In March 2016, citizens of Merrimack, New Hampshire, learned that their public water supply was contaminated with perfluorooctanoic acid (PFOA). A subsequent state-led investigation revealed widespread contamination of both public and private well water with PFOA and several related chemicals, broadly termed per- and polyfluoroalkyl substances (PFAS). This research examines the local response to PFAS contamination of the public water system and well water in Merrimack and the results from the health survey administered by a local advocacy group, Merrimack Citizens for Clean Water (MCFCW). MCFCW designed and implemented a community health survey (n = 596) representing 213 households exposed to PFAS through drinking water. The surveys were conducted in the summer of 2017. Respondents used an online survey platform to report demographic information, exposure sources, and health conditions. Logistic regression was used to analyze the community-based health survey results . There were several important associations that warrant further investigation and more immediate attention, especially: 1) elevated incidence of developmental, autoimmune and kidney disorders among those under 18 years of age; 2) elevated levels of health concerns, multiple health concerns, autoimmune disorders, and reproductive disorders among women, 3) elevated levels of health concerns, multiple health conditions, cardiovascular, respiratory, reproductive, and liver disorders in those with industrial occupational exposures, and; 4) elevated incidence of health concerns, cardiovascular, and developmental disorders among those who have been living in Merrimack for a long time versus newer residents. The limitations inherent in the study design warrant caution in interpreting the results, however the associations found in this study merit further investigation. This health survey highlights foremost the critical gap in information—lack of access to blood testing, medical monitoring and physician guidance of PFAS-exposed residents. This study provides a model for conducting community-based health studies to advocate for pathways to state supported biomonitoring and medical monitoring for those exposed to industrial toxins and to take into consideration the human health burden in shaping the future of chemical regulation.

中文翻译：

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让不可见的变得可见：新罕布什尔州梅里马克饮用水 PFAS 污染后社区主导的健康调查结果

2016 年 3 月，新罕布什尔州梅里马克的市民得知他们的公共供水受到全氟辛酸 (PFOA) 的污染。随后由国家主导的调查显示，公共和私人井水普遍受到全氟辛酸 (PFOA) 和几种相关化学物质（广义上称为全氟烷基物质和多氟烷基物质 (PFAS)）的污染。本研究考察了梅里马克当地对 PFAS 污染公共供水系统和井水的反应，以及当地倡导组织梅里马克清洁水公民组织 (MCFCW) 进行的健康调查的结果。MCFCW 设计并实施了一项社区健康调查（n = 596），调查对象为通过饮用水接触 PFAS 的 213 个家庭。该调查于 2017 年夏季进行。受访者使用在线调查平台报告人口统计信息、暴露来源和健康状况。采用Logistic回归分析社区健康调查结果。有几个重要的关联值得进一步研究和更立即的关注，特别是：1）18 岁以下人群中发育、自身免疫和肾脏疾病的发病率升高；2) 女性的健康问题、多种健康问题、自身免疫性疾病和生殖疾病的水平升高， 3) 从事工业职业接触的人的健康问题、多种健康状况、心血管、呼吸系统、生殖和肝脏疾病的水平升高，以及; 4) 与新居民相比，长期居住在梅里马克的居民健康问题、心血管疾病和发育障碍的发生率更高。研究设计固有的局限性需要谨慎解释结果，但本研究中发现的关联值得进一步研究。这项健康调查首先强调了信息方面的关键差距——接触 PFAS 的居民缺乏血液检测、医疗监测和医生指导。这项研究提供了一个进行基于社区的健康研究的模型，以倡导对接触工业毒素的人进行国家支持的生物监测和医学监测的途径，并在塑造化学品监管的未来时考虑人类健康负担。