know.
Speaker 2 (12:56):
It is hard to know. You're right there, are you know?
Part of the reason we're so concerned about p FOS
is because of evidence in the scientific research that has
been done that there are adverse health effects associated with
p FOSS exposure. We know this from studies that have
been done on occupational workers from some of the companies
(13:19):
that I'm you know I mentioned earlier, but also we
know this from lab studies on animals and exposing them
to high levels of PFOS. But because we have limited
epidemiological evidence from human subjects research from following people over time,
and they're real world exposures that are at this range
(13:39):
that most people are exposed to just from living their
normal lives. It's really hard to say. So, you know,
there's our associations with p FOS exposure with different types
of cancer as well as kidneying, liver disease, some respiratory
and reproductive outcomes, but it's there's no causal, really strong
causal evidence and large epidemiological studies, yet we just don't
(14:02):
have that kind of data yet.
Speaker 1 (14:03):
Yeah, and it seems in some I mean, the more
information the better, with the exception that it all sometimes
can come at once and it's overwhelming, doesn't not a
day that goes by I don't hear, of course, I'm
you know, reading the news every day, but some sort
of link of PIFAs to whether it be cancer. Just
(14:23):
this morning there was a couple hundred chemicals out there
linking to breast cancer, like in food packaging and our
plastic knives and you know, the utensils, And I mean
it's it's a good question, I think begs the question
of is this why we're seeing increasing cases in younger
(14:44):
women of breast cancer than what we did before? Is
there just better detection or could be some of both?
I guess yeah, I answer that.
Speaker 2 (14:54):
I'm sorry.
Speaker 1 (14:54):
Oh, you're not an oncologist.
Speaker 2 (14:57):
Yeah, and I don't know if we know. I think
it's important to keep in my because I am an
environmental epidemiologist, but I really focused on studying exposures with
human outcomes. But more on the exposure side. Is what
makes this challenging is is that we're not exposed to
just peaceofts. So we're exposed to metals, We're exposed to
(15:17):
other stressors, hormones, pharmaceuticals that are in the water, even
that had not been removed from drinking water. And there
are other chemicals that you're exposed to as well that
are not pithos. And so it's possible some people that
are exposed to high levels of pthos are also exposed
to high levels of lead, for instance, and it's the
(15:39):
lead that's driving that association that you might be seen.
And so it's really it really takes like a lot
of difference in many studies to build that evidence space
so you can consistently say, yeah, this is causing you know,
X is causing hy pthos is causing this outcome. Sure,
and that is why it is so challenging to definitively
give them one an answer. But we are working on it,
(16:02):
and I think every study helps in terms of finding
associations and connections to build this evidence of Okay, well
we should set standards, we should limit exposure.
Speaker 1 (16:11):
Because yeah, for years, as far back as I can remember,
and it wasn't always the case, but when it was
determined that hey, pregnant women mercury and fish, is it
specifically Great Lakes? I think it is Great Lakes?
Speaker 2 (16:23):
Right, Great, Yeah, so mercury and fish and that can
be found elsewhere, not just in Great Lakes. But yeah,
so there are all sorts of exposures, right that we.
Speaker 1 (16:33):
Yeah, we've been saying that for years. So I mean
that doesn't that's a naturally occurring chemical, correct, Yes, And
so it's not like it's man made. We can really
you know, it's there. We just got to go about
putting the advisories, you know, for certain populations to be
(16:56):
leery of it.
Speaker 2 (16:57):
That's a great point. There are plenty of natural occurring
compounds that work supposed to. Arsenic radon are naturally occurring
as well, but you know, being exposed a high levels
to those also have adverse health outcomes and can be
linked are our linked to cancer outcomes. So and this
(17:17):
kisp fast is a human made chemical. Sure, so we're
supposed to both in our lives, and so understanding how
both human made and naturally occurring compounds and elements and
chemicals and environment affect our health is what we're all
working on and work sposed to mixtures of them and
physically looking at mixtures of exposure that you're you know,
(17:41):
people are exposed to on a regular basis is challenging.
But we are trying, you know, we're working on and
we're doing the best we can.
Speaker 1 (17:47):
So Yeah, and also remediation efforts, I mean, we there's
just I mean it's dumbfounding just how how big the
issue is and how they're everywhere. We can never completely
clear our earth or groundwater of PIFAs, can we.
Speaker 2 (18:07):
Yeah, So I don't know what the future holds. I
will say that EPA, the United States and Brama Protection Agency,
this year in twenty twenty four, has finalized several rules
to regulate pfots, and so I think people should feel
better knowing that there are now federal regulations around it.
(18:28):
So they're regulating it at the manufacturing and processing level.
