Human Health Workgroup

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Mission:

To assist Michigan Department of Health and Human Services (MDHHS), Michigan Department of Environment, Great Lakes, and Energy (EGLE), Michigan Department of Agriculture and Rural Development (MDARD), and other state agencies with the evaluation of the public health implications associated with environmental releases of per- and polyfluorinated alkyl substances (PFAS). Discuss and build understanding of interdepartmental coordination on public health topics. Be notified of MDHHS public health determinations and regulatory departments’ determinations that impact public health. The workgroup will endeavor to provide impacted communities with public health information in a way that is science-based, equitable, and is protective of everyone in Michigan including the most vulnerable and sensitive individuals of Michigan’s population.

This workgroup is led by MDHHS and consists of representatives from multiple MPART agencies. Most of its members are environmental health toxicologists and risk-assessors.

Recent Accomplishments:

  • Working through MDHHS as the lead agency, the Human Health Workgroup (HHWG) developed public health drinking water screening levels for five PFAS.
    • MDHHS, and by extension HHWG, serves to protect the health of the residents in our state. Our role extends beyond regulations to ensure the best available science is employed through in-depth risk assessments at all sites of contamination across the state, identifying who may be exposed, how they may be exposed, and what protections should be employed – be it mitigation or education – to ensure even the most vulnerable residents of our state are protected from harm from contaminants – regardless of source. Providing public health perspectives and recommending protective actions at sites of contamination is a role MDHHS has been undertaking for decades with myriad chemicals at many sites. Although PFAS are classified as an emerging contaminant, the method by which we determine screening levels, assess risk, and recommend protective actions are tried, true, and recognized by state and federal agencies.
    • These screening levels provide a common well-studied baseline for use by toxicologists as they conduct risk assessments and provide guidance to local health departments and/or implement public health actions directly at sites under investigation.
    • Health-based screening values were developed for the five PFAS listed below because enough scientific knowledge is currently available to make conclusions about them. As more information becomes available MDHHS and the HHWG will continue to update existing screening levels and develop new screening levels for additional PFAS.
      1. PFOS
      2. PFOA
      3. PFHxS
      4. PFNA
      5. PFBS
  • The HHWG saw an unmet need for the development of a document comparing PFAS standards from around the United States and the world that includes information on how such standards are created. The HHWG developed the “Matrix of Agency Screening Levels Worksheet” (Section 9; page 153) to meet this need. Both the general public and various state and local agencies expressed frustration over the complex, evolving and at times inconsistent approaches taken by different agencies to develop PFAS standards around the United States and the world - this comparison document (linked above) clearly lays out the approaches taken by different agencies for the development of PFAS screening levels and compares those to the approach taken by MDHHS. This matrix is still available for public use and, as needed, can be updated and revised.
  • Often, MPART agencies develop protocols or procedures that touch on issues related to human health. With environmental toxicologists and risk assessors among its members, the HHWG is able to provide valuable review and insight to such efforts. Recently, the HHWG has reviewed and provided comment on documents originating from the MPART Air Quality workgroup and the home-raised products sub-workgroup. HHWG also routinely supports activities undertaken by MDHHS, such as health studies that are trying to answer important questions about how PFAS can affect health. Additional, recent or ongoing, examples also include:
    • Review of existing information/published literature on Perfluoroethylcyclohexane Sulfonate (PFECHS) to understand what is currently known about its use and toxicity (read the Current Knowledge of Physiochemical Properties, Environmental Contamination and Toxicity of PFECHS Whitepaper)
    • Development of protocol for the toxicological evaluation of PFAS-containing ‘natural’ foam (on waterbodies) to determine if an advisory is needed
    • Development of responses to public comments received on the health-based values (HBVs) that were used in the development of EGLE’s maximum contaminant levels (MCLs)

Next Steps:

This workgroup will continue to:

  • Determine how PFAS released in the environment affects public health
  • Discuss and share ways to protect everyone’s health, especially those most negatively affected by PFAS
  • Develop science-based information on the PFAS that impact communities
  • Review key MPART products, such as protocols and screening levels, which affect human health
  • Develop screening levels for additional PFAS based on the best, most up-to-date science
  • Update existing screening levels based on the best available science

Reports:

Public Health Drinking Water Screening Levels for PFAS.

