Share Public Health Transcript: Rural Health, Environmental Health is Public Health

Season 2 Episode 10

Hannah Shultz: Welcome to Share Public Health, the Midwestern Public Health Training Center’s podcast connecting you to public health topics, issues, and colleagues throughout our region and the country, highlighting that we all share in public health. Thank you for tuning into this series which focuses on rural health in the Midwest. Over 10 episodes, we talk with people in a variety of communities about their experiences and perspectives on rural life, employment, and health. Our aim is to deepen understanding about the complexity of rural life and celebrate rural areas. We’re so happy you’re listening and learning along with us.

Welcome back. I’m Hannah Shultz from the University of Iowa College of Public Health. In today’s episode of Share Public Health, we’re going to talk about climate change and environmental health. These topics deserve their own series, but we’re going to do our best to talk about them here today. We’re going to start today’s episode with Art Cullen. We’ve heard from Art a couple of times in this series already. His input and work is particularly interesting for today’s conversation. In 2017, Cullen wrote a series of editorials about Des Moines’ water pollution and won a Pulitzer Prize for “editorials fueled by tenacious reporting, impressive expertise, and engaging writing that successfully challenged powerful corporate agricultural interest in Iowa.” I asked almost every guest for this series what the biggest threats to their communities are. There were a couple of themes and climate change was one of them. Art talks a bit about why climate change is such a threat to Iowa specifically.

Art Cullen: Nobody watches the weather like farmers. They’re concerned about it and they’re concerned about crop yields and they know that they’re losing soil. And, they know that Des Moines’ drinking water is polluted by farm chemicals and they know that things have to change. They want to be more resilient. They’re scared of these floods and these torrential rains that end up into a spade of drought and they can’t plan from year to year. So, they’re buying into the idea of a more resilient agriculture, whether people in town are, I’m not so sure. There’s a lot of big diesel pickups. Poll after poll, Iowans cite climate as a top concern, but yet they’ll think nothing of driving to Souix City for an hour to shop in an SUV that gets 10 miles to the gallon. In 30 years, we might not be able to grow corn in southern Iowa because of heat. This is not me BS’ing, this is Gene Tackley who shared a Nobel Prize for climate modeling at Iowa State University. He’s the one saying that it’s going to become difficult growing corn in southern Iowa, southwest Iowa in particular, within 30 years, 2050. He’s the one suggesting that there could be a 30 to 35% decline in corn yields. But, we have all the expertise at Iowa State University to solve this problem, whether it’s cover crops or hemp and switch grass as an ethanol, feed stock. We know how to do it, we know how to create a resilient agriculture. The question is, are we willing to pay farmers to do it?

Hannah Shultz: Now, we’re joined by David Osterberg. David served in the Iowa House of Representatives from 1983 to 1995, has worked in health and climate policy at the University of Iowa and was co-founder of the Iowa Policy Project among other things. I talked with David primarily about wind and solar energy in Iowa.

David Osterberg: Public policy is what I have done for a long time. Public health policy, because my two areas are energy and water quality and they are economic development issues, they are health issues, they are the future of Iowa issues, actually. When it comes to renewable energy, you find that the latest numbers for 2019, 42% of every kilowatt hour produced in the state of Iowa came from a wind turbine. We lead the nation in the percentage of electricity that we get from wind. We’re second in the total wind being produced, to Texas. They’re way, way ahead of us. But, we are number two in the amount, but more important, we’re number one in per capita.

Hannah Shultz: Anyone who’s driven through Iowa has seen some of the thousands of wind turbines across the state. But why? Why wind instead of solar?