So companies now must get EPA to review and do
risk determination before starting or resuming production of three hundred
and twenty nine p fasts. And in drinking water, they
set a national drinking water standard. So EPA set an
enforceable limit for p fats and drinking water for two
(18:50):
most prevalent and common p FOSS compounds p fo and
pfots for four parts of per trillion, and they set
a few other different drinking water standards as well. In
public water systems now must by twenty twenty seven must
inform the public about p FoST levels and they're drinking water,
and so we're there are things happening at the federal level,
including cleanup. So the EPA designated p FOA and pfos
(19:13):
as hazardous substances under the Superfund Act. And that's huge
because now there's an enforcement policy, so parties that who
have significantly contributed to PFOSS release into the environment can
go to court and be held responsible for paying wing
up and paying for damages. So there are regulations in place.
(19:38):
There's been enough evidence for that to happen. So we
are making progress, definitely, I believe.
Speaker 1 (19:43):
Here in Wisconsin, we're still kind of mired in a
battle between governor and legislature. Correct, maybe you haven't been
following the political saga over the release of some PIFAs
moneys for community, but it's tied to maybe not holding
(20:04):
those responsible, being able to hold them responsible. I guess
that's kind of what the fight is over.
Speaker 2 (20:12):
Yeah, and I follow the state standards and regulations put
in place. I haven't been selling the political battle quite
as much want to, but I will say. I mean,
one great thing about having federal standards is that while
states can set stricter standards, at least there will be
a benchmark federally that all shirts must meet. So that
(20:33):
will be great for everyone in the United States who
doesn't have the privilege of moving to another state because
they've got better regulations.
Speaker 1 (20:41):
And yeah, I suppose all that data is available, and
sure that could be more attractive a factor and you know,
luring somebody from state to state. Hey, look at our
PIFA levels are under the national average.
Speaker 2 (20:59):
Yes, if that's what motivates someone to move or go
somewhere else, then yeah, by all means, did you.
Speaker 1 (21:06):
See around the nation. I don't know if it's gotten
to that point yet, but schools, you know, look at
good schools, the church community and PIFAs. Yeah, is there
any part of the country that you know offhand amy
that seems to really be have the higher levels than
anywhere else in the nation, or are just focused on
(21:26):
the situation here in Wisconsin.
Speaker 2 (21:30):
Yeah, that's a challenging question to definitively answer because all
we know is where PIFAs has been tested, So where
it's been tested, among where it's been tested, who has
higher levels compared to the other places that have been tested.
(21:50):
So it's really hard to stay because there's some states
and areas in the country where there's not a lot
of testing happening, so we don't know it's missing data,
we don't know it be higher there or not. But
in general, if you look at a map of where
testings occurred from state agencies, mostly it's it's really predominantly
where you would probably suspect where a lot of historical
(22:12):
manufacturing has occurred, So in the Midwest, in the Northeast
near you know, New Jersey, that area in Michigan and Minnesota, Wisconsin,
so there there's definitely regions Ohio and then down near
like West Virginia, so there's regions where Pennsylvania, So there's
(22:32):
regions kind of been more in the eastern half, you know,
east of the Rockies, but there have been sites all
over because we know there's manufacturing in piafost all over
the country. So it's not an easy question to answer,
especially because with you know, we distribute products and they
come from all sorts of areas and people are still
(22:55):
engaging with products that have pea foss in them as well.
Speaker 1 (22:59):
You know, yeah, a product I use just about every
day every other day, at least nonstick cookware. You know,
they manufacturers have they changed the contents or is it
about changing contents of the makeup of these products, or
you change the contents you know, no longer have that product.
Speaker 2 (23:21):
Yeah, and it's an ever changing landscape, so that's also
tricky to answer. So nonstick cookware historically has used p FOS.
Testlon itself is pfas it's a brand name, But more
and more there are becoming nonstick products, nonstick cookware pans
(23:43):
that claim there are no p face in them, but
it may be that that p FOS referring to are
these commonly known long chain p sauce, But there are
new generations of pot or p soce like compounds. The
industries are producing I have similar properties that we don't
know the health effects of. Again, so it's an ever
(24:04):
fighting uphill battle as more and more industries release more
and more chemicals what their health effects are. So I
would encourage people that are really concerned about exposure from
cookwaar to really look for alternative like stainless steel, cast
iron glass or enamel would be good alternative.
Speaker 1 (24:25):
Yeah, and does it I wonder if then, again, this
is more of a medical question. I was just wondering
if it falls along the lines as we know, like
with influenza or any sort of disease virus, the very old,
very young, and immune compromise tend to be more at risk.
But do you know that offhand or like I said,
that's more of a medical question.
