Read our Coronavirus Coverage Here

North Carolina Health News

News. Policy. Trends. North Carolina.

Donate Now

Additional Thanks

Thank you all for joining our first Health Care Half Hour!

Categories

Pender County

Shows arial view of construction of a thermal oxidizer to mitigate PFAS, machinery, building, etc at a the Chemours facility that has dumped PFAS and other fluorochemicals into nearby rivers, the air.

North Carolina fines Chemours $200,000 more for failing to stop PFAS pollution

by

North Carolina fines Chemours $200,000 more for failing to stop PFAS pollution - North Carolina Health News

State regulators found that treatment measures Chemours took failed to stop residual PFAS from escaping the plant’s boundaries and getting into the Cape Fear River. The DEQ says the measures are working as intended now.

By Greg Barnes

North Carolina environmental regulators have penalized Chemours nearly $200,000 for failing to meet terms of a consent order and violations related to the construction and installation of required measures to treat residual “forever chemicals” at the company’s Fayetteville Works plant.

Those treatment measures became operational in September at what is referred to as Old Outfall 002 — a drainage canal at the Bladen County chemical plant where per- and polyfluoroalkyl substances known as PFAS once flowed freely into the Cape Fear River.

In 2017, the Department of Environmental Quality ordered Chemours to stop discharging its wastewater into the river, but residual PFAS have continued to escape from the outfall and groundwater seeps on the company’s property.

The treatment measures are designed to stop 99 percent of the residual PFAS from flowing into the Cape Fear River, where New Hanover, Pender and Brunswick counties draw their drinking water. Additional corrective action is scheduled to stop other groundwater seeps.

The measures, which the DEQ says are now working as intended, are required as part of a consent order Chemours entered into with the DEQ and the environmental group Cape Fear River Watch in February 2019.

Chemours noncompliance

The DEQ said in January that it found several instances of Chemours’ noncompliance with the consent order — including design and operational problems with the treatment measures — in September, October and November.

The DEQ said Chemours also violated the U.S. Environmental Protection Agency’s pollution permit for the company by “exceeding an effluent limit, failure to meet flow requirements, improper operation and maintenance and failure to mitigate during storm events.”

“DEQ is committed to protecting communities and their water quality and ensuring that Chemours meets all its requirements and obligations, including those under the Consent Order to prevent PFAS from entering the Cape Fear River,” new DEQ Secretary Dionne Delli-Gatti said in the news release. “We will take all appropriate enforcement actions, whenever they fall short of those obligations.”

Kemp Burdette, the Cape Fear Riverkeeper, said Cape Fear River Watch supports holding Chemours accountable for violating terms of the consent order.

“This clean up must happen on time and it must be done right,” Burdette said. “Hundreds of thousands of North Carolinians are counting on that, and we will continue to demand it.”

Chemours responds

Chemours released its own statement on Wednesday afternoon, saying it is reviewing the information it received from the DEQ.

“Chemours takes seriously our obligation to be a responsible manufacturer. We have reduced our overall site PFAS emissions by 97%, and we’re continuing to work hard to meet our remaining commitments,” the company said in the statement. “Throughout this entire process, we have not backed away from our responsibilities and continue to make progress with our site remediation plan, including working through operational challenges with one of the new treatment systems we installed to reduce legacy PFAS discharges to the Cape Fear River.”

According to the DEQ’s release, the department has notified Chemours of the following penalties:

What are PFAS?

PFAS are a group of more than 9,000 different substances used in firefighting foam and a vast array of everyday household products, including nonstick pans, raincoats, food packaging and dental floss.

Although the health effects of PFAS are still not widely known, the Centers for Disease Control and Prevention says they are believed to impact the immune system and may reduce antibody responses to vaccines, including those for COVID-19.

Studies on laboratory animals have found a link between PFAS and liver, kidney, testicular, pancreas and thyroid cancer. Studies also suggest that PFAS can cause high cholesterol, pre-eclampsia and immune suppression. PFAS are called “forever chemicals” because they don’t break down easily and accumulate in the human body.

DuPont began producing a type of PFAS called PFOA at its Bladen County plant around 2003. It switched at the EPA’s prompting to what was thought to be a more environmentally friendly chemical cousin called GenX in 2009. Debate continues on whether GenX and other newer PFAS are any safer than the older substances with longer chemical chains.

In 2016, a research team headed by N.C. State University scientist Detlef Knappe found high levels of GenX in the Cape Fear River and in Wilmington’s drinking water.

In 2017, the Wilmington Star-News reported on the issue, and the DEQ forced Chemours to stop discharging its wastewater into the river.

Chemours has been cited for other violations and penalties in the past. For a list of violations and other documents, visit https://deq.nc.gov/ChemoursConsentOrder.

Steve North and Amanda Martin of the Center for Rural Health Innovation, which administers the Spruce Pine-based MY Health-e-Schools program.

School-based health centers fill rural provider vacuum

by

School-based health centers fill rural provider vacuum - North Carolina Health News

Making healthcare available to students, faculty and staff on campus is vital to well-being in rural areas.

By Melba Newsome

Growing up in a small town in central Wisconsin, many of Steve North’s relatives and friends assumed he would follow his father into medicine but North had other ideas. He earned a liberal arts degree at the University of Wisconsin-Madison in 1993 but, instead of applying for medical school, he applied for Teach for America.

For the next two years, North taught 5th- through 8th-grade exceptional education in Edgecombe County where he saw how unaddressed medical problems kept his students from reaching their academic potential.

ad reminding readers to support our COVID coverage

“The kids were frequently coming to school sick or missing lots of school,” recalls North. “I started doing some reading and got turned on to the idea of school-based health centers (SBHC), which were relatively new on the national scene at the time.”

What he learned persuaded North to finally follow in his father’s footsteps and he was accepted to medical school at UNC Chapel Hill.

While practicing family and adolescent care medicine in Bakersville, a remote mountain town with fewer than 500 residents, North continued to look for ways to provide better care to the children he served. A Jim Bernstein Community Health Leadership Fellowship gave him the support and resources to start the Center for Rural Health Innovation, a non-profit dedicated to improving rural access to health care. That led to the formation of Health-e-Schools, remote clinics that provide primary care and behavioral health services for school kids.

