How Well Do Product Labels Indicate the Presence of PFAS in Consumer Items Used by Children and Adolescents?

PFAS are persistent and toxic chemicals used in many commercial and industrial applications that are often added to consumer products, including those used by children and adolescents, to impart water and stain resistance. Since product labels rarely list chemical additives, including PFAS, we evaluated whether other information on product labels can be used by consumers to select products without PFAS. We selected 93 items marketed to or often used by children and adolescents across three product types (furnishings, apparel, bedding) and five labeling groups representing different combinations of water and/or stain resistance and "green" (including "nontoxic") assurances. We screened all products for total fluorine (F) and analyzed solvent extracts from a subset (n = 61) for 36 targeted PFAS and from a smaller subset (n = 30) for perfluoroalkyl acids (PFAAs) generated by precursor oxidation using the total oxidizable precursor (TOP) assay. Products advertised as water- and/or stain-resistant had more frequent detections and higher concentrations of total F than those without such claims, and targeted PFAS were detected only in products labeled as water- and/or stain-resistant. Concentrations of PFAAs generated by precursor oxidation using the TOP assay often exceeded pre-oxidation concentrations, suggesting that PFAA precursors contribute to solvent-extractable PFAS from products. Among products advertised as water- and/or stain-resistant, detection frequencies and concentrations of targeted PFAS were similar regardless of green assurances. This study illustrates many nonessential uses of PFAS in products used by children and adolescents and suggests that while water- and stain-resistant assurances can identify products likely to contain PFAS, current green assurances do not consistently indicate the absence of PFAS.

Wastewater-contaminated groundwater as a source of endogenous hormones and pharmaceuticals to surface water ecosystems.

Increasing residential development in watershed recharge areas increases the likelihood of groundwater and surface water contamination by wastewater effluent, particularly where on-site sewage treatment is employed. This effluent contains a range of compounds including those that have been demonstrated to mimic or interfere with the function of natural hormones in aquatic organisms and humans. To explore whether groundwater contaminated by discharge from on-site septic systems affects water quality in surface water ecosystems, we measured steroidal hormones, pharmaceuticals, and other organic wastewater compounds (OWCs) in water collected from six aquifer-fed ponds in areas of higher and lower residential density on Cape Cod (Massachusetts, USA). We detected both a greater number and higher concentrations of OWCs in samples collected from ponds located in higher residential density areas. Most often detected were the steroidal hormones androstenedione, estrone, and progesterone and the pharmaceuticals carbamazepine, pentoxifylline, sulfamethoxazole, and trimethoprim. Of particular concern, estrogenic hormones were present at concentrations approaching those that induce physiological responses in fish. While a number of papers have reported on surface water contamination by OWCs from wastewater treatment plants, our results show that surface water ecosystems in unconfined aquifer settings are susceptible to contamination by estrogenic and other biologically active OWCs through recharge from aquifers contaminated by residential septic systems.

Breast cancer risk and drinking water contaminated by wastewater: a case control study.

BACKGROUND: Drinking water contaminated by wastewater is a potential source of exposure to mammary carcinogens and endocrine disrupting compounds from commercial products and excreted natural and pharmaceutical hormones. These contaminants are hypothesized to increase breast cancer risk. Cape Cod, Massachusetts, has a history of wastewater contamination in many, but not all, of its public water supplies; and the region has a history of higher breast cancer incidence that is unexplained by the population's age, in-migration, mammography use, or established breast cancer risk factors. We conducted a case-control study to investigate whether exposure to drinking water contaminated by wastewater increases the risk of breast cancer. METHODS: Participants were 824 Cape Cod women diagnosed with breast cancer in 1988-1995 and 745 controls who lived in homes served by public drinking water supplies and never lived in a home served by a Cape Cod private well. We assessed each woman's exposure yearly since 1972 at each of her Cape Cod addresses, using nitrate nitrogen (nitrate-N) levels measured in public wells and pumping volumes for the wells. Nitrate-N is an established wastewater indicator in the region. As an alternative drinking water quality indicator, we calculated the fraction of recharge zones in residential, commercial, and pesticide land use areas. RESULTS: After controlling for established breast cancer risk factors, mammography, and length of residence on Cape Cod, results showed no consistent association between breast cancer and average annual nitrate-N (OR = 1.8; 95% CI 0.6-5.0 for > or = 1.2 vs. < .3 mg/L), the sum of annual nitrate-N concentrations (OR = 0.9; 95% CI 0.6-1.5 for > or = 10 vs. 1 to < 10 mg/L), or the number of years exposed to nitrate-N over 1 mg/L (OR = 0.9; 95% CI 0.5-1.5 for > or = 8 vs. 0 years). Variation in exposure levels was limited, with 99% of women receiving some of their water from supplies with nitrate-N levels in excess of background. The total fraction of residential, commercial, and pesticide use land in recharge zones of public supply wells was associated with a small statistically unstable higher breast cancer incidence (OR = 1.4; 95% CI 0.8-2.4 for highest compared with lowest land use), but risk did not increase for increasing land use fractions. CONCLUSION: Results did not provide evidence of an association between breast cancer and drinking water contaminated by wastewater. The computer mapping methods used in this study to link routine measurements required by the Safe Drinking Water Act with interview data can enhance individual-level epidemiologic studies of multiple health outcomes, including diseases with substantial latency.