Speaker 2 (24:45):
Yeah, it's more of a medical question there. I know
that there's been research studies that have looked into that,
certainly because p FOSS and any chemical exposure has the
potential to increase inflammatory responses in the body, just like
you know, produces a stress response, and so there have
been studies looking at that. I know that there have
been some studies that found associations others that haven't. I
(25:08):
am not sure what the current evidence is for that
right now, so I can't really speak to that.
Speaker 1 (25:14):
Let me ask you, now, PIFAs are the ce minuscule.
Let's my drinking water. I use a brit A filtered water.
Does that protect you or now?
Speaker 2 (25:29):
Yeah, So it depends what type of filter you have.
So certainly filters, carbon filters can remove some PIFAs or
a percentage of PIFAs that's in water, it should say,
especially if it's National Science Foundation certified, which a lot
of under the sink filters or whole house filters which
(25:52):
are more expensive, but you can get under the sink
filters that are just filtering your drinking water, or picture filters.
That should tell you that they been tested, meaning that
a third party or government party such as the National
Science Foundation hasted to see how much is reduced by
using a filter for each type of compound. It's usually
(26:12):
not just p sass, but they'll report on lead and
and other compounds as well. So yes, certainly carbon filtration
is a good way to remove some pithos, and municipalities
are again working on removing pifos, and we'll need to
have measures in place under the new EPA standard to
(26:33):
get it to the level that they're setting, so it's
in the works. And then of course if you're on
a private well, I would encourage people to get their
well water tested to see what their shovel is and
if they need to be concerned about it.
Speaker 1 (26:47):
So, even at this stage of the game, still so
much unknown, but are there are some small things we
can do to try and protect ourselves somewhat, because it's
not just simply staying away from a process s diet obviously,
because you know, even raw fresh they're exposed to PIFAs
in the groundwater, what have you.
Speaker 2 (27:08):
Yeah, that's correct. Yeah, yeah, I think there's a lot
of things people can do. They can look at the
their municipal report for their water municipality service to see
if they've tested for p sos and what the levels are,
and if they are concerned, they could get a filtration
device in their house, either a picture one under the
(27:29):
zinc one, depending on how much they are able to
spend and want to spend. Again. Cookware, replacing some of
your nonstick cookware with stainless steel or cast iron, and
then being mindful of when you're buying new products, trying
to unless it's an essential feature that you're looking for.
Not selecting stain resistant, water proof, water resistant unless it's needed,
(27:53):
because that will probably are more likely to have pifoss
in it. Yeah. And then of course fast food containers, packaging,
you know, takeout containers can have lined be lined with
pece austin. So limiting your fast food consumption or transferring
fast food into a you know, onto a enamel plate
or into a glass bowl before you reheat it or
(28:16):
eat from it. Oh yeah, it can also reduced. Yeah.
Speaker 1 (28:18):
I heard of that about five years or so ago,
and I've taken notice and do that.
Speaker 2 (28:25):
Yeah.
Speaker 1 (28:26):
Never never reheat a styrophoam oh god, no, never do that.
Always put into glass.
Speaker 2 (28:33):
Yeah. Yeah, so there are some small things people can
do to reduce their composer.
Speaker 1 (28:37):
Yes, all right again, I've been speaking with Amy Schultz.
She is an epidemiology Senior data scientist with the Reach
Program UW School and Medicine Public Health. Amy, what's are
you still working on this research that you just put
out information about a couple of weeks ago or what's
next here?
Speaker 2 (28:59):
Yeah, we're definitely looking to take this to the next step,
which would be to expand our study sample to include
more residents in other parts of the state, more diverse
populations within the state, and then actually measure p fast
and drinking water and food among the same participants in
a hustle dust and actually try to understand what routes
(29:21):
of exposure are really driving some of these associations, and
capture more information on diet and consumer product use, so
we can really get a more holistic picture of what
are the main drivers among a statewide sample, not among
people that we know are predominantly exposed to drinking water
or occupation. So, yeah, we're still working on it, so
(29:42):
we'll hopefully have some more findings soon.
Speaker 1 (29:44):
All right, Well, you've got job security, that's for sure.
Good morning. I'm Robin Culbert and this is Madison Forum.
I guess this morning is Amy Schultz, an epidemiology senior
data scientist with a Reach program at the UW School
of Medicine and Public Health. Amy, thank you so much
for joining me this morning, and we're going to be
talking PIFAs. We hear about PIFAs. Boy, it's really increased
(00:20):
over the past five ten years or so, Amy, if
you want to just walk us through initially, what are PIFAs.
