U.S. Sen. Bob Casey, D-Scranton, announced Thursday that he has helped secure language mandating the Department of Defense pay for a national health study on people exposed to toxic chemicals PFOS and PFOA in their drinking water.
Such a commitment has remained elusive: Despite setting aside billions of dollars to investigate contamination at hundreds of military sites across the country, military officials have previously declined to financially back a health study. That refusal rankled affected communities across the country, including those in Bucks and Montgomery counties, where an estimated 70,000 current residents were exposed to the chemicals in nationally high amounts.
As reported earlier this week, Casey has been pressing colleagues such as Arizona Sen. John McCain, chairman of the Senate Armed Services Committee, to include a health study requirement in the National Defense Authorization Act. That bill is one of two key military spending bills passed each year. Casey’s office said Thursday that the requirement made it into the final “markup” of the 2018 bill when it was drafted this week.
A legislative aide to Casey said the bill’s language is not yet publicly available, but that the health study component calls for a five-year study, with funding for the first year at $7 million. That number could grow with additional funds in future years.
The language does not detail the design of the study, such as which communities across the country would be included or whether or not it would require blood testing. Those decisions would likely fall to the U.S. Agency for Toxic Substances and Disease Registry (ATSDR), a wing of the U.S. Centers for Disease Control and Prevention that is typically responsible for conducting such studies.
The ATSDR has already been working on a “feasibility study” laying out what a national health study on PFOS and PFOA could incorporate. In a September 2016 meeting convened by Casey, officials from the agency stated it would take between $20 million and $30 million over five years to complete such a study. Those figures align with the language inserted into the NDAA bill this week.
This spring, the ATSDR also released a draft feasibility study on a PFOS and PFOA national health study. The document laid out several possibilities for health studies, including for children, adults and former military personnel. But to complete all possible studies, it would need a large sample of individuals from multiple contaminated sites around the country. The study did feature Bucks and Montgomery County residents among highly affected communities.
Questions sent to the ATSDR on Thursday morning regarding what an initial funding of $7 million could accomplish were not immediately returned.
The health study language also faces a long road to becoming law. According to Casey’s office, it would need to survive consideration of the NDAA bill by the full Senate, likely to take place sometime this summer. It would also need to be included in the House’s version of the bill, or make it through a reconciliation process between the two chambers. Bucks congressman Brian Fitzpatrick, R-8, of Middletown, previously said he was working on legislation to force a health study.
Asked how his efforts could converge with Casey's, Fitzpatrick spokesman Aaron Clark wrote that "the Senate and House Armed Services Committees priorities are often different, therefore the amendments allowed by each chairman and ranking member are usually different. Regardless, we are planning on taking advantage of the National Defense Authorization Act as a way to make a difference in the House version."
Congress also passes a similar military appropriations bill each year, and the $7 million in funding would need to be included in that as well. Casey's office pointed out the senator previously worked with the appropriations committee on requiring the Department of Defense to deliver a progress report on PFC cleanup, meaning the issue is already on the committee's radar.
“We’re not all the way there yet, but the voices of these families are having an impact,” Casey said. He worked with U.S. Sen. Jeanne Shaheen, D-New Hampshire, who sits on the Armed Services Committee, to include the language.
Regardless of the legislative slog ahead, local residents affected by the contamination reacted to the news with optimism Thursday morning.
Hope Grosse, who grew up across the street from Warminster’s former Naval Air Warfare Center and believes contamination from the base sickened her family members and neighbors, simply said “that’s awesome” when told of the news.
“It’s everything we’ve been pushing for,” Grosse said. “I can’t believe it, actually.”
Grosse said she’d personally like to see blood testing conducted, as well as regular monitoring for the area’s children. “I know the kids hold more chemicals than I do,” she said.
Valerie Secrease, a 64-year-old Franconia resident who worked at NAS-JRB Willow Grove for about 26 years as a civilian and reservist, has been pressing the military to conduct a study and help veterans for years. In 2014, drinking water testing at the Horsham Air Guard Station, which was also formerly consumed by Willow Grove personnel, found the chemicals at more than 200 times the safe level.
“I hope they call me,” Secrease joked when asked what she’d like to see from a health study. “I would like to see them start some kind of (blood testing) right away.”
She said she’s felt the federal government has been letting down former personnel. Two of her former colleagues recently died of cancer, joining a list she thinks has grown suspiciously long.
“Pancreatic cancer is huge among people who were at Willow Grove,” she said.
A national study, should it come to fruition, would be significant because knowledge of the toxic effects of PFOS and PFOA is still limited compared to more well-known contaminants such as lead and arsenic. Animal studies have found links to a wide range of health effects, particularly for the reproductive system, offspring development, and to organs such as the liver.
There have been fewer retrospective studies on people exposed to the chemicals, with inconsistent results. The largest human study to date examined about 69,000 people along the Ohio River who had been exposed to PFOA. But PFOS was not included, leaving an even larger gap of understanding about what exposure to that chemical meant for residents in areas like Bucks and Montgomery counties.
Emory University professor and epidemiologist Dr. Kyle Steenland was one of the researchers who compared the Mid-Ohio Valley residents’ PFOA blood levels and found “probable links” to six illnesses: high cholesterol, ulcerative colitis, thyroid disease, testicular cancer, kidney cancer and pregnancy-induced hypertension.
“If those things popped out again, that would be powerful evidence,” Steenland said Thursday, adding a comprehensive study would look at as many health effects as possible, as well as other chemicals related to PFOS and PFOA.
There are a lot of factors to consider when designing such a study, Steenland said. Choosing which communities are worth studying should be based on PFOS and PFOA blood levels, not just drinking-water levels, to ensure actual exposure, he said. Analyzing blood would also allow researchers to determine at which exposure levels certain health effects occur.
“There’s a lot of talk about what’s in the water, but what’s in the blood is what they want to know,” he said.
Other variables for a study include population size, funding limitations and time constraints.
“With a larger population you’re always going to get more information, you’re going to have more statistical power to see an effect,” Steenland said, noting that researchers could combine populations from different areas by adjusting for factors such as background disease rates and smoking rates.
The availability of time and money could also affect how far researchers look into the past, as well as into the future. Reconstructing past exposures is more expensive and may take time, Steenland said. But tracking individuals' health in the future would require ongoing financial and research commitments for at least five years to see what illnesses pop up.
“There’s a lot of complications to just walking in and saying what (illnesses) do you have now?" Steenland said. "You have to follow people over time.”