Most people in the United States have some level of PFAS in their blood, according to the CDC. (Getty Images)
Carol Williams doesn’t live in New Hampshire anymore, but she links her cancer to the 36 years she lived in Bedford, just over the Merrimack town line. Williams only recently learned that the drinking water at her house contained chemicals called per- and polyfluorinated substances, or PFAS, which can be harmful to human health.
The first diagnosis came in 2010: breast cancer. Williams had a successful lumpectomy and radiation treatment, and thought she could move on with her life. The kidney cancer came two years later, a more serious diagnosis than early-stage breast cancer and surprising to Williams, with no family history of the cancer, which is twice as common in men. She wasn’t a smoker or overweight. She had always been an avid runner – and that meant she drank a lot of water. In 2020, she was diagnosed with bladder cancer.
Neither breast nor bladder cancer have been linked to PFAS exposure, but scientists have found a link between kidney cancer and PFAS – chemicals identified as possible carcinogens by the International Agency for Research on Cancer. Bladder cancer has been linked to arsenic, another environmental exposure from well water that is more common in northern New England than the rest of the country.
Williams learned her cancer could be tied to environmental factors only after a state report was released in December 2021, finding more cases of kidney and renal pelvis cancer than expected in the town of Merrimack: a 42 percent excess the state determined was statistically significant.
The investigation into health impacts was itself triggered by the 2016 findings of elevated PFAS in the water supply. Williams wrote to the New Hampshire Department of Health and Human Services, asking it to prioritize the investigation and expand its geographic bounds to include her town. While the state did look at cancer rates for Bedford, Litchfield, and Londonderry – and didn’t find a signal to indicate concern – taking a town-by-town approach could dilute the analysis, said Laurene Allen, a citizen advocate who works with Merrimack Citizens for Clean Water. She advocates for “looking at what, regardless of town boundaries, we know is the contamination area.”
Allen argues the state should use the area of exposure when analyzing cancer rates, and the Department of Environmental Services has already done mapping to model air, ground, and water contamination, she said.
“What we need is the whole area to be addressed because people need answers at the end of the day. … And if they want to pursue legal action, my god, they have every right to do that,” she said.
Questions, and more questions
The recent report from the state has prompted a slew of questions from others in the region six years after residents first learned that PFAS had leached from the Saint-Gobain Performance Plastics plant into the groundwater, contaminating hundreds of private wells. The company – which declined a request for comment on this story – uses PFAS to manufacture protective fabrics, used by the military (desert shelters and biohazard suits) and in construction (sport stadium rooftops).
Saint-Gobain has provided bottled water to some of those impacted, and paid to extend municipal water lines for some water treatment systems, according to a 2018 agreement with the state. And the state required Saint-Gobain to install a treatment system to remove chemicals from the air leaving the plant. After missing the initial deadline, last July Saint-Gobain unveiled the new system, which is now the subject of an enforcement action after the state found a bypass stack it said was unauthorized.
“Is there medical data about the local incidence of cancer? Is there evidence of the link to Saint-Gobain?” asked one participant during a community meeting in January with state health officials to address cancer concerns in Merrimack. “Does this have anything to do with the town’s water problems?” asked another.
But the state Department of Health and Human Services was clear that it doesn’t have satisfying answers to many of these questions. And even if they pursue further study, there are some questions that will be left unanswered, like the cause of a particular cancer.
Whitney Hammond, the chronic disease director for the department, said only a higher-than-expected number of kidney cancer cases has been found, not higher rates of cancer overall. “And at this point, we don’t have the ability to link that with any particular organization, or any particular environmental contaminants,” she said at the January meeting.
Even if the state decides it’s feasible to move forward with a more comprehensive study of the area, even if they can secure the funding and an academic partner to undertake that work, the state does not expect to answer that question, according to Hammond. “I know everybody really wants to understand if some particular thing caused their cancer or their family member’s cancer, but that’s not what the department’s able to do,” she said. Hammond and advocates urged residents who think they may be impacted to contact the state.
PFAS are often called “forever” chemicals since they don’t biodegrade and can accumulate in people, animals, and the environment. The man-made chemical used globally in commercial and industrial products since the 1950s is present in common household products that repel water, like stain repellents, stain-resistant carpets and couches, cookware, and food packaging.
The chemical is a major environmental concern being taken up by the Legislature this year – driven in no small part by lawmakers from Merrimack.
