09 December
A long-delayed project to convert organic waste into natural gas for heating fuel at the city’s Newtown Creek Wastewater Treatment Plant is on track to launch as early as next month, according to sources with knowledge of the effort.
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- Exposed: BPA science
- Agents of Change
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- Cancer risk in Pittsburgh
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- Peak Pig: The soul of rural America
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A report released in July and new courses for medical professionals aim to change that. The National Academies of Sciences, Engineering and Medicine report recommends offering per- and polyfluoroalkyl substances, commonly known as PFAS, blood testing to individuals likely to have had elevated exposure and prioritizes certain types of medical screening for affected individuals. In addition, in October 2022, our team launched a free Continuing Medical Education course, initiated by and including perspectives from community activists, along with a Clinician Resources webpage on the PFAS Exchange.
These recommendations and resources are urgent: PFAS—used to impart stain, water, grease and heat-resistance to many common consumer products—are persistent in the environment and our bodies and have likely impacted the drinking water of more than 200 million Americans. PFAS have been linked to far-ranging health effects, including high cholesterol, immune suppression, thyroid disease and cancer.
Our aim to increase the medical community’s knowledge and resources in addressing PFAS is gaining traction. These efforts are part of a growing recognition of the need for more health professional education and guidance on health implications of PFAS exposure, obtaining and interpreting PFAS blood testing and improving patient care.
PFAS testing can save lives
The importance of clinician education regarding PFAS is demonstrated in the lives of those affected by these chemicals. Michigan resident Sandy Wynn-Stelt learned in 2017 that she and her late husband Joel had consumed highly contaminated water for over a decade prior to his fatal liver cancer diagnosis. Her quest for answers led her to get tests — both her blood and her private well had extremely high levels. She shared her test results with her doctor along with information about PFAS health effects. This information likely saved her life: Wynn-Stelt’s physician monitored her health and was able to make an early diagnosis of thyroid cancer based on the results of her PFAS blood test and other information.
Related: Where did the PFAS in your blood come from? These computer models offer clues
Similarly, Ayesha Khan became concerned about PFAS after her firefighter husband Nate Barber was diagnosed with testicular cancer in 2019 and she learned that PFAS exposure is a risk factor for the condition. PFAS contamination was discovered in groundwater near the Nantucket Airport close to their home around that time and she was additionally concerned to learn that firefighters are exposed to PFAS from firefighting foam, as well as their protective gear. In 2020, she and her close friend Jaime Honkawa founded the Nantucket PFAS Action Group, a community organization that educates firefighters and the public about the risks of PFAS — and helps them take protective action.
Our new course was prompted by a request from the Nantucket Cottage Hospital to the Nantucket PFAS Action Group to develop training for their medical professionals about PFAS exposure. The Nantucket PFAS Action Group worked with the PFAS-REACH collaborative team and the Mid-America Pediatric Environmental Health Specialty Unit to develop the course.
Released this October through Children’s Mercy Hospital, the course features both scientific experts as well as people who’ve experienced contamination. It was designed to be useful to all health professionals, and especially those in PFAS-impacted areas or whose patients have been occupationally or otherwise exposed. It can be accessed via the Children’s Mercy Hospital website or on the Clinician Resources page of the PFAS Exchange website.
Testing individuals for PFAS
PFAS blood samples taken in 2018 and 2020 from residents in Wilmington, North Carolina, and three towns in El Paso County, Colorado.Credit: Dylan WallisIn the past, the federal Agency for Toxic Substances and Disease Registry and other health agencies have emphasized the benefits of testing at the population, rather than individual, level. So the National Academies of Sciences, Engineering and Medicine report’s recommendation to offer PFAS blood testing to individuals who have likely experienced elevated exposures is noteworthy. The report highlighted the importance of patient autonomy with informed, shared decision making between clinicians and patients about PFAS blood testing and medical screening with discussion of its benefits, harms and limitations. It noted how testing can help people feel empowered in managing their own health and can relieve the stress of not knowing one’s exposure.
For patients with moderately elevated PFAS blood levels, the report recommends that clinicians focus on screening for high blood pressure, pregnancy induced hypertension and breast cancer based on age and other risk factors. For patients with higher total PFAS in their blood, the report additionally recommends that clinicians test for thyroid function and assess for signs of ulcerative colitis as well as kidney and testicular cancer.
