Lessons from Italy's PFAS Disaster: Toxic Chemicals in the Water

PFAS Pollution: A Disaster in the Shadow of Magnificent Cities

The Veneto region in northeastern Italy is home to world-famous destinations: the canals of Venice, Verona, the city of Romeo and Juliet, and beautiful Lake Garda. Yet it may also be home to the world's largest contamination by per- and polyfluoroalkyl substances (PFAS).

In 2013, chemicals containing PFAS were discovered in drinking water across a "red zone" covering 30 municipalities in the provinces of Vicenza, Verona and Padua. These chemicals were found to have caused a serious public health crisis affecting approximately 350,000 people living in the region.

What Are PFAS?

PFAS (per- and polyfluoroalkyl substances) are man-made chemical compounds widely used since the 1940s for their water-, heat- and grease-resistant properties.

• They are found in many products, including Teflon-coated cookware, waterproof clothing, food packaging and firefighting foams.
• However, they do not readily break down in nature. They can accumulate in the environment and the human body, potentially causing long-term health problems.
• PFAS chemicals are manufactured to be durable and tend to persist in the environment.

PFOA stands for perfluorooctanoic acid. It is one of the most widespread and harmful chemicals in the PFAS group.

The PFAS Crisis in Veneto

For years, people in Veneto unknowingly drank and cooked with PFAS-contaminated water. The source of the pollution was the Miteni chemical plant in Trissino, Vicenza. Operating from the 1960s until its closure in 2018, the plant discharged wastewater into the Almisano aquifer, an underground water source described as Europe's second-largest freshwater source.

In spring 2013, Italy's National Research Council found dangerously high PFAS levels in groundwater and rivers. In some areas, concentrations reached 1000 times international safety limits. An estimated 120,000 people with prolonged exposure to contaminated water were identified as being at serious risk.

The authorities acted quickly after these findings. Within 6 months, dual carbon filtration systems were installed at the affected water sources. Residents were advised to use bottled water and avoid local foods.

The Veneto government launched a biomonitoring program in 2015-2016. Blood samples from 507 people living in exposed and uncontaminated areas were compared. The results showed 8 times more PFAS in the blood of people living in the red zone.

Under a Health Surveillance Plan launched in 2017, 90,000 local residents and former Miteni employees underwent blood testing. Kidney, liver, metabolic and thyroid function were assessed. More than 55,000 people had participated by 2022, and 60% were found to have organ or metabolic damage associated with PFAS exposure.

Another study of 105,000 people in 2022 found that blood levels of PFOA, the most common type of PFAS, in Veneto's red zone reached 20 times the Italian average.

The Health Effects of PFAS Exposure

These high PFAS levels have serious health implications. Research found that, between 1985-2018, Veneto's red zone experienced 3,890 more deaths than expected, equivalent to one additional death every 3 days. Cardiovascular diseases, kidney cancer and testicular cancer are among the most common diseases.

There are also concerns about the effects of PFAS on reproductive health. Analyses by Professor Annibale Biggeri that have not yet been published suggest that PFAS crosses the placenta to the fetus during pregnancy. A Danish study also found that higher PFAS exposure could adversely affect sperm motility and morphology.

Psychological Effects: Anxiety Caused by an Invisible Threat

Concern about PFAS pollution is not limited to physical health. Residents also struggle with the psychological burden of years of exposure to these chemicals.

Dr. Marialuisa Menegatto, a psychologist and researcher at the University of Padua, describes this experience in three phases:

1. Shock and disbelief: Residents felt deeply let down when they learned that their home area had been polluted. This created a sense that their personal space had been violated.

2. Lifestyle changes: Families had to change their everyday habits to avoid contaminated water. They had to avoid local foods, drink bottled water and, in some cases, move away.

3. Living with PFAS: Over time, people had to accept the situation, but this acceptance was accompanied by persistent uncertainty. Not knowing how their children would be affected in the long term created intense feelings of guilt, particularly among mothers.

"Unlike a natural disaster, it is unclear when this kind of human-made disaster will end," says Menegatto. "As a result, those affected live with ongoing stress, anxiety and depression."

Not Just Italy!

PFAS pollution is not confined to Veneto. In Europe, high levels have also been found in Belgium, the Netherlands, Germany, France and the UK. Many countries, including the US, Australia and China, face similar environmental problems.

The Human Biomonitoring Initiative (HBM4EU), launched in 2016 by the European Environment Agency and the European Commission, aims to measure levels of chemicals such as PFAS in people and assess health risks. The Partnership for the Assessment of Risks from Chemicals (PARC), launched in 2022, aims to further improve chemical risk management.

Healthcare professionals need to recognize the possible health effects of PFAS exposure. Exposure should be considered particularly in cases of kidney disease, metabolic disorders, hormonal imbalances and certain cancers.

Despite years of research and ongoing regulatory efforts, the long-term effects of PFAS are still not fully understood. Yet the Veneto disaster has become a stark illustration of the need for stronger action against these "forever chemicals."