Per- and Polyfluoroalkyl Substance Exposure Risks in US Carceral Facilities, 2022.

Objectives. To assess the US incarcerated population's risk of exposure to per- and polyfluoroalkyl substances (PFASs). Methods. We assessed how many of the 6118 US carceral facilities were located in the same hydrologic unit code watershed boundaries as known or likely locations of PFAS contamination. We conducted geospatial analyses on data aggregated from Environmental Protection Agency databases and a PFAS site tracker in 2022 to model the hydrologically feasible known and presumptive PFAS contamination sites for nearly 2 million incarcerated people. Results. Findings indicate that 5% (∼310) of US carceral facilities have at least 1 known source of PFAS contamination in the same watershed boundary and that it is at a higher elevation than the facility; also 47% (∼2285) have at least 1 presumptive source. A minimum of 990 000 people are incarcerated in these facilities, including at least 12 800 juveniles. Exposure risks faced by incarcerated youths are disproportionately underassessed. Conclusions. The long-term impacts from potential exposures to PFAS are preventable and exacerbate health inequities among incarcerated populations. Widespread public attention to PFASs can be parlayed into broader environmental monitoring for imprisoned people. (Am J Public Health. 2024;114(5):501-510. https://doi.org/10.2105/AJPH.2024.307571).

PFAS Contamination in Europe: Generating Knowledge and Mapping Known and Likely Contamination with "Expert-Reviewed" Journalism.

While the extent of environmental contamination by per- and polyfluoroalkyl substances (PFAS) has mobilized considerable efforts around the globe in recent years, publicly available data on PFAS in Europe were very limited. In an unprecedented experiment of "expert-reviewed journalism" involving 29 journalists and seven scientific advisers, a cross-border collaborative project, the "Forever Pollution Project" (FPP), drew on both scientific methods and investigative journalism techniques such as open-source intelligence (OSINT) and freedom of information (FOI) requests to map contamination across Europe, making public data that previously had existed as "unseen science". The FPP identified 22,934 known contamination sites, including 20 PFAS manufacturing facilities, and 21,426 "presumptive contamination sites", including 13,745 sites presumably contaminated with fluorinated aqueous film-forming foam (AFFF) discharge, 2911 industrial facilities, and 4752 sites related to PFAS-containing waste. Additionally, the FPP identified 231 "known PFAS users", a new category for sites with an intermediate level of evidence of PFAS use and considered likely to be contamination sources. However, the true extent of contamination in Europe remains significantly underestimated due to a lack of comprehensive geolocation, sampling, and publicly available data. This model of knowledge production and dissemination offers lessons for researchers, policymakers, and journalists about cross-field collaborations and data transparency.

Non-stick science: Sixty years of research and (in)action on fluorinated compounds.

Understandings of environmental governance both assume and challenge the relationship between expert knowledge and corresponding action. We explore this interplay by examining the context of knowledge production pertaining to a contested class of chemicals. Per-and polyfluorinated alkyl substances (PFASs) are widely used industrial compounds containing chemical chains of carbon and fluorine that are persistent, bioaccumulative and toxic. Although industry and regulatory scientists have studied the exposure and toxicity concerns of these compounds for decades, and several contaminated communities have documented health concerns as a result of their high levels of exposure, PFAS use remains ubiquitous in a large range of consumer and industrial products. Despite this significant history of industry knowledge production documenting exposure and toxicity concerns, the regulatory approach to PFASs has been limited. This is largely due to a regulatory framework that privileges industry incentives for rapid market entry and trade secret protection over substantive public health protection, creating areas of unseen science, research that is conducted but never shared outside of institutional boundaries. In particular, the risks of PFASs have been both structurally hidden and unexamined by existing regulatory and industry practice. This reveals the uneven pathways that construct issues of social and scientific concern.

Can Chemical Class Approaches Replace Chemical-by-Chemical Strategies? Lessons from Recent U.S. FDA Regulatory Action on Per- And Polyfluoroalkyl Substances.

Concern about the toxicity and exposure of per- and polyfluoroalkyl substances (PFASs) is growing among scientists, regulators, and residents of contaminated communities. In 2016, the United States Food and Drug Administration (FDA) removed three food contact substances (FCSs) containing perfluorinated chemicals from the list of approved FCSs due to concerns regarding chemical safety. To investigate the significance and limitations of the FDA's regulatory action for environmental health research, advocacy, and regulation, we conducted a media analysis and qualitative interviews with a range of involved stakeholders. We find that the FDA's regulatory action represents a potential shift from chemical-by-chemical regulation toward class-based regulation, where groups of chemicals can be identified as sharing properties and risks, and are thus evaluated and regulated together. The FDA decision sets an important precedent of using a petition process to delist chemicals based on a safety standard. However, the narrow reach of this action also highlights the need for more comprehensive, precautionary chemical regulation capable of thoroughly evaluating classes of chemicals, and raises important questions about how classes of chemicals are delimited in environmental health science and regulation.

