CDC Now Encouraging Doctors To Consider More Blood Testing For 'Forever Chemicals' (go.com) 65
An anonymous reader quotes a report from ABC News: Doctors are now being encouraged to consider more blood testing for PFAS, also known as "forever chemicals," according to guidance released (PDF) by the Centers for Disease Control and Prevention (CDC). The federal agency is recommending providers have a discussion with their patients regarding consumer and environmental exposures to large levels of the chemicals, and if blood testing may be of benefit.
"This information is intended for individuals and communities around the country, who are concerned about exposure to PFAS to have productive conversations with their medical providers" Dr. Aaron Bernstein, Director of CDC's National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR), told ABC News. "Over 90% of people in this country have been exposed to PFAS and many, many communities around the country there have been very high exposures. And we've learned more and more in recent years about how exposures to PFAS may increase risk for many disease" he added.
The new guidance advises providers to consider an individual's exposure history; the results of PFAS testing from a patient's water supply, food sources, or other exposures; and whether those results can inform regarding ways to reduce future exposures. Most Americans are exposed to PFAS through drinking water, according to Bernstein, who also notes that many municipal water agencies are already testing for PFAS, and those test results are typically publicly available. [...] While blood tests for PFAS may help guide exposure reduction or provide psychological relief to patients, such tests do not help identify the source of exposure, nor can they be directly linked to a health condition. There are also currently no approved medical treatments available to reduce PFAS in the body, according to the CDC. "A PFAS level is one piece of data that needs to be taken in a broader context. We need to understand the individual's health history, their family history, what other exposures they may have that might increase the risk of diseases that can also be associated with PFAS," Bernstein said.
"What is clear is that this is an evolving landscape [...] we are at a point in time that both the science around PFAS, the accessibility of testing, and what is being tested for is changing. We are committed at CDC to stay on top of it and update this information as needed."
"This information is intended for individuals and communities around the country, who are concerned about exposure to PFAS to have productive conversations with their medical providers" Dr. Aaron Bernstein, Director of CDC's National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR), told ABC News. "Over 90% of people in this country have been exposed to PFAS and many, many communities around the country there have been very high exposures. And we've learned more and more in recent years about how exposures to PFAS may increase risk for many disease" he added.
The new guidance advises providers to consider an individual's exposure history; the results of PFAS testing from a patient's water supply, food sources, or other exposures; and whether those results can inform regarding ways to reduce future exposures. Most Americans are exposed to PFAS through drinking water, according to Bernstein, who also notes that many municipal water agencies are already testing for PFAS, and those test results are typically publicly available. [...] While blood tests for PFAS may help guide exposure reduction or provide psychological relief to patients, such tests do not help identify the source of exposure, nor can they be directly linked to a health condition. There are also currently no approved medical treatments available to reduce PFAS in the body, according to the CDC. "A PFAS level is one piece of data that needs to be taken in a broader context. We need to understand the individual's health history, their family history, what other exposures they may have that might increase the risk of diseases that can also be associated with PFAS," Bernstein said.
"What is clear is that this is an evolving landscape [...] we are at a point in time that both the science around PFAS, the accessibility of testing, and what is being tested for is changing. We are committed at CDC to stay on top of it and update this information as needed."
Cue the bullshit (Score:1, Interesting)
Why of course it behooves our public health agencies to quantify the presently unknown effect of $synthetic_chemical on human health in a rigorous, thorough, and scientific manner.
One might do this by randomly selecting anonymized blood samples from regular bloodwork done routinely on most people who see a PCP, and correlating the (anonymized) health of the individual to blood levels of the scary whatever.
Then one might infer a lethal dose, a carcinogenic dose, etc from the data.
But of course, advising indi
Re:Cue the bullshit (Score:5, Insightful)
Having worked for a number of years dealing with public health data, I have to say that unassailable data is something you never have.
Your universal randomized anonymized sampling idea would be great, but so far as I know nothing like that has ever been done and I'm not sure how you would even attempt to do it in the US health care system on a nationwide basis. There's problems with the ideas of both *randomization* and *anonymization*; for example people who get regular blood tests aren't by any means a representative sample of the population, so if there's an association of PFAS with some rare cancer, you're going to catch the cancer but not the data leading up to it.
Sometimes it's just a case of Rome not having been built in a day. You always want more data no matter how much you have, but *some* data even if it leaves a lot to be desired is a start.
