New national guidance on the health risks of perfluorinated chemicals (PFCs) has been issued by enHealth, Australia’s peak environmental advisory body, in the wake of high-profile media coverage of water contamination in Williamtown, NSW, and concerns in other states about PFC contamination.
The Environmental Health Standing Committee (enHealth) guidance was developed at a national summit convened in December 2015 for reporting through to the Australian Health Protection Principal Committee (AHPPC), to which enHealth reports.
The summit, hosted by NSW Health and co-facilitated by enHealth and including representatives from all nine Australian jurisdictions as well as medical and environmental risk experts, was asked to develop a nationally–consistent approach to PFC contamination, not just for water, but also for food and any other risk areas.
Minimise exposure as a precaution
The enHealth guidance statements and an AHPPC fact sheet, released last month, advise that blood tests, have “no current value in informing clinical management”. However, they say that because PFCs persist in humans and the environment, it is recommended that human exposure to these chemicals be minimised as a precaution.
“In humans, research has not conclusively demonstrated that PFCs are related to specific illnesses, even under conditions of occupational exposure,” the statements say. “It is understandable that communities living in PFC-affected areas may want to know what their level of exposure to PFCs is and what this means for their health and the health of their families. The lack of certainty around the potential for health effects can compound concerns.
“ … tests are not routine and there is at present insufficient scientific evidence for a medical practitioner to be able to tell a person whether their blood level will make them sick now or later in life, or if any current health problems are related to the PFC levels found in their blood.”
On breast feeding, the statements say the significant health benefits of breast feeding are well established and far outweigh any potential health risks to an infant from any PFCs transferred through breast milk, therefore it does not recommend that mothers living in or around sites contaminated with PFCs cease breast feeding.
For pregnant women, it says “there is currently no consistent evidence that exposure to [PFCs] causes adverse human health outcomes in pregnant women or their babies. Nonetheless, enHealth recommends that pregnant women should be considered a potentially sensitive population when investigating [PFC] contaminated sites, with a view to minimising their exposure.”
enHealth convened an expert group last week to provide advice to the AHPPC on the development of an Australian interim health reference value for the PFCs, for use in human health risk assessments. The reference value will consider international guidelines, as well as contemporary scientific and technical issues.
Prudent to contain contamination
Professor Brian Priestly, a toxicologist and head of the Australian Centre for Human Health Risk Assessment at Monash University, who gave expert advice to the summit, said the database of toxicological and epidemiological studies on PFCs was now quite extensive.
“Given the structural similarities between [PFCs] and fatty acids, many of the adverse health effects predicted to be associated with high exposures were related to disturbances of lipid homeostasis,” he said.
“While some recently published epidemiological studies are suggesting an association between higher levels of [PFC] exposure and an increase in some health effects, the studies are inconsistent with regard to which [PFCs] are involved and generally fall short of establishing a causal relationship. Overall, the toxicological database suggests that at current levels of [PFC] exposure, even around some contaminated sites, there are unlikely to be causally-related effects on human health.”
However, he supported enHealth’s position that, because these chemicals are environmentally persistent and can accumulate in food chains and in the body over time, it is prudent to take steps to contain environmental contamination and to limit human exposures.
Dr Xavier Schobben, Director, Environmental Health at the Northern Territory Department of Health said: “Broadly speaking from my perspective working in a very busy albeit small jurisdiction, national guidance proves to be a valuable tool as part of the environmental health risk assessment/risk management framework, in responding to any environmental contamination incidents”.