The recommendations have been well received by those impacted by PFAS contamination. Andrea Amico of Testing for Pease in New Hampshire called the report’s recommendations “huge milestones in the right direction,” and Emily Donovan of the community action group Clean Cape Fear in North Carolina wrote that the new report is “an important first step for our community” and that it “allows us to begin the process of caring for the elevated disease burdens our region is experiencing.” Amico, Donovan and many others from PFAS-impacted communities across the country provided valuable input for the report.
Taking action on PFAS pollution
PFAS science and activism have expanded enormously in less than a decade and engagement of medical professionals has not kept pace. Now, the combination of the National Academies of Sciences, Engineering, and Medicine report and our Continuing Medical Education course opens up new avenues to address health effects and should spur health professionals to join in work to halt the upstream production and emissions of PFAS.
If you are a resident of a PFAS-impacted community, you can share our Resources for Clinicians page with your medical providers and explore our PFAS Exchange website. If you are a medical professional, please consider enrolling in our course and sharing the information with your network of medical and public health organizations.
Together, we can empower PFAS-affected people and help tackle this insidious pollution.
For more information:
- Download the National Academies of Sciences, Engineering and Medicine report
- Access our free Continuing Medical Education (CME) Training at the Children’s Mercy Hospital Continuing Medical Education page.
- Check out our Resources for Clinicians, which includes video of the training, a link to feedback survey, and medical screening guidance
PFAS-REACH (Research, Education, and Action for Community Health) is a collaboration among Silent Spring Institute, Northeastern University, Michigan State University, Testing for Pease, Massachusetts Breast Cancer Coalition, and Slingshot. We acknowledge the work of Elizabeth Friedman, MD and Alan Ducatman, MD who are responsible for the medical content of the CME course.
The paper, published this week in Nature, calls into question the plan’s treatment of biomass — organic material from trees, plants and animals — as carbon neutral, as this incentivizes cutting down trees and planting more crops that can be burned for energy. Burning biomass not only removes trees that can store carbon, but releases greenhouse gasses as well.
The authors warn this will destroy habitats for important wildlife and spur deforestation, and that Europe does not have the land space to produce additional biomass. Europe already relies heavily on land abroad for farm production and these imports account annually for about 400 million tons of carbon dioxide — eclipsing the benefits from the growth of European forests in recent decades.
“Thus, rather than Europe having spare land or wood to supply additional bioenergy or other consumption, climate strategies require the bloc to ‘give back’ land and carbon either to nature or to supply others,” the authors wrote.
There is a more sustainable path forward for Europe, the authors point out, but the current climate plan as written diverts 20% of Europe’s land for crops to those that can be burned for energy.
“The simplest solution is for the EU to stop treating biomass from energy crops and wood harvests as carbon neutral,” the authors wrote.
What is Fit for 55?
The plan in question is called Fit for 55 — a law that mandates the EU reduce greenhouse gas emissions by at least 55% by 2030 (relative to 1990 levels). It also aims to make the entire EU climate neutral by 2050. The package includes a number of plans to achieve these goals including bolstered energy efficiency, an emissions trading system, more infrastructure for renewable energy, stricter emissions standards for vehicles and other measures.
The plan is the first of its kind on the planet. The European Parliament and the European Council are still negotiating the final details.
Why is biomass a problem?
Deforestation destroys habitats for wildlife, and means carbon stored in trees can release back into the atmosphere as carbon dioxide.
Credit: World Bank
The new Nature analysis says not only must the world decrease fossil fuel consumption but also its “land carbon footprint” — which is “the quantity of carbon lost from native habitats to supply agricultural products and wood.”
“By treating biomass as ‘carbon neutral’, [Fit for 55] create[s] incentives to harvest wood and to divert cropland to energy crops, regardless of the consequences for land-based carbon storage.”
Growing trees and crops strictly for energy use has urgent food security consequences as well. The authors estimate that cutting 85% of Europe’s biodiesel use and half of U.S. and European grain ethanol would “free up enough crops to replace all Ukraine’s vegetable oil and grain exports.”