As for the variety of advice people get from their doctors, that's arguably a feature of our system, not a bug. You choose a doctor you trust and whose approach to medicine makes sense to you, but that means you get different advice from someone who chooses a different kind of doctor. Even leaving aside the fact that this leads people to some doctors who have extremely heterodox positions like anti-vaxx, there's diversity in approaches even within the mainstream. The system doesn't really do much to protect you from making a bad choice.
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some doctors who have extremely heterodox positions like anti-vaxx,
AFAIK, over here, doctors are required by law to follow best practices as established by the science regardless of personal beliefs. It was originally to prevent religious doctors from imposing their own beliefs on patients about things like birth control & abortion but has all kinds of other applications too, like anti-vaxx. Doctors are entitled to their personal opinions in their personal lives but when they're treating patients, they're doing a professional job & they're expected to behave profes
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I don't know what laws we have or not, but even if there were such laws, they aren't enforced. We have plenty of doctors pushing religious beliefs. People have forgotten the reason there was intended to be separation between Church and State.
"You choose a doctor you trust and whose approach to medicine makes sense to you"
This doesn't make sense to me. Second, Third opinions matter, but if someone is going against the science, then they shouldn't have a medical license. If you want to go to anyone, I don't c
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"You choose a doctor you trust and whose approach to medicine makes sense to you"
This doesn't make sense to me.
Nor to me, at least if taken to the extreme. But it's important to recognize that it *is* a feature of the system that people will resist changing, and choosing a doctor you personally trust *does* have benefits within the confines of evidence-based medicine.
I'm personally not a huge fan of "integrative medicine" for myself, but I have a friend who's an MD who does it and she's a good doctor. As long as her care is otherwise consistent with standards of care, if she sends her patients to yoga, meditation,
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I've never had a doctor push their religion on me, in the US and in most of Europe that would be sufficient to get their medical license.
However, I have doctors today that will present an argument for a treatment and I have doctors that simply push a treatment. The older, more conservative doctors, typically will give you a range of options and discuss the benefits, because they understand people believe differently and may want to choose on more than just whatever "the science" recommends (today). The more
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The more younger and liberal doctors will often push the science-du-jour and not even offer any alternatives or options and can even be hard pressed to KNOW about the alternatives, which is how you get to doctors pushing opioids because the science told them they were safe.
Huh, I had the exact opposite experience just a few years ago so I'm curious if there's any data to back up your claims. I had to move to a new primary care doctor and the doctor I got was in his 60's and wanted to dictate everything related to my health to me. "You want to try fasting to get your blood pressure back down? Nope. You need medication, no debate". I ditched the grumpy prick and my current, significantly younger doctor, is great at laying everything out for me.
The fasting worked at reducing my
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I really don't understand the distaste for Science. It's very simply an organized, logical way of gathering and testing empirical data. It's not perfect, but it's the best we have. Anything you think/believe works, can be tested through the scientific method. You're right in one respect, real doctors won't point you to a completely unproven treatment that might be harmful. They might try something, that has shown promise e.g. a drug already proven safe, but not yet fully sanctioned for the purpose they are
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If science (which we should not worship as some kind of god) and medicine in particular had all the answers, i'd agree. It does not. Sometimes the materials provided by the scientific apparatus may solve particular problems or more frequently improve them without eradicating the cause. A lot - perhaps most of the time - it does not and you need to go further.
I find that the older you are, the better you understand this. The young usually don't have the health problems that would bring this into focus.
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I have no problem with people finding solace in their beliefs, or seeking "faith" healing. Science isn't a "religion" it's very simply an organized logical way of gathering and testing empirical data. It may not be perfect, but it's more provable than anything else, and that's why it's what is taught in medical schools
If you prefer your religious beliefs, fine, but those methods shouldn't be state sanctioned, because they aren't provable. I know, I know, X book says this thing cured Y person, and gives more
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Well, you obviously haven't met the ragged edge of what is possible within Western medicine. I met it at 21.
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Agreed about the regular bloodwork. I get extensive bloodwork done 4 times a year. I'm diabetic, have been for 33 years. Hardly representative of the general population. Extrapolating from my results blindly would get you into trouble fast.
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It sounds like an idea for a small study, it appears there have been small studies and large studies on the subject with no obvious results.
What the CDC is trying to do here is make a really large study, which likely has been shot down already by NIH and co for having no value, by scaring people and having them pay for blood tests they really don't need and then hoping that if you shake hard enough, something falls out of the empty box.
You can always find patterns in data if you have enough data or if you t
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This makes no sense because there is no treatment for PASF, and for that matter, there are no known health effects either.
I suppose eating a lot of activated charcoal might reduce the level.