David Osterberg: It kind of looks like the ocean. When you look out there, those corn fields and soy bean fields, just like off-shore wind is a great place to make electricity from wind, so are the Great Plains. We’re in the edge of that and where we are in the edge of it, we produce an awful lot of wind. The Dakotas, Kansas, Oklahoma, Texas, those are the states that are all big producers of wind, but the point is, Iowa led the nation in 1983, when I was in the legislature. We passed what became to be called a renewable portfolio standard. We told the investor-owned electric companies, you have to have some renewable energy. You may not want to, tough, you have to have it. It really pissed them off, of course. They don’t want to be told what to do. But, in fact, that started the process and while these companies certainly objected to being told what to do, when they were told what to do, and they tried wind power, they found it was an enormous success and they could make a lot of money. So, you look at one of our investor-owned utilities… Investor-owned, what I mean by that is, they are private companies, but they have a monopoly. They have a monopoly in a certain area of the state. Alliant has a monopoly which tends to be north and maybe east. And, MidAmerican is central and further out towards the west. But, because they’re a monopoly and you can’t trust a monopoly, you have to have them be regulated and they are regulated by a board. That board tells them what they can do and what they can’t do. So, their renewable portfolio standard added that to the things they could be told what to do and they did it. And now, as I said, 42% of all the electricity produced in the state of Iowa comes from wind turbines. Mainly from MidAmerican, but also from a lot of co-ops out in rural areas. You often have co-ops are the providers of your electricity. Sometimes it’s municipalities, City of Ames, City of Cedar Falls, have their own companies in their city. So, I guess we need to talk about that. Because, otherwise, it doesn’t make sense to most people. Most people… this is capitalism. When we think about, we can either go to one coffee shop or another one. In Iowa, you can only go to one, that’s MidAmerican, they have a monopoly. But, they are a regulated monopoly. And, that’s part of why we find so much wind here. But, the other reason and the reason we have to talk about besides policy, is that there’s been a transformation in the production of electricity in the world. Wind started up in the 80s. And now, is very big worldwide. Solar is doing the same kind of thing. So renewable energy is solar, or wind, practically, also hydro. There’s quite a bit of hydro in every place in the world. Hydro power, where you dam up a river and then use the flow of that river to produce electricity. But, we’re moving away from coal, we’re moving towards natural gas, because it’s so cheap, but we’re certainly moving away from coal, and we’re moving towards renewable energy.

Hannah Shultz: David’s comments are interesting. Renewable energy makes economic sense. But, it started in Iowa due to policy.

David Osterberg: Let me just talk about solar. And, there’s two ways of doing it. I read this morning that Sukup Manufacturing up in Northern Iowa has just put in a 780 kilowatt solar array for their production plant. Sukup does farm equipment and stuff. But, that’s just short of a megawatt owned by a company that is in the business of making grain bins and things like that. MidAm, only two weeks ago, announced that they were going to put three megawatts of solar up in Waterloo. North Iowa Area Community College, when I read the Sukup article, found that in September, they broke ground for their Community College. Lots of places. Michigan State University has a megawatt and a half on covering up a place where people park cars. The problem, of course, is, Iowa. We really suck. We are terrible when it comes to solar, we ought to be doing more. But, there’s two kinds of solar. And, that is the big arrays put together by companies, or by utility companies. Now, that’s different from distributed solar. On my garage roof, I have a two kilowatt system. It’s very small, it’s only 20% or so of the total electricity I use. But, it’s something. And, many people are moving towards distributed energy. Now what that says to a company like MidAmerican, and have I praised them enough for all their wind, they’re really good… They are terrible when it comes to solar power, because they don’t own it. Because, they don’t own it, it is just like kilowatt hours subtracted from their company that they used to produce. They do not want solar power, distributed solar power. The reason distributed solar power is so good are several reasons. One, it is subsidized. Therefore, when I put my solar panels up, I got 30% of it back as a tax credit, as a federal tax credit. Because, my tax appetite is enough, I put a $10,000 system in. About $3000, I got back that year that I didn’t have to pay in taxes. And then, Iowa also has one which was half of the Federal. So, 45% of the cost of that distributed solar system that I have, paid for with tax credits. But, the other thing that’s really important is something called net metering. When I’m producing a little more electricity than I need, and it only happens in the summer, when the sun is high… It only happens in a great sunny day… I produce extra kilowatt hours and it goes back to the grid. The same line that brings in power, now will take some power out. That’s what MidAmerican went after. They tried to figure it out so that I would have to pay an extra $200 a year simply for the privilege of having solar power. That’s what they wanted to do. It was a terrible thing to do, and yet they were doing it. They passed it through the Iowa Senate, came roaring. The Republicans control both houses. So, came roaring through. And, we thought we were in real trouble, we environmentalists. Even more in trouble because some dark money group, they put out 1,000,000.2 on TV by saying, you know what, solar energy is okay, but why should you pay for that rich guy’s solar power? Here he is with this nice solar array on his roof, but you’re paying for it because of all these subsidies. Not true, by the way. But, the point was, they were coming at the few environmental groups and the solar industry, trying to keep some jobs going. There were about 800 of those jobs statewide. Well, how are we going to stop this, a giant company, big advertising blitz? We stopped them with the Iowa Pork Producers Association. And, if you think about it for about a 10th of a second, they have awfully big roofs and these big KFOs, and they have an awful lot of demand to keep them hogs cool in the summertime. They are a natural place to have solar power. And, they knew that and they saw MidAmerican coming at this and decided we’re not going to let them do it. And, they did it. We stopped that company cold. This was 2019. The 2020 legislative session, instead of continuing to fight because MidAm knew they were dead, they could not go forward, they made a deal with pork producers, the environmentalists. MidAmerican got together, and they’re now coming up with some kind of a deal before the Iowa Utilities Board which is where you’re supposed to make these kinds of decisions, on what’s going to happen with net metering. And, the outline of the plan is, for the next seven years you get net metering. That is, when I’m producing more kilowatt hours, then it goes to my neighbor Jackie over here, because it doesn’t go very far when I’m producing it, they will continue to pay me net metering. And after that, they don’t just get to figure out the prices, they have to do a steady and authoritative study on what really is the value of solar. When they do that, we’ll find it’s going to be pretty close to net meter. So, there is an interesting story. So, to wrap up, first, you got big, either community, solar, or massive solar, put together by utility companies, or manufacturing companies like Sukup. That is incredibly cheap. It is so cheap, it is cheaper than an existing coal-fired power plant. And, that’s why so many of them are closing down. Iowa just lost its only nuclear power plant this year, a few months ago, because it could no longer compete with wind and solar. From a brand new plant. It’s an old plant, it’s nearly 40 years old, it’s been there a long time, it’s all depreciated, but it doesn’t matter. Kilowatt hours, how much it costs to produce those kilowatt hours with an old existing plant, is more than a brand new solar or wind plant. And, that’s going on worldwide. And, that’s what’s going to… If we have a chance of stopping climate change, that’s one of the big reasons is, the technology has come down in price so much, and good public policy has made that happen. Here we are, now in Iowa, with great opportunities. And finally, MidAm. They’ve been terrible. Three megawatts is a lot of solar, but to put it in perspective, it’s about as much as one of their turbines. They have 2000 turbines, and their three megawatts is only about the size of one of their GE 2.3 megawatt machines that they’re putting up right now. But, the other part, which has a lot of capacity, and a lot of potential as well, is this distributed power. Why don’t I use my roof to make some electricity? It’s already there. I don’t tear up ground. I don’t do anything. And, since it’s so close, it’s just a natural way of doing some solar. Utility companies hate it. And, right now, in the state of Iowa, we’re going to continue to have both kinds of solar. I think we have a great future in renewable energy in the state.