This is the document described above in Accomplishment #1. This document explains how MDHHS/Human Health Workgroup developed the public health drinking water screening levels for several PFAS. It includes the selection of critical studies that were identified by the US Environmental Protection Agency, the Agency for Toxic Substances and Disease Registry, and several other states who are at the forefront with Michigan proactively responding to PFAS.

Matrix of Agency Screening Levels Worksheet (Section 9; page 153).

This is the document described above in Accomplishment #2, it is a table of PFAS standards from other agencies, the methods they used to develop those standards and how those compare to the approach taken by the HHWG and MDHHS in the development of their screening levels.

MDHHS Research and Surveillance studies that are supported by the Human Health Workgroup: 

MDHHS has started multiple projects to learn more about PFAS exposure in Michigan residents and to learn more about the links between PFAS exposure and health. Among these efforts are two health studies that will enroll eligible adults and children from the Belmont/Rockford area (in North Kent County), the city of Parchment, and Cooper Township. The first study will be run by MDHHS and is called the Michigan PFAS Exposure and Health Study (MiPEHS). It is a multi-year epidemiological study enrolling eligible Michiganders that seeks to answer the question, “has exposure to PFAS affected human health?”. In the second study, information collected in Michigan will be combined with information from six other locations around the country.  This Multisite PFAS Health Study (MSS) will be run by MDHHS in Michigan and coordinated by the Agency for Toxic Substances and Disease Registry (ATSDR), which chose seven sites around the country to study. Michigan’s ATSDR Multisite PFAS Health Study (MSS) seeks to answer the question, “what is the relationship between PFAS exposure and health outcomes among differing populations?” (CDC press release: CDC and ATSDR Award $7 Million to Begin Multi-Site PFAS Study Sept 23 2019; ATSDR Multi-site Health Study - PFAS Cooperative Agreement webpage). To learn if you are eligible or to learn more about the study purpose(s) please call the MDHHS PFAS hotline at 844-464-7327 and in the coming weeks we will also have a study website.

In addition to those health studies, the following activities are also underway: Michigan Chemical Exposure Monitoring (MiChEM) (press release: Michigan wins $4 million CDC grant to improve monitoring of residents' toxic chemical exposure, Sept 3 2019; website coming soon) is a public health surveillance project that will test a sample of Michigan adults for PFAS and other chemicals. It seeks to answer the questions, “What is the average exposure of Michigan adults to environmental chemicals?” and “Which Michigan adults are most exposed to PFAS?”. And finally, PFAS in Firefighters of Michigan Surveillance (PFOMS) (press release: Michigan wins $4 million CDC grant to improve monitoring of residents' toxic chemical exposure, Sept 3 2019; website coming soon) is a targeted public health surveillance project that will measure PFAS in the blood of Michigan firefighters. It seeks to answer the question, “What is the average exposure to PFAS in Michigan firefighters?"

Timeline of Accomplishments:

  • 2018/2019: Home-raised foods sub-workgroup formed
  • February 22, 2019: MDHHS PFAS Screening Level document published
  • February 22, 2019: Matrix of Agency PFAS Screening Levels Worksheet published
  • September 23, 2019: MDHHS is named as one of 7 awardees of ATSDR multisite PFAS Health Study
  • February 2020: Completes review of draft screening level document for an MPART agency
  • March 2020: Completes review of draft protocol document for an MPART agency
  • 2020: MiPEHS and MSS Health study planning and recruitment; MiCHEM and PFOMS planning

Workgroup Lead Name and Email:

Jordan Bailey, MDHHS
BaileyJ17@Michigan.gov