Yale School of Public Health Symposium: An overview of the challenges and opportunities associated with per- and polyfluoroalkyl substances (PFAS)

Abstract

On December 13, 2019, the Yale School of Public Health hosted a symposium titled “Per- and Polyfluoroalkyl Substances (PFAS): Challenges and Opportunities” in New Haven, Connecticut. The meeting focused on the current state of the science on these chemicals, highlighted the challenges unique to PFAS, and explored promising opportunities for addressing them. It brought together participants from Yale University, the National Institute of Environmental Health Sciences, the University of Massachusetts Amherst, the University of Connecticut, the Connecticut Agricultural Experiment Station, the Connecticut Departments of Public Health and Energy and Environmental Protection, and the public and private sectors. Presentations during the symposium centered around several primary themes. The first reviewed the current state of the science on the health effects associated with PFAS exposure and noted key areas that warranted future research. As research in this field relies on specialized laboratory analyses, the second theme considered commercially available methods for PFAS analysis as well as several emerging analytical approaches that support health studies and facilitate the investigation of a broader range of PFAS. Since mitigation of PFAS exposure requires prevention and cleanup of contamination, the third theme highlighted new nanotechnology-enabled PFAS remediation technologies and explored the potential of green chemistry to develop safer alternatives to PFAS. The fourth theme covered collaborative efforts to assess the vulnerability of in-state private wells and small public water supplies to PFAS contamination by adjacent landfills, and the fifth focused on strategies that promote successful community engagement. This symposium supported a unique interdisciplinary coalition established during the development of Connecticut's PFAS Action Plan, and discussions occurring throughout the symposium revealed opportunities for collaborations among Connecticut scientists, state and local officials, and community advocates. In doing so, it bolstered the State of Connecticut's efforts to implement the ambitious initiatives that its PFAS Action Plan recommends.

Introduction

Per- and polyfluoroalkyl substances (PFAS), a family of >9000 synthetic organic chemicals (EPAa), have captured the attention of people across the globe due to a growing concern about the health risks posed by widespread PFAS contamination in drinking water sources and other environmental media. While PFAS vary widely in their physical and chemical properties, they all contain at least one chain of carbon atoms in which one or more of the carbon atoms is perfluorinated, i.e., has fluorine atoms attached at all bonding sites not occupied by another carbon atom (Buck et al., 2011). Since their initial introduction in the 1940s, PFAS have become pervasive in consumer products and industrial processes because of the unique properties imparted by their chemical structures, including stability, heat resistance, friction reduction abilities, and oil and water repellence (Buck et al., 2012). However, as an unintended consequence of these same useful properties, many PFAS are now persistent pollutants that spread throughout the environment, contaminate food and drinking water sources, and ultimately bioaccumulate in animals and humans (Sunderland et al., 2019). Toxicological and epidemiological research has associated exposure to certain PFAS, particularly certain long-chain perfluoroalkyl acids, with a wide range of adverse health effects (reviewed in depth in Fenton et al., 2020), including thyroid disruption (Andersson et al., 2019; Ballesteros et al., 2017; Blake et al., 2018; Caron-Beaudoin et al., 2019), ulcerative colitis (Steenland et al., 2018; Steenland et al., 2013), high cholesterol (Lin et al., 2019; Nelson et al., 2010), pregnancy-induced hypertension (Starling et al., 2014), decreased immune responsiveness (DeWitt et al., 2019), and kidney and testicular cancer (Barry et al., 2013; Shearer et al., 2020). Measurable levels of some PFAS are present in the blood of over 95% of U.S. residents, and PFAS contamination has been discovered in drinking water nationwide (Hu et al., 2016). During the third Unregulated Contaminant Monitoring Rule (UCMR3; 2013–2015) water survey, the U.S. Environmental Protection Agency (EPA) found that 1.3% of the nation's largest public water systems, which provide drinking water to an estimated 5.5 million people, contained at least one PFAS compound in concentrations exceeding its reference concentration of 70 ng/L (ppt) (EPA, 2016).

In the absence of timely federal action to regulate PFAS or set enforceable drinking water standards and in response to community concerns, many U.S. states have taken independent action to safeguard their residents against the health risks posed by PFAS (reviewed in Blake and Fenton, 2020 and Post, 2020). In July 2019, Connecticut Governor Ned Lamont established the Interagency PFAS Task Force to advise his administration and formulate an action plan containing a comprehensive state strategy to address PFAS. The task force was led by the Commissioners of the Connecticut Departments of Public Health (CTDPH) and Energy and Environmental Protection (CTDEEP) and comprised representatives from 18 state agencies and entities. To enable all affected stakeholders to take part in the process, the task force established three subcommittees, each open to public participation, to discuss strategies to (1) minimize environmental exposure of Connecticut residents to PFAS, (2) minimize future releases of PFAS into the environment, and (3) identify, assess, and clean up historical releases of PFAS into the environment, respectively. This process brought together key academic, government, and private- and public-sector stakeholders from across the state. An action plan, developed by the Task Force and its subcommittees, was released in draft form in October 2019 for public comment. After revisions to reflect public input, the finalized PFAS Action Plan was delivered to Governor Lamont on November 1, 2019 and released to the public soon thereafter (The Connecticut Interagency PFAS Task Force, 2019). The plan laid out a series of actions that the State of Connecticut could take to protect public health, identify and remediate existing PFAS pollution, prevent future pollution, and enhance outreach and communication with the general public on the adverse health effects of PFAS exposure and strategies for mitigating exposure.

To foster continued collaboration between local scientists, government officials, public citizens, and other parties, the Yale School of Public Health hosted a daylong symposium on December 13, 2019 titled “Per- and Polyfluoroalkyl Substances (PFAS): Challenges and Opportunities.” This symposium drew participants from Yale, CTDEEP, CTDPH, the Connecticut Agricultural Experiment Station, the National Institute of Environmental Health Sciences (NIEHS), the University of Massachusetts Amherst, the University of Connecticut, and key stakeholders in the public and private sectors. Presentations during the symposium centered around several primary themes. The first reviewed the current state of the science on the health effects of PFAS and noted key research gaps that require further study. As research in this field relies on specialized laboratory analyses, the second theme considered commercially available methods for PFAS analysis as well as several emerging analytical approaches that support new health studies and facilitate the investigation of a broader range of PFAS. Since mitigation of PFAS exposure requires prevention and cleanup of contamination, the third theme highlighted new nanotechnology-enabled PFAS remediation technologies and explored the potential of green chemistry to develop safer alternatives to PFAS. The fourth theme covered a collaboration between Yale researchers and CTDEEP to assess the vulnerability of private wells and small public water supplies to PFAS contamination by adjacent landfills, and the fifth focused on strategies that promote successful community engagement. Discussions occurring throughout the symposium revealed opportunities for collaborations that would support ongoing CTDEEP and CTDPH efforts to implement the initiatives recommended in the Connecticut PFAS Action Plan. The highlights of these sessions' presentations are summarized herein. This summary provides a valuable snapshot of early dialogue between researchers, government officials, and representatives of local health and nonprofit organizations convened to share cutting-edge scientific advances and coordinate future multisector collaborations to help the state confront an environmental health issue of national and global importance.