Hannah Shultz: So, to state the obvious, this is a public health podcast. Why are we talking about renewable energy? Why does David work with the University of Iowa College of Public Health?

David Osterberg: When it comes to health, there is no question, solar and wind are superior to coal, all the time. We’ve got to deal with climate change. It is the most serious threat to public health we have ever seen happen in the world. And, solar and wind are one of the ways in which we can continue to have the society we have, the economy we have, and yet not delude ourselves.

Hannah Shultz: I really appreciate David Ostenberg’s comments and experience with renewable energy, and his clear connection of climate change and health. We started today’s episode talking with Art Cullen, and mentioned his writing about water pollution. For the rest of today’s episode, we’re going to talk about water. We’ll turn now to David Cwiertny. I’ll let him introduce himself.

David Cwiertny: I’m David Cwiertny. I’m a professor of Civil Environmental Engineering at the University of Iowa. I also direct the Center for Health Effects of Environmental Contamination, which is a state-funded research center, really looking at the links between environmental toxins and public health. And, we have a particular expertise in drinking water issues here in Iowa and across the Midwest.

Hannah Shultz: I’ll admit, I almost never think about water quality. I live in a city with city water and it rarely crosses my mind. So, what should we be thinking about when it comes to water quality in Iowa?

David Cwiertny: Well, here in Iowa, we have a pretty well-engineered or completely re-engineered landscape as a result of our agricultural activities. So, we take for granted that we have a lot of inputs to our land, and we benefit from those in terms of the economic outputs that come out due to agriculture. We lead in corn, we lead in soy, but that takes work. There’s chemical inputs from the pesticides that we use. There’s fertilizers and nutrients that we apply. And lately, because of the big boom we’ve had in Iowa, particularly in animal agriculture, we have about 20 million hogs in the state, there’s a lot of readily available manure. The nutrients it contains that we take advantage of, is a cheap form of fertilizer. So, we land apply all that. So, that ends up being a big challenge in terms of what we end up applying on the land, almost inevitably finds its way into our water resources, whether it be surface waters, like the river systems we have here as part of the Mississippi watershed, or our groundwater and some of the aquifers that we have a lot of rural residents in Iowa, relying on for their water supply. So, a lot of the work we do is trying to think about the risks to public health associated with exposures that come through drinking water. A lot of our focus is on agricultural inputs, the pesticide exposures, the nutrient exposures. There’s been a lot of work done thinking about nitrate as a contaminant and the risks that it might pose, not just for how we’ve historically worried about nitrate but for things like Blue Baby Syndrome, and its ability to influence how oxygen is transported in the body. But, also for emerging evidence that there might be more chronic long-term health effects resulting from nitrate exposure in drinking water. Things like bladder cancer, or colorectal cancer and birth defects and things that might be levels that the regulatory bodies like the EPA might have standards in place that don’t account for these health effects. And, you might be getting exposure, like with what many people consider safe and still have these risks associated with the exposure. All this is compounded by the fact that, in Iowa, we don’t just have these human made inputs that we have in our water supply. We still have a very heavy groundwater reliance. If you’re not in a big city, you’re pretty much almost certainly on groundwater. And so, most of the rural residents of Iowa are using groundwater. Then, you have all the same challenges that anybody on groundwater would have. Naturally occurring contaminants like arsenic and manganese, that can be present in the water supply that are there and needing to be dealt with. Then, of course, the challenge with all that is, you can’t really see those or taste those, it all just depends on if you’re doing enough robust monitoring to understand that they’re there. So, that if they are, a necessary treatment can be put in place. The challenge, particularly for rural Iowans, and lots of places in the rural Midwest is, people that aren’t being served by public water systems that are regulated under the Safe Drinking Water Act, but are actually relying on private wells that are unregulated, usually unmonitored. There’s no requirements in most places for routine monitoring of those wells. So, the homeowners are really on their own to make sure that their water is safe. And, that’s presents numerous challenges in terms of, do the people that run wells understand that they’re responsible for making sure the water is safe? Are they able to seek out resources to help them with testing so they can understand what risks are posed to them? And, in the event they find something, are they able to get access to an alternative supply or do rehabilitations on their wells to fix any damage that might be leading to contamination or a treatment system they can install in their home? There’s a big economic burden there for people that are on private supplies, if they are even aware that they might [inaudible]. If you are on a regulated supply, a public water system, there are mandates, federally, of how frequently you have to test and what you have to test for. So, we have schedules that are usually pretty good, but there are some disparities. A bigger city will test more frequently than a smaller community. So, I think a big concern is, at the risk of potentially creating more regulatory burden for these smaller communities, are we not sampling enough and testing enough to understand where there might be variability in water quality, particularly when you have things that vary seasonally, like agricultural inputs, where you can see pretty dramatic swings in our water quality around things like nitrate, depending on rainfall events and when farmers might be applying the land. On top of all that, our analytical instrumentation has gotten incredibly good. That’s probably an understatement over the last several years. In many instances, you can find whatever you’re looking for. So, we have the ability now to find the needle in the haystack of needles with a lot of our analytical tools. I think that actually puts a big onus on public health researchers that think about water quality issues, to be able to really explain what the risks are, of when you find something in a water supply. So, there’s been so much attention lately on things like pharmaceuticals and personal care products and things that we use in our everyday lives as consumers that then end up in our drinking water supply, and should we be worried about those? I think the jury is still out in that we shouldn’t be surprised that we find them just based on how our wastewater is linked to our drinking water. But at the same time, we shouldn’t be cavalier and think that maybe it’s not a big deal that they’re there and that’s why a lot of folks are doing research on that. At the same time, there’s different types of contaminants these days, like these perfluorinated chemicals that are all over the United States and impacting rural communities that might be situated next to landfills or military installations or firefighting facilities that are sources for these perfluorinated chemicals. There, we absolutely need analytical methods that help us detect down to parts per trillion or nanogram per liter levels, because that’s where the data is showing that there’s health effects. So, it’s a… the PFAS a great example of a chemical class, that, if we didn’t have these analytical advances, we may not even realize what the problems are because we probably couldn’t find them at the levels in which they pose significant risk.

Hannah Shultz: I asked David what people don’t know about or what he wishes they understood about water quality and safety.