A doctor’s office on campus

North Carolina has been trying to solve the state’s provider scarcity problem for decades with varying degrees of success. In the western part of the state, the doctor-to-patient ratio can be as high as one to 2,000 in some of the most remote areas. School-based health clinics (SBHCs) bring together educators and health practitioners to bridge the health care and education gap and help reduce the disparities that impact school children in rural burgs.

SBHCs are essentially doctors’ offices conveniently located on campus to provide a range of health care services for students, as well as for teachers and staff. For many rural, low-income residents in health care deserts, these clinics are their only access to care.

With permission from a parent or guardian, students are enrolled at the beginning of the school year and can take advantage of available resources. In addition to seeking medical attention for acute issues such as ear and stomach aches, enrollees can also receive chronic disease management, immunizations, well-child checkups, sports physicals, adolescent medicine consultants, and hearing and vision screenings.

North Carolina law also allows minors to seek medical health services for the prevention, diagnosis and treatment of sexually transmitted diseases, pregnancy, substance misuse or emotional disturbances without parental consent.

Additionally, these clinics also help reduce the number of days of classes missed by students.

“This is a good thing because when they come back after being out for a couple of days, they’re behind and it takes a while for them to get back up to speed,” said North. “If that happens more frequently with chronic absenteeism, it can be really tough to bring students back on track.”

SBHCs continue to expand

SBHCs continue to grow across the country and the state, particularly in areas with a shortage of health care providers. Some are funded through private grants but many others are supported by state and federal appropriations. Most partner with the local school district and a community health organization, such as a community health center, hospital or local health department. All are committed to serving every student, regardless of insurance or ability to pay.

When North and the Center for Rural Health Innovation launched Health-e Schools in 2011, the program served just three schools. Now, it reaches more than 25,000 students in 80 schools across three western counties, McDowell, Mitchell and Yancey.

“Parents might work 30 miles in one direction and children go to school 20 miles in the other,” said North. “Before this, when that inevitable call comes in that said ‘Johnny is sick,’ parents had to drive to school, pick up the child and go to the doctor’s office. A lot of those people would end up in the ER who probably didn’t need to be there.”

Shows a man smiling behind a mask worn to prevent transmission of COVID-19. He's standing next to a sign for the Health-e Schools sign for a clinic site at Greenlee School.
Jason Hall, principal of Greenlee Primary School in the Mitchell County town of Spruce Pine shows off his school’s affiliation with Health-e Schools. Photo credit: Lacey Jones, RHI

Similar alliances operate all across the state. Blue Ridge Health operates 13 SBHCs in Henderson, Buncombe, Swaine, Jackson, Rutherford and Polk counties. Many of their students have an hour-long bus ride to and from school so the convenience of on-site clinics means a child doesn’t have to miss a day of school just to see a doctor.

On the other end of the state, the Pender Alliance for Teen Health (PATH) operates three SBHCs in southeastern Pender County, filling a big gap in a place where families routinely drive 50 miles one-way to see a health care provider.

“We have certainly improved their access,” said Kimberly Collins, lead nurse for Pender County Schools. “More kids are getting their annual physicals and getting vaccinated on time. Our staff is able to see them for whatever needs they might have without having to leave work or take a whole day off, or even a half a day off.”

Using high-definition video conferencing with specially equipped stethoscopes and cameras, a centrally located health care provider can examine students at multiple schools without traveling.

As these programs continue to grow, equipping them with these tools becomes more economical, said North.

“It used to cost $30,000 to put telemedicine technology in a school,” he said. “We can now equip a school nurse for about $2,000, with a better piece of equipment that they can take from school to school.”

Behavioral care a gaping need

A study in JAMA Pediatrics found that 72 percent of North Carolina children diagnosed with a behavioral health condition waited more than a year to meet with a licensed mental health provider. According to a brief from the North Carolina Institute of Medicine, this is due in large part to the shortage of specialized instructional support personnel such as nurses, counselors, psychologists and social workers. For example, the recommended ratio is one social worker for every 250 students. North Carolina has one for every 1,427 students, according to the NC IOM report.

Lack of high-speed internet can complicate telehealth delivery in rural communities but SBHCs have made great strides in using technology to connect students to counselors, psychologists and social workers.

In September 2018, Hurricane Florence dropped more than 40 inches of rain in one day on Pender County. Up to 70 percent of the county was under water, 3,000 homes were damaged, and tens of thousands of residents were displaced. Schools remained closed for 29 days while families tried to rebuild or relocate.

By the time the coronavirus pandemic hit 18 months later, hundreds of families still lacked permanent housing.

“The pandemic is like a second wave gut punch for Pender County,” said Sandy Rowe, PATH executive director. “We were still reeling from Florence. With the poverty, remote areas and the domestic violence against our kids, they are feeling like they can’t count on anything.

“We’ve focused on doing what we can to reach them and offer services early enough in the process so that we don’t have a bigger problem later on.”

When a post-Hurricane Florence mental health risk assessment found that 30 percent of the children were at risk for depression, PATH stepped in to add two full-time teletherapy counselors and a health coach to its team of providers. It also boosted preventive measures by developing a mindfulness curriculum for teachers.

Blue Ridge has on-staff counselors for district students and Health-e-Schools partners with Mission Health to address the needs of students with complex mental health issues. Instead of missing school and possibly driving an hour to see a therapist, they can see a mental health provider and still get back to class before the school day ends.

There is a growing recognition of the value SBHCs have to their communities. In 2016, the Federal Office of Rural Health Policy and the Health Resources and Services Administration encouraged expanding access to SBHCs and provided more than $6 million in grants for rural telehealth programs. Last year, HRSA awarded $11 million to SBHCs for technological upgrades.

This is a win-win that bodes well for the growth of SBHCs, particularly in rural areas.

Melba Newsome is a 2020 EWA Reporting Fellow. This story is produced as part of EWA’s drive to support enterprising journalism that informs the public about consequential issues in education. 

shows a person with a cuff on their arm, a pair of hands in rubber gloves is about to draw blood

Duke study finds high PFAS levels in Pittsboro residents’ blood

by

Duke study finds high PFAS levels in Pittsboro residents’ blood - North Carolina Health News

The study says about 1 million people may be drinking water that contains PFAS contamination that originates in the Haw River and flows downstream into the Cape Fear River.