Speaker 2 (00:30):
Yeah, PIFAs are It's an acronym stands for perchloro elko
and polyflorolical substances. They are a group of synthetic human
made chemicals. There's thousands of different types of PIFA. What
makes them unique is that they have a carbon fluorine
bond that is difficult to break. That's why they're called
(00:52):
fever chemicals. They break down slowly. They build up in
humans and the environment. But they're desirable for their chemical properties,
which is they are resistant to heat, oil, water, and
greece and those are properties and products that we often desire,
which is why they came to be so prevalent.
Speaker 1 (01:10):
Yeah, I was just doing a little background brushing up
on PIFAs and it's like, because I been in media
here now over thirty years, but yeah, it's a good
Has it been about ten years that they've really come
to the forefront. I see that the chemistry itself surrounding
PIFAs actually that was discovered like in the late thirties.
Speaker 2 (01:32):
Yeah, that's correct. You're right. Production of PEA boss mostly
the most common would be PFOS and p FOA started
in the nineteen thirties and nineteen forties, and so it
begs the question as to why are we all of
a sudden just hearing about it. Yeah. I mean the
first legal case, even though it's been in production since
(01:55):
nineteen thirties and forties, didn't happen until nineteen ninety nine,
the tenant versus a DuPont's case. There's actually a film
on Netflix about it, and that was a West Virginia farmer,
Wilburt Tenant, that filed a claim against a PFOCE company DuPont,
and that ever since there's been more lawsuits. But part
(02:18):
of the reasons just coming to the forefront is well,
some communities and companies have been aware of these dangers.
They weren't disclosed by companies or they changed manufacturing practices,
So that's part of the reason. And then the other
part of the reason is it's really difficult to study
pfos because there's thousands of pfoce chemicals. They have varying
(02:39):
toxicity levels and effects on human health. It can be
expensive and stetistically challenging to study someone's exposure to thousands
of chemicals that they're exposed to, potentially simultaneously from different
sources and so, and also what types are exposed to
and how often they're exposed can change throughout their life.
So well, these cases have come up and people have
(03:04):
very high levels potentially near contamination sites or in their
occupation if they're working in a facility that is using
for manufacturing p FoST. What we don't know a lot
about is at lower doses of exposure to p fos
through diet, drinking water, consumer products. At that level, what
are the health effects. And that's because it can take
much longer to see health effects at a lower dose.
(03:26):
It might not appear for decades.
Speaker 1 (03:28):
Let us not forget back in the day when doctors
are smoking a cigarette and encouraging you to do it
as well.
Speaker 2 (03:36):
Yeah, exactly, that's right. So it takes time sometimes for
research to really uncover some of these associations and sign
causal associations with an exposure.
Speaker 1 (03:47):
And outcome and just the vast amount and as you mentioned,
different levels and different sort of chemicals and what have you.
I mean, it's always been just kind of mind boggling
to me to think about. I get it when you
think of pifa's contamination with firefighting foam. I know that's
a biggie and it's like, wait a minute, So the
stuff that's used in firefighting foam. Wait, that's what I'm
(04:09):
spraying out of my can of pam, you know.
Speaker 2 (04:13):
No, Yeah, that's a great, great question. Yeah, so that
the properties of pifos. Again, there's many different types, right,
so it might not be the exact same compound of PIFAs,
but those properties are used in all sorts of products. Yeah,
it can be the same in terms of your nonstick cookware,
a dental floss coating, oil collage, Yeah, firefighting foams. It
(04:36):
can be in paint and in carpeting and clothing that
has stain resistant or water resistant properties. So we find
them in the liners of food containers, glossy paper that
doesn't seem to absorb grease can be coated with PIFAs,
So yeah, it can be found in a lot of products.
Speaker 1 (04:52):
Jeez, wow, dental floss.
Speaker 2 (04:53):
I didn't know that.
Speaker 1 (04:55):
And so now you've been part a very fascinating study
that the UW School of Medicine and Public Health conducted.
Was just trying to gauge how Wisconsinites are impacted by
these forever chemicals in our blood. Amy when did this
research began? How long did it run?
Speaker 2 (05:17):
So we started doing this research in twenty twenty, but
actually we used existing data. So we collaborate with the
Stale Health Department and the State Laboratory of Hygiene here
in Wisconsin. We asked the question, what is p FOS
exposure in Wisconsin. We wanted to know generally among a
statewide representative sample of adults, not people that we know
(05:39):
live near known contamination sites. We wanted to know what
their levels of exposure were. And there was a cohort
that existed called the Survey of Health of Wisconsin. Adults
had already provided donated blood and survey data and demographics
diet behaviors. So we went ahead and we analyzed blood
theorem levels of thirty eight piece of compounds on six
(06:01):
hundred and five adults and for just discute levels were
and then we also characterize that by different demographics, behaviors,
dietary factors to see, you know, who has higher levels.
