As class action settlements against corporations for contaminating public drinking water with PFAS increase, ‘forever chemicals’ can be found in the blood of nearly every single person in America.
By Genni Burkhart
Per- and polyfluoroalkyl substances (PFAS) consist of over 15,000 synthetic chemicals. In use since the 1940s, these synthetic, manufactured chemicals are all around us, inside us, and impossible to avoid.
Often referred to as forever chemicals, PFAS molecules are composed of a chain of interconnected carbon and fluorine atoms. Due to the strength of the carbon-fluorine bond, these substances do not readily break down in the environment - hence, “forever.”
PFAS are highly resistant to heat, water, and oil, which raises significant concerns about their connection to various health issues, including cancer, liver damage, cardiovascular disease, immune deficiencies, insulin regulation, reproductive problems, bone density, and tooth decay.
Woven into nearly every aspect of modern-day life, forever chemicals can be found in public drinking water systems, pesticides, firefighting foam, landfills, manufacturing facilities, food (and its packaging), household products, clothing, building materials, and personal care items, such as shampoo, toothpaste, and dental floss. PFAS have even been found in rainfall over the Great Lakes, snow in Antarctica, and the Tibetan plateau.
As such, traces of forever chemicals can be found in 99 percent of all humans, including those in utero.
Due to their prevalence in everyday products and the environment, PFAS can build up in the human body, leading to bioaccumulation, a process in which individuals ingest more chemicals than they can eliminate. Current PFAS research is focused on determining how bioaccumulation of forever chemicals affects human health.
As a relevant and trending issue, it is essential to recognize the potential harm of PFAS, their prevalence in everyday life, and their impact on human health.
The Asbestos Correlation
The North Carolina Oral Health Collaborative published an article in 2021 comparing the widespread use of asbestos in the 1960s and 70s to the current PFAS situation. The article highlights the parallels between the two substances and the potential long-term consequences associated with PFAS use.
From 1930 to the late 1970s, asbestos was ubiquitous - found in everything from clothing and building materials to automotive manufacturing and vinyl goods. Due to its versatility, chrysotile asbestos was used in various dental products, such as casting rings, dental tapes, dental inlays, crowns, bridges, and periodontal dressing powders. However, the dangers of asbestos exposure are now well-documented. Asbestos has led to numerous adverse health effects (mesothelioma and other cancers), countless class action lawsuits, and ongoing efforts to safely mitigate it from human exposure entirely.
The asbestos comparison to the current PFAS situation raises important questions about widespread chemical use's potential risks and long-term impacts. It serves as a reminder of the importance of scientific research and understanding the possible consequences of introducing synthetic substances into our environment and daily lives.
Watershed Moment
A recent article by The New York Times reported on leaked audio from a plastics industry presentation. At this conference, lawyer Brian Gross told a room full of plastic industry executives that PFAS lawsuits could “dwarf anything related to asbestos.”
For reference, the estimated cost of asbestos litigation totals $265 billion, the most expansive (and ongoing) corporate-liability legal battle in U.S. history.
Mr. Gross declined to comment to the N.Y. Times. However, Emily M. Lamond, who specializes in environmental law at Cole Schotz, spoke with the N.Y. Times and stated, "To say that the floodgates are opening is an understatement.” Lamond continues, “Take tobacco, asbestos, MTBE, combine them, and I think we’re still going to see more PFAS-related litigation.”
The NY Times article claims that potential PFAS litigation could total “hundreds of billions of dollars.”
Public Drinking Water: The Bellwether of PFAS Exposure
For decades, PFAS linked to the Chemours Fayetteville Works site, where the chemicals are manufactured, were discharged into North Carolina’s Cape Fear River, the primary drinking source for Wilmington, North Carolina.
It wasn't until 2017, when Star News broke the story, that the public became aware of a nearby chemical facility releasing various PFAS, including GenX, into the Cape Fear River since 1980.
Subsequently, the GenX Exposure Study, a research initiative by North Carolina State University, was launched in 2017 in direct response to the news that the chemical GenX, which DuPont had started producing in 2009, was present in the drinking water of some 300,000 Wilmington, NC residents. North Carolina's Pittsboro and other communities along the Haw River have since been added to the list of high-exposure communities in the region.
This study found four legacy PFAS (PFHxS, PFOA, PFOS, PFNA) in 97 percent (or greater) of the participants. Furthermore, the levels of legacy PFAS in the participants’ blood were significantly higher than U.S. national levels (found in the 2015-2016 National Health and Nutrition Examination Survey) and remained the same in repeated samples.
The chemical company has since stopped releasing PFAS into the Cape Fear River and has been legally required to clean up its Fayetteville facility and assist residents affected. In February of this year, The United States District Court for the District of South Carolina approved a $1.185 billion settlement against Dupont, Chemours, and Corteva (spin-offs of Dupont) to settle liability claims from multiple public water systems across the U.S. This settlement was tied to the findings of the GX Exposure Study.