By Greg Barnes

A new Duke University study has found that the concentrations of some potentially cancerous per- and polyfluoroalkyl substances — or PFAS — are two to four times higher in the blood of Pittsboro residents than the U.S. population as a whole.

The study also found that some types of PFAS chemicals found in Pittsboro residents’ blood are “strikingly similar” to those found in the blood of Wilmington residents during an earlier study conducted by N.C. State and East Carolina universities.

ad reminding readers to support our COVID coverage

The findings suggest that two of the legacy PFAS compounds — PFOA and PFOS — and at least one newer type of the substance are coming from the Haw River and finding their way downstream into the Cape Fear River, potentially contaminating drinking water for 1 million people, or 10 percent of North Carolina’s population.

“These data suggest that any drinking water utility drawing water from the Haw or Cape Fear River between Burlington and Wilmington could have similar exposures, and that’s a lot of people,” said Heather Stapleton, a Duke University researcher in the Nicholas School of the Environment. Stapleton is the lead investigator for the study.

Communities that draw their drinking water directly from the Cape Fear or Haw rivers include Sanford, Harnett County, Fayetteville, Wilmington and Pittsboro.

Previously, many people assumed that contamination found in drinking water for New Hanover, Pender and Brunswick counties had been coming largely from the Chemours chemical plant in Bladen County, Stapleton said.

Chemours has been ordered to stop releasing GenX and other PFAS into the Cape Fear River, though some contaminants continue to leach into it from groundwater.

Stapleton said some of the PFAS showing up in Wilmington’s drinking water have no apparent connection to Chemours and are likely coming from upstream of the company’s Fayetteville Works plant.

“What this suggests to me is that the source of exposure could be the same,” she said. “If you think about the fact that the Haw River empties into the Cape Fear River then it’s likely that a lot of the PFAS that is reaching Wilmington is coming from the Haw River itself.”

Study presented to Pittsboro residents

Stapleton and other researchers presented preliminary study results Saturday at a town hall Zoom meeting for Pittsboro residents. The study had a small sample size — researchers drew blood from 49 Pittsboro residents and tested their tap water for PFAS.

While the study was underway, Duke researchers had been collecting water samples since 2018 at sites along the Haw River. Since 2019, weekly samples have been collected along the river at nine sites from Burlington to Pittsboro. At least two collection sites are on Jordan Lake, where concentrations of PFAS have been detected at lower levels. The Haw flows into the lower end of the lake, where the Cape Fear begins.

The researchers tested for 13 types of PFAS in the 49 Pittsboro participants — 18 men and 31 women between the ages of 33 and 86. The levels of PFAS detected in drinking water ranged from none — largely because those people were either drinking bottled water or used advanced filtration systems — to 452 parts per trillion (also measured as nanograms per liter.)

The legacy compounds PFOA and PFOS were found in the residents’ blood at the highest concentrations. A shorter-chain compound, called perfluorohexane sulfonic acid (PFHxS), was found at the third-highest concentration. Stapleton said the three substances made up about 90 percent of the PFAS found in residents’ blood.

“What’s in your blood today is a result of your exposure, not just in the last 24 hours or the last week, but really over a lifetime, and particularly over the last decade,” Stapleton said. “PFOA, PFOS and PFHxS in particular have very long half-lives in the body. That means once they get into our body, it is a long time before they’re lost or excreted from our body.”

a woman in rubber boots collects water from a muddy river, looking for PFAS. She's wearing a sweater, winter clothes
Emily Sutton, the Haw River riverkeeper, taking samples in the Haw River in early 2019. A sample she took in July 2018 near Pittsboro drinking water intake measured 1,076 parts per trillion of PFAS, the highest recorded in the state. Photo credit: Greg Barnes

Stapleton explained that PFOS has a half-life of about 3.4 years. Without any additional exposure, she said, it would take that long for half of the substance’s concentration to leave the body, seven years for it to drop to 25 percent and 11 years before it reached 12 percent.

Another substance called perfluorodecanoic acid (PFDA) was found in the study participants at a level five times higher than the general U.S. population. It is often used as a wetting agent, which allows for water to saturate a surface. PFDA is also used as a flame retardant. The substance was not found in the blood of  Wilmington residents.

No conclusions on residents’ health

The federal Environmental Protection Agency does not regulate the estimated 5,000 types of PFAS known to exist. The only health advisory the agency has set is for PFOA and PFOS at 70 parts per trillion, either by themselves or in combination.

Pittsboro is the only community that draws its drinking water from the Haw, where total PFAS levels have been detected exceeding, at times, 1,000 parts per trillion. The highest level found in Pittsboro’s drinking water during this study was 760 parts per trillion, or nearly 11 times higher than the EPA’s health advisory for the consumption of PFOA and PFOS over a lifetime.

The study, which is still being developed, has so far drawn no conclusions on whether the health of Pittsboro residents is being harmed by the PFAS contamination.

“We are going to be collaborating with N.C. State with the hope of expanding this study and recruiting volunteers to collect more blood samples,” Stapleton said in an interview with NC Health News before the town hall meeting. “Our hope is that we can try to determine if higher levels are associated with any adverse health risks, with a focus potentially on thyroid disease or immune function.”

The study is also looking at whether high levels of PFAS in pregnant women is associated with lower birth weights in infants. Stapleton said it’s statistically hard to determine whether birth weights are lower in Pittsboro than elsewhere because of its small population of about 4,000 people.

Where is it coming from?

Drinking water is the primary source of PFAS in Pittsboro residents, but the contaminants also come from firefighting foam and many common household products, including food packaging, Teflon pans, rain-resistant clothing, stain-proof fabrics and anything that keeps food or liquid from sticking. PFAS are known as forever chemicals because they do not break down easily in the environment and accumulate in the human body.

The legacy compounds PFOA and PFOS are associated with kidney and liver disease, high cholesterol and immune suppression in humans. Although those compounds have been phased out in the U.S. in favor of what were originally thought to be safer, shorter-carbon-chain PFAS cousins, they continue to be found in high levels throughout the Cape Fear River basin.

