Tapwater Exposures, Effects Potential, and Residential Risk Management in Northern Plains Nations

Tapwater exposures, residential risk, and mitigation in a PFAS-impacted-groundwater community

Tapwater (TW) safety and sustainability are priorities in the United States. Per/polyfluoroalkyl substance(s) (PFAS) contamination is a growing public-health concern due to prolific use, widespread TW exposures, and mounting human-health concerns. Historically-rural, actively-urbanizing communities that rely on surficial-aquifer private wells incur elevated risks of unrecognized TW exposures, including PFAS, due to limited private-well monitoring and contaminant-source proliferation in urbanizing landscapes. Here, a broad-analytical-scope TW-assessment was conducted in a hydrologically-vulnerable, Mississippi River alluvial-island community, where PFAS contamination of the shallow-alluvial drinking-water aquifer has been documented, but more comprehensive contaminant characterization to inform decision-making is currently lacking. In 2021, we analyzed 510 organics, 34 inorganics, and 3 microbial groups in 11 residential and community locations to assess (1) TW risks beyond recognized PFAS issues, (2) day-to-day and year-to-year risk variability, and (3) suitability of the underlying sandstone aquifer as an alternative source to mitigate TW-PFAS exposures. Seventy-six organics and 25 inorganics were detected. Potential human-health risks of detected TW exposures were explored based on cumulative benchmark-based toxicity quotients (∑TQ). Elevated risks (∑TQ ≥ 1) from organic and inorganic contaminants were observed in all alluvial-aquifer-sourced synoptic samples but not in sandstone-aquifer-sourced samples. Repeated sampling at 3 sites over 52-55 h indicated limited variability in risk over the short-term. Comparable PFAS-specific ∑TQ for spatial-synoptic, short-term (3 days) temporal, and long-term (3 years quarterly) temporal samples indicated that synoptic results provided useful insight into the risks of TW-PFAS exposures at French Island over the long-term. No PFAS detections in sandstone-aquifer-sourced samples over a 3 year period indicated no PFAS-associated risk and supported the sandstone aquifer as an alternative drinking-water source to mitigate community TW-PFAS exposures. This study illustrated the importance of expanded contaminant monitoring of private-well TW, beyond known concerns (in this case, PFAS), to reduce the risks of a range of unrecognized contaminant exposures.

Household-Level Variability of Nontarget Analytical Results for Drinking Water Provides a Tool for Uncovering Constituents Introduced by Distribution System Components

The variability in the nontarget chemical composition of tap water from 120 households and 15 brands of retail water was analyzed during two seasons. Fifteen households in eight separate community water systems were evaluated with the goal of identifying compounds with high within-source variability and investigating potential origins of the observed variation. High resolution mass spectrometry with liquid and gas chromatography was implemented and 10 chemical features from each water system with the highest coefficient of variation and a tentative library match were prioritized for investigation. This prioritization filter reduced the number of considered features from the 16,929 originally isolated to 282. High confidence structural annotations could be assigned to 134 compounds, which were then categorized based on plausible contaminant inputs. The most common source category was plastic (potentially originating from piping, fittings or packaging), with 47/50 of the GC compounds and 22/40 of the LC compounds having possible plastic-related origins. Other important source categories included other distribution system components (polychlorinated biphenyls, historically used in caulking), disinfection byproducts (trihalomethanes), and contaminants present in source waters at varying levels (sucralose, PFAS). The findings highlight the diverse constituents introduced into drinking water from the distribution system and the importance of assessing chemical exposures via drinking water at the point of use.

Statewide cumulative human health risk assessment of inorganics-contaminated groundwater wells, Montana, USA

Across the United States, rural residents rely on unregulated and generally unmonitored private wells for drinking water, which may pose serious health risks due to unrecognized contaminants. We assessed the nature, degree, and spatial distribution of cumulative health risks from inorganic contaminants in groundwater. Our analysis included nearly 84,000 data points from 6500+ wells, across 51 of Montana's 98 watersheds, using a public groundwater database. We compared a drinking water screening level cumulative risk assessment (CRA) for inorganics based on the U.S. Environmental Protection Agency (EPA) protective health thresholds (Maximum Contaminant Level Goals, Health Advisories [MCLG-HAs]) to a CRA based on EPA public supply enforceable Maximum Contaminant Levels (MCLs). Based on median concentrations of 19 inorganics (antimony, arsenic, barium, beryllium, boron, cadmium, chromium, copper, fluoride, manganese, molybdenum, nickel, nitrate, lead, selenium, strontium, thallium, uranium, zinc), 75% of watersheds had MCLG-HA-based cumulative risk values > 1.0; arsenic and uranium contributed the most risk, followed by strontium, fluoride, manganese and boron. Hence, this screening level (Tier I) CRA indicated widespread potential for unrecognized human health risk to private well users from inorganic contaminants considering both carcinogenic and non-carcinogenic risks. Sensitivity analysis showed that benchmarks applied (MCLG-HAs versus MCLs) exerted the largest control on results. Our findings identify priority regions for Tier 2 risk assessments to elucidate local sources and distributions of geogenic versus anthropomorphic contaminants. Our study is the first statewide assessment of cumulative health risk from groundwater that we are aware of, and results support increased statewide drinking water education and testing to reduce human health risks from contaminated private well water.