Can we distinguish if there's different types of subpopulations that
are being exposed to higher levels.
Speaker 1 (06:20):
And so and what you found very interesting, I guess
I'll start with some of the more positive news. As
far as Wisconsin's concentration levels of PIFAs nationwide were below
the national average correct correct.
Speaker 2 (06:37):
We compared our state representative adult sample serm levels of
pithos to those that were measured in a national study
as well. It was called ENHANES. It's the National Health
and Nutrition Examination Survey, and on average, PITHA serm levels
among Wisconsin adults were lower than those in the national study.
Speaker 1 (06:57):
And any attribution to that, any thinking is that the
findings as well in this region like the Upper Midwest,
or is it just it's hard to know.
Speaker 2 (07:10):
It is challenging to know. You know, there's certainly pockets
in Wisconsin where there are higher levels detected in groundwater
and in people near Maryett, for instance, where there's plants
there's old mills that biosloves are brains spread on agricultural fields,
and private wells are having very high levels. So we've
(07:32):
seen that in a couple areas, actually more than a
couple areas in Wisconsin and throughout the United States. That's
not uncommon. I think what we knew less about prior
to this study was what are levels among a general
population that doesn't have necessarily high exposure that we know
of based on where they live or their occupation. Because
(07:54):
I mentioned it's in so many different products, we wanted
to see. You know, something that's great about doing research
is that it can uncover other subpopulations that might be
at higher risk that we didn't already know about and
we could maybe identify that. So that was one of
the reasons for doing this. So there are other regions
in the state, specific locations that have higher levels. We
(08:17):
didn't detect that with our statewide sample. We didn't have
enough people in an area of known high contamination to
uncover that.
Speaker 1 (08:28):
But I'm guessing I feel very comfortable in saying this
is not a one and done sort of study. I mean,
the piphas are with us now very much a part
of the scientific community and what have you. I mean,
there's constantly different studies and reviews going on.
Speaker 2 (08:45):
Correct, correct, There's a lot of research to be done still,
and I should say that, you know, this was a
first look at what's going on in Wisconsin. It's a
cross sectional studies, meaning we only measured and looked at
levels at one point in time, and as I mentioned,
they can change over time. Cross exmo studies can't really
good at causality. You know, it is some of these
(09:09):
characteristics we look at causing p FOSS we can't say
for sure. So in our study, you know, we found
more than ninety six percent of Wisconsin adults head serum
levels above the lower limit of detection for six p fosts,
so a majority of people have p FOS in their blood.
It's worth noting that eight of the p FOS compounds
we looked at, no one had detectable levels of. So
(09:30):
just because there are thousands of PFOS chemicals doesn't mean
we're exposed to all thousands you know of them. And
we did find associations in our models older people, male sex,
white race, higher household income, eating locally caught fish. We're
all positively associated with having a higher theoerreum p FoST
level in our study. However, you know, we know howsehold income,
(09:54):
for instance, doesn't cost pfos, right, so the next step
in the next step in the research would really be
too Okay, Well, let's collect more information about people, collect
more data to understand what is it about those in
our study sample who had higher income, What is it
about their characteristics, their behaviors or diet that could be
(10:15):
explaining that association. Because again, we used existing data. So
you know, we found locally caught fish consumption, for instance,
was associated with higher levels of p fos. But you know,
we didn't capture data on how many fish they eat
per year, or what type of fish, or what water bodies.
We didn't capture information on nonstick cookware, so there could
(10:35):
be other factors explain the association that we weren't able
to on comer.
Speaker 1 (10:39):
Okay, but but yeah, that's just a link that stood out.
And I mean, if you think about it, you know,
back back in the day, fish used to be uh oh,
of course if you catch it yourself, it's cheap. But
it fish used to be relatively cheap, but nowadays it's
it is more of a a pricier option for some.
Speaker 2 (10:57):
Yeah, that's true, but it's not like it's.
Speaker 1 (11:01):
Not like you know of New York strip or something
like that, but.
Speaker 2 (11:07):
Right, correct, Yeah, so yeah, I mean, and part of
the reason fish consumption particularly we looked at local fish
consumption is Wisconsin has historically been a paper mill production state,
and so we already knew of other forever chemicals and
(11:28):
prior years that have been found in fish and fist
waters and ground water. And so because pi fos can
get into rivers, streams, lakes from reas water treatment facilities,
from polluters, dumping from just byproducts from landfills and airports,
and stuff running off into water, we knew that fish
(11:50):
is always going to be a a source or a
diapary source of potential contamination.
Speaker 1 (11:56):
Yeah, yeah, yeah, that makes sense. And also I guess
I'm surprised as far as as just according to this
uh this study, but our concentrations below the national because
we are are used to be a lot more a
heavy manufacturing state.