Additionally, Europe’s reliance on food imports means its forests have grown, but the region’s imports led to about 11 million hectares of deforestation elsewhere, mostly in the tropics.
This deforestation destroys habitats for wildlife, and means carbon stored in trees can release back into the atmosphere as carbon dioxide.
Biomass accounting error
The plan considers biomass carbon neutral because the emissions from burning it would be presumably offset by growing new plants. The new paper argues this is faulty logic because land is required to grow those plants. Using land for biomass crops means you cannot grow food on the land, so other land needs to be converted or the food must be imported. Also, trees cut down for biomass means less carbon stored in the forests.
The Fit for 55 estimates biomass use will double from 2015 to 2050 — requiring annual biomass amounts that are double Europe’s current wood harvest.
“Land is not ‘free’” the authors wrote.
How can Europe’s plan improve?
The authors estimate Europe could free up roughly 17 million hectares of land by 2050, by reducing both consumption of biomass fuels and livestock farming. This would free up land to grow more of its own food and reduce imports.
The authors also recommend restoring habitats, drained peatlands and preserving older forests.
“Europe could reasonably choose a mix of these goals for its land future, but they all require a smaller footprint.”
See the full paper in Nature.
What is happening with sperm counts?
This study shows, for the first time, that sperm counts are declining everywhere, not only in North America, Europe, Australia and New Zealand, which was shown previously, but also in South America, Asia and Africa. This new analysis found that sperm count globally dropped by more than 50% between 1973 and 2018, and that the decline is accelerating: Since 1972, sperm count has dropped by about 1% each year. Since 2000, the annual decrease has been, on average, more than 2.6%.
What do lower sperm counts mean for our health?
This accelerated decrease in global sperm counts means more people will need to use assisted reproduction to get pregnant. These findings imply more than decreased fertility; lower sperm counts are linked to more disease later in life (cardiovascular disease, diabetes and reproductive cancers) and a shorter life expectancy.
Why are sperm counts declining?
The decline is too rapid to be due to genetic causes alone. Some risk factors for lower sperm counts have to do with lifestyle; smoking, obesity, stress and binge drinking. In addition, environmental chemicals — particularly those that can alter the body’s hormones called endocrine disrupting chemicals (pesticides, phthalates, BPA, PFAS chemicals and others) — have been shown to reduce sperm counts and quality and are likely contributing to this decline.
What can be done about lower sperm counts?
While scientists continue to tease out the causes, men should avoid smoking, a sedentary lifestyle, excessive weight gain, drug and alcohol abuse, and potentially toxic chemicals. This means buying organic food when possible or washing fruits and vegetables that may have pesticide residues. Another good idea is avoiding plastics in food contact materials and personal care and household products that contain phthalates and other endocrine-disrupting compounds.
Read more about the new study: A new analysis shows a “crisis” of male reproductive health
Watch Dr. Shanna Swan discuss the work and implications
The report, published by the Australian Minderoo Foundation, estimates that the plastics industry is costing society around $100 billion annually in environmental clean-ups, ecosystem degradation, shorter life expectancy and medical treatments. Minderoo is a philanthropic organization focused on the environment and climate, among other causes.
“We found that the negative impacts of plastic on human health are at least as consequential as the environmental risks about plastics that tend to dominate the story,” Dominic Charles, director of finance and transparency at the Minderoo Foundation and one of the study’s coauthors, told EHN. “Working to actually put a number on these social costs was a real eye opener.”
To estimate these costs the researchers reviewed more than 5,000 academic papers to determine where there was scientific consensus on health harms associated with plastic ingredients. Then they estimated the global rates of disease and mortality associated with exposures to those ingredients to put a dollar amount on the public health costs. Finally, they worked with a group of attorneys who specialize in modeling risk for investors and insurers to estimate the legal liability plastics manufacturers are likely to face.
“The challenge is that plastics are completely ubiquitous, so it’s very hard to pinpoint the source of a harmful exposure,” Charles explained. “Eventually that leads you to the somewhat absurd conclusion that it doesn’t matter how toxic your product is — as long as lots of companies are producing as much of it as possible, in as many different ways as possible, nobody has any liability. But that’s something we’re seeing change. There’s an evolution being made in the legal doctrine to deal with that.”
