Note: Colorado regulators will host a community open house on Monday aimed at setting a groundwater standard for perfluorinated compounds in the Widefield aquifer. That will be from 3:30 p.m. to 6:30 p.m. Monday, Oct. 23 at the Fountain Library, 230 S. Main St. in Fountain. Also Monday, local water district leaders are set meet with Air Force officials at the Pentagon on ways to be reimbursed for the millions of dollars spent responding to toxic water in the aquifer.
Unexplained stomach pains tortured Penny Cimino's third-grade son. Then came a noncancerous mass the size of a baseball on her own liver.
After dealing with those health concerns, news surfaced of toxic chemicals fouling her drinking water that have been tied to the long-term use of firefighting foam at Peterson Air Force Base.
"We need answers," said Cimino, a Fountain resident of 24 years.
A University of Colorado School of Public Health researcher last month submitted a grant application to the National Institutes of Health seeking $275,000 to look for those answers. If approved, it will be the first field study measuring the chemicals, called perfluorinated compounds, in the bloodstreams of Security, Widefield and Fountain residents.
The study could offer the first clues as to whether elevated levels of those toxins in southern El Paso County are associated with liver and immune system function.
"Everybody's anxious about some answers," said John Adgate, the CU professor leading the effort. "And I hope to kind of lower their anxiety level. I hope to provide them with evidence-based answers on ways to reduce their own exposure that are feasible in the short-term."
If approved, the study would examine 200 adults across Security, Widefield and Fountain - with a focus on people with high blood toxin levels, who were exposed for a long period of time.
Researchers would collect a blood sample from each person, testing for different chemicals. They will include a variant similar to one found in the replacement firefighting foam that Air Force officials say is safer than the toxic mixture used for decades at Peterson Air Force Base.
Toxicologists will then analyze those blood samples, as well as local water samples and participants' health surveys, to determine any possible links between exposure and health effects.
Studies go back decades
The Air Force began studying the potential health impacts of its firefighting foam during the Carter administration.
Studies by the Air Force as far back as 1979 demonstrated the chemicals were harmful to laboratory animals, causing liver damage, cellular damage and low birth weight of offspring.
The Army Corps of Engineers, considered the military's leading environmental agency, told Fort Carson to stop using the foam in 1991 and in 1997 told soldiers to treat it as a hazardous material, calling it "harmful to the environment."
In 2000, the EPA called for a phaseout of the chemicals and later declared they were "likely to be carcinogenic to humans."
The military quit using the foam at Peterson late last year.
Studies have linked perfluorinated compounds to immune system and liver damage and to cancers, especially of the kidneys and testicles. Fetal development problems and low birth weight, a leading cause of infant mortality, are a concern. And, at a minimum, the firefighting foam can cause high cholesterol, a precursor to heart disease.
Now, even with the chemical filtered out of drinking water supplies in Security, Widefield and Fountain, hazards remain.
Dr. Paul Brooks, a physician in West Virginia who led the nation's largest study into the health effects of perfluorinated compounds, says the chemicals linger in the body for decades even after exposure to them has stopped.
Congress is now debating a wider study of the chemical's effect on humans as part of the National Defense Authorization Act, which has landed in a conference committee to work out differences between the chambers.
The Air Force is also expected to kick off a study in the coming year to more closely examine how the firefighting foam from Peterson wound up in drinking water pumped from the Widefield aquifer.
The Air Force, though, hasn't shown interest in finding out how its foam has impacted public health.
Last fall, Mark A. Correll, a deputy assistant secretary of the Air Force overseeing environmental concerns, said the service wouldn't be paying for blood tests on residents or airmen who have been exposed.
The service aligned itself with the stance taken by the Colorado Department of Public Health and Environment: simply knowing how many perfluorinated chemicals are in a person's bloodstream does not predict specific future ailments.
"At this point in time, they haven't recommended it as something that folks should do and, consequently, the Air Force is not in a position to expend taxpayer dollars until we get a recommendation that that's something we should do," Correll said.
Locals seek answers
Cimino, 51, wants herself or her children to be included in the CU study.
Arriving in Fountain in the early-1990s, she drank her tap water for more than a decade, including while pregnant with her two sons, now 19 and 22. The source of that water was always apparent, with a wellhead connected to the Widefield aquifer located just behind her house in a nearby park.
Eleven or 12 years ago, she switched to bottled water for everything but tea and cooking, because the smell of tapwater was overpowering.
"I'd always joke around - I can't get the water past my nose sometimes," Cimino said.
Water officials told her the smell was due to higher mineral concentrations in the water.