Stapleton said the sources of PFOA and PFOS in the basin include household products that get into the rivers as waste, runoff of biosolids from farm fields and industrial byproducts that flow unfiltered through wastewater treatment plants.

Most of the other types of PFAS have not been well studied in humans, but those that have been suggest a link between an increased risk of thyroid disease, preeclampsia, higher blood cholesterol levels and blood pressure, a decrease in the body’s response to vaccines and lower infant birth weight.

Searching for sources

Researchers and the state Department of Environmental Quality don’t know the sources of most of the PFAS and 1,4 dioxane in the Cape Fear River basin, but they are trying to find out.

The DEQ last year ordered 25 municipal utilities in the basin to test for the substances at their sewer treatment plants. Of those, 19 reported total PFAS levels of more than 100 parts per trillion.

Sanford’s sewer plant recorded the highest level of PFOS at 1,000 parts per trillion. After extensive sampling, officials now believe a single, unknown discharge occurred that caused the spike. The levels measured since then have been far lower, though total PFAS was found at 399 parts per trillion at the same sewer plant in April.

The DEQ also asked 19 industries known to be using PFAS to measure their discharges into the river basin. High levels were found leaving many of them.

Meanwhile, the N.C. PFAS Network has been sampling drinking water from all public utilities in the state. Of the 320 utilities tested, nearly half had detectable levels of PFAS. The highest level measured was 846 parts per trillion in Pittsboro.

The DEQ’s investigations into discharges of 1,4 dioxane have resulted in special orders by consent against Greensboro and Reidsville, which hold the pretreatment permits for their sewer utilities. Those cities have been ordered to reduce the levels of 1,4 dioxane leaving their sewer treatment plants.

Correction: This story originally stated that perfluorodecanoic acid is a short-chained PFAS. However, PFDA has 10 carbons and is not considered short chained.  For PFCAs, carbon fewer than 7 is considered short chained.

When the water at the Sanford water plant in September, it had high rates of PFAS

State lawmaker says fighting PFAS in NC will require more than enforceable standards

by

State lawmaker says fighting PFAS in NC will require more than enforceable standards - North Carolina Health News

Rep. Pricey Harrison would welcome new maximum contaminant levels for certain types of PFAS, but she worries that industries would just switch to another PFAS compound, resulting in a game of whack-a-mole. Part 2 of 2

By Greg Barnes

Months after DuPont bought the rights to produce Perfluorooctanoic acid (known as PFOA or C8) from Minnesota’s 3M Corp. in 2002, DuPont discovered that the suspected carcinogen used to make Teflon had leaked into the groundwater under the company’s Fayetteville Works plant.

Except for some local newspaper articles and rumblings from environmental groups, the full extent – and the possible consequences – of the contamination flowing into the Cape Fear River was not publicly known until the Wilmington Star News published an exposé in June 2017. 

ad reminding readers to support our COVID coverage

By then, the Chemours chemical company had spun off from DuPont and taken over ownership of the plant along the banks of the Cape Fear River in Bladen County.

When the contamination became public, the state Department of Environmental Quality moved swiftly to stop per- and poly-fluoroalkyl substances (known collectively as PFAS) from getting into the air and into downstream drinking water for New Hanover, Pender and Brunswick counties.

In February 2019, Chemours entered into a consent order with the DEQ and Cape Fear River Watch that forced Chemours to spend $100 million on a thermal oxidizer that the DEQ says has lived up to its expectations of removing 99.9 percent of airborne PFAS from the plant.

What are PFAS?

Per- and polyfluoroalkyl substances (PFAS) are a group of man-made chemicals that includes PFOA, PFOS, GenX, and an estimated  5,000 types of PFAS, none of which are federally regulated. PFAS have been manufactured and used by industries worldwide since the 1940s, used in everything from Teflon pans to raincoats to dental floss. They are also used in firefighting foams.

The two most extensively produced and studied, PFOA and PFOS, have been phased out in the U.S., but they don’t break down easily and can accumulate in the environment and in the human body. There is evidence that exposure to PFAS can lead to adverse human health effects.

Among many other things, the order has also prohibited Chemours from releasing its processed wastewater into the Cape Fear River, significantly reducing PFAS in the river and in downstream drinking water. Contamination still occurs though, mostly because of seepage from groundwater at the plant.

In August, the DEQ and the Southern Environmental Law Center, on behalf of Cape Fear River Watch, announced that they planned to further strengthen the order by requiring Chemours to eliminate the groundwater contamination getting into the river.

Three days earlier, state Attorney General Josh Stein announced that he had begun an investigation into industries that pollute the state’s waterways with PFAS.

Researchers and some state lawmakers applaud those actions but say the legislature needs to follow other states and impose enforceable standards on North Carolina’s most troubling PFAS. Currently, the state has an unenforceable health guideline for only one type of PFAS, which goes by the industry name GenX.

GenX toxicity study

Three years and many toxicological studies since PFAS were found flowing freely from Chemours, the chemical company continues to say the contamination detected in private wells surrounding the plant “[does] not pose a risk to human health.”  Nonetheless, the consent order has forced Chemours to provide bottled water or water filtration systems to more than 3,000 homeowners near the plant whose wells contain high levels of GenX or other PFAS.

Numerous studies on laboratory animals, including those conducted by DuPont, show that GenX causes negative effects to the liver and blood, along with disruptions of the immune system and cancer of the liver, pancreas and testicles. Far less is known about the effects of GenX in humans, but the EPA classifies the substance as a “suggestive carcinogen.”

Members of the N.C. Secretaries’ Science Advisory Board discussed one of the most recent GenX toxicology studies at a meeting on Aug. 31. The study, by the National Institute of Environmental Health  Sciences, was published in February in Environmental Health Perspectives.

The study found that low doses of GenX caused nearly identical health problems in pregnant laboratory mice — including negative effects of the liver, placenta and mammary glands — as PFOA, an older compound.

DuPont switched from producing PFOA to using GenX around 2009 thinking it was safer, but the NIEHS study and others suggest that is not the case. (Newer PFAS have shorter carbon chains and do appear to leave the body more quickly, however.)