Speaker 2 (12:11):
Yes, it definitely was, and it isn't as much. But
again p fos can stick around in the environment for
many years. Yeah, so some historical uses still we might
be seeing health impacts and exposures from and there still
are plants that are in Wisconsin still, so yeah, it
(12:34):
might have reduced, but we're still dealing with some of
the consequences and.
Speaker 1 (12:39):
Of sor you know, like, oh my god. Okay, so
they're out there, and we have some in our blood stream,
although below the national average, not always detected, but oh
my god, are we going to get cancer? Or what
what is this gonna what is this going to mean?
And I guess that that's also kind of a hard
to know.
Speaker 2 (12:56):
It is hard to know. You're right there, are you know?
Part of the reason we're so concerned about p FOS
is because of evidence in the scientific research that has
been done that there are adverse health effects associated with
p FOSS exposure. We know this from studies that have
been done on occupational workers from some of the companies
(13:19):
that I'm you know I mentioned earlier, but also we
know this from lab studies on animals and exposing them
to high levels of PFOS. But because we have limited
epidemiological evidence from human subjects research from following people over time,
and they're real world exposures that are at this range
(13:39):
that most people are exposed to just from living their
normal lives. It's really hard to say. So, you know,
there's our associations with p FOS exposure with different types
of cancer as well as kidneying, liver disease, some respiratory
and reproductive outcomes, but it's there's no causal, really strong
causal evidence and large epidemiological studies, yet we just don't
(14:02):
have that kind of data yet.
Speaker 1 (14:03):
Yeah, and it seems in some I mean, the more
information the better, with the exception that it all sometimes
can come at once and it's overwhelming, doesn't not a
day that goes by I don't hear, of course, I'm
you know, reading the news every day, but some sort
of link of PIFAs to whether it be cancer. Just
(14:23):
this morning there was a couple hundred chemicals out there
linking to breast cancer, like in food packaging and our
plastic knives and you know, the utensils, And I mean
it's it's a good question, I think begs the question
of is this why we're seeing increasing cases in younger
(14:44):
women of breast cancer than what we did before? Is
there just better detection or could be some of both?
I guess yeah, I answer that.
Speaker 2 (14:54):
I'm sorry.
Speaker 1 (14:54):
Oh, you're not an oncologist.
Speaker 2 (14:57):
Yeah, and I don't know if we know. I think
it's important to keep in my because I am an
environmental epidemiologist, but I really focused on studying exposures with
human outcomes. But more on the exposure side. Is what
makes this challenging is is that we're not exposed to
just peaceofts. So we're exposed to metals, We're exposed to
(15:17):
other stressors, hormones, pharmaceuticals that are in the water, even
that had not been removed from drinking water. And there
are other chemicals that you're exposed to as well that
are not pithos. And so it's possible some people that
are exposed to high levels of pthos are also exposed
to high levels of lead, for instance, and it's the
(15:39):
lead that's driving that association that you might be seen.
And so it's really it really takes like a lot
of difference in many studies to build that evidence space
so you can consistently say, yeah, this is causing you know,
X is causing hy pthos is causing this outcome. Sure,
and that is why it is so challenging to definitively
give them one an answer. But we are working on it,
(16:02):
and I think every study helps in terms of finding
associations and connections to build this evidence of Okay, well
we should set standards, we should limit exposure.
Speaker 1 (16:11):
Because yeah, for years, as far back as I can remember,
and it wasn't always the case, but when it was
determined that hey, pregnant women mercury and fish, is it
specifically Great Lakes? I think it is Great Lakes?
Speaker 2 (16:23):
Right, Great, Yeah, so mercury and fish and that can
be found elsewhere, not just in Great Lakes. But yeah,
so there are all sorts of exposures, right that we.
Speaker 1 (16:33):
Yeah, we've been saying that for years. So I mean
that doesn't that's a naturally occurring chemical, correct, Yes, And
so it's not like it's man made. We can really
you know, it's there. We just got to go about
putting the advisories, you know, for certain populations to be
(16:56):
leery of it.
Speaker 2 (16:57):
That's a great point. There are plenty of natural occurring
compounds that work supposed to. Arsenic radon are naturally occurring
as well, but you know, being exposed a high levels
to those also have adverse health outcomes and can be
linked are our linked to cancer outcomes. So and this
(17:17):
kisp fast is a human made chemical. Sure, so we're
supposed to both in our lives, and so understanding how
both human made and naturally occurring compounds and elements and
chemicals and environment affect our health is what we're all
working on and work sposed to mixtures of them and
physically looking at mixtures of exposure that you're you know,
(17:41):
people are exposed to on a regular basis is challenging.