Eight years ago, she developed a liver hemangioma - a noncancerous tangle of blood vessels that normally remains small and requires no treatment.
Hers grew much larger for reasons doctors can't explain. Surgeons removed a third of her liver.
Now she wonders if the water played a role - and what problems may be in the offing for her sons.
"It's the unknowns that are scary," Cimino said. "If you don't know - what are your kids going to be looking at in the future, health wise, because of these chemicals? If we know, maybe we can keep an eye on this."
Carol Benedict agrees.
From 1999 through 2012, she relied on a private well connected to the aquifer while living off Old Pueblo Road, south of Fountain.
During that time, she was pregnant with her youngest child, Bryson. While she drank bottled water, she used the tap for cooking.
She developed joint paints about six months after moving in - a short timeframe for health ailments stemming from perfluorinated compounds. The first test came back positive for lupus, a chronic autoimmune disease. But follow-up tests have muddied that diagnosis, suggesting rheumatoid arthritis and multiple sclerosis. Doctors at the Mayo Clinic said she suffered from some type of auto-immune disorder, but couldn't say which one.
Benedict's identical twin sister has experienced none of the same symptoms.
But Benedict's son, Bryson, also has suffered strange health ailments.
Complaining of similar pains, doctors at Children's Hospital in Aurora found his blood platelet levels as low as someone with leukemia. But they couldn't explain why.
"It's frustrating," Benedict said. "They said until he either develops more symptoms or they come up with a reason, we won't know anything."
Even understanding how many perfluorinated compounds are in her blood likely won't solve that riddle.
At least the study would be a start, she said. "It's the only way we're maybe going to get some answers"
Understanding whether PFCs are the cause of health problems can be frustratingly difficult.
Researchers suspect the chemicals are immunotoxic - meaning they weaken the immune system, leaving their exact effects difficult to determine.
Adding to those problems are the fact that hardly any studies have been conducted on the foam itself, only individual chemicals within it. That makes understanding the foam's exact effect on people exposed to fouled drinking water - where a host of different perfluorinated compounds may interact in unforeseen ways - almost impossible to predict.
More than 99 percent of the U.S. population has some level of perfluorinated compounds in their blood, because of their widespread use in household products, such as Scotchgard, Teflon, fast food wrappers and nonstick raincoats and appliances. Also, they break down on a time frame that one leading researcher has described as "geologic." So once exposed, the chemicals stick around for a long time.
Exposures have decreased since the turn of the century, which coincides with the decision of the chemicals' leading manufacturer, 3M, to cease production.
But that isn't true for every community, such as areas where drinking water was contaminated with firefighting foam like that used at Peterson Air Force Base.
The EPA issued a health advisory in 2016 warning Americans against consuming water with a perfluorinated compound level higher than 70 parts per trillion. That's a shotglass of the chemical in 107 million gallons of water.
In the Widefield aquifer, levels topping 2,000 parts per trillion were recorded.
Study method questioned
If it gets approved, the El Paso County study would be minuscule compared to an effort that began more than a decade ago that was led by Dr. Brooks.
Researchers collected blood samples from 69,000 people in the mid-Ohio Valley, a region east of Cincinnati centered on Parkersburg, W.Va.
He said the modest El Paso County study may comfort locals, but will do little to advance science.
"From big numbers is where you get the evidence you need to find problems," Brooks said.
Big studies, though cost big money.
Adgate also wants a national study. But he acknowledged needing to find a cost-effective sample size, especially given his request for fast-track approval. He said statisticians tabbed for the proposed study assured him that 200 people would be enough to draw statistically-significant conclusions.
And, he added, there's great value in getting peak exposure readings as soon as possible, he said.
Law firms also are taking note.
Residents have banded together in a class-action suit against firms that manufactured the foam for the Air Force. Evidence of the foam's health impact will be key if they get a day in court.
Representatives from at least two law firms suing the manufacturers of the Air Force's firefighting foam were present at the community meeting earlier this month where Adgate discussed his proposed study.
Small studies are more easily discounted in court, Brooks warned.
"They're wasting their time doing small numbers," Brooks said. "This is exactly what industry would love for them to do."
But bigger numbers, exponentially bigger, may be ahead.
Congress is considering a national study of perfluorinated compounds directed by the Centers for Disease Control.
There's also a push for a national study from the federal Agency for Toxic Substances and Disease Registry, which could involve a significant portion of the 6 million Americans who may have consumed drinking water tainted by perfluorinated compounds flowing from more than 400 military and industrial sites.
Brooks said as Americans grow increasingly alarmed over the contamination tied to the military, a mammoth study is likely.
"It has to be done because the whole world is animated about this," he said.