PFAS have been found throughout the state. In November, the Department of Environmental Services issued an advisory warning people not to eat fish caught in five lakes in southern New Hampshire because of how much PFOS – or perfluorooctane sulfonic acid (a type of PFAS) had been found in the fish. The lakes included in the advisory were Beaver Lake in Derry, Robinson Pond in Hudson, Horseshoe Pond in Merrimack, Canobie Lake in Salem, and Cobbetts Pond in Windham. “These are even surface water bodies we wouldn’t have anticipated,” said Mindi Messmer, an environmental scientist.
House Bill 1440 – introduced this session – would set standards for PFAS in surface water, which Messmer said would be an important acknowledgement of the connection between surface water and public and private water supplies. Another bill looks at establishing regulations for soil, and gained the support of DES, which proponents say could help identify and prevent PFAS from getting into groundwater.
Most people in the United States have some level of PFAS in their blood, according to the CDC. In Merrimack, the level of PFOA, or perfluorooctanoic acid, one type of PFAS, was 4.4 times the national average among the 219 private well drinkers who were tested by the state in 2016 and 2017. Allen believes that if more people had access to sampling, it could reveal higher numbers.
“This is the largest industrial contamination of groundwater in the state’s history, and it’s still spreading,” said Rep. Rosemarie Rung, a Merrimack Democrat and the chairwoman of the state commission charged with investigating the environmental and public health impacts associated with PFAS. “What people in Merrimack want is we want to know why.”
A community advisory council that used to be an avenue for dialogue with Saint-Gobain has essentially been disbanded, and has not met for the past few months, Rung said.
According to Mike Wimsatt, waste management division director at the Department of Environmental Services, around 2,000 wells have been tested for levels of PFAS that exceed state standards, and 936 of those wells are in what’s called the consent decree area, a boundary the state and the company agreed on in 2016. Within that area, Saint-Gobain is required to provide bottled water and test wells thought to be contaminated. Outside that area, 1,094 additional private wells have tested for PFAS above the state standards; around 80 percent of those wells are in southern New Hampshire, Wimsatt said.
“We certainly believe there are many wells outside the consent decree area that are contaminated above the standard as a result of Saint-Gobain’s deposition,” he said.
Just in January, the state sent out 232 letters to properties within 500 feet of a well in violation of groundwater quality standards; 115 of those letters went to Bedford, the town where Williams had lived. The letters don’t guarantee that the state will provide testing, but, Wimsatt said, so far they’ve been able to test every property that has requested it. Wimsatt said he thinks that inside the decree area, Saint-Gobain will finish sampling wells within a few months. But beyond it, the timeline is less clear.
“I’m not sure how many more samples we will end up taking,” he said. “It comes down to whenever we get data that suggests where people are above standards, we draw our circle, we make notifications, we get requests, and we react to them. We will probably be at that for a while to come.”
Rung said the findings of the December report didn’t come as a surprise, but rather lent scientific legitimacy to people’s lived experience with cancer in the region.
More research needed
Kyle Steenland, an epidemiologist and professor of environmental health at Emory University, has examined the impact of PFAS on human health in a study of around 70,000 individuals exposed to PFOA in contaminated drinking water near a DuPont factory in West Virginia. The blood levels Steenland observed in West Virginia were higher than in Merrimack, which he said should reassure residents. “If I were a resident, then I wouldn’t be super alarmed here because the evidence is still not definitive and also because kidney cancer is rare.” And, he said, the levels of PFOA in private wells are not extremely high.
But Steenland also pointed to sampling done by the National Cancer Institute two years ago, which implied that even lower levels of PFOA in blood could be linked to kidney cancer. Steenland echoed the state’s message: more research is needed.
Nancy Murphy, a former state representative who has advocated for PFAS-related legislation, said that while scientists continue to work, for her the connection is clear. Murphy, a retired nurse, has six children, three of whom are adopted, and they each have health issues linked to PFAS, she said. “I live less than 2 miles from Saint-Gobain.” Her husband has cancer. Her parents have cancer. (Murphy is also adopted and so doesn’t have the same genetic makeup as her parents.)
“Can I prove it? No. But they can’t convince me that’s not the reason,” she said.
The link, she said, is important: “We’ve got to call it what it is and recognize that we’re killing ourselves and we don’t need to be.”
Williams, who travels from her home in New Jersey to the Dana-Farber Cancer Institute in Boston every three months, has lost a kidney, part of her right lung and pancreas, and her gallbladder. Since her 2012 kidney cancer diagnosis, the cancer has progressed to stage 4, which means it is incurable.
She worries that her two sons may develop cancer later in life.
She wants accountability. “I want to be able to say that Saint-Gobain is taking responsibility for this. And I would like the state to enforce some of the things that they’re trying to do to control the pollutants in the environment.”
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