David Cwiertny: It’s funny, I think, the average American… I’ve been interacting with a lot of people in different settings that, if you’re on a centralized supply, you tend to believe that your drinking water is good enough. I know, I’ve heard people describe to me their drinking water is, it’s a problem, but not a crisis. There’s just so many crises these days that it’s hard to get worked up over, is my drinking water safe enough? But, it links everybody. As silly as that sounds, everybody needs it to live. If you’re drinking your doctor-recommended doses, it can be a lot. Two liters, that’s the type of level per day that people are encouraged to drink to stay healthy and hydrated. And, it is a direct input into us, into our bodies. And if it’s contaminated, we run the risk of bearing the brunt of that over the time in which we’re drinking it. So, I think we want to be aware of what’s there because I think it is a big determinant on our health. But, it’s one that we can take for granted if we just assume that everything is okay. There’s a good example of this, we’ve been looking at sodium levels in groundwater, and there’s some places that rely on really salty groundwater for their drinking water. And if someone was taking their recommended doses of water a day to stay hydrated, they’d be getting some really large, like almost half of their allowable sodium intake per day just through their water alone. If you think of someone who might be trying to stay on a low sodium diet or have hypertensive disorders, that’s something that they may not even appreciate if we aren’t really thinking holistically about what’s in our water supply and how it’s ultimately linked to our health. So, it’s one of those things that we need to be vigilant of because, I guess, the other piece to this is that, we often don’t… If you ask most Americans where their water comes from, they say the tap. There are some instances where it’s polluted by things that we do, say, with the plumbing in our homes with lead and copper. But, often if your water’s contaminated, you have no idea because something else caused that or somebody else caused that. So, I think it’s human nature to assume that if it’s coming to my home, it’s got to be clean. But, it’s not always that way. So, it’s the challenge to make sure that we’re being vigilant to ensure water supplies are safe, but not being sensationalistic where we undermine consumer confidence in the quality of water that’s being delivered to homes.

Hannah Shultz: So, what is it that we don’t understand about our water?

David Cwiertny: I think the average American doesn’t understand what’s in it. I think everybody assumes it’s, quote-unquote, safe. I think that assumption is right, 95% of the time. So, it’s not a bad assumption to have. But, I think one of the things we’ve been… I’ve always been surprised that, when you talk to people about their water, is a general confidence that it’s fine, but if you ask them, have you ever worried about this? Or, do you know if this is in it? It’ll largely be, no, I have no idea. And, why would that be there? So, I think there is an awareness issue. One thing that particularly worries me, is that we do have laws in place to regulate our water supplies if you’re on a public system, if you’re not on your own private well. That’s the Safe Drinking Water Act, but the Safe Drinking Water Act has not stayed up to date as well as it should. We’re [inaudible 00:29:12] using new chemicals, regulated as quickly as we should. You can certainly end up with water that meets the letter of the law, but you know is contaminated with unsafe chemicals because we have not regulated them yet. And, we’re too slow, as the political process or as the policy process plays out to get that done. So, those sorts of things worry me as well. Actually, it makes for a really wicked science communication problem, where you’re trying to make sure people are as informed as possible. Like I said earlier, you don’t want to undermine their confidence in what’s coming out of their taps in the water into their homes. But, there are legitimately times when we should question whether the water is safe as we assume it to be just because we know that there are holes in how we regulate our drinking water and there shouldn’t be. In a perfect world, we would not have those in place, and we would make sure that what was being delivered was unequivocally safe by the best science that we have available to us in terms of dose response and toxicology and everything else that we understand. It’s also hard to communicate to people that we put things, intentionally, into our water to clean it, that make it dirtier. So, we have to be controlled in how we do that. So, that’s the process of disinfection. So, water treatment is a trade off. We certainly want to kill pathogens that are in the water supply. So, that’s why we add disinfectants like free chlorine to do that. But, we know that that comes at a consequence of potentially adding things like disinfection byproducts, which is one of the regulated chemical classes that we have the most number of violations of every year in terms of public drinking water systems. And, we know that things like chloroform that get generated as a byproduct of disinfection are a carcinogen. We know that there are unsafe levels that we can get exposed to in water. But, we choose to still disinfect because we see the threat from pathogens is greater than the threat of the long term, chronic effects from the byproducts. And, we also hope that the water quality engineers that are doing the processes at the treatment plant are measured enough in doing that treatment to make sure that we’re not generating too many unwanted by products. But, we do it. We add things to our water that change its quality, and that’s a necessary evil, if you think of it that way, for delivering safe water supply under the risk paradigm that we use to determine what is an acceptable level of risk and what is safe for drinking water.

Hannah Shultz: To wrap up the conversation with David Cwiertny, I asked him what he recommends for people who either aren’t on city drinking water, or for people like me who don’t know a whole lot about their water supply.