Removal of perfluoroalkyl and polyfluoroalkyl substances from tap water by means of point-of-use treatment: A review

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are widely used synthetic chemicals known for their environmental persistence and adverse health effects. For this reason, they have come under increasing scrutiny in drinking water, with several groundbreaking drinking water regulations adopted recently in the US and the EU. Nevertheless, conventional treatment processes often fail to remove PFAS effectively, raising concerns about drinking water quality and consumer health. More advanced treatment processes can remove PFAS with varying success from drinking water treatment plants. Using similar technology to that used in centralized PFAS treatment, many types of point-of-use/point-of-entry (POU/POE) water treatment devices are also commercially available. Herein, an overview of the literature regarding POU/POE efficacy in the removal of PFAS from tap water was compiled and critically discussed. Generally, they employ treatment technologies like granular activated carbon, ion exchange, and reverse osmosis to remove PFAS contamination. Despite their laboratory testing and often certification for removal of perfluorooctanoic and perfluorooctanesulfonic acid and other PFAS in tap water, in most cases their efficacy in actual use has yet to be well characterized. In particular, inconsistent testing and insufficient real-life studies complicate assessments of their long-term performance, especially against short-chain PFAS. Furthermore, improperly maintained activated carbon systems might even raise PFAS levels in purified water. Only a few peer-reviewed studies have measured PFAS levels at the tap after POU/POE treatment, with just five assessing removal efficiency in real-life scenarios. Limited to the findings described, not all filters were demonstrated to be effective, especially against short-chain PFAS. Additionally, inconsistent testing methods that do not follow standard guidelines make it hard to compare filter results, and the long-term performance of these systems remains uncertain. More occurrence studies are essential to verify performance over time and understand exposure to these contaminants through water treated by household systems.

Distribution of inorganic compositions of Japanese tap water: a nationwide survey in 2019-2024

A nationwide survey of inorganic components of tap water all over Japan was conducted from 2019 to 2024. In this survey, 1564 tap water samples were collected, and an additional 194 tap water samples were collected from 33 other countries. The water samples were analyzed for 27 dissolved inorganic components, with a primary focus on the distribution of major and trace components, including Ca, Mg, K, Na, Cl-, NO3-, SO42-, total-hardness, Al, Fe, Cu, Mn, and Zn. The Japanese tap water hardness was 50.5 ± 30.2 (± 1σ SD) mg/L, classified as soft water according to the World Health Organization (WHO) classification. The average content of each major component in Japanese tap water tended to be lower than those in other countries. Furthermore, Piper trilinear diagrams were used to categorize Japanese tap water types. The dominating water types were the Ca-HCO3 and mixed types, which had a nationwide distribution. Japanese tap water generally complied with Japanese and WHO drinking water criteria, with only 1% (17/1564 sites) of the samples exceeding water quality standards. Observations of water quality changes for 2 years at three household faucets revealed that fluctuations in major components and trace metals (Al, Fe, Cu, Mn, and Zn) varied in different patterns. This suggests that the behavior of trace metal elements is influenced by local infrastructure, such as supply pipes, distinct from the variability in source water quality.

The Contribution of Declines in Blood Lead Levels to Reductions in Blood Pressure Levels: Longitudinal Evidence in the Strong Heart Family Study

BACKGROUND

Chronic lead exposure is associated with both subclinical and clinical cardiovascular disease. We evaluated whether declines in blood lead were associated with changes in systolic and diastolic blood pressure in adult American Indian participants from the SHFS (Strong Heart Family Study).

METHODS AND RESULTS

Lead in whole blood was measured in 285 SHFS participants in 1997 to 1999 and 2006 to 2009. Blood pressure and measures of cardiac geometry and function were obtained in 2001 to 2003 and 2006 to 2009. We used generalized estimating equations to evaluate the association of declines in blood lead with changes in blood pressure; cardiac function and geometry measures were considered secondary. Mean blood lead was 2.04 μg/dL at baseline. After ≈10 years, mean decline in blood lead was 0.67 μg/dL. In fully adjusted models, the mean difference in systolic blood pressure comparing the highest to lowest tertile of decline (>0.91 versus <0.27 μg/dL) in blood lead was -7.08 mm Hg (95% CI, -13.16 to -1.00). A significant nonlinear association between declines in blood lead and declines in systolic blood pressure was detected, with significant linear associations where blood lead decline was 0.1 μg/dL or higher. Declines in blood lead were nonsignificantly associated with declines in diastolic blood pressure and significantly associated with declines in interventricular septum thickness.

