National Academies of Sciences report calls for expanded PFAS testing for people with history of elevated exposure, offers advice for clinical treatment

Report fails to issue warnings on seafood ingestion and breast feeding.

By Pat Elder
August 3, 2022

A report  by the National Academies of Sciences, Engineering, and Medicine (NASEM) has heightened the importance of the PFAS crisis and has elevated the significance of food over drinking water as the leading pathway to human ingestion. The 298-page report mentioned the word “food” 224 times. It mentions fish 115 times while there are references to drinking water 195 times. It’s an improvement in the national dialogue.

I look around in my own community and I see the primary pathway to ingestion is through the consumption of seafood from the Chesapeake Bay and its tributaries due to naval activities. Most homes here are served by wells that tap into the deep Piney Point aquifer. I had my drinking water tested and it was free of 55 PFAS compounds. The large municipal water providers, like the Washington Suburban Sanitary Commission, are serving up water in the single digits for the analytes tested. Sure, the levels are hundreds and often thousands of times above the EPA’s new health advisory of .02 ppt for PFOS and .004 ppt for PFOA, but they’re nowhere near the concentrations of the toxins in seafood.

There’s an assumption throughout the NASEM report that there is more awareness in our communities and in the medical profession about PFAS than actually exists. From my very narrow perspective in this southern Maryland peninsula formed by the confluence of the Potomac River and the Chesapeake Bay, I asked four medical doctors over the last year with Medstar Health in Leonardtown, Maryland and none of them had heard of PFAS. I don’t know anyone who has been tested for PFAS in Southern Maryland. This is an area with a large naval presence, including four large installations with documented PFAS contamination. The Patuxent River Naval Air Station and the Naval Research Laboratory-Chesapeake Bay Detachment contaminate the Chesapeake Bay, while the  Indian Head Naval Surface Warfare Center and Joint Base Andrews poison the Potomac. (PFAS isn’t the only chemical in the seafood – Mercury, PCBs, Chlordane, DDT, Dieldrin, and Toxaphene are also present. – Don’t eat the “mustard” in crabs)

You’d think medical professionals here would have heard about PFAS by now, but the local media is loath to publish reports critical of the military.

Even if the local doctors were aware of PFAS, the Agency for Toxic Substances and Disease Registry has been instructing them to tell patients that blood tests will not provide information to predict health problems. Andrea Amico, with the New Hampshire group, Testing for Pease says physicians haven’t had the knowledge or tools to treat those with PFAS exposure. “Most haven’t heard of PFAS, or the health effects associated with exposure,” she said. Many doctors simply don’t receive detailed environmental health training. The NASEM report ought to help in this regard.

Community Liaison

I was honored to be included as a community liaison for this study. The Academy captured my essence in their report:   

“Patrick Elder (Military Poisons) - Patrick Elder articulated concerns and insights about the understudied role of PFAS exposure from food. Elder stated that he believes there is too much emphasis on PFAS levels in drinking water, with too limited a focus on PFAS exposure from food, particularly seafood.

Elder contextualized this position by detailing his experiences testing surface water and seafood items near his home in Southern Maryland, adjacent to the Naval Air Station Patuxent River Webster Field Annex. Elder’s efforts resulted in the detection of significant PFAS concentrations in surface water and seafood items. Elder published the results in the local press, leading to concern and outrage in the community.

He indicated that a subsequent public meeting with Navy officials resulted in an unsatisfactory exchange of information with the local community, as Navy officials reiterated that the chemicals in question were no longer in use and there was no medical treatment to reduce PFAS in the human body. The community sought increased testing on seafood items and water, expressing disagreement with the Navy’s assertion that not enough is known about PFAS in seafood and the human body to justify immediate intervention.

Elder further highlighted the untenable data gaps for PFAS in food in the United States through a comparison: the European Food Safety Authority recommendations suggest up to 86 percent of PFAS exposure stems from food intake while the U.S. Food and Drug Administration (FDA) issued a statement suggesting there is no evidence that dietary choices should consider PFAS contamination. Overall, Elder emphasized the importance of better limiting PFAS exposure from food and seafood items in the United States and incorporating this vector of exposure when considering health effects and health studies.”