Steroid estrogens, nonylphenol ethoxylate metabolites, and other wastewater contaminants in groundwater affected by a residential septic system on Cape Cod, MA.

Septic systems serve approximately 25% of U.S. households and may be an important source of estrogenic and other organic wastewater contaminants (OWC) to groundwater. We monitored several estrogenic OWC, including nonylphenol (NP), nonylphenol mono- and diethoxycarboxylates (NP1EC and NP2EC), the steroid hormones 17beta-estradiol (E2), estrone (E1) and their glucuronide and sulfate conjugates, and other OWC such as methylene blue active substances (MBAS), caffeine and its degradation product paraxanthine, and two fluorescent whitening agents in a residential septic system and in downgradient groundwater. E1 and E2 were present predominantly as free estrogens in groundwater, and near-source groundwater concentrations of all OWC were highest in the suboxic to anoxic portion of the wastewater plume, where concentrations of most OWC were similar to those observed in the septic tank on the same day. NP and NP2EC were up to 6- to 30-fold higher, and caffeine and paraxanthine were each 60-fold lower than septic tank concentrations, suggesting net production and removal, respectively, of these constituents. At the most shallow, oxic depth, concentrations of all OWC except for NP2EC were substantially lower than in the tank and in deeper wells. Yet boron, specific conductance, and the sum of nitrate-and ammonia-nitrogen were highest at this shallow depth, suggesting preferential losses of OWC along the more oxic flow lines. As far as 6.0 m downgradient, concentrations of many OWC were within a factor of 2 of near-source concentrations. The results suggest that there is the potential for migration of these OWC, which are unregulated and not routinely monitored, in groundwater.

Breast cancer risk and historical exposure to pesticides from wide-area applications assessed with GIS.

Pesticides are of interest in etiologic studies of breast cancer because many mimic estrogen, a known breast cancer risk factor, or cause mammary tumors in animals, but most previous studies have been limited by using one-time tissue measurements of residues of only a few pesticides long banned in the United States. As an alternative method to assess historical exposures to banned and current-use pesticides, we used geographic information system (GIS) technology in a population-based case-control study of 1,165 women residing in Cape Cod, Massachusetts, who were diagnosed with breast cancer in 1988-1995 and 1,006 controls. We assessed exposures dating back to 1948 (when DDT was first used there) from pesticides applied for tree pests (e.g., gypsy moths), cranberry bogs, other agriculture, and mosquito control on wetlands. We found no overall pattern of association between pesticide use and breast cancer. We found modest increases in risk associated with aerial application of persistent pesticides on cranberry bogs and less persistent pesticides applied for tree pests or agriculture. Adjusted odds ratios for these exposures were 1.8 or lower, and, with a few exceptions, confidence intervals did not exclude the null. The study is limited by uncertainty about locations of home addresses (particularly before 1980) and unrecorded tree pest and mosquito control events as well as lack of information about exposures during years when women in the study lived off Cape Cod and about women with potentially important early life exposures on Cape Cod who were not included because they moved away.