CONCLUSIONS

Declines in blood lead levels in American Indian adults, even when small (0.1-1.0 μg/dL), were associated with reductions in systolic blood pressure. These findings suggest the need to further study the cardiovascular impacts of reducing lead exposures and the importance of lead exposure prevention.

Juxtaposition of intensive agriculture, vulnerable aquifers, and mixed chemical/microbial exposures in private-well tapwater in northeast Iowa

In the United States and globally, contaminant exposure in unregulated private-well point-of-use tapwater (TW) is a recognized public-health data gap and an obstacle to both risk-management and homeowner decision making. To help address the lack of data on broad contaminant exposures in private-well TW from hydrologically-vulnerable (alluvial, karst) aquifers in agriculturally-intensive landscapes, samples were collected in 2018-2019 from 47 northeast Iowa farms and analyzed for 35 inorganics, 437 unique organics, 5 in vitro bioassays, and 11 microbial assays. Twenty-six inorganics and 51 organics, dominated by pesticides and related transformation products (35 herbicide-, 5 insecticide-, and 2 fungicide-related), were observed in TW. Heterotrophic bacteria detections were near ubiquitous (94 % of the samples), with detection of total coliform bacteria in 28 % of the samples and growth on at least one putative-pathogen selective media across all TW samples. Health-based hazard index screening levels were exceeded frequently in private-well TW and attributed primarily to inorganics (nitrate, uranium). Results support incorporation of residential treatment systems to protect against contaminant exposure and the need for increased monitoring of rural private-well homes. Continued assessment of unmonitored and unregulated private-supply TW is needed to model contaminant exposures and human-health risks.

Bottled water contaminant exposures and potential human effects

BACKGROUND

Bottled water (BW) consumption in the United States and globally has increased amidst heightened concern about environmental contaminant exposures and health risks in drinking water supplies, despite a paucity of directly comparable, environmentally-relevant contaminant exposure data for BW. This study provides insight into exposures and cumulative risks to human health from inorganic/organic/microbial contaminants in BW.

METHODS

BW from 30 total domestic US (23) and imported (7) sources, including purified tapwater (7) and spring water (23), were analyzed for 3 field parameters, 53 inorganics, 465 organics, 14 microbial metrics, and in vitro estrogen receptor (ER) bioactivity. Health-benchmark-weighted cumulative hazard indices and ratios of organic-contaminant in vitro exposure-activity cutoffs were assessed for detected regulated and unregulated inorganic and organic contaminants.

RESULTS

48 inorganics and 45 organics were detected in sampled BW. No enforceable chemical quality standards were exceeded, but several inorganic and organic contaminants with maximum contaminant level goal(s) (MCLG) of zero (no known safe level of exposure to vulnerable sub-populations) were detected. Among these, arsenic, lead, and uranium were detected in 67 %, 17 %, and 57 % of BW, respectively, almost exclusively in spring-sourced samples not treated by advanced filtration. Organic MCLG exceedances included frequent detections of disinfection byproducts (DBP) in tapwater-sourced BW and sporadic detections of DBP and volatile organic chemicals in BW sourced from tapwater and springs. Precautionary health-based screening levels were exceeded frequently and attributed primarily to DBP in tapwater-sourced BW and co-occurring inorganic and organic contaminants in spring-sourced BW.

CONCLUSION

The results indicate that simultaneous exposures to multiple drinking-water contaminants of potential human-health concern are common in BW. Improved understandings of human exposures based on more environmentally realistic and directly comparable point-of-use exposure characterizations, like this BW study, are essential to public health because drinking water is a biological necessity and, consequently, a high-vulnerability vector for human contaminant exposures.

Development and application of an evidence-based directed acyclic graph to evaluate the associations between metal mixtures and cardiometabolic outcomes

Objectives

Specifying causal models to assess relationships among metal mixtures and cardiometabolic outcomes requires evidence-based models of the causal structures; however, such models have not been previously published. The objective of this study was to develop and evaluate a directed acyclic graph (DAG) diagraming metal mixture exposure and cardiometabolic outcomes.

Methods

We conducted a literature search to develop the DAG of metal mixtures and cardiometabolic outcomes. To evaluate consistency of the DAG, we tested the suggested conditional independence statements using linear and logistic regression analyses with data from the San Luis Valley Diabetes Study (SLVDS; n=1795). We calculated the proportion of statements supported by the data and compared this to the proportion of conditional independence statements supported by 1,000 DAGs with the same structure but randomly permuted nodes. Next, we used our DAG to identify minimally sufficient adjustment sets needed to estimate the association between metal mixtures and cardiometabolic outcomes (i.e., cardiovascular disease, fasting glucose, and systolic blood pressure). We applied them to the SLVDS using Bayesian kernel machine regression, linear mixed effects, and Cox proportional hazards models.

Results

From the 42 articles included in the review, we developed an evidence-based DAG with 74 testable conditional independence statements (43 % supported by SLVDS data). We observed evidence for an association between As and Mn and fasting glucose.

Conclusions

We developed, tested, and applied an evidence-based approach to analyze associations between metal mixtures and cardiometabolic health.