I like the word “untenable,” although they didn’t embrace my positions. They just can’t. The problems are too big and there’s too much money on the line. It’s all about the money.

For instance, I’d re-word this from the report:  “Known environmental exposures to PFAS include living in a community with PFAS-contaminated drinking water, living near industries that use fluorochemicals, serving in the military, and consuming fish and game from areas with known or potential contamination.”  I’d mention that living in a community near a military installation greatly increases the likelihood of exposure.  

Recommendation 4-4 from the report says:  “In areas with known PFAS contamination, clinicians should advise patients that PFAS can be present in fish, wildlife, meat, and dairy products and direct them to any local consumption advisories.”  I would have included areas without known PFAS contamination as well, considering that Bumble Bee clams from China contain 20,133 ppt of PFOA, about 7 orders of magnitude higher than the concentrations the EPA says is a danger in drinking water.

There aren’t many areas in the country with fish advisories for PFAS. For instance, Maryland has one fish advisory for PFAS and it took four years of campaigning to get them to adopt it in Piscataway Creek, the one that drains from the burn pits at Andrews AFB. The DOD says groundwater at the home of Air Force One contains 435,000 ppt of PFOA, which is 108.75 million times above the EPA’s health advisory.

I would have had these numbers in the opening paragraph of NASEM’s summary.

(photo - PFAS foam on a tributary of the lower Potomac River)

Maryland’s advisory still allows consumption of fish by children and adults once a month containing 359,000 ppt of PFOS. Oysters with more than 1 million ppt of PFOS in the Chesapeake and Smallmouth Bass with more than a half million ppt of PFOS in the Potomac don’t merit advisories in Maryland.

I was pleased to read that NASEM addressed subsistence fishing among the poor who regularly consume their catch. It’s an important issue in Southern Maryland where times are tough for many, and the poisoned fish are plentiful.  

This statement from the NASEM report was convoluted: “While it may seem obvious that avoiding exposure to sources of PFAS would result in reduced intake of PFAS and, in turn, lower internal PFAS levels, some caution in assuming that exposure and risk reduction would ensue is warranted. For example, if one is advised to avoid locally caught fish because of known PFAS contamination in that fish, such avoidance could result in reduced exposure. However, if dietary fish is replaced by another food that is also high in PFAS, avoiding the fish may not result in lower PFAS exposure.”

Around here, seafood consumed from the Potomac and the Chesapeake are known to be highly contaminated while the state has not been proactive in testing food. If testing of food items from other states and from the EPA years ago is an indication, then it is the frutti di mare that is a far greater threat here.  Produce grown on farms in Southern Maryland that are slathered with PFAS-laden sewer sludge may be an exception.

Breastfeeding, Children, and Pregnancy

A study of 45 breastfeeding women in Massachusetts showed the average PFOS concentration was 6,550 times over what the EPA says is safe in drinking water. The highest detection of PFOS was 30,850 times over the limit. The numbers for PFOA were even more shocking. The average PFOA level was 10,950 over the EPA threshold, while the highest concentration was 40,250 times over the limit.

Knowing this, how can we accept the NAS advice when they write, “While PFAS can pass through breast milk from mother to baby, research has consistently shown benefits of breastfeeding even while PFAS exposures have been occurring for many years. PFAS may also be present in water used to reconstitute formula and potentially in packaged formula and baby food.”

I don’t buy it. It’s not tough for the state to step in to ensure that the water and formula used is PFAS-free. We tend to forget the regulatory powers that could be marshalled. Breast milk from all lactating mothers ought to be tested with mom’s consent. This is a crisis. We’re poisoning our babies while NASEM extols the virtues of breastfeeding.

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We’d like to test the seafood in South Florida where officials encourage pregnant women to eat plenty of it. We’re a third of the way toward our $10,000 goal. It costs $300 per sample and we need to hire a scientist so folks will take the results seriously. Donate here.