David Cwiertny: I would always advocate awareness, in that finding the resources available to them in the county or the city in which they live or the state in which they live in terms of getting their water supply tested. I think that’s really critical for things like lead and copper, which we know comes from older homes. So, I would advocate and encourage anybody to think about where the risks are from the water supply. Do you live in an old building? Are you in a rural setting? If you’re on private well, hopefully you’re a little bit more aware of those risks. Then, once you’ve thought about those, seek out resources. They’re not well-advertised, usually not well-funded enough to help everybody, but there usually are resources here and there to help people better understand what’s in their water supply. From resources to help with testing to if you’re a private well, like we have the Grants to Counties program here in the state of Iowa, which is a great program, where every year money is put into an account to help well users test their water supply for nitrate, arsenic and bacteria. There’s money in there to help rehabilitate damaged wells. That’s important if a well damage is leading to contamination. And then to plug abandoned wells because we know if you have an abandoned well, it’s essentially a straight shot down into the aquifer that can lead to contamination. So, it’s a great program. We know that here in Iowa all the money is never fully utilized. Lots of people aren’t aware it’s there for them. So, I would just encourage everybody to seek out those resources. If they don’t want to do the work because it can be a little daunting, where to start, seek out help from your local county public health agencies. If you’re in a college town, seek out the academics and the researchers on campus. Usually people are happy to help push you in the right direction. So, try to be proactive, that would be the best advice I can give. Because, if there’s resources that can help plug the gap of what you know, you should take advantage of that.

Hannah Shultz: We’ll turn now to Brian Hanft for a local perspective on water quality and the importance of monitoring water. Brian is the Director of Public Health in Cerro Gordo county in North Central Iowa, but his background and passion is in environmental health. We started our conversation by talking about why it’s important to think about water quality.

Brian Hanft: With water, it’s so easy, right, to just turn on the tap and not think about what’s really in it. So much can get into it. That’s why public water supplies are so heavily regulated. And, people should understand that they can reach out to their public water supply and request a report of all the contaminants that they test for. It’s what we pay for in our water bill. We pay for that testing. It’s necessary. It’s important. The problem is, there’s no regulatory requirement for people who live on a farm or live in a rural part of the state or country for that matter, to get their water tested. To find out some of the basic contaminants that might be in that. Coliform bacteria is an indicator bacteria in and of itself, it’s not going to make you sick, but it will tell us if there’s an avenue or a way in which contaminants can get down into the well, basically from the top-down. The problem with arsenic is, at least in our case, is it’s a bottom-up problem where the rocks that we drilled through contain arsenic. In our case, it was iron pyrite, had to deal with the iron levels, that would either be oxygenated or oxygen removed in those certain states, would precipitate that arsenic into the water supply. So, as water moves up in the column and down in the column, it introduces oxygen as that moves through that chamber. When we turn our water on, it draws that down. And, when we turn our water off, it pushes it up. So, there’s a constant movement of air in that column. So, it’s important because, number one, arsenic is one of the most deadliest substances known to man. It is incredibly toxic in the human body. It impacts multiple organs, and it really doesn’t have any limits to what it can’t impact depending on the levels. So, knowing what your level is, knowing if you have it… and that limit now is 10 parts per billion, some would argue that 10 is too high. I would like to research that and determine… Well, there’s a whole host of additional steps we would like to take as far as where we go from here, as far as the research goes, and the science. But yeah, arsenic is nothing that we should be consuming and trying to eliminate that as much as possible, certainly from our drinking water, and, in our food, in some cases. People need to know where it comes from and make sure that they don’t ingest it.

Hannah Shultz: Cerro Gordo County had a problem with arsenic a few years ago. Brian told me a bit more about that.