But we are trying, you know, we're working on and
we're doing the best we can.
Speaker 1 (17:47):
So Yeah, and also remediation efforts, I mean, we there's
just I mean it's dumbfounding just how how big the
issue is and how they're everywhere. We can never completely
clear our earth or groundwater of PIFAs, can we.
Speaker 2 (18:07):
Yeah, So I don't know what the future holds. I
will say that EPA, the United States and Brama Protection Agency,
this year in twenty twenty four, has finalized several rules
to regulate pfots, and so I think people should feel
better knowing that there are now federal regulations around it.
(18:28):
So they're regulating it at the manufacturing and processing level.
So companies now must get EPA to review and do
risk determination before starting or resuming production of three hundred
and twenty nine p fasts. And in drinking water, they
set a national drinking water standard. So EPA set an
enforceable limit for p fats and drinking water for two
(18:50):
most prevalent and common p FOSS compounds p fo and
pfots for four parts of per trillion, and they set
a few other different drinking water standards as well. In
public water systems now must by twenty twenty seven must
inform the public about p FoST levels and they're drinking water,
and so we're there are things happening at the federal level,
including cleanup. So the EPA designated p FOA and pfos
(19:13):
as hazardous substances under the Superfund Act. And that's huge
because now there's an enforcement policy, so parties that who
have significantly contributed to PFOSS release into the environment can
go to court and be held responsible for paying wing
up and paying for damages. So there are regulations in place.
(19:38):
There's been enough evidence for that to happen. So we
are making progress, definitely, I believe.
Speaker 1 (19:43):
Here in Wisconsin, we're still kind of mired in a
battle between governor and legislature. Correct, maybe you haven't been
following the political saga over the release of some PIFAs
moneys for community, but it's tied to maybe not holding
(20:04):
those responsible, being able to hold them responsible. I guess
that's kind of what the fight is over.
Speaker 2 (20:12):
Yeah, and I follow the state standards and regulations put
in place. I haven't been selling the political battle quite
as much want to, but I will say. I mean,
one great thing about having federal standards is that while
states can set stricter standards, at least there will be
a benchmark federally that all shirts must meet. So that
(20:33):
will be great for everyone in the United States who
doesn't have the privilege of moving to another state because
they've got better regulations.
Speaker 1 (20:41):
And yeah, I suppose all that data is available, and
sure that could be more attractive a factor and you know,
luring somebody from state to state. Hey, look at our
PIFA levels are under the national average.
Speaker 2 (20:59):
Yes, if that's what motivates someone to move or go
somewhere else, then yeah, by all means, did you.
Speaker 1 (21:06):
See around the nation. I don't know if it's gotten
to that point yet, but schools, you know, look at
good schools, the church community and PIFAs. Yeah, is there
any part of the country that you know offhand amy
that seems to really be have the higher levels than
anywhere else in the nation, or are just focused on
(21:26):
the situation here in Wisconsin.
Speaker 2 (21:30):
Yeah, that's a challenging question to definitively answer because all
we know is where PIFAs has been tested, So where
it's been tested, among where it's been tested, who has
higher levels compared to the other places that have been tested.
(21:50):
So it's really hard to stay because there's some states
and areas in the country where there's not a lot
of testing happening, so we don't know it's missing data,
we don't know it be higher there or not. But
in general, if you look at a map of where
testings occurred from state agencies, mostly it's it's really predominantly
where you would probably suspect where a lot of historical
(22:12):
manufacturing has occurred, So in the Midwest, in the Northeast
near you know, New Jersey, that area in Michigan and Minnesota, Wisconsin,
so there there's definitely regions Ohio and then down near
like West Virginia, so there's regions where Pennsylvania, So there's
(22:32):
regions kind of been more in the eastern half, you know,
east of the Rockies, but there have been sites all
over because we know there's manufacturing in piafost all over
the country. So it's not an easy question to answer,
especially because with you know, we distribute products and they
come from all sorts of areas and people are still
(22:55):
engaging with products that have pea foss in them as well.
Speaker 1 (22:59):
You know, yeah, a product I use just about every
day every other day, at least nonstick cookware. You know,
they manufacturers have they changed the contents or is it
about changing contents of the makeup of these products, or
you change the contents you know, no longer have that product.
Speaker 2 (23:21):
Yeah, and it's an ever changing landscape, so that's also
tricky to answer. So nonstick cookware historically has used p FOS.
Testlon itself is pfas it's a brand name, But more
and more there are becoming nonstick products, nonstick cookware pans
(23:43):
that claim there are no p face in them, but
it may be that that p FOS referring to are
these commonly known long chain p sauce, But there are
new generations of pot or p soce like compounds. The
industries are producing I have similar properties that we don't
know the health effects of. Again, so it's an ever
(24:04):
fighting uphill battle as more and more industries release more
and more chemicals what their health effects are. So I
would encourage people that are really concerned about exposure from
cookwaar to really look for alternative like stainless steel, cast
iron glass or enamel would be good alternative.
