01.02.19 Board of Health Meeting Minutes1601
Dr. Robert Schiff el, Chair of the New Hanover County Board of Health, called the regular
business meeting of the Board of Health (BOH) to order on January 2, 2019 at 8:00 a.m. in
the Carl Durham Auditorium of the New Hanover County Public Health Department.
Members Present:
Melody Speck Evans, DVM
Kim Thrasher Horne, PharmD
Amy Mclane, PE
Mark W. Morgan, MD
Michael Musselwhite, Public Member
Candy Robbins, Vice-Chair
Robert J. Schiffel, DDS, Chair
Stephanie D. Smith, PhD, RN, Public Member
Edward Weaver, Jr., OD
Rob Zapple, County Commissioner
Members Absent:
LeShonda Wallace, PHO, FNP-BC
Others Present:
Avril Pinder, Assistant County Manager
Lisa Wurtzbacher, Chief Financial Officer
Bunny McClure, Deputy Chief Financial Officer
Phillip Tarte, Public Health Director
David Howard, Deputy Public Health Director
Regina James-Boston, Administrative Manager
Katelyn Matney, Public Health Strategist & Health Promotion Supervisor
Nikki Todd, Public Health Nurse Supervisor
Alicia Pickett, Environmental Health Supervisor, EHS -Food Safety
Andrea Benton, Administrative Technician, Support Services -EHS
Christian Capra, Administrative Technician, Support Services -Customer Care
Whitney Parrish, Administrative Technician, Support Services -Customer Care
Susan Wright, Environmental Health Specialist
Lisa Brown, Preparedness Coordinator
Madi Jones, UNC PharmD Intern for Ms. Thrasher-Horne
Heather Jernigan, Recording Secretary
Approval of Agenda: Commissioner Zapple moved that the agenda be approved as submitted.
Dr. Stephanie Smith seconded. Upon vote, the agenda was approved as submitted.
Approval of Minutes: Commissioner Zapple moved that the minutes from the last meeting be
approved as submitted. Kim Thrasher-Home seconded. Upon vote, the minutes of the December
5, 2018 meeting were approved as submitted.
Approval of Consent Agenda: Commissio ner Zappia moved to approve the consent agenda.
Ms. Candy Robbins seconded. The Board approved the ratification of application and, if awarded,
the acceptance of $5,000 in grant funding from the Delta Dental Foundation and the associated
budget amendment.
New Hanover County Board of Health
Next Steps for Emerging and Existing Compounds
January 2, 2018
Background
A study titled, Legacy and Emerging Perfluoroalkyl Substances Are Important Drinking Water
Contaminants in the Cape Fear River Watershed of North Carolina, was published in 2016
describing the presence of unregulated compounds within the Cape Fear Region. The
publication, referred by us as the ‘Knappe’ study, led by Detlef Knappe, PhD from NC state, was
published in Environ. Sci. Technol. Lett.; November 10, 2016
o The main purpose was to look at ten legacy PFASs and seven recently discovered
perfluoroalkyl ether carboxylic acids (PRECAs) and (1) their occurrence in the Cape Fear
River watershed, (2) their fate in water treatment processes, and (3) their absorbability
on powdered activated carbon.
There is evidence that exposure to PFAS may cause harmful health effects in humans as it does
in animals . (https://www.atsdr.cdc.gov/pfas/health-effects.html). Studies show that PFAS may
impact:
Thyroid hormone disruption (for PFOS).
Changes in cholesterol
Developmental effects to fetuses during pregnancy or to breastfed i nfants (e.g., low birth
weight)
Liver effects (e.g., tissue damage)
Immune effects (e.g., depressed antibody production in response to vaccination)
Cancer
In 2017, DHHS released GenX Health Effects Summary – The health goal was set at 140 ng/L
(PPT) for the most vulnerable population- i.e. bottle-fed infants, the population that drinks the
largest volume of water per body weight.
o This assessment was not a boundary line between a “safe” and “dangerous” level of a
chemical for humans rather,
o This is the concentration of GenX at which no adverse non-cancer health effects would
be anticipated over an entire lifetime (70 years) to the most sensitive population
To further explore potential effects on humans, NC DHHS reviewed trends from The North
Carolina Central Cancer Registry between the years 1996–2015, looking at pancreatic, liver,
uterine, testicular and kidney cancers specifically in New Hanover, Brunswick, Pender and
Bladen counties. Incidence rates were compiled for the entire 20-year period and separately
for each 5-year interval therein (1996–2000, 2001–2005, 2006–2010 and 2011–2015).
(https://www.ncdhhs.gov/news/press-releases/nc-dhhs-releases-summary-selected-cancer-
rates-counties-cape-fear-region)
The findings were as follows:
ATTACHMENT I
New Hanover County had a higher 20-year rate of testicular cancer during 1996–2015 and a
higher 5-year rate of liver cancers during 2006–2010. Rates of both cancers were similar to
the state rates during the most recent period (2011-2015)
Brunswick County had a lower 20-year rate of pancreatic cancer during 1996–2015; a lower
5-year rate of uterine cancer during 2006–2010; and a lower 5-year rate of pancreatic
cancer during 2011–2015 compared with the state
Overall, cancer rates in the four counties were similar to state rates
Since this issue became public in 2017, New Hanover Public Health (Board of Health and staff) has an
active role in participating in GenX and other related compound activities and initiatives at a local,
state and federal level. (Original meeting with Chemours, various panels and workgroups, local science
advisory committee (NC State study), NC Science Advisory Board, EPA state panel.)
Next Steps
Below you will find examples of state initiatives across the country to advocate and support public
health related activities.
Assessing and Monitoring examples
Food packaging: determine whether a safer alternative to the chemical is available other
than PFAS. https://legiscan.com/NJ/text/S2879/id/1817868
Research and assessments: legislation to provide an opportunity to advance research and
assessments that will enable NC to better understand the health outcomes of PFAS
contamination and communicate with the public about exposure risks. Potential that states
with established quality standards and restriction on the use or sale of products containing
PFAS are better able to protect the public’s health.
Setting Standard examples:
Michigan: Three proposed resolutions in Michigan (SCR 35, HCR 24, HR 351) call for the
federal government to release draft toxicological profile on PFAS prepared by the Agency
for Toxic Substances and Disease Registry https://www.atsdr.cdc.gov/ to develop a national
environmental limit for PFAS and increase coordination and funding.
New Jersey: Evaluate and set ambient ground water quality standards for PFAS, set
maximum contaminant limits (MCL) for public drinking water, and develop a plan for
establishing surface water quality standards for PFAS
http://gencourt.state.nh.us/bill_status/billText.aspx?sy=2018&id=1854&txtFormat=html
https://whyy.org/articles/new-jersey-water-systems-must-start-testing-for-pfna-in-early-
2019/
Remediation and Response examples:
Vermont: Enacted a law in 2017authorizing the secretary of natural resources to determine
whether a person that released PFOA into the air, groundwater, surface water, or land is
liable for the costs