In an August interview with the USA Today Network, Andrew Wheeler, administrator of the U.S. Environmental Protection Agency, said Chemours should switch from GenX to a safer compound. He did not name the substance.

That interview happened a day before Wheeler appeared in Fayetteville for a roundtable discussion on PFAS with federal, state and local officials. Wheeler talked extensively about his agency’s PFAS Action Plan and how it will one day be used to clean up contamination across the country.

In a news conference after the roundtable, state Rep. John Szoka (R-Fayetteville) said he expects the EPA will finish a more definitive GenX toxicological study by mid-winter. Szoka and U.S. Rep. Richard Hudson, who hosted the roundtable, believe the study will go a long way toward protecting public health.

Hudson, a Republican who represents North Carolina’s 8th Congressional District, said people living around the Chemours plant are scared.

“Their neighbors have cancer,” Hudson said. “They don’t know if it’s caused by GenX. They don’t know if it’s going to impact their children. They don’t know if it’s impacted the air they breathe, the water they drink or the food they eat. People are really worried and until we can get a final toxicity report from the EPA we truly aren’t going to know the extent of this chemical and what it’s going to take to clean it up.”

Water pouring out of a pipe along the Yadkin-Pee Dee River may be a source of PFAS to the river ecosystem. Photo credit: N.C. State University
Municipal and industrial effluents discharged into the Yadkin-Pee Dee River downstream of Rockingham are probable sources of PFAS to the river ecosystem. Credit: N.C State University

It’s not just GenX 

But GenX is far from the only PFAS that has been detected in drinking water downstream of Chemours and in well water surrounding the plant. The DEQ is so concerned about the levels being found in the private wells that it has ordered Chemours to provide bottled water or filtration systems if the concentration of a single PFAS measures above 10 parts per trillion.

During the science advisory board meeting, N.C. State researcher and board member Detlef Knappe said more studies are needed on the health effects of other PFAS that have been found in drinking water downstream of Chemours and in well water surrounding the plant. Knappe said concentrations of one type of PFAS — called PFMOAA — had been detected in Wilmington at concentrations 100 times higher than GenX.

Knappe also mentioned another PFAS, Nafion by-product 2, which has also been detected in high concentrations in drinking water downstream of Chemours and in well water.

“GenX is never the dominant contaminant in well water,” Knappe told the board.

High levels of PFOS in Sanford

Chemours and DuPont are seen as the villains in North Carolina largely because they are thought to be the only manufacturer of PFAS in the state and because they knew about the contamination for decades. The PFAS they released was easily traced back to them.

But many other companies use the chemicals, especially in the Cape Fear River basin, from above Greensboro to the coast.

In July, the NC PFAST Network, a group of researchers from seven universities working through the state-funded NC Policy Collaboratory, released its first full findings of PFAS in raw water samples taken from 320 municipal water treatment plants in the state.

Although the network found no instances in which PFOA, PFOS or GenX exceeded EPA or state health guidelines, it found a troubling number of plants with high levels of total PFAS — the combination of all of the PFAS measured.

The highest level was detected in raw water for Pittsboro at 844.8 parts per trillion. Raw water is water used for drinking before it goes through the treatment process. Most water treatment plants in North Carolina are incapable of filtering out PFAS. It can be done, but it’s expensive.

Levels of total PFAS measuring over 100 parts per trillion were detected at 14 water treatment plants. The network did not try to determine who was responsible for the contamination.

While the network was doing its sampling, the DEQ ordered 25 municipalities to test for PFAS at their sewer plants. Industries discharge PFAS and other waste directly into municipal sewer systems, which are incapable of filtering them out. Typically, the waste enters a major river and flows downstream into drinking water supplies.

DEQ data show that 1,000 parts per trillion of PFOS — and 4,026 parts per trillion of total PFAS — was detected at a Sanford wastewater treatment plant on Sept. 4, 2019.

The data became public on Jan. 16. The same day, NC Health News asked the DEQ if it had identified the source of the contamination in Sanford.

The DEQ responded that it “has initiated additional sampling and source identification measures with the city of Sanford. The city will perform monthly effluent sampling for at least six months and the city has been asked to evaluate the potential source(s) of PFOA and PFOS in their wastewater system.”

A year later, the DEQ has not determined the source of the contamination or tested for PFAS in Sanford’s drinking water. A DEQ spokeswoman said Sanford was expected to test its drinking water in early September.

The DEQ did provide data showing that the levels of PFOA and PFOS measured at the sewer plant did not exceed EPA health guidelines after the high reading for PFOS last September. But the data did show high levels of total PFAS that were measured monthly from January through May. A concentration of 399 parts per trillion of total PFAS was recorded in April.

The PFAST network’s testing of Sanford’s raw drinking water was done a day after the spike was detected at the city’s sewer plant. The city’s water intake is unusual in that it lies downstream of its sewer plant.

Lee Ferguson, a Duke civil engineering professor and co-leader of the network, said in an email in January that it’s “entirely feasible” that the contaminated water had not reached the Sanford water treatment plant when the network conducted its tests. Ferguson said the types of PFAS detected at the sewer plant strongly suggest the contamination came from firefighting foam, which is often used in military and airport training to put out fires.

Multiple PFAS sources

The second-highest concentration of total PFAS detected through the DEQ’s monitoring program measured 2,296 parts per trillion at the East Burlington sewer treatment plant.

So much PFAS contamination has been found in Burlington that the Haw River Assembly has threatened to sue the city if it doesn’t do something to force industries to stop polluting.

Greensboro has also seen high levels of PFAS in its water. A primary source of that contamination is believed to also be from firefighting foam once used for training at Piedmont Triad International Airport. Greensboro planned to spend $31 million on a system to filter out PFAS, but those plans are now on hold as the city awaits regulations from the state and federal governments and for the coronavirus pandemic to ease, according to the Greensboro News & Record.

The PFAS contamination from Brunswick, Greensboro and other cities flows into the Haw River and downstream to Pittsboro, the only city to use the Haw as its drinking water source. Pittsboro is also considering a filtration system.

Birnbaum had been invited to speak to Pittsboro officials about the contamination at a virtual meeting on Aug. 24, but she canceled her presentation after the town spent about three hours addressing other issues before getting to her.

