In January 2018, MDH published a report in response to community concerns in the East Metro. The analyses look at specific health outcomes in Washington and Dakota County communities affected by 3M’s disposal of perfluorochemicals (PFASs), and the subsequent contamination of local groundwater and drinking water. MDH examined vital records data for elevated premature birth and low birth weight in Washington county areas impacted by PFAS contamination, as well as the rest of Washington County and the Metro region. This analytical work reaffirms the value of the protective steps Minnesota has taken to limit health impacts from PFAS chemicals.

Waterfield, Sunding et al considered similar data in their analysis and reached different conclusions published in the Reducing exposure to high levels of perfluorinated compounds in drinking water improves reproductive outcomes: evidence from an intervention in Minnesota. MDH reviewed their article and methods used in their analysis. In response, we describe some issues that would contribute to reaching a different conclusion, including differences in assumptions, data and type of analysis. These issues are echoed in open access Peer Review reports for this article, and they do not appear to have been sufficiently addressed in the publication.

MDH scientists examined individual vital records data for low birth weight and prematurity in babies born to mothers in PFC-affected east metro communities in three time periods: 2001-2005, 2006-2010 and 2011-2015. They compared data from those areas to data from unaffected communities in the rest of Washington County and the metro region. While they found a lot of variation in those outcomes – with some higher rates and some lower rates of negative health outcomes – the variation was well within the range that would be expected.

East Metro Birth Outcomes Low Birth Weight and Prematurity in Washington and Dakota Counties (PDF)

This report responds to concerns in east metro communities around legacy perfluorochemicals (PFCs) contamination and adverse birth outcomes. MDH examined vital records data for two key indicators: low birth weight and prematurity. We looked at community-level trends to identify areas with unusually high rates of these indicators. Specifically we looked at whether these trends show differences related to social and economic factors that are important in identifying communities where people don’t have what they need to be healthy.

Key findings

There is a lot of variation but the small differences are not outside of what we would expect given what we know about the east metro and the rest of the state.
Variation across areas and differences over time do not suggest any unusual increase in low birth weight or premature births in Washington County.
Health inequities across the diverse county population are consistent with differences and trends we see across Minnesota. Addressing these inequities is a central piece of the department of health’s work and priorities.

While these findings are instructive, the department only examined data for two potential health outcomes: birth outcomes and cancer. MDH has not collected public health data on other types of potential health effects reported in the scientific literature, such as liver and kidney effects, thyroid disease, or immune system changes. While MDH’s water guidance values protect against all of these effects, data on their occurrence in people are not available.

Adverse birth outcomes can have life-long health risks

Being born too soon (premature) or too small (low birth weight) can lead to serious life-long health risks. Premature and low birth weight babies are vulnerable to sickness and infection and have higher risks for infant mortality. Roughly 7% of babies in Minnesota are born premature before reaching “full-term” at 37 completed weeks of pregnancy (not counting multiple births, like twins). That’s over 5,000 babies a year born premature in Minnesota. Roughly 2% of single full-term births in Minnesota are born with low weight.

Most recent statewide data show that teens and women over age 40 are more likely to have a low birth weight or premature birth. Non-white mothers – including Hispanic, African American, American Indian, Asian and Pacific Islander mothers – are also more likely than white mothers to have adverse birth outcomes.

Steps to take for a healthy pregnancy and healthy baby

Women who are pregnant or may become pregnant can reduce the likelihood of an adverse birth outcome with the following guidelines:

Stop smoking and avoid exposure to secondhand smoke.
Do not use alcohol or illegal drugs.
Get preconception health care and early prenatal health care.
Follow nutritional and other advice carefully, including taking 400 micrograms of folic acid daily.
Maintain a healthy weight.
Avoid exposure to mercury (in fish), lead, and other chemical toxins at work and home.

What's being done to improve birth outcomes?

The MDH Center for Health Statistics collects, analyzes, and reports state and county data on a variety of health outcomes, including births and deaths.

The MDH Maternal and Child Health (MCH) Section provides statewide leadership and public health information to promote, improve, and maintain the health of women, children, and families in Minnesota. MCH programs include activities to reduce infant mortality, promote healthy birth outcomes, and support positive parenting.

The Minnesota Pregnancy Risk Assessment Monitoring System (PRAMS) collects and provides data on maternal and child health indicators.

Annual data on birth outcomes are available on the MN Public Health Data Access portal.

The Centers for Disease Control and Prevention provides data and other information about Pregnancy.

Report

East Metro Birth Outcomes (PDF)

Minnesota Pollution Control Resources

3M and PFCs: 2018 settlement

For more information, contact health.tracking@state.mn.us.