You Are What You Eat: Fish and Forever Chemicals

For these news posts we like to report positive stories that inspire hope. Sometimes it is important to share stories you might have missed that may well be less hopeful but suggest actions you can take to protect yourself and others.

On 1/17/22 CNN reported on a recent study that highlighted the high concentrations of certain “forever chemicals” in locally caught freshwater fish that are eaten throughout the United States. Forever chemicals are called that because they last for long periods without breaking down. The forever chemicals involved are per- and polyfluoroalkyl substances, or PFAS. These chemicals are used in products to resist stains and create nonstick surfaces and water-resistant fabrics, from clothing to carpets and couches, cell phones, and cosmetics.  There are “tens of thousands of potential environmental contaminants, including over a thousand chemicals previously or currently approved for use in the US.”

Levels of PFAS (particularly PFOS, perfluorooctane sulfonates or perfluorooctane sulfonic acid) in these fish caught in American streams and lakes were particularly high by the Great Lakes, but high levels were found throughout the nation, and not always in close proximity to known industrial sources of contamination. The news is that the levels found in these fish were extremely high. They are high enough to show increases in levels measured in the blood of people who eat only one locally caught freshwater fish per year! One of the authors of the study estimated that you would have to drink a month of contaminated water to get the same exposure as a single serving of freshwater fish.

The PFAS don’t only accumulate in freshwater fish, but also in shellfish, livestock and dairy. PFAS are in our drinking water; the level the EPA tolerates now is 70 parts per trillion, and there is so much concern about the health effects of these chemicals that it has been suggested that it be lowered dramatically to 0.02 parts per trillion in drinking water!

These chemicals have been associated with health problems, including cancer and birth defects. They also appear to limit the immune response to vaccines!

Actions

Regarding contaminated fish:

Educate your family, friends, and neighbors (and if you are a clinician, your patients ) who go fishing and eat what they catch about the issue.

You can consider contacting your elected officials and relevant agencies to make sure they are aware of the problem in areas where fishing is popular. Of course doing so may not make you popular.

Regarding PFAS in general:

Monitoring

Is your source of water monitored? Monitoring matters, but isn’t enough as there are so many new chemicals that aren’t monitored. From the CDC:

“Since 2002, production and use of PFOS and PFOA in the United States have declined. As the use of some PFAS has declined, some blood PFAS levels have gone down as well.

• From 1999-2000 to 2017-2018, blood PFOS levels declined by more than 85%.

• From 1999-2000 to 2017-2018, blood PFOA levels declined by more than 70%.

However, as PFOS and PFOA are phased out and replaced, people may be exposed to other PFAS.”

Other agencies, such as the Agency for Toxic Substances and Disease Registry (ASTDR), are also concerned with PFAS.

Of course, PFAS are found in many products, and PFAS levels can be very high in these products and still be sold to consumers. There are class action lawsuits, including one reported by the Guardian on January 19, 2023 against Coca-Cola for their orange juice ‘Simply Orange’ that is marketed as pure and healthy, but was found to have high levels of PFAS. The FDA does do monitoring, and we need them to do more. We need our regulatory agencies to be vigilant and our politicians to support them and help them do thier jobs, and we need to hold companies responsible for not being responsible.

Personal actions

Using water filters at home may help reduce exposure and avoiding locally caught freshwater fish in the US or other known contaminants is certainly reasonable, especially for high-risk individuals.

The Silent Spring Institute PFAS Exchange has suggestions, both for personal protection and community actions, and a resource that tracks local contamination and local groups that are active.

There are active lobbying efforts by vested interests to prevent regulatory legislation. You can let your elected officials know that you are a voter in their district and that you are in favor of regulation, even if you don’t link it to a specific bill.

Should we do blood testing?

Should doctors test for PFAS levels in patients? These are expensive tests and won’t predict the exact risk for developing specific diseases nor will they help decide if a disease is due to exposure to PFAS in a given individual. On the other hand, it may be important to monitor exposure for individuals in certain occupations or where exposure can be modified. It has been suggested that those most sensitive to adverse health effects of PFAS include developing fetuses, early childhood and the elderly, as well as firefighters or those who work in the plants that use or make these chemicals, and those who live near airports, landfills, military bases, wastewater and sewer treatment plants.

Update

A group called the Ecology Center out of Ann Arbor Michigan did a citizen scientist study they made public in February 2023 that found PFAS in all fish caught in two rivers. Their website has information on PFAS. They are also involved with other aspects of ecology and the environment.

Additional resources

The CDC has a list of state resources.

The EPA has additional information about PFAS, and the CDC has information for the public in English and Spanish.

PFAS-REACH has a wealth of information.

There is a wonderful free online one hour medical eduction course availble through December 2023 on these chemicals from Children’s Mercy Kansas City. You have to sign up, a minor nuisance.

The ASTDR has information about PFAS in English and Spanish.