Michigan’s new standards

While North Carolina struggles to keep PFAS out of public drinking water, other states have given up waiting on the EPA to set enforceable standards and have done so themselves.

In Michigan, new maximum contaminant levels for certain types of PFAS will go a long way toward ridding the contaminants from drinking water, said Charlotte Jameson of the Michigan Environmental Council, a nonprofit coalition of 70 groups that helps drive the state’s environmental policies.

What is a maximum contaminant level and what would setting one mean? 

As per the EPA, a maximum contaminant level for drinking water is “the highest level of a contaminant that is allowed.” They are set as close to pre-existing goals as possible and feasible “using the best available treatment technology and taking cost into consideration.”

When the EPA sets an MCL, it becomes a nationwide standard. But states have also begun setting MCLs to address waterway contamination in the absence of EPA action.

What makes an MCL significant is that it’s an enforceable standard. This means that industries or water utilities surpassing the MCL could be subject to fines and legal action.

Michigan is said to have the most PFAS contamination sites in the country. The contaminants have been found in varying levels at utilities serving about 1.9 million people. North Carolina’s PFAS contamination ranks third nationally.

Under the new MCL standards, Michigan’s water utilities will be required to test for PFAS in their drinking water annually, Jameson said. Those with contamination known to exceed the standards will test quarterly, she said. Utilities where water tests above the new standards will be required to bring the levels into compliance.

The new standards will affect about 2,700 utilities, schools and large businesses that provide water to the public. State regulators say the standards are expected to cost utilities serving more than 25 people a statewide total of about $11 million to install treatment and $6.4 million to test for PFAS during the first year, according to MLive, a Michigan news outlet.

Jameson said industrial sites that exceed the standards will be required to clean them up, but she said the standards will not force industries to curtail PFAS contamination in the state’s waterways.

“That’s kind of a key flaw with a water or drinking water MCL,” Jameson said. “We can’t require polluters within this MCL to stop polluting or to install proven technology. There are other regulatory mechanisms, like discharge permits, and other things like that that can help better target the source of the pollution. But the MCL will never necessarily do that.”

Instead, she said, Michigan will force the public utilities to install PFAS filtration systems if they fail to meet the standards.

Regulating PFAS as a single class

North Carolina Rep. Pricey Harrison (D-Greensboro) has been among the legislature’s most staunch supporters of environmental reform. During her 16 years in the General

Assembly, Harrison has been the primary sponsor of countless environmental bills that have been brushed aside.

“I just don’t know why we can’t get the political will to actually tackle problems because it’s a real public health crisis from my perspective,” Harrison said.

Harrison is a proponent of setting maximum contaminant levels for PFAS in North Carolina, but she sees it only as a good first step.

“Yeah, MCLs are great but you know what the industry is doing is just introducing new chemicals in the same family that wouldn’t be covered by the MCL. So now it’s just sort of whack-a-mole … I am very frustrated by the way legislators handle this.”

Harrison, DeWitt and Birnbaum believe PFAS should be regulated as a single class. So instead of setting an MCL for PFOA or PFOS, the MCL would regulate the entire spectrum of PFAS as a group.

DeWitt and Birnbaum were among the co-authors advocating for the class approach in a research paper published June 30 in Environmental Science & Technology Letters.

The two researchers also say they want government restrictions that would limit the use of PFAS and other hazardous chemicals to those considered essential until safer alternatives are developed.

Until then, they continue to advocate for the maximum contaminant levels. Even if the standards result in a game of industrial whack-a-mole, they say, they can still be used to protect drinking water.

The question is whether those standards will be set — either at the federal or state level — anytime soon.

“I don’t know why we would expect there to be any faster movement on additional compounds when it’s been two decades,” DeWitt said. “I guess I don’t have great promise that the current environment within the EPA is being particularly proactive or precautionary.”

Harrison doesn’t sound optimistic, either.

“I’m sorry I sound frustrated but this has been one of the biggest frustrations of my 16-year legislative career,” she said. “We have not been able to tackle this issue that is clearly a public health crisis. I just hope that we’re gonna get a crop of legislators that will put a priority on public health and maybe tackle it.”

shows large storm approaching the north carolina coast

Coronavirus Today – Aug. 3 – Awaiting Isaias; Curfews and evacuations; Landfall in southeastern NC?

by

Coronavirus Today – Aug. 3 – Awaiting Isaias; Curfews and evacuations; Landfall in southeastern NC? - North Carolina Health News

North Carolina awaits the dawn after its first major storm amid the coronavirus pandemic.

By Anne Blythe

As Tropical Storm Isaias gets closer to North Carolina’s southeastern coastline, where it is expected to come ashore later tonight, Gov. Roy Cooper has cautioned people not to get caught up in weather semantics.

Isaias rose out of a tropical wave off the African coastline and organized into a tighter storm with gale-force winds. On July 30, Isaias became the ninth named storm of this hurricane season.

As the storm cut a path westward and northward, its winds grew to hurricane strength of 80 miles per hour. As of 2 p.m. Monday, its maximum sustained winds were at 70 miles per hour with occasional gusts as strong as 85 miles per hour.

ad reminding readers to support our COVID coverage

At some points during its approach toward the North Carolina coast, Isaias has been a hurricane. At other times its wind speed downgraded it to a tropical storm. The storm could intensify again to hurricane-level winds, forecasters say.

Hurricane warnings have been issued for Brunswick, New Hanover and Pender counties.

Tropical storm warnings and watches have been issued for much of eastern and central North Carolina, and utility companies, transportation officials, state troopers and swift-water rescue teams are at the ready for emergencies related to flooding and power lines toppled in high winds.

“As we’ve cautioned before, the status or category of a storm can be misleading,” Cooper said. “Whether it’s labeled a tropical storm or a hurricane, you should take this storm seriously, and make sure your family is ready. That means taking care of your pets, too.”

Curfews, storm surge and expected flooding

Weather forecasters are predicting life-threatening storm surge on beaches, particularly those south of Wilmington and the Cape Fear River.

Many counties have issued states of emergency. Some have issued curfews to keep people off the streets from late Monday afternoon through early Tuesday morning.