Factors associated with self-reported health: implications for screening level community-based health and environmental studies.

BACKGROUND: Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based health indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mortality, suggesting that self-reported health (SRH) may be useful in screening-level community assessments. This paper evaluates whether SRH is an appropriate surrogate indicator of health status by evaluating relationships between SRH and sociodemographic, lifestyle, and health care factors as well as serological indicators of nutrition, health risk, and environmental exposures. METHODS: Data were combined from the 2003-2006 National Health and Nutrition Examination Surveys for 1372 nonsmoking 20-50 year olds. Ordinal and binary logistic regression was used to estimate odds ratios and 95 % confidence intervals of reporting poorer health based on measures of nutrition, health condition, environmental contaminants, and sociodemographic, health care, and lifestyle factors. RESULTS: Poorer SRH was associated with several serological measures of nutrition, health condition, and biomarkers of toluene, cadmium, lead, and mercury exposure. Race/ethnicity, income, education, access to health care, food security, exercise, poor mental and physical health, prescription drug use, and multiple health outcome measures (e.g., diabetes, thyroid problems, asthma) were also associated with poorer SRH. CONCLUSION: Based on the many significant associations between SRH and serological assays of health risk, sociodemographic measures, health care access and utilization, and lifestyle factors, SRH appears to be a useful health indicator with potential relevance for screening level community-based health and environmental studies.

Quantifying Disparities in Per- and Polyfluoroalkyl Substances (PFAS) Levels in Drinking Water from Overburdened Communities in New Jersey, 2019-2021.

BACKGROUND: Policymakers have become increasingly concerned regarding the widespread exposure and toxicity of per- and polyfluoroalkyl substances (PFAS). While concerns exist about unequal distribution of PFAS contamination in drinking water, research is lacking. OBJECTIVES: We assess the scope of PFAS contamination in drinking water in New Jersey (NJ), the first US state to develop regulatory levels for PFAS in drinking water. We test for inequities in PFAS concentrations by community sociodemographic characteristics. METHODS: We use PFAS testing data for community water systems (CWS) (n=491) from the NJ Department of Environmental Protection (NJDEP) from 2019 to 2021 and demographic data at the block group level from the US Census to estimate the demographics of the NJ population served by CWS. We use difference in means tests to determine whether CWSs serving "overburdened communities" (OBCs) have a statistically significant difference in likelihood of PFAS detections. OBCs are defined by the NJDEP to be census block groups in which: a) at least 35% of the households qualify as low-income, b) at least 40% of the residents identify as people of color, or c) at least 40% of the households have limited English proficiency. We calculate statewide summary statistics to approximate the relative proportions of sociodemographic groups that are served by CWSs with PFAS detections. RESULTS: We find that 63% of all CWSs tested by NJDEP from 2019 to 2021 had PFAS detections in public drinking water, collectively serving 84% of NJ's population receiving water from CWSs. Additionally, CWSs serving OBCs had a statistically significant higher likelihood of PFAS detection and a higher likelihood of exposure above state MCLs. We also find that a larger proportion of people of color lived in CWS service areas with PFAS detections compared to the non-Hispanic white population. DISCUSSION: These findings quantitatively identify disparities in PFAS contamination of drinking water by CWS service area and highlight the extent of PFAS drinking water contamination and the importance of PFAS remediation efforts for protecting environmental health and justice. https://doi.org/10.1289/EHP12787.

Chemical regulation on fire: rapid policy advances on flame retardants.

Chemicals that are widely used in consumer products offer challenges to product manufacturers, risk managers, environmental regulators, environmental scientists, and the interested public. However, the factors that cause specific chemicals to rise to the level of regulatory, scientific, and social movement concern and scrutiny are not well documented, and scientists are frequently unclear about exactly how their research impacts policy. Through a case study of advocacy around flame retardant chemicals, this paper traces the pathways through which scientific evidence and concern is marshaled by both advocacy groups and media sources to affect policy change. We focus our analysis around a broad coalition of environmental and public health advocacy organizations and an investigative journalism series published in 2012 in the Chicago Tribune. We demonstrate that the Tribune series both brought the issue to a wider public audience and precipitated government action, including state policy revisions and federal Senate hearings. We also show how a broad and successful flame retardant coalition developed, leveraged a media event, and influenced policy at multiple institutional levels. The analysis draws on over 110 in-depth interviews, literature and Web site reviews, and observations at a flame retardant manufacturing company, government offices, and scientific and advocacy conferences.

Presumptive Contamination: A New Approach to PFAS Contamination Based on Likely Sources.