Alex Jones with right? (Score:3)
In all seriousness though, this is a pretty serious issue. Are there any home test kits that can reliably test tap water for PFAS / PFOA chemicals?
Re: Alex Jones with right? (Score:5, Funny)
A quicker way is to run outside, find a frog, and ask him his pronouns.
Re: Alex Jones with right? (Score:5, Funny)
A quicker way is to run outside, find a frog, and ask him his pronouns.
I’m not sure about the frogs, but I did ask the water spouts at Yellowstone and they were guy and sir.
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I’m not sure about the frogs, but I did ask the water spouts at Yellowstone and they were guy and sir.
How many children do you have? 10? You sir are a dad joke master. *tips hat*
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Reminds me of a funny post I saw on Twitter recently. Someone posted a lament about how park rangers used to be middle aged bachelors who just loved geology and forestry, and now they all gay with pronouns.
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Gays are, by definition, male. Despite being lumped together with transexuals for political expediency, these are not the same thing.
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No. Gays *were* by definition male. Actually more technically correct gays *were* by definition any person cheerful and carefree. Language evolves, and today gays by definition applies to any homosexual people, and the use of that term in this way well and truly predates any political bullshit you pretend to associate it with.
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Go further back and gay referred to prostitutes.
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Gays are, by definition, male. Despite being lumped together with transexuals for political expediency, these are not the same thing.
That hasn't been true for maybe, like, 35 years now? Lesbians have routinely referred to themselves as "gay" for at least that long (possibly longer, but I'm speaking from personal experience here). Also I've known various NB, gender queer, and trans folks to refer to themselves as gay since at least the early 2000s. Depending on the context and the person you are talking to "gay" can sometimes be roughly translated as "queer" and you can't infer much more from it than "not straight/cisgender". The word
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No, by definition it's homosexuals in general https://www.merriam-webster.co... [merriam-webster.com] . It is more commonly used for gay men though as the definition indicates.
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"making the frogs gay" sounds more like Bisphenol A
But isn't that guy rather slightly right leaning? The same right that tries to shut down EPA as unnecessary bureaucracy that is damaging the oh so poor businesses? And suddenly chemicals in the water are bad...
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Lets say I test positive for high levels of these chemicals then what? Is there any treatment? Serious question I'm not trying to be a smart ass like Right Wing Nutjob.
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And do what with the results? (Score:3)
CDC encourages testing, but gives no guidance on what to do next.
There is no data on what level of a given chemical would be harmful. There is no data on what levels might be linked to which health conditions. If we did identify a dangerously high level, nobody has any idea what to do about it.
Just running tests is not helpful right now. They would not benefit patients. It would be irresponsible for doctors to run these tests on people without having a lot more information first.
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It would, however, benefit the labs, the insurance companies (which are required to spend at least x% of revenue on claims payments and a couple of other things - so the more they all have to pay in claims, the more profit they allowed to make and they are all in the same boat so there's a level playing field and will have to charge higher premiums).
It will not benefit those insured as their premiums will go up.
It will not benefit the taxpayer as Medicare spending, Medicaid spending, and health insurance pr
Re: And do what with the results? (Score:5, Informative)
It's for Psychological Relief! (Score:2)
While blood tests for PFAS may help guide exposure reduction or provide psychological relief to patients, such tests do not help identify the source of exposure...
I can just see it now: "Well the good news from your blood tests is that you don't have high cholesterol. However, we also ran a test for PFAs and with levels this high you run a much higher risk of developing cancer but we've no idea where your exposure comes from.". That's the sort of "psychological relief" I could really do without thanks.
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Blood "donations" (Score:3)
Apparently the issue with PFAS is that it accumulates in the blood plasma and it affects men more than women (due to "that time of the month").
Draw blood from the patient on a regular basis and dispose of in a suitable high temperature incinerator.
Effect of Plasma and Blood Donations on Levels of Perfluoroalkyl and Polyfluoroalkyl Substances in Firefighters in Australia
https://www.ncbi.nlm.nih.gov/p... [nih.gov]
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Is there anything else I can help you with?
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I disagree for two reasons. First, without a baseline of how many individuals are affected, it would be hard to assess how widespread the problem is and to what degree. Because the PFAs are in firefighting foam used at many airports, military bases, and wildfire responses, many people might be affected perhaps from dir
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Some further background information which explains the origin of the Australian study, courtesy of the Australian Broadcasting Corporation
Mick Tisbury's 12-year fight to protect firefighters from PFAS toxic foam contamination [abc.net.au]
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There is no data on what level of a given chemical would be harmful. There is no data on what levels might be linked to which health conditions.