Ocean Isle issued a mandatory evacuation order for vacationers, renters and guests on Saturday and suggested that residents and property owners evacuate on Monday. Holden Beach also issued a voluntary evacuation directive.

shows men clad in emergency operations shirts and face coverings arrivinng on a stage
Gov. Roy Cooper (at podium) and Emergency Management director Mike Sprayberry arrive for a hurricane briefing on the afternoon of Monday, Aug. 3, ahead of Tropical Storm/ Hurricane Isaías. Screenshot courtesy: UNC TV

The Town of Sunset Beach on the state’s southern tip issued a 6 p.m. to 7 a.m. curfew in anticipation of the storm but did not order an evacuation of vacationers.

“This storm will bring dangerous weather conditions to much of our state overnight,” said Cooper. “Heavy rains, flash floods and storm surge can quickly inundate low-lying areas.”

Tornados also are a possibility.

North Carolina has been preparing for this scenario for several months. Modelers earlier this year predicted an active hurricane season in the Atlantic Ocean.

The coronavirus pandemic adds another thorny layer to preparations in a state that has seen its share of hurricanes, flooding and other weather-related disasters in recent years.

Some coastal and low-lying communities in eastern North Carolina have yet to fully rebound from those disasters. Now Isaias is threatening to bring more destructive wind and heavy rains.

Mike Sprayberry, director of Emergency Management for the state, and Cooper encourage anyone fleeing the storm or damage from it to try to stay with family and friends or at a hotel before heading to emergency shelters.

There will be shelters set up in some places.

Brunswick County opened shelters at Cedar Grove Middle School in Supply and at Town Creek Middle School in Winnabow.

Face coverings must be worn at all times, according to shelter rules, and individuals and families must stay in an assigned section of the building at all times.

People will be screened for COVID-19 symptoms before they are checked in. Anyone suspected of having the virus will be isolated either at a specially designated area of the shelter or at a medical facility.

Sprayberry also said that there are hotel rooms set aside across the state as a form of “non-congregate shelter” for those who may be sick with the coronavirus or at increased risk.

Tuesday morning will bring a clearer picture of how North Carolina fared in its first major storm during the pandemic.

As people begin to move about again after the storm passes, Cooper and his emergency management team urge drivers to turn around if water is pooled on roads or if a barricade blocks the path forward.

“As little as 18 inches can sweep a car away,” Cooper said. “We’ve lost too many lives after these storms because of people trying to drive through water.”

Ocracoke Island and several other beach communities along the northeastern barrier islands ordered evacuations and tried to thin out the tourists in the many vacation rentals. According to the Department of Transportation, about 3,500 people and about 1,700 vehicles evacuated from the island ahead of the storm.

In a 5 p.m. briefing, the National Hurricane Center said Isaias was expected to make landfall as a hurricane near Wilmington, then move up the East Coast with heavy rain and flooding.

Another big decision ahead

As many across North Carolina await Isaias and the potential damage the storm will leave in its wake, another unanswered question remains in this phase of the pandemic.

An executive order that Cooper signed several weeks ago is set to expire Friday afternoon. The order continues to shutter bars, gyms, theaters, bowling alleys and other such venues deemed to be high-risk for transmission of COVID-19.

Last week, Mandy Cohen, secretary of the state Department of Health and Human Services, said the metrics and trends that her public health team monitor showed some stabilization of COVID-19 infection rates after a period of steady and sharp rise.

Cooper said Monday he likely would have an announcement on Wednesday about whether he would renew the executive order or make room for some of those riskier businesses to open.

That will be a day of looking forward as emergency teams look back on what damage, if any, North Carolina’s first big storm of the 2020 hurricane season leaves in its path.

“Now I know that North Carolinians have had to dig deep in recent months to tap into our strength and resilience during the pandemic,” Cooper said. “That hasn’t been easy, but with this storm on the way we have to dig a little deeper. Let’s keep each other safe from the wind and the water as well as from the virus.”

“As this storm arrives in just a few hours, remember the power that comes from helping one another,” Cooper added shortly after 3 p.m. “We’re all better off when we work together.”

Coronavirus by the numbers

According to NCDHHS data, as of Monday afternoon:

  • 1,982 people total in North Carolina have died of coronavirus.
  • 125,219 have been diagnosed with the disease. Of those, 1,057 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
  • 105,093 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious.
  • To date, 1,837,410 tests have been completed. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the coronavirus tests performed in the state.
  • People ages 25-49 make up the largest group of cases (44 percent). While 12 percent of the positive diagnoses were in people ages 65 and older, seniors make up 79 percent of coronavirus deaths in the state.
  • 307 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,168 ventilators in hospitals across the state and 804 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.
shows men bent over green plants, pulling peppers into baskets

Coronavirus Today – July 23 – Follow the three Ws, say Mexican and Guatemalan consulate leaders; Plug for Medicaid expansion; ‘Not yet turned a corner’

by

Coronavirus Today – July 23 – Follow the three Ws, say Mexican and Guatemalan consulate leaders; Plug for Medicaid expansion; ‘Not yet turned a corner’ - North Carolina Health News

North Carolina is on steadier ground than many Southern states in its fight against COVID-19, but cases continue to rise especially in Latino communities.

By Anne Blythe

North Carolina’s governor, top public health officials and high-ranking leaders from the Mexican and Guatemalan consulates sent an urgent message to Latinx and Hispanic residents on Thursday.

COVID-19 is spreading swiftly and disproportionately among their communities, and the best way to fight the virus and keep their communities strong and healthy is to follow oft-issued guidance.

ad reminding readers to support our COVID coverage

Wear a face mask over the nose and mouth, stay safe by keeping six-feet apart from others when masking is not possible, and routinely wash hands.

“While we are on steadier ground than most southern states who continue to see viral spread accelerate, we have not yet turned a corner here,” said Mandy Cohen, secretary of the state Department of Health and Human Services. “Unfortunately, we continue to see increases in cases and there has especially been a notable and concerning increase in COVID-19 cases among members of our state’s LatinX, Hispanic community.”

Hispanic residents are just under 10 percent of the state’s population, but they represent 43 percent of the lab-confirmed coronavirus cases for which race and ethnicity are reported.

