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Public Health Service

Agency for Toxic Substances and Disease Registry

Atlanta, GA 30333

February 10, 2009

Barbara Taylor, Director Office of Environmental Health Services Bureau for Public Health West Virginia Department of Health and Human Resources Capitol and Washington Streets One Davis Square Suite 200 Charleston, West Virginia 25301

Dear Ms. Taylor:

This letter is in response to your request to the Agency for Toxic Substances and Disease Registry (ATSDR) for an evaluation of the public health issues related to using water contaminated with perfluorooctanoate (PFOA) to reconstitute baby formula. This evaluation additionally considers the more general issue of water consumption by communities in the area around the Washington Works Facility (Wood County, West Virginia). As you are aware, since your request (letter dated January 18,2006 and our subsequent response dated February 7, 2006), we have been engaged in ongoing health education and technical review activities. Much of the information contained in this letter has been communicated previously through verbal updates with your staff.

Completed and ongoing studies involving area residents have shown that communities near the Washington Works Facility have elevated serum levels of PFOA. These elevated PFOA levels are primarily a result of using contaminated drinking water.

Defining a safe

level ofPFOA in the water near the Washington Works

Facility has been very difficult. A number of issues contribute to this problem, including: (1) an incomplete characterization of the exposures leading to elevated PFOA levels in the area residents, (2) limited research on the health effects ofPFOA in humans, and (3) difficulties relating the pharmacokinetic data obtained from test animals to humans. Due to the scientific limitations and uncertainties, ATSDR has not established a guidance value, a "Minimal Risk Level" that may be used to help define a safe level of PFOA in drinking water.

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