Indeed. I propose we test for the chemicals so that we can start to correlate its concentration with potential harm and determine at what level it may be linked with health conditions. /s
Wait, I'm being sarcastic, but ... did you not understand this is the whole point...?
Re: And do what with the results? (Score:2)
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Running the tests generates data on levels on people with various health problems. That data is valuable.
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Running tests may not benefit the patient, but it would collect data on how wide spread the really is, and get an idea of typical concentrations. Then you can cross-correlate that to the population of gay frogs, low sperm counts, or anything else you deem interesting and see if you really do have a problem.
Remember these chemicals are used because they are not chemically reactive. They shouldn't be doing anything. If they are it's because they coincidentally have the right shape to fit somewhere.
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How on earth do you find out if there are any health problems with these chemicals if you dont first gather data on their concentration in individuals? Only then can you find out if people with concentrations over X amount are having health problems. In other words, this is exactly the first step we should be taking to understand these things.
A random thought (Score:2)
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How can one measure for pfas, etc feedstocks when the measuring equipment is made of fluoropolymer?
You do a control measurement.
Now ask a hard one.
Re:A random thought (Score:5, Informative)
PEEK and PAEK are expensive and extremely hard to form (both require much higher temperature than standard injection molding machines are capable of producing; they also tend to chew up the molds faster). Syringes will mostly be made of PP, PE or rarely out of glass, some kind of elastomer for the seal and some metal (most likely 300 series stainless steel, for the needle, depending on if it's required). Sample bottles will almost always be PP, PE or glass.
The elastomer for the seal is the tricky part. The elastomer for the seal COULD be Viton, which is fluorinated but it's more expensive and hence unlikely to be used unless necessary. Most syringes that do use Viton use Viton O-rings; which is a considerably more expensive way to build a syringe. The vast majority of syringes today use what's called a Themoplastic Elastomer or TPE. A TPE is a plastic that has some flexibility. Usually the performance isn't quite as good as a true elastomer, but the advantage is that it can be overmolded onto the piston. Overmolding is a technique where plastic is injection molded over a preexisting part. The part could be plastic or metal. It could be the same material (for example a part all in PP in two separate colors) or a different material (such as a TPE seal over a PP piston). The finished part is a single composite part that can be made to good tolerances in high volumes, cheaply.
In something like 99.99% of medical applications, the syringe body will be PP, the needle will be some kind of Stainless steel, and the seal will be a TPE. The sample collection jar (and lid) will be PP. No fluorinated materials in the needle. But it can be (and should be) qualified as part of the testing procedure.
I thought ... (Score:2)
... the modern move was away from excessive testing? It just leads to worried, hypochondriac patients, excessive interventions that don't statistically do any good, etc.
WTH is this test for, where there is no actionable guidance at all for the results? Why should doctors order this test?
Is it just for politics, so we can say "ooh, look at all these scary chemicals out there??"
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Is it just for politics, so we can say "ooh, look at all these scary chemicals out there??"
Have a glass of safe drinking water [youtube.com]. Don't worry about those scary chemicals. They can't harm you.
Watch film Dark Waters (2019) (Score:2)
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I was washing a pan I bought from the Dollar Store less than a year ago and noticed giant flakes of Teflon where coming off it where food had stuck. I could scrape it off with my finger nail with no problem.
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Here's a lighthearted take on it (if that's possible), with Danny Devito.
"Dupont: We're already in you!"
https://www.youtube.com/watch?... [youtube.com]
More stupidity (Score:1)
Let's wait until we detect the level of chemicals needed to hurt people, so then we have a group of hurt people (aka customers) that will need new healthcare treatments we will have to develop for profit.
They just keep proving that an ounce of prevention isn't worth a big pile of money.
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Indeed. If only there was a way of preventing the 30-fold increase [bbc.com] in measles in Europe in the past year. I guess we'll never know if that could be done.
PFAS in inhalers (Score:2)
Anybody wonder why PFAS is in everybody's system? It's because it's in everything. Some people have inhaled it directly into their lungs for years.
https://aacijournal.biomedcentral.com/articles/10.1186/s13223-017-0202-0
"Current pressurised metered dose asthma inhaler (pMDI) propellants are not inert pharmacologically as were previous chlorofluorocarbons, have smooth muscle relaxant partial pressure effects in the lungs and inhaled hydrofluoroalkane 134a (norflurane) has anaesthetic effects. Volumes of prope
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Why? (Score:2)
There is no point to such testing unless it can inform a clinical decision. This just seems political.
Another test doctors can bill you for (Score:2)
'nuff said.
While they're at it ... (Score:2)