“Many members of our LatinX, Hispanic communities work in essential jobs that are the backbone of the state’s economy,” Cohen said. “The nature of these jobs put people at higher risk for getting infected from COVID-19 at work and then potentially transmitting it back into their communities. In light of the trends I mentioned earlier, we need to turn up the volume on our core preventative messages.”

‘Unite to defeat this illness’

Claudia Velasco-Osorio, Consul General of Mexico in Raleigh, and Jorge Archila, Consul General of Guatemala, joined Cohen at Thursday’s media briefing to try to convey that sense of urgency.

“This is an opportunity for all of us to unite in order to defeat this disease,” Archila said.

He urged people to get tested for coronavirus if they had such symptoms as headaches, a sore throat, fever, chills, coughs, nausea, runny nose, congestion, shortness of breath, loss of taste or smell, fatigue, muscle pain, diarrhea or trouble breathing.

Shows hospitalizations due to COVID growing in the Charlotte area.
A graph from the Department of Health and Human Services COVID-19 data dashboard shows how hospitalization in the 13 county area around and including Charlotte has steadily grown over the past month. This area, along with the northern Triad region have the most hospitalizations in the state.

Strategies to help

This month, the state is providing free testing in communities of color which have long had difficulties getting access to health care.

Additionally, the state has issued $100,000 grants to five community organizations with strong ties to Latinx and Hispanic communities to help provide a broader safety net for people who sometimes remain in the shadows because of their residency status.

Those grants went to:

Cohen and her public health team and task force members have spoken routinely about the disparate impact of COVID-19 on communities of color.

Often people in those communities work so-called “essential” jobs at meat processing plants, construction sites and lower-paying service industry jobs that have not been shut down during the pandemic.

Messaging campaigns

Velasco-Osorio implored Latinx and Hispanic residents to follow the social distancing, testing and other recommendations from the public health officials, “making sure that in our homes, these instructions are followed fully, and without excuse, and that we all assume responsibility in this emergency.”

The consulate leaders and Cohen said they communicate routinely with other states and consulates in search of measures working elsewhere to slow the virus spread in more vulnerable communities.

shows a woman standing at a podium, talking about COVID. In a box on the screen is another woman, gesturing with her hands, who is a sign language translator.
Claudia Velasco-Osorio, the Consul General of Mexico in Raleigh, spoke to the state, and particularly to the Hispanic community during a media briefing on July 23. “It is imperative to attend each one of the authorities’ recommendations, making sure that in our homes, their instructions are followed fully and without excuse, and that we all assume our responsibility in this emergency,” she told Mexicans in North Carolina. Screenshot courtesy: UNC TV

“We are definitely trying to share best practices among states in a number of ways,” Cohen said. “As we thought about our testing strategy, as well, I know in San Antonio, in particular, they are doing this kind of testing work where they are surging testing sites that are free, that are paid for by the state in a number of their communities and really trying to be mobile and bring testing to where people are.”

Archila said the Guatemalan consulates have translated all the information they are getting about the pandemic, prevention measures and guidance for those who become infected not only are translated into Spanish but also into all the Mayan dialects used in the Central American country.

Gov. Roy Cooper recently announced that 900,000 face masks, along with hand sanitizer and infection-control supplies would be sent to N.C. Cooperative Extension offices in 31 counties to be distributed to agricultural workers, many of whom are Latinx migrants who live and work in close quarters and carry out critical food supply chain jobs.

The counties which received the first deliveries are Alamance, Alleghany, Ashe, Avery, Bladen, Columbus, Cumberland, Duplin, Durham, Edgecombe, Forsyth, Franklin, Granville, Greene, Guilford, Harnett, Henderson, Johnston, Lee, Lenoir, Lincoln, Martin, Mecklenburg, Nash, Pender, Pitt, Robeson, Sampson, Wake, Wayne and Wilson.

During the media briefing, reporters raised thorny issues that have come up before about some Latinos being turned away from health care, even when they were sick, because they lacked insurance. Some also have relayed that members of the Latinx community avoid care for fear of being asked about their residency status.

There also were questions about where people could get help with rent, food and other necessities if they lost their jobs during the pandemic.

The consulates could provide help with the insurance issue, Archila said, and Cohen reminded listeners about the organizations that received the $100,000 grants, in part to help with those issues.

Another push to expand Medicaid

Cohen reiterated the importance of focusing resources on the state’s Latinx to address the disproportionate impact of the disease.

“We’re trying to do everything from making sure we’re getting the word out and everyone knows about the three Ws to making sure that we are surging testing availability,” Cohen said. “But we also know an important part of this is making sure folks can stay home and isolate and get access to the care they need.”

Community health centers and other providers have stepped in to help people who are uninsured or underinsured. Even before the pandemic, North Carolina had the seventh-highest rate of uninsurance in the country, a rate which has no doubt increased since hundreds of thousands have lost work.

Cohen said part of the reason for that high rate is because the state did not expand Medicaid.

The people who would be eligible for the federal assistance “are folks who are working hard, most of the time two or three jobs, none of those jobs offer health insurance,” Cohen said.

“One of the ways we can really improve our ability to respond to this crisis is to expand access to insurance coverage and we can do that without investing any state dollars,” Cohen said. “We can just bring federal dollars here to help us fight COVID-19 and to help folks access the coverage that they need.

“We need to make sure that we are using every tool that is out there and we are not using one of those tools right now and that’s Medicaid expansion.”

Coronavirus by the numbers

According to NCDHHS data, as of Thursday afternoon:

  • 1,726 people total in North Carolina have died of coronavirus.
  • 106,893 have been diagnosed with the disease. Of those, 1,188 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
  • 78,707 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious.
  • To date, 1,458,997 tests have been completed. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the coronavirus tests performed in the state.
  • People ages 25-49 make up the largest proportion (44 percent) of those with lab-confirmed cases of coronavirus. While 12 percent of the positive diagnoses were in people ages 65 and older, seniors make up 78 percent of coronavirus deaths in the state.
  • 243 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,190 ventilators in hospitals across the state and 875  ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.
[email]
[email]
[zip]
[zip]
[listGroups]
[listGroups]
[email]
[email]
[zip]
[zip]
[listGroups]
[listGroups]