While research and regulatory attention to per- and polyfluoroalkyl substances (PFAS) has increased exponentially in recent years, data are uneven and incomplete about the scale, scope, and severity of PFAS releases and resulting contamination in the United States. This paper argues that in the absence of high-quality testing data, PFAS contamination can be presumed around three types of facilities: (1) fluorinated aqueous film-forming foam (AFFF) discharge sites, (2) certain industrial facilities, and (3) sites related to PFAS-containing waste. While data are incomplete on all three types of presumptive PFAS contamination sites, we integrate available geocoded, nationwide data sets into a single map of presumptive contamination sites in the United States, identifying 57,412 sites of presumptive PFAS contamination: 49,145 industrial facilities, 4,255 wastewater treatment plants, 3,493 current or former military sites, and 519 major airports. This conceptual approach allows governments, industries, and communities to rapidly and systematically identify potential exposure sources.

Staring at the Sun during Wildfire Season: Knowledge, Uncertainty, and Front-Line Resistance in Disaster Preparation.

As climate change increases the frequency and severity of disasters, and population and social changes raise the public's vulnerability to disaster events, societies face additional risk of multiple disaster events or other hazards occurring simultaneously. Such hazards involve significant uncertainty, which must be translated into concrete plans able to be implemented by disaster workers. Little research has explored how disaster managers incorporate different forms of knowledge and uncertainty into preparations for simultaneous hazards or disaster events, or how front-line disaster workers respond to and implement these plans. In this paper I draw on ethnographic research working as a wildland firefighter, interviews with firefighters and fire managers, and state and agency planning documents to examine preparations for two events occurring in Central Oregon in August 2017: (1) the height of wildfire season and (2) hundreds of thousands of anticipated visitors for a total solar eclipse. I find that different qualities of risk, hazard, and uncertainty across these two events were central to the development and implementation of disaster plans. Agency leaders devised worst-case scenario plans for the eclipse based on uncertain predictions regarding hazards from the eclipse and the occurrence of severe wildfires, aiming to eliminate the potential for unknown hazards. These plans were generally met with skepticism by front-line disaster workers. Despite the uncertainties that dominated eclipse-planning rhetoric, firefighters largely identified risks from the eclipse that were risks they dealt with in their daily work as firefighters. I conclude by discussing implications of these findings for conceptual understandings of disaster planning as well as contemporary concerns about skepticism and conspiracy theories directed at government planning and response to disaster events.

Re-envisioning EPA and its work in the post-Trump era: perspectives from EPA employees.

The Trump administration has severely curtailed the work of the United States Environmental Protection Agency (EPA). The EPA has rolled back environmental protections, lost ground on addressing climate change and environmental justice, and shed large numbers of experienced staff. All of this has accelerated a longer-term decline in EPA resources, expertise, and authority. Here, we present perspectives of EPA employees and retirees on reconfiguring and strengthening the agency to address current and future environmental health problems, based on qualitative data obtained through 100 semi-structured interviews with 76 current and former EPA employees. Interviewees emphasized a number of internal and external issues, including a hyper-partisan context in which the agency operates, lack of public understanding of the extent of domestic and global environmental problems, budget shortfalls, staffing and leadership challenges, reduced scientific capacity and use of science in decision-making, insufficient attention to environmental justice, and lagging technology. We argue that reforms cannot only be expert-driven but must also come from the public, incorporating community driven solutions and focusing on remedying environmental injustice.

COVID-19 as Eco-Pandemic Injustice: Opportunities for Collective and Antiracist Approaches to Environmental Health.

The COVID-19 pandemic has coincided with a powerful upsurge in antiracist activism in the United States, linking many forms and consequences of racism to public and environmental health. This commentary develops the concept of eco-pandemic injustice to explain interrelationships between the pandemic and socioecological systems, demonstrating how COVID-19 both reveals and deepens structural inequalities that form along lines of environmental health. Using Pellow's critical environmental justice theory, we examine how the crisis has made more visible and exacerbated links between racism, poverty, and health while providing opportunities to enact change through collective embodied health movements. We describe new collaborations and the potential for meaningful opportunities at the intersections between health, antiracist, environmental, and political movements that are advocating for the types of transformational change described by critical environmental justice.

Correction: Guideline levels for PFOA and PFOS in drinking water: the role of scientific uncertainty, risk assessment decisions, and social factors.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Environmental Chemicals and Public Sociology: Engaged Scholarship on Highly Fluorinated Compounds.