Speaker 1 (24:25):
Yeah, and does it I wonder if then, again, this
is more of a medical question. I was just wondering
if it falls along the lines as we know, like
with influenza or any sort of disease virus, the very old,
very young, and immune compromise tend to be more at risk.
But do you know that offhand or like I said,
that's more of a medical question.
Speaker 2 (24:45):
Yeah, it's more of a medical question there. I know
that there's been research studies that have looked into that,
certainly because p FOSS and any chemical exposure has the
potential to increase inflammatory responses in the body, just like
you know, produces a stress response, and so there have
been studies looking at that. I know that there have
been some studies that found associations others that haven't. I
(25:08):
am not sure what the current evidence is for that
right now, so I can't really speak to that.
Speaker 1 (25:14):
Let me ask you, now, PIFAs are the ce minuscule.
Let's my drinking water. I use a brit A filtered water.
Does that protect you or now?
Speaker 2 (25:29):
Yeah, So it depends what type of filter you have.
So certainly filters, carbon filters can remove some PIFAs or
a percentage of PIFAs that's in water, it should say,
especially if it's National Science Foundation certified, which a lot
of under the sink filters or whole house filters which
(25:52):
are more expensive, but you can get under the sink
filters that are just filtering your drinking water, or picture filters.
That should tell you that they been tested, meaning that
a third party or government party such as the National
Science Foundation hasted to see how much is reduced by
using a filter for each type of compound. It's usually
(26:12):
not just p sass, but they'll report on lead and
and other compounds as well. So yes, certainly carbon filtration
is a good way to remove some pithos, and municipalities
are again working on removing pifos, and we'll need to
have measures in place under the new EPA standard to
(26:33):
get it to the level that they're setting, so it's
in the works. And then of course if you're on
a private well, I would encourage people to get their
well water tested to see what their shovel is and
if they need to be concerned about it.
Speaker 1 (26:47):
So, even at this stage of the game, still so
much unknown, but are there are some small things we
can do to try and protect ourselves somewhat, because it's
not just simply staying away from a process s diet obviously,
because you know, even raw fresh they're exposed to PIFAs
in the groundwater, what have you.
Speaker 2 (27:08):
Yeah, that's correct. Yeah, yeah, I think there's a lot
of things people can do. They can look at the
their municipal report for their water municipality service to see
if they've tested for p sos and what the levels are,
and if they are concerned, they could get a filtration
device in their house, either a picture one under the
(27:29):
zinc one, depending on how much they are able to
spend and want to spend. Again. Cookware, replacing some of
your nonstick cookware with stainless steel or cast iron, and
then being mindful of when you're buying new products, trying
to unless it's an essential feature that you're looking for.
Not selecting stain resistant, water proof, water resistant unless it's needed,
(27:53):
because that will probably are more likely to have pifoss
in it. Yeah. And then of course fast food containers, packaging,
you know, takeout containers can have lined be lined with
pece austin. So limiting your fast food consumption or transferring
fast food into a you know, onto a enamel plate
or into a glass bowl before you reheat it or
(28:16):
eat from it. Oh yeah, it can also reduced. Yeah.
Speaker 1 (28:18):
I heard of that about five years or so ago,
and I've taken notice and do that.
Speaker 2 (28:25):
Yeah.
Speaker 1 (28:26):
Never never reheat a styrophoam oh god, no, never do that.
Always put into glass.
Speaker 2 (28:33):
Yeah. Yeah, so there are some small things people can
do to reduce their composer.
Speaker 1 (28:37):
Yes, all right again, I've been speaking with Amy Schultz.
She is an epidemiology Senior data scientist with the Reach
Program UW School and Medicine Public Health. Amy, what's are
you still working on this research that you just put
out information about a couple of weeks ago or what's
next here?
Speaker 2 (28:59):
Yeah, we're definitely looking to take this to the next step,
which would be to expand our study sample to include
more residents in other parts of the state, more diverse
populations within the state, and then actually measure p fast
and drinking water and food among the same participants in
a hustle dust and actually try to understand what routes
(29:21):
of exposure are really driving some of these associations, and
capture more information on diet and consumer product use, so
we can really get a more holistic picture of what
are the main drivers among a statewide sample, not among
people that we know are predominantly exposed to drinking water
or occupation. So, yeah, we're still working on it, so
(29:42):
we'll hopefully have some more findings soon.
Speaker 1 (29:44):
All right, Well, you've got job security, that's for sure.
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