Brian Hanft: A little background on that, arsenic in the groundwater here started with public water supplies. Public water supplies had to be monitoring arsenic. Back in the, I don’t know, late 1980s, 1990s, arsenic levels were allowed to be at 50 parts per billion. They were monitoring that. I don’t remember exactly when they had to start monitoring for arsenic, but Mason City’s public water supply triggered the highest known arsenic concentration to this day at, I think it was 567 parts per billion. Yeah, so when I brought that up with some of my other counterparts around the country, I say, “567 parts per billion,” and they say, “Oh, yeah, well, how about this? There’s parts in Wisconsin where I’ve been told they’ve had 15,000 parts per billion.” So, we’re not the only area of the country that has problems with arsenic. But, we didn’t know where that arsenic was coming from. A gentleman by the name of Paul Van Dorp, he has since passed away, he’s a friend and a colleague, he used to work for the Iowa Geological Survey Bureau, had a real interest in this issue of arsenic in groundwater. So, he was doing some research, just on his own, looking at the data, and looking at the well morphologies that might give him some indication of where it was coming from. So, we worked with him a little bit. He had sent some information to our department over in the early 2000s. We knew we had a problem, we really didn’t know where it was coming from. He had an idea. He had a speculation, but we really didn’t have any money or any way to deal with it or really study it. So, we just limped along for a while, without really any significant known… We didn’t have any money to put toward getting into the research of it until about 2006 or 2007. Lorelei Krinsky, with the State Hygienic Lab at the time, contacted our department and wanted to look into the data a little bit more. What we had for data, comparing it to the data that they had in their database. Because, a lot of the samples were going through them. So, we shared all of our water tests. At the time, it was, I don’t know, over 1000 water tests. We estimate we have about 3200 wells in our county. So, at the time, I think we had tested not quite a third, maybe a little bit over a quarter of those wells. And she was using a grad student to pick apart some of the data to see if there was anything else that she could find. We started to talk as a group a little bit more and eventually in, 2000… I think it was 2009, maybe late 2008, CDC came out with some money that would was made available through their environmental health specialists network, EHS-Net. That program was paying for some research related to food safety issues in environmental health. And, several parts of the country were getting some of those funds and Iowa Department of Public Health was one of those. So, we were working with the Department of Public Health, doing some food sample collection for their research. Anyway, we were familiar with EHS-Net. When EHS-Net came out with EHS-Net water, we talked about it internally, about applying for some of those funds to help pay for the research. So, we proposed it to this network of team that we had been talking with, the State Hygienic Laboratory, a couple of other DNR, Paul Van Dorp, and they were all very much on board. I talked to Pam Mollenhauer, who, at the time was with SHL. And, we developed a hypothesis, but we brought a whole bunch more partners in. We brought in Dave Cwiertny from CHEEC. I reached out to Dr. Doug Schnabel who was a co-primary investigator with me. I knew him from the US Geological Survey Bureau. He had an interest in looking at arsenic, but they had a little money but not very much money, and they wanted us to partner with them, back in the early 2000s on trying to start researching this arsenic issue. It just didn’t come to, but I never forgot Doug and Doug’s a great guy. He went from the USGS to the University of Iowa. So, we reached out to Doug, Doug was 100% on board. We brought Doug on board. He had a grad student that he brought into the mix as well. We brought in a private well contractor, Shawver Well Company was brought on board as a partner, and were really instrumental in a lot of the policy changes that we then implemented based on the work that we did. Anyway, long story short, brought this group of people together. We developed a hypothesis, we put together a really good application, we submitted it to the CDC, and it was accepted. So in 2010, we started that five-year grant. It was about 506,000 over the course of five years. I think it produced some of the best water quality work we’ve seen in, I think, several decades because of the long-term impacts that I believe that that will have and the ability to test arsenic across the state using Grants to Counties funds. It’s one of my greatest achievements being a part of that. I don’t take ownership of the entire project by any means. I really didn’t do a lot of the work. It was Sophia Walsh, Dan Riesen, our office. It was people like Paul Van Dorp. It was people like Lorelei Krinsky, Sherry Marine, those people at the lab. Yeah, it was a fantastic group project. Ryan Budke from Shawver. A lot of these agencies, we all got together and we worked really well together and produced a