As PFASs are commonly found in homes around the world, what are the health and economic impacts of these chemicals forever? In this interview, we talk to Dr. Linda Kahn to find out more!
Can you please introduce yourself and tell us what inspired your latest research?
I am an assistant professor in the Division of Environmental Pediatrics at the New York University Grossman School of Medicine. Among other things, my research focuses on the health effects of environmental chemicals that we are routinely exposed to in our daily lives.
While it’s great to advise people on lifestyle changes they can make to try to avoid exposure to toxic chemicals, sometimes these options are expensive, for example buying only organic food and sometimes , you simply have no choice. For example, if your water system is contaminated.
A much more effective public health strategy is to regulate chemicals at their source, so that they do not enter our food and water, our personal and household care products, and the environment built in the first place. But industries fight this kind of regulation, and governments worry about both the political and economic costs.
We thought it might help persuade policymakers to take action if we presented them with the health care costs and lost productivity of inaction, which turns out to be very high, and focused on just one class of chemicals !
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In your latest research, you looked at the economic costs of “chemicals forever.” What is meant by the term “forever chemicals” and where are these chemicals commonly found?
The chemicals we have focused on (per and polyfluoroalkyl substances (PFAS)) are known as “forever chemicals” because they break down very slowly in the environment. And once they enter your body, they can take years to clear, meaning they have plenty of time to do damage.
PFASs have been around since the 1930s when it was discovered that they could be used to provide non-stick and waterproof coatings on surfaces. Eventually, they were incorporated into all kinds of consumer products, including nonstick cookware, the lining of microwave popcorn bags, the lining of food containers (have you ever wondered why the doesn’t pizza grease seep through the cardboard box?), stain-resistant fabrics and carpets; they have also been found in chain lube, dental floss and even some cosmetics.
At the same time, some members of the PFAS family were found to have firefighting potential and became firefighting foams used at airports and military bases. For this reason, communities near factories that produce these consumer products (eg, Teflon) and communities near airports and military bases often have water supplies contaminated with PFAS. Even if we don’t live in these areas, almost all of us have detectable levels of PFAS in our blood.
Although these chemicals are commonly used in household items, they can lead to harmful health problems later in life. What are some of the health problems associated with daily exposure to these chemicals?
PFAS can interfere with your hormones, your endocrine system, which controls thyroid function, reproduction, and metabolism. So many health effects that have been shown to be associated with PFAS exposure are in these areas: increased obesity, diabetes, polycystic ovary syndrome, endometriosis, infertility, low birth weight, testicular cancer , breast cancer, hypothyroidism and thyroid cancer. Additionally, exposure to PFAS can suppress your immune system, making vaccines less effective.
Can you tell us more about your latest study, including how it was conducted and what you discovered?
Using nationally representative data on PFAS exposure in the United States, US Census data on populations affected by each disease (eg, women of reproductive age for polycystic ovary syndrome), and the strength of the ‘association of PFAS with each health outcome, calculated what percentage of cases of each disease that occur each year could be attributed to PFAS. We then calculated the cost of each case, both direct (healthcare costs) and indirect (loss of productivity), and multiplied it by the number of attributable cases to obtain an annual cost for each disease.
When we summarized the cost of diseases with the strongest evidence of association with PFAS exposure, we obtained a conservative estimate of $5.52 billion per year; when we also took into account health outcomes for which we think associations are likely, but more research is still needed, the estimate increased to $62.6 billion annually.
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If the presence of these chemicals in homes were to be reduced, what impact would this have not only on people’s health but also on the economy?
The effect of disease cannot be measured in dollars and cents alone. Most importantly, people would be healthier and lead happier and more productive lives. In the US, where we don’t have national health insurance, illness is a huge source of stress and financial strain for people.
In addition, we have costs to the government, which also pays the price when people get sick, for example, if they receive public insurance (Medicaid or Medicare) and provides reparations for children who are disabled because they were born too young. The cost to the economy is also huge, as people are less productive when they are sick or have to care for sick family members.
Despite the results of your study and other supporting evidence, these chemicals are still commonly distributed around the world. What more should governments, policy makers and organizations do to raise awareness of PFAS and associated health issues?
It is essential to translate the results of scientific research on the adverse health effects of PFAS into a language that policy makers and the general public can understand. I think the word about PFAS is finally getting out, certainly in areas where water contamination has occurred, and citizens are becoming more vocal in demanding action from politicians and industry.
But in the United States in particular, it’s all about money, so demonstrating the enormous costs of inaction can be particularly effective in drawing the attention of policymakers who may have so far balked at the price of reparation.
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The Environmental Protection Agency has also recently decided to lower the allowable safety limit of these chemicals in water. How important was this decision and what implications will it have for American citizens?
It is important, but only if it is applied. Many of us believe that even this new limit is too high and that we need to lower it even further. One of the paradoxes about endocrine disrupting chemicals is that they often have negative effects at very low doses, and there may be no truly “safe” limit.
What are the next steps for you and your research?
My colleagues and I will continue to conduct studies to increase the evidence base on the health effects of PFAS and other environmental chemicals and to try to communicate our findings in ways that can make a positive difference in the lives of people
Where can readers find more information?
About Dr. Linda Kahn
Linda G. Kahn, PhD, MPH, is an assistant professor in the Departments of Pediatrics and Population Health at NYU Grossman School of Medicine, where she applies a life course approach to reproductive epidemiology. Her research interests span three interrelated areas: 1) the role of preconception and prenatal environmental exposures in pregnancy and postpartum health, 2) predictors of male and female reproductive development and fertility, and 3) health outcomes of assisted reproduction in both women and children.
Dr. Kahn received her MPH in Population and Family Health and her PhD in Epidemiology at Columbia University’s Mailman School of Public Health. Prior to her career in public health, she spent two decades as a book editor and contributor specializing in women’s studies, psychology, health, motherhood, and child care.