Guidance on PFAS Exposure, Testing, and Clinical Follow-Up (2022) / Chapter Skim
Currently Skimming:
1 Introduction
1 Introduction
Pages 18-41
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 18... ...
. continued 1 See https://www.acs.org/content/acs/en/molecule-of-the-week/archive/p/perfluorooctanoic-acid.html (accessed June 22, 2022)
|
From page 19... ...
. SOCIOHISTORICAL TIMELINE OF PFAS Public concern about the impact of PFAS contamination on human health and the environment began in the late 1990s when PFOA water contamination was identified in Parkersburg, West Virginia.2 In response, 3M, a primary PFAS manufacturer, initiated a voluntary phase-out of some PFAS (PFOA, perfluorooctanesulfonic acid [PFOS]
|
From page 20... ...
Environmental Protection Agency; MRL = minimal risk limit; ng/L = nanograms per liter; NHANES = National Health and Nutrition Examination Survey; PFAS = per- and polyfluoroalkyl substances; PFC = perfluorochemicals; PFHxS = perfluorohexane sulfonic acid; PFNA = perfluorononanoic acid; PFOA = perfluorooctanoic acid; PFOS = perfluorooctane sulfonic acid. SOURCE: Committee generated based on slides included by Patrick N
|
From page 21... ...
Locations were mapped using the best data available from official records, including data provided by tests of public drinking water systems, the Safe Drinking Water Information System and the Department of Defense report Addressing Perfluorooctane Sulfonate (PFOS) and Perfluorooctanoic Acid (PFOA)
|
From page 22... ...
. While environmental justice research specific to PFAS contaminants has been limited, place-based factors that may put individuals at greater risk of exposure (siting of chemical companies, refineries, and industrial sites)
|
From page 23... ...
; core environmental justice issues relevant to PFAS also include rural health, industrial siting, and access to environmental exposure reduction (Bullard, 1996) and clinical care.
|
From page 24... ...
Understanding the historical and social context influencing how and where PFAS are distributed is an essential part of identifying effective mitigation strategies. Second, Pellow's Environmental Justice Framework emphasizes the complex roles of the stakeholders involved.
|
From page 25... ...
(c) FIGURE 1-5 Serum PFAS concentrations (unadjusted geometric means)
|
From page 26... ...
26 Guidance on PFAS Exposure, Testing, and Clinical Follow-Up (a)
|
From page 27... ...
. PFAS in the environment can contaminate drinking water when the chemicals reach public drinking water systems and private wells (Hu et al., 2016)
|
From page 28... ...
. The extent to which the use of such products contributes to human exposures remains unclear, however, because the relative contribution of PFAS exposures from sources other than food or water is not well characterized (DeLuca et al., 2021)
|
From page 29... ...
The agency has not yet designated PFOS or PFAS as hazardous, however. And the Safe Drinking Water Act would be more protective if the standards were enforceable.10 Policy changes that could reduce PFAS exposures may be forthcoming.
|
From page 30... ...
PROVIDING CLINICAL ADVICE IN COMMUNITIES EXPOSED TO PFAS To help clinicians14 respond to patient concerns about PFAS exposure, the Agency for Toxic Substances and Disease Registry (ATSDR) published PFAS: An Overview of the Science and Guidance for Clinicians on Per- and Polyfluoroalkyl Substances.15 This guidance summarizes general information about PFAS and PFAS health studies and suggests answers to example patient questions.
|
From page 31... ...
The lawsuit resulted in the formation of the C-8 Science Panel to determine "probable link conditions" associated with PFOA-contaminated drinking water. The settlement agreement defined "probable link" to mean that, based on the weight of the available scientific evidence, it is more likely than not that there is a link between exposure to PFOA and a particular human disease (Frisbee et al., 2009)
|
From page 32... ...
The National Academies will also provide recommendations regarding potential changes to CDC/ATSDR PFAS clinical guidance including: Options and considerations to guide decision making for PFAS testing in a patient's blood or urine. PFAS concentrations that could inform clinical care of exposed patients.
|
From page 33... ...
Problem Formulation and Community Engagement The committee held six public meetings between February 4 and August 12, 2021 (see Appendix C for the agendas of these public meetings)
|
From page 34... ...
Health Effects Associated with PFAS Exposure The committee carefully considered the purpose of the literature review of putative health effects prescribed in its Statement of Task: to establish a basis for prioritized clinical surveillance or monitoring of PFAS health effects. Accordingly, the committee's review was focused on determining a set of health effects that may be associated with PFAS, which could then be used for preventive medicine recommendations and decisions.
|
From page 35... ...
SOURCE: See https://www.cdc.gov/niosh/topics/hierarchy/default.html (accessed June 16, 2022)
|
From page 36... ...
Finally, Chapter 8 considers the implementation of the committee's recommendations. Appendix A provides biographical information on the committee members, National Academies staff, and the community liaisons; Appendix B provides a summary of the town halls; Appendix C contains the agendas of the committee's public meetings; Appendix D is a summary of the methods used in the committee's literature review; and Appendix E is a white paper describing a review of the PFAS personal intervention literature.
|
From page 37... ...
2021. Trends in the regulation of per- and polyfluoroalkyl substances (PFAS)
|
From page 38... ...
2021. Preparing for effective, adaptive risk communication about per- and polyfluoroalkyl substances in drinking water.
|
From page 39... ...
in U.S. drinking water linked to industrial sites, military fire training areas, and wastewater treatment plants.
|
From page 40... ...
Race, poverty, and chemical disasters. Brattleboro, VT: Environmental Justice and Health Alliance for Chemical Policy Reform.
|
From page 41... ...
2021. Per- and polyfluoroalkyl substances (PFAS)
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.