fantastic piece of public health, environmental health work. So, the project itself ramped up over one year. We hired, basically, a field expert, somebody to lead the charge and do a lot of the work out in the community. That was year one. Year two, three and four was the data collection. So, we collected a pretty significant volume of water tests from about 70 homes that we enrolled in the program. Before we enrolled homes in the program, we needed to reach out to these homes and ask them if they were interested. We had to select those wells based on a certain criteria and wells needed to have certain criteria met before we can enroll them. We found about 110 wells that could be enrolled. So, we reached out to those 110, and, again, about 70 said, sure, we’re happy to participate. So, that’s a 70-plus percent positive enrollment rate, which is unheard of. So, we did all the water tests, we collected water in the wet months and the dry months. And, those are clearly defined, what time of year those were. But, we collected two sample sets over the course of that time, and then the last year was simply looking at the data and then looking at how we address policy to it. So, to answer your question, what was the outcome? What was the end result? Well, the final goal was to impact a policy change that would otherwise provide public health protections. We did that successfully by adopting a revised well ordinance in our county that required drilling depths to be increased through our Lime Creek formation down to the Cedar Valley aquifer. And, in some cases, that added 100 to 150 feet to a person’s well. But, it was necessary. Not only did we drill through the Lime Creek formation down into the Cedar Valley aquifer, but we also had to case that and grout it. So what that did was seal off that aquifer with arsenic contaminated water, which was coming from the rock, it was precipitating out of the rock. So, we seal that off, and it led to significant improvement in the number of wells that we were seeing arsenic in. Now, you might ask why was Shawver Well Company interested in that? They were interested because they would go out and drill in a well, to 300 feet. Somebody would pay $50 a foot for that well, it’s $15,000. Then, we go out and take a water test and they find out that there’s arsenic. Now who’s on the hook? Well, the well drillers are usually the first in line. The homeowner says, “Why do I have arsenic in my water? You drilled me a brand new well.” So, by figuring out how to minimize that exposure, and change how wells are installed they can then not only give accurate information to their customers, but also drill them a safe well. So, we changed our local ordinance to require those items that I just told you, fully case holes that are drilled through the Lime Creek and the Cedar Valley aquifer, and then that was used also to adjust and make the case to the state of Iowa to include testing for arsenic through the Grants to Counties program statewide. Now, we know that we have a much broader problem of arsenic throughout the state than just, say, Cerro Gordo County or surrounding counties around us. So yeah, I think it’s been a fantastic project that will likely lead to significant reductions in arsenic poisoning. We had a member of our public who was also a partner with us, who… Jack and Sandy Davis, there’s a video of them on our website, that they dealt with… Sandy dealt with some pretty serious neurological issues from drinking a lot of arsenic contaminated water. They drank 70 parts per billion arsenic water for many years. They had a house on Clear Lake, they still do. Yeah, she talks about her neurological problems. So yeah, a lot of things culminated from that project, but namely, we had policy change that impacted how wells are drilled, and how they’re cased. If we’re talking about bacterial contamination, we recommend people test their well, at least every couple years. If they have problems, then it wouldn’t hurt to be doing that annually. Some of our research that we looked into for arsenic was, is there a great fluctuation in the value of arsenic? Not only in the wet months and the dry months, but year after year. We know that there’s not a lot of fluctuation in those numbers. We also studied arsenic – and, this gets into the chemistry – arsenic three and arsenic five, which [when] you combine those two gives you a total arsenic value. It’s important to know the difference in what type of arsenic you have because that can impact treatment. What we learned is that most of our wells had arsenic five. So, what that means is, you just need a more robust treatment process which basically requires reverse osmosis. Back to arsenic, what we learned is, arsenic doesn’t need to be sampled all that often. Once you have it, you have it and it doesn’t change a great deal, on total arsenic. It may shift some between arsenic three and arsenic five. But again, we treat for worst case scenario. So, we always recommend people install the reverse osmosis versus maybe a lesser treatment that would just take out arsenic three. So, to let the viewers know, testing for arsenic, I think, once every five years is probably reasonable, but you’re still not going to see a lot of fluctuation. When you have it, you have it.

