[00:00:03] Megan Hall: Welcome to Humans in Public Health. I'm Megan Hall.

In the past few years, the field of public health has become more visible than ever before, but it's always played a crucial role in our daily lives. Each month, we talk to someone who makes this work possible. Today, Amber Hall.

[00:00:27] Amber is a Postdoctoral Research Associate at Brown University, where she studies the effects of chemicals and toxic metals on young children. Recently Amber published a study which found that using certain products during pregnancy, like makeup, lotion or nail polish, can expose babies to dangerous chemicals. These chemicals are called PFAS, or forever chemicals.

She says she's wondered about the effects of chemicals since she was a kid, living in Tennessee.

* soundscape of crickets, car noise and sound of a factory *

[00:00:59] Amber Hall: I grew up near a chemical company. It was five minutes away from our home and we would drive by there every day. And when you have these giant smokestacks and you see stuff being emitted every day, I think the next natural question is, what is that? And is that okay?

* soundscape fades out *

[00:01:20] Megan Hall: And so Amber set out on a career that looked at these questions. She studied chemistry in college and thought about going into medicine. But then she realized she wanted to take a different approach.

[00:01:31] Amber Hall: And after working in a hospital for a while, I realized I wanted to make a bigger difference at the population level, doing more population level science, which is what led me into epidemiology.

[00:01:42] Megan Hall: So instead of kind of patient by patient, you wanted to say, how can I make a impact on a whole population of people

[00:01:48] Amber Hall: Exactly. Yeah. Biostatistics is one of the first things I fell in love with. I loved the idea that one person can tell you something is wrong, but then when you have a hundred, and sometimes a thousand people volunteer their time over, let's say, ten years to give you their data so that, Like, you will be given the opportunity to say X is associated with Y, we do see an association with these chemicals and this health effect, that can make a really big impact.

[00:02:15] Megan Hall: Which led Amber to looking at PFAS. You might have heard them called forever chemicals. But, what are they, exactly?

[00:02:23] Amber Hall: So PFAS is an acronym and it stands for per- and polyfluoroalkyl substances. And this is referring to a very large chemical class, so a bunch of different types of chemicals. And they're known for their oil, water, and heat resistant properties. So things that are water resistant, stain resistant, heat resistant, nonstick surfaces like Teflon pans, for example, things of that nature will often contain PFAS.

[00:02:47] Megan Hall: But what's the problem with them? Like why are we worried about these chemicals?

[00:02:51] Amber Hall: Yeah, we're worried about them because we have found associations with a lot of different health effects: Kidney and testicular cancers, different thyroid disruptions, in children it's been associated with decreased vaccine response, low birth weight. And then also, it takes a really long time to leave our bodies. A lot of chemicals we're exposed to, they leave within a matter of a few hours or a few days. With PFAS, it takes several years.

[00:03:15] Megan Hall: And how widespread are these chemicals?

[00:03:17] Amber Hall: These chemicals have been found on all seven continents, including Antarctica. So they are very widespread and they are considered ubiquitous, which is a fancy way of saying simply they're everywhere. They have been found in the blood of 95 percent of the U. S. population, and that is only testing for four of the PFAS compounds and so pretty much everybody that you've met, the majority of people do have detectable levels of PFAS in their blood.

[00:03:42] Megan Hall: So these chemicals are everywhere. When pregnant people have them in their bodies, they can expose these chemicals to their babies.

[00:03:49] Amber Hall: So studies have found that PFAS can be transmitted through the placenta. So during pregnancy, if a pregnant person is exposed to PFAS, that can then go through the placenta and reach the child.

[00:04:02] Megan Hall: Amber says, that's not great for the baby.

[00:04:05] Amber Hall: Because during pregnancy, that's just such a very sensitive window of development. You have so many things that are happening, so many processes that are occurring to create a human being that disruptions during that time can often have a greater impact than they would if you were exposed later in life.

[00:04:21] Megan Hall: Amber knew that a lot of products pregnant people use- like makeup, hair dye, nail polish, perfumes and lotion contain PFAS.

[00:04:29] Amber Hall: But what we didn't know was whether or not exposure to PFAS from these products was actually getting inside of us.

[00:04:35] Megan Hall: She wondered – did pregnant people who used these products have more PFAS in their bodies?