Lawsuits unfolding related to other ubiquitous chemicals like PFAS (per- and polyfluoroalkyl substances), glyphosate, and even opioids are forging new legal pathways, the report points out. In the case of PFAS, the chemicals are pervasive, with many companies selling products that contain them, but only a handful of companies manufacture them — and those are the companies being sued. The story is similar, Charles said, when it comes to the most harmful additives in plastic products.
“The plaintiffs in these cases are using innovative legal arguments, particularly related to public nuisance theories of harm, to successfully bring these cases forward,” Charles said. “We think these kinds of new legal strategies will also open the door to plastic litigation.”
How is plastic harming us?
While the research is still unfolding, the report concluded that there’s “robust scientific consensus on human health harms resulting from some of the performance-enhancing chemical additives used in plastics.”
These include certain phthalates, bisphenols (like BPA and its replacements) and flame retardants. All three classes of chemicals contain endocrine-disrupting compounds, which cause problems in the body’s hormonal systems and are linked to significant health issues including infertility, early puberty, developmental issues like ADHD and autism, and metabolic disorders like type II diabetes and obesity. There’s also evidence that they increase cancer risk.
The study estimates that manufacturers of these chemical additives are most likely to be exposed to litigation stemming from these health harms. Manufacturers of these types of chemicals include companies like BASF, Dow Chemical Company, Eastman Chemical Company and ExxonMobil Corporation.
The researchers also examined emerging research on the health harms associated with micro or nano plastics — microscopic plastic pieces that humans ingest through tap and bottled water, seafood, salts, milk, fruit and vegetables. Exposure has been linked to respiratory, immune, reproductive and digestive system problems and increased cancer risk.
“Micro or nano plastics have the same kind of persistence in the environment as PFAS chemicals,” Charles said. “Those legal proceedings are going to be highly relevant to the future of plastics litigation.”
Charles added that although these lawsuits could total billions of dollars, they won’t keep pace with the social costs, especially in the near term. These hazards enter the stream of commerce and it’s many years later that scientists start piecing together how harmful they are, he said. Then, it takes years to reach a scientific consensus, and it still takes years before lawyers take action after that.
Related: The US falls behind most of the world in plastic pollution legislation
“That’s why the threat of liability isn’t working as a sufficiently preventative measure right now,” he said. “We also need to change the way we’re regulating these chemicals.”
The American Chemistry Council, a trade and lobbying group for chemical manufacturers, issued a statement saying the report is “detached from reality” and emphasizing that plastics are important to modern medicine and innovation. A spokesperson for the group declined to answer questions about what specific aspects of the report the Council disagrees with, and whether the group has ever conducted its own risk assessments or addressed potential litigation related to health and environmental damages from plastics.
What does this mean for petrochemical development?
Shell's new petrochemical complex in southwestern Pennsylvania.
Credit: Nate Smallwood for Environmental Health News and Sierra Magazine
In the first 13 years of the 21st century, plastics manufacturing surpassed total production in the last century, and production is expected to double again in 20 years and almost quadruple triple by 2050. Lawsuits have the potential to slow that growth.
“This report is basically communicating that if you invest in plastics, you’re taking a calculated risk and there are threats looming,” Sean O’Leary, a senior researcher focused on energy and petrochemicals at the Ohio River Valley Institute, a progressive think tank, told EHN.
O’Leary, who was not involved in the Minderoo study, said petrochemical development in Appalachia’s Ohio River Valley, which spans parts of western Pennsylvania, Ohio, West Virginia, Virginia, Kentucky, Indiana, Illinois and Tennessee, has already been hampered by unfavorable market conditions for plastics.
Shell is about to open a massive new plastics plant in the Ohio River Valley, about 35 miles northwest of Pittsburgh, which will turn fracked ethane gas into up to 1.6 million metric tons of plastic pellets annually, most of which are expected to produce single-use packaging and plastic bags. It’s one of five such facilities that have been proposed in the Ohio River Valley, but the only one that’s gotten off the ground. None of the other projects are expected to move forward.