Hannah Shultz: As I said in Brian’s intro, he’s an environmental health guy. So, I asked a question that has always been confusing to me. Why are public health and environmental health sometimes separate?

Brian Hanft: I’ve never understood why they’re separate. I’ve always worked in agencies where… Well, I can’t say that. Polk County has environmental health housed within secondary roads. I would say, most of your larger counties, that’s how it’s structured. I think it’s important that they work together. There’s so much… Not overlap, but there’s so much ability of the agencies to support one another and provide assistance to one another. For example, when you get a foodborne outbreak that happens, utilizing nursing skills and environmental health services in order to do… Environmental health does the inspections in the facilities. We bring a lot to the table when it comes to epidemiology investigations. Nurses also provide some support and assistance with that epidemiological process as well. So, I think those are… They go well together. It’s the right network that should be utilized. So, I’ve never understood why they’re separate. But, again, it’s 99 counties. When you’ve seen one health department, you’ve seen one health department.

Hannah Shultz: That’s a wrap for today’s episode of Share Public Health. Thanks so much for tuning in. Join us next week as we talk about cultural identities and rural communities.

Thank you for tuning into this episode of Share Public Health. Thank you to the Injury Prevention Research Center, Iowa Center for Agricultural Safety and Health, the Healthier Workforce Center of the Midwest, the Heartland Center for Occupational Health and Safety, the Great Plains Center for Agricultural Health, the Midwestern Public Health Training Center, the Prevention Research Center for Rural Health and the Rural Policy Research Institute. The theme song for this series is Walk Along John. It’s performed by Al Murphy on fiddle, Mark Janssen on mandolin, Brandy Janssen on banjo, Warren Hamlin on guitar and Aletta Murphy on bass. Al learned these songs from a Fiddler named Albert Spray, who is from Kahoka, Missouri. A transcript, evaluation and discussion guide for this episode are available at mphtc.org and in the podcast notes.

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