[00:04:39] Amber Hall: And that is the question that this study really set out to answer.

[00:04:43] Megan Hall: To find out, Amber and her team of researchers worked with almost 2,000 participants who were pregnant or recently had a baby. Then they tested their blood and breast milk for a few of the most common types of PFAS.

[00:04:55] Megan Hall: And then you interviewed all of the women about the kinds of products they use. So like, have you had your nails painted or have you had your hair dyed or how often do you wear makeup? That kind of thing?

[00:05:06] Amber Hall: Yes, so we gave them questionnaires at four different time points to assess that, and many of those questionnaires didn't just get at do you use the product, but how often do you use the product. So whether or not you never use it, you sometimes use it, or you frequently use it, so we could get at whether or not these usage habits were impacting their PFAS concentrations at specific points in time.

[00:05:29] Megan Hall: So, what did you learn?

[00:05:31] Amber Hall: So what we learned, I was honestly very astonished as a scientist, cause we will sometimes see trends, but we normally don't see so many things pop up. But many of the items that we tested we found that higher use of these items was associated with higher PFAS levels in both blood and the human milk.

[00:05:54] Megan Hall: So, participants who used makeup, nail care products, perfumes, hair dyes and hair sprays had higher levels of PFAS chemicals in their bodies. Plus their PFAS levels went up the more they used these products.

[00:06:07] So, what does that mean if, if these pregnant women using these products, the PFAS is getting into their bloodstream and into their breast milk, what does that mean for the baby?

[00:6:16] Amber Hall: Yeah, so that could mean that the baby is being exposed to PFAS during this very vulnerable period of time which could have biological and health implications.

[00:06:28] Megan Hall: So I have to ask, when I was pregnant, I wasn't typically the kind of person that would get my nails done, but carrying around a baby made my feet hurt. So I had a lot of pedicures because I just liked having my feet rubbed and washed because I couldn't even see them near the end, and they would paint my nails. So what did that do to my baby?

[00:06:51] Amber Hall: Oh that is a good question. We did unfortunately find a lot of associations specifically with nail care products and that was consistent at different time points.

[00:07:02] Megan Hall: So because I needed those pedicures, I like, I passed something on to my kid?

[00:07:07] Amber Hall: Potentially, yes.

[00:07:09] Megan Hall: What, what advice would you give to pregnant people or people who are thinking about conceiving about how they might change their behaviors?

[00:07:18] Amber Hall: That’s a good question and unfortunately this goes back to the biological half lives of PFAS because they can remain in our bodies for so long that if you're thinking of having a baby in the next year, it's often too late. We really need to take steps earlier in order to mitigate the exposure. And so I think the best advice would be to anyone who thinks they may get pregnant in the next 10 years to really try to mitigate exposure to PFAS. And I think that also really speaks to the need for policy and regulatory action with relation to these chemicals, because what is the average age of pregnancy now, like close to 30? A woman in her sophomore year of college, in her twenties, isn't really going to think about her nail care products use and how that relates to her unborn child a decade from now. So we really need to take a step back and think about mitigating exposure to these, what I would consider dangerous chemicals. And I personally would like to see some regulatory policies and some actions around that.

[00:08:22] Megan Hall: Yeah I was going to say, how realistic is it for women to avoid makeup, nail polish, gel, hairspray, lotion? Like, how realistic is it for anyone to avoid all those products, especially, you know, living in a modern era where there are certain beauty standards for women?

[00:08:42] Amber Hall: No, that's completely fair. I wear makeup every day. That's part of what made this study so interesting, is it was so personal to myself and so many women who use these products.

[00:08:53] Megan Hall: I mean, is it realistic to be expecting women to go without all of these products?

[00:08:58] Amber Hall: I wouldn't say so. I don't think people like to change their habits, especially if it's something they enjoy. I think one step that people could actively take to at least lower their exposures, checking the back of the products, to see if it contains a PFAS ingredient or a PFAS chemical.

[00:09:14] Megan Hall: What should they be looking for?

[00:09:16] Amber Hall: Yeah, so there are common indicators in these items. , words like “perfluoro” or “fluoro.” So if you see PERFLUORO, or FLUORO, then that means that they likely contain a PFAS compound.