The More You Know:
- 3M settled its $10.3 billion Forever Chemicals Suit in June 2023, the largest water contamination settlement in U.S. History.
- Dupont is not new to PFAS litigation. In 2005, it was ordered to pay $10.25 million to settle EPA violations related to PFAS and give $6.25 million to supplemental environmental projects.
- The Department of Defense became involved in PFAS development in the 1960s. In 1970 nearly every Navy ship and military base utilized forever chemicals as a foam for fire prevention and training.
- Over the years, this foam has been spilled into local waterways, bare ground, and the ocean, contaminating countless drinking water supplies. According to the nonprofit Environmental Working Group, there are 710 military sites with “known or suspected” PFAS contamination in the U.S., Guam, Puerto Rico, and the U.S. Virgin Islands.
If you’re left wondering how safe your drinking water is, The USGS (U.S. Geological Survey) estimates that 45 percent of the nation’s tap water is contaminated with one or more forever chemical. (Read the USGS’ PFAS drinking water contamination article <here and view the contamination map here.)
PFAS and Oral Health
A 2020 study by researchers at the West Virginia University School of Dentistry suggests that children with higher concentrations of a forever chemical in their blood are more likely to develop cavities.
The study, conducted by scientists R. Constance Wiener, DMD, PhD, Associate Professor, Dental Public Health and Professional Practice Chairperson, and Christopher Waters, Research Labs Director at West Virginia University School of Dentistry, focused on the impact of PFAS on children's dental health. The researchers found that higher concentrations of PFAS correlated with more significant tooth decay, explicitly linking it to perfluorodecanoic acid.
The study analyzed blood samples and tooth decay levels of 629 children aged 3 to 11. The researchers believe that PFAS, particularly perfluorodecanoic acid, may disrupt healthy enamel development, making teeth more susceptible to decay. However, the exact mechanism of how perfluorodecanoic acid causes cavities requires further research.
The Fluoride Fight
Understanding the impact of PFAS pollution from a public health perspective is essential, particularly for dental providers.
Even the ADA (American Dental Association) has gotten involved.
From clinical research to public health campaigns, the fight against PFAS pollution and oral health has gone beyond toothpaste and floss. The ADA has taken a stand, ensuring the EPA (Environmental Protection Agency) doesn't overlook the importance of oral health when addressing PFAS contamination.
In 2023, the ADA wrote a letter to the EPA asking it to consider PFAS filtration standards that would not inadvertently remove fluoride from public water systems.
In April of this year, the EPA revised its PFAS National Primary Drinking Water Regulation from 1.0 ng/L to 4.0 ng/L, the enforceable level suggested by the ADA. The ADA suggested a final level four times higher than the original EPA proposal, perhaps indicating a compromise between the two organizations. Various factors, such as scientific research, public input, and considerations of feasibility and cost-effectiveness, may have influenced this change.
While it may not seem immediately relevant, oral health providers can be crucial in addressing PFAS contamination. For example, a reverse osmosis two-stage filter can help eliminate about 99 percent of PFAS chemicals from drinking water. However, these filters also remove fluoride from the water, potentially leading to oral health issues.
Perhaps this is all the more reason for dental professionals to integrate discussions about water filtration devices into dental health questionnaires and fluoride supplementation, especially in heavily affected communities.
While many communities are grappling with mistrust over public water fluoridation programs, perhaps the more critical conversations should revolve around the presence, abundance, and filtration of forever chemicals in our drinking water.
Limiting Exposure Through Dental Products
Commercial chemistry is rapidly growing, making it challenging for scientists and regulators to monitor and track all the forever chemicals produced, leaving the medical community, including dentists, unsure of the lasting impact on our health.
While avoiding forever chemicals altogether is virtually impossible, limiting our exposure is within our power. Referencing back to bioaccumulation, lower exposure to forever chemicals allows more time for your body to eliminate them. One way to do this is to consider the products used in your home and dental practice, including toothbrushes, toothpaste, dental floss, aligners, mouthguards, tooth whitening kits, and mouthwash.
In Conclusion
Like many communities worldwide, the U.S. is not alone in wondering how safe its water supplies are. Despite some advancements in monitoring, environmentalists and experts agree that more needs to be done to prevent potentially catastrophic consequences.
As we've seen in North Carolina, our waterways are not just resources but fragile ecosystems. Our health is closely linked to the environment we depend on.
All across the U.S., public water supplies are under scrutiny and subject to stricter PFAS regulations—but is it enough? Our trust in our public water supplies cannot be understated. Ultimately, the safety of our drinking water is an integral component of our overall health, including our oral health.
If you're not yet subscribed to receive the Incisor newsletter, filled with cutting-edge dental news sent directly to your inbox twice a month, you can do so here.
Author: With 14 years as a published journalist, editor, and writer, Genni Burkhart's career has spanned politics, healthcare, law, business finance, technology, and news. She resides in Northern Colorado, where she works as the editor-in-chief of the Incisor at DOCS Education.
