At the Department of Health, we believe that health starts in our communities. It starts with the air we breathe, the food we have access to and eat, and the water that we drink. An important part of promoting health in our communities involves evaluating the best science available and creating sound public health policy that responds to emerging environmental health concerns. That is what is happening right now in Rhode Island with per- and polyfluoroalkyl substances (PFAS). The Department of Health will be promulgating regulations in the coming months that will set a maximum level of PFAS for drinking water in our state.
PFAS are a group of chemicals used in a variety of industries. Their widespread use in thousands of everyday consumer products that are non-stick, stain-resistant, or waterproof is one way people can be exposed to PFAS. PFAS can also be found in drinking water from wells and surface water due to contamination from industrial facilities, their use in firefighting foam, and other sources. Almost everyone in the United States has been exposed through one of these everyday sources, and therefore has some PFAS in their blood. Studies suggest that PFAS exposure can affect people’s health, including through changes to developing fetuses, cholesterol levels, and immune systems.
Work to address PFAS has been a priority in Rhode Island. The Department of Health has been working with the Department of Environmental Management, Brown University, and other academic partners to do an extensive analysis of PFAS in our public water systems. The Department of Health and partners have tested PFAS for all school and municipal water supplies, as well as some childcare centers and smaller drinking water systems potentially at-risk of PFAS contamination. Finally, the Department of Environmental Management has been testing private wells. Through this sampling, one water system in Rhode Island was found to have exceeded the PFAS level that EPA has set for possible health concerns. (This system was located in a section of Burrillville.) The Department of Environmental Management did an investigation into the source of the PFAS, and both agencies provided public education and engineering services and helped ensure that funding was available for the system to connect to a safer source of drinking water.
Throughout this process, environmental health and drinking water experts from the Department of Health have been working closely with researchers and officials at water systems throughout the state to evaluate establishing a PFAS limit for Rhode Island that is lower than the federal level. (This is known as a maximum contaminant level.) We are learning from other states in the region that are considering their own steps on these emerging chemicals, and we are ready to work with advocates and members of the General Assembly who are interested in seeing Rhode Island take action. Additionally, we recognize the need for Rhode Island’s science-driven public health policy on PFAS to have input from the public. All Rhode Islanders will have an opportunity to weigh-in during the public comment portion of the process of developing health regulations.
In all this collaboration, there are many considerations involved, including technical, economic, and health factors. For example, we are currently reviewing engineering costs and options for controlling PFAS, and we are evaluating the health benefits at different regulatory levels. State law requires this kind of cost-benefit analysis that considers how ratepayers and taxpayers will be affected by the engineering upgrades that would be required on the public water systems that we all own. In addressing PFAS it is important that we be deliberate, thorough, and also mindful of how rate increases would impact the more vulnerable people and families in our communities.
Giving all Rhode Islanders in every ZIP code in the state an equal opportunity to be healthy means simultaneously addressing emerging environmental health concerns, such as PFAS, and the more deeply rooted factors in our communities that also impact health outcomes. These include factors like housing, education, discrimination, transportation, access to good jobs with fair wages, and access to fresh fruits and vegetables. The healthier Rhode Island that we all envision can only be built upon a foundation of healthy communities and a healthy environment.
Nicole Alexander-Scott, MD, MPH is the director of the Rhode Island Department of Health.