[00:09:32] Megan Hall: Okay that's great because I was hoping you could help me! I have the products that I use almost every day.

[00:09:37] Amber Hall: Oh! Okay, yeah, yeah.

[00:09:39] Megan Hall: So you can tell me how bad my PFAS levels are.

* music enters *

[00:09:45] Megan Hall: So I usually put a little bit of gel in my hair every day.

[00:09:49] Amber Hall: pure, clean styling gel by Garnier Fructis.

[00:09:54] Megan Hall: So what's the verdict on that one

[00:09:56] Amber Hall: She uses the aloe extract. Let's see.

[00:10:00] Megan Hall: Sorry, it's kind of slimy.

[00:10:01] Amber Hall: Oh, no, you're good. This one mostly looks okay.

[00:10:06] Megan Hall: No way!

[00:10:07] Amber Hall: It does say perfume fragrance. And so that could contain PFAS. There's no telling. But it's not listed as an active ingredient on the back of it.

[00:10:18] Megan Hall: Okay, so I can keep wearing my gel and not be too nervous.

[00:10:19] Amber Hall: You can keep wearing your gel. Yes.

[00:10:24] Megan Hall: This is like super natural. It's, it's jojoba oil.

[00:10:29] Amber Hall: Yeah, this only has two ingredients and neither are PFAS.

[00:10:33] Megan Hall: Okay good. I can keep wearing that one. Okay, this one is probably the grossest one that I wear. It's a face moisturizer that's also a sunscreen that also, like, tans my face a little bit.

[00:10:45] Amber Hall: Okay!

[00:10:46] Megan Hall: It's like a self tanner for your face.

[00:10:49] Amber Hall: No, this guy looks good. You are PFAs free, you're doing well!

[00:10:51] Megan Hall: Oh, even this one that I'm so embarrassed by? My self tanner. Okay, this one might not even have ingredients on it.

[00:10:59] Amber Hall: I was going to say, always a positive sign

[00:11:02] Megan Hall: I don't know if you can even tell what's in that. All right. So then the last one is my Olay Eyes Eye Lifting Serum.

[00:11:11] Amber Hall: Not the eye lifting serum. Please be okay.

[00:11:14] Megan Hall: Oh, maybe it doesn't even have the ingredients on it.

[00:11:16] Amber Hall: It doesn't. It just says in large letters, avoid contact with eyes.

* music exits *

[00:11:26] Megan Hall: So, I got lucky, and none of my products say they include PFAS, but it doesn’t seem fair. People shouldn't have to play this game of checking every label just to stay safe. And Amber says she's optimistic that things could change soon.

[00:11:42] Amber Hall: Legislators are starting to pay attention to this. So there is a House Representative Bill, the new PFAS and Cosmetic Act, which is at the House right now. And then also Rhode Island has passed a law about PFAS in cosmetics. And so they're wanting to, over the next several years, not allow PFAS and cosmetic products.

One good thing about state regulations is it often pushes for product level change. For example, when California enacts certain bans against certain chemicals, if a company wants to keep selling to California and they don't want to make special products for that state, it forces them to change their practices so that they can sell to the United States as a whole, which It's a pretty cool thing to me because it shows how even something at the state level can really drive a national change.

[00:12:30] Megan Hall: So, is that the answer here? I mean, instead of telling women 10 years before they wanna get pregnant to stop using any personal care product. Is the real answer, now that we know that it has these extreme effects, we need to push for policy changes instead of personal changes?

[00:12:44] Amber Hall: I would say both. So I think pushing for policy change would be ideal. But there are still active steps that you can take by reading the label on your clothing, reading the label on your makeup, looking at the backs of the products that you're buying and making sure that they don't contain PFAS as an ingredient.

[00:13:03] Megan Hall: Great. Well, Amber Hall, thank you so much for coming in. I learned a lot. This is really interesting.

[00:13:07] Amber Hall: Oh, thank you for having me.

[00:13:10] Megan Hall: Amber Hall is a Postdoctoral Research Associate in the Department of Epidemiology at the Brown University School of Public Health

Humans in Public Health is a monthly podcast brought to you by Brown University School of Public Health. This episode was produced by Nat Hardy and recorded at the podcast studio at CIC Providence.

I'm Megan Hall. Talk to you next month!