Association between residence on Cape Cod, Massachusetts, and breast cancer.

PURPOSE: Massachusetts cancer registry and case-control data suggest that breast cancer incidence is elevated on Cape Cod relative to other parts of the state. We examined the association between length of residence on Cape Cod and breast cancer, since residential history could be acting as a surrogate for unidentified environmental risk factors. METHODS: We computed odds ratios (OR) and 95% confidence limits (CL) for 1121 cases occurring between 1988 and 1995 on Cape Cod and 992 controls, according to categories of residence time on Cape Cod, after adjusting for age, family history, parity and age at first live or stillbirth, education, body mass index, and breast cancer history. RESULTS: Breast cancer risk was elevated among women living on Cape Cod 5 or more years with a peak occurring in the 25 to less than 30 year category (adjusted OR=1.72; 95% CL, 1.12, 2.64). Adjusting for confounding strengthened the associations. Odds ratios did not increase monotonically over categories of longer residence. CONCLUSIONS: Our results suggest that longer residence on Cape Cod is associated with elevated breast cancer risk, however inconsistency in the pattern of association limits conclusions that might be drawn about it. Suspected environmental exposures include pesticides and drinking water contaminated by industrial, agricultural, and residential land use.

Historical reconstruction of wastewater and land use impacts to groundwater used for public drinking water: exposure assessment using chemical data and GIS.

Land use in geographic areas that replenish groundwater and surface water resources is increasingly recognized as an important factor affecting drinking water quality. Efforts to understand the implications for health, particularly outcomes with long latency or critical exposure windows, have been hampered by lack of historical exposure data for unregulated pollutants. This limitation has hindered studies of the possible links between breast cancer risk and drinking water impacted by endocrine disrupting compounds and mammary carcinogens, for example. This paper describes a methodology to assess potential historical exposure to a broad range of chemicals associated with wastewater and land use impacts to 132 groundwater wells and one surface water body supplying drinking water to 18 public distribution systems on Cape Cod, MA. We calculated annual measures of impact to each distribution system and used the measures as exposure estimates for the residential addresses of control women in the Cape Cod Breast Cancer and Environment Study (Cape Cod Study). Impact was assessed using (1) historical chemical measurements of nitrate at the water supply sources (performed as required by the Safe Water Drinking Act) and (2) a geographic information system analysis of land use within the zones of contribution (ZOCs) delineated for each well in a state-mandated wellhead protection program. The period for which these impact estimates were developed (1972-1995) was constrained by the availability of chemical measurements and land use data and consideration of time required for groundwater transport of contaminants to the water supply wells. Trends in these estimates for Cape Cod suggest increasing impact to drinking water quality for land use over the study period. Sensitivity analyses were conducted to assess the effect on the distribution of controls' cumulative exposure estimates from (1) reducing the area of the ZOCs to reflect typical well operating conditions rather than extreme pumping conditions used for the regulatory ZOCs, (2) assuming residences received their drinking water entirely from the closest well or cluster of wells rather than a volume-weighted annual district-wide average, and (3) changing the travel time considered for contaminants to reach wells from land use sources. We found that the rank and distribution of controls' cumulative exposure estimates were affected most by the assumption concerning district mixing; in particular, assignment of exposure estimates based on impact values for the closest well(s) consistently produced a larger number of unexposed controls than when a district-wide average impact value was used. As expected, the results suggest that adequate characterization of water quality heterogeneity within water supplies is an important component of exposure assessment methodologies in health studies investigating impacted drinking water.

Arsenic mobility and groundwater extraction in Bangladesh.

High levels of arsenic in well water are causing widespread poisoning in Bangladesh. In a typical aquifer in southern Bangladesh, chemical data imply that arsenic mobilization is associated with recent inflow of carbon. High concentrations of radiocarbon-young methane indicate that young carbon has driven recent biogeochemical processes, and irrigation pumping is sufficient to have drawn water to the depth where dissolved arsenic is at a maximum. The results of field injection of molasses, nitrate, and low-arsenic water show that organic carbon or its degradation products may quickly mobilize arsenic, oxidants may lower arsenic concentrations, and sorption of arsenic is limited by saturation of aquifer materials.