We report here on a multifaceted body of research on per- and polyfluoroalkyl substances (PFAS), chemicals that have become a well-known group of 'emerging contaminants' in recent years. Our PFAS Project team of over 10 researchers - faculty, postdocs, graduate students, and undergraduates - has been working since 2015 to study the extent and health effects of PFAS contamination through a broad model of engaged public sociology. Our model of research combines organic public sociology with elements of community-based participatory research, a related but distinct research form most widely used in the environmental health sciences. Based on long-term, place-based relationships, our engaged public sociology has led to numerous academic, regulatory, and social movement effects. We argue that this form of engaged, intervention-oriented public sociology is appropriate and beneficial for research in many areas of environmental sociology given the social and ecological stakes in the current moment. Engaged public sociology involves collaborative, reflexive research with broadly-conceived communities or publics. It facilitates the creation of previously undone science by addressing research topics of interest to community members, and allows researchers to directly contribute to environmental and social justice movements by acting as reflexive, observant participants.

Combining Social Science and Environmental Health Research for Community Engagement.

Social science-environmental health (SS-EH) research takes many structural forms and contributes to a wide variety of topical areas. In this article we discuss the general nature of SS-EH contributions and offer a new typology of SS-EH practice that situates this type of research in a larger transdisciplinary sensibility: (1) environmental health science influenced by social science; (2) social science studies of environmental health; and (3) social science-environmental health collaborations. We describe examples from our own and others' work and we discuss the central role that research centers, training programs, and conferences play in furthering SS-EH research. We argue that the third form of SS-EH research, SS-EH collaborations, offers the greatest potential for improving public and environmental health, though such collaborations come with important challenges and demand constant reflexivity on the part of researchers.

Guideline levels for PFOA and PFOS in drinking water: the role of scientific uncertainty, risk assessment decisions, and social factors.

Communities across the U.S. are discovering drinking water contaminated by perfluoroalkyl and polyfluoroalkyl substances (PFAS) and determining appropriate actions. There are currently no federal PFAS drinking water standards despite widespread drinking water contamination, ubiquitous population-level exposure, and toxicological and epidemiological evidence of adverse health effects. Absent federal PFAS standards, multiple U.S. states have developed their own health-based water guideline levels to guide decisions about contaminated site cleanup and drinking water surveillance and treatment. We examined perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) water guideline levels developed by the U.S. Environmental Protection Agency (EPA) and state agencies to protect people drinking the water, and summarized how and why these levels differ. We referenced documents and tables released in June 2018 by the Interstate Technology and Regulatory Council (ITRC) to identify states that have drinking water and groundwater guideline levels for PFOA and/or PFOS that differ from EPA's health advisories (HAs). We also gathered assessment documents from state websites and contacted state environmental and health agencies to identify and confirm current guidelines. Seven states have developed their own water guideline levels for PFOA and/or PFOS ranging from 13 to 1000 ng/L, compared to EPA's HA of 70 ng/L for both compounds individually or combined. We find that the development of PFAS guideline levels via exposure and hazard assessment decisions is influenced by multiple scientific, technical, and social factors, including managing scientific uncertainty, technical decisions and capacity, and social, political, and economic influences from involved stakeholders. Assessments by multiple states and academic scientists suggest that EPA's HA is not sufficiently protective. The ability of states to develop their own guideline levels and standards provides diverse risk assessment approaches as models for other state and federal regulators, while a sufficiently protective, scientifically sound, and enforceable federal standard would provide more consistent protection.

Correction: Guideline levels for PFOA and PFOS in drinking water: the role of scientific uncertainty, risk assessment decisions, and social factors.

This paper was originally published under a standard licence. This has now been amended to a CC BY licence in the PDF and HTML.

Gender and Racial/Ethnic Disparities: Cumulative Screening of Health Risk Indicators in 20-50 Year Olds in the United States.

This study explored potential gender and racial/ethnic disparities in overall health risk related to 24 health risk indicators selected across six domains: socioeconomic, health status and health care, lifestyle, nutritional, clinical, and environmental. Using the 2003-2006 National Health and Nutrition Examination Surveys (NHANES), it evaluated cross-sectional data for 5,024 adults in the United States. Logistic regression models were developed to estimate prevalence odds ratios (PORs) adjusted for smoking, health insurance status, and age. Analyses evaluated disparities associated with 24 indicator variables of health risk, comparing females to males and four racial/ethnic groups to non-Hispanic Whites. Non-Hispanic Blacks and Mexican Americans were at greater risk for at least 50% of the 24 health risk indicators, including measures of socioeconomic status, health risk behaviors, poor/fair self-reported health status, multiple nutritional and clinical indicators, and blood lead levels. This demonstrates that cumulative health risk is unevenly distributed across racial/ethnic groups. A similarly high percentage (46%) of the risk factors was observed in females. Females as compared to males were more likely to have lower income, lower blood calcium, poor/fair self-reported health, more poor mental health days/month, higher medication usage and hospitalizations, and higher serum levels of some clinical indicators and blood cadmium. This analysis of cumulative health risk is responsive to calls for broader-based, more integrated assessment of health disparities that can help inform community assessments and public health policy.