man speaking at table as two women look onThe U.S. has one of the world’s safest drinking water systems, yet two out of five Americans rate their water quality as poor.

"When people lose faith in the water supply, they lose faith in their government. For public servants working to fix the problem, that lack of trust can be the biggest challenge," Patrick Breysse, PhD, CIH, told the audience at yesterday’s U.S. Senate briefing on water protection.

Breysse, director of the National Center for Environmental Health and the Agency for Toxic Substance and Disease Registry at the Centers for Disease Control and Prevention, helped lead the response to water contamination in Flint, Michigan. He joined other public health experts at the briefing on the role of federal, state and local agencies in tackling water contaminants in the U.S. 

The "What’s in Your Water" briefing took place on Capitol Hill and was co-sponsored by APHA and other groups, including the National Environmental Health Association. NEHA's executive director, David Dyjack, DrPH, CIH, moderated the panel and recognized that October is Children’s Health Month, significant because children are most vulnerable to the health effects of water contamination. 

Across the U.S. each year, 1 million people fall ill and 1,000 die from water-borne infectious diseases, with an annual cost of $1 billion in medical treatment. The country’s aging infrastructure is a big part of the problem.

"We need to increase our investment in public health by funding infrastructure replacement and other efforts, like addressing the perfluoroalkyl and polyfluoroalkyl substances, or PFAS, in our water supply," Breysse said.

PFAS are chemicals that have been used on non-stick cookwear, stain-resistant carpets, water-repellent clothing, firefighting foam, canned goods, even pizza boxes for the past 50 or 60 years.

"PFAS are in our drinking water and they’re in over 98% of Americans right now. We didn’t know it was an issue until the EPA started sampling for it," Breysse said. "Now we’re trying to figure out how much PFAS in the body is too much and what the health effects are."

Beyond the public surface water supply, one in nine Americans relies on private wells for groundwater. These are not regulated and can become contaminated in numerous ways. "The burden of protecting these small water systems falls on state and local health departments that are not adequately resourced to deal with it," Breysse said. 

Two states aggressive in tackling contaminants, particularly for those with private wells, are New Hampshire and Michigan. As director of the Public Health Laboratory in New Hampshire, Christine L. Bean, PhD, MBA, MT(ASCP) works on water testing in her state. She discussed a CDC-funded biomonitoring study conducted on the arsenic and uranium levels in the water.

Almost half of residents in New Hampshire get their water from unregulated private wells. Long-term exposure to the state’s naturally occurring arsenic, which seeps into the groundwater, can result in skin disorders, diabetes, hypertension and certain cancers.

"If you live in New Hampshire, you have a 37% higher than national average risk of acquiring bladder cancer. Our incidents are higher than those of 46 other states,” Bean said.

She spoke about how her agency has applied these study methods to other contaminants like PFAS, with a special focus on community outreach. "We have a lot of work to do on educating our citizens about their own private wells and what they need to do to keep themselves safe."

Karla Black, PhD, MEP, PEM, REHS, emergency preparedness coordinator for the Kent County Health Department in Michigan, talked about the health effects that industry has had on the residents there.

"For over 20 years, as they waterproofed their shoes with Scotchgard, the Wolverine shoe company dumped waste into Kent County — totally legal at the time; we didn’t know what Scotchgard would potentially do," Black said. "We didn’t know about PFAS." 

The chemicals contaminated Kent County’s private wells and has led to an ongoing environmental investigation and study of impacts on human health in the county. “We’re starting to see a lot more potential health effects as more studies come out  —  high cholesterol, ulcerative colitis, a couple types of cancer, pregnancy-induced hypertension that can lead to miscarriages.” 

The county has the highest-ever private well levels of PFAs and the highest human blood levels in its citizens.

"When people find out their well is contaminated, that has a mental health effect," Black said. "They wonder ‘What does this mean for me?' There’s a huge economic impact: 'Will I be able to sell my house?' Their spouse just passed away from liver cancer. They wonder, 'What did the PFAS do?'"

Black says the best thing they can do locally is communicate with residents through town hall meetings, a dedicated website, weekly e-newsletters, a FAQ phone line. Local agencies like Black’s depend heavily on help from the state and federal levels — on agencies like Breysse’s. "We don’t have toxicologists or regulatory authority to find out what happened and then clean these things up. We rely on our partners.”

For more information, check out APHA's new fact sheet, "Creating the Healthiest Nation: Water and Health Equity".