Other plans “died not because we convinced a lot of investors to become more climate conscious or environmentally caring,” O’Leary said, “but because we demonstrated that these investments were not wise ones.”
“Shell still has additional investment decisions to make concerning their plant,” he added, “and now they’ll have to take into account at least the possibility of legal action and the risk posed by that.”
Residents near Shell’s plant have expressed concern about how the millions of tons of air pollution the plant will generate annually will impact their health. The Minderoo report only briefly acknowledges liability related to pollution from plastics manufacturing plants, but Charles said these communities are particularly at risk from the effects of the industry.
“Exposures around production facilities are relatively small compared to the ubiquitous exposures and potential liabilities arising from plastics as a whole,” he said. “That said, they are probably easier to build a case on, and those cases may well be some of the first to be brought in terms of plastic litigation.”
Chemicals may drift away from farms and land on birds’ skin and feathers, they might seep into soil and water where they kill the insects and invertebrates birds love to eat. Sometimes, birds directly ingest them when the pesticide is a granule or coated onto a seed.
Birds are far from the only victims of these neonicotinoid insecticides, called “neonics” for short. Every year, millions of pounds of neonics are applied to crop seeds, which can be eaten by birds and other wildlife. Due to a gaping loophole in federal law, these deadly seeds receive almost no regulatory oversight, and the Environmental Protection Agency, or EPA, recently doubled down on its position to leave birds, invertebrates and even people at a higher risk level.
In response to a petition from 2017 that requested pesticide-coated seeds receive the same scrutiny as other pesticide applications, EPA has upheld its decision to keep such seeds classified as “treated articles.” This exempts coated seeds from the regulations and oversight mandated in the Federal Insecticide, Fungicide and Rodenticide Act, which covers everything from pesticide label requirements to funds for victims of pesticide poisoning — all of which are not required for seeds covered in deadly chemicals.
Deadly seed coatings
American Bird Conservancy found that a single seed coated with neonics is enough to kill a songbird.
Credit: Noah Rosenfield/Unsplash
It took five years for the EPA to respond to a petition brought by American Bird Conservancy, the Center for Food Safety, the Pesticide Action Network of North America, the American Honey Producers Association and many others. Even then, it only did so when compelled by a lawsuit brought in 2021 and ultimately decided that their current system was fine, despite growing peer-reviewed evidence that indicates otherwise.
Seed coatings are the main use of these neurotoxic neonics. American Bird Conservancy found that a single seed coated with neonics is enough to kill a songbird. Most of the pesticide (as much as 97%) leaves the seed and blankets surrounding lands as bee-killing dust or it leaches into the local ecosystem. Once in soil and water, it kills insects and aquatic invertebrates, depriving birds of important food sources. Barn Swallows are among the species most heavily impacted by insect loss – 40% have disappeared in the last five decades.
Clarifying the regulatory loophole would give regulators and wildlife advocates a better idea of where, when and in what quantity these chemicals are used. Without a change in this provision, it is impossible to enforce the Endangered Species Act and other wildlife-saving laws fully.
The exemption has resulted in myriad ecological disasters, including loss of birds, birth defects in deer and the poisoning of an entire town in Nebraska where coated corn seeds were turned into ethanol (a state bill has since ameliorated the situation in Nebraska, but there is still no federal action).
A long overdue step for wildlife conservation
For all the harm they cause, many studies on soybeans and corn grown with coated seeds show an insignificant or nonexistent increase in the number of crops grown.
Farmers who do not want to use these seeds are given little choice; most corn and soybean seeds come pre-treated and farmers have to special order untreated seeds. The coatings come at a huge markup, making them lucrative profit opportunities for seed distributors and pesticide manufacturers.
Changing the special status of coated seeds is a long overdue step for wildlife conservation. We are facing a catastrophic loss of birds in North America – there are nearly three billion fewer than in 1970, with prey loss and poisoning as major contributors.
Closing this loophole and moving treated seeds within the grasp of scientific regulation would benefit birds and humans for decades to come. Exempting them puts us all in danger.
Hardy Kern is the Director of Government Relations, Pesticides and Birds Campaign at the American Bird Conservancy. He can be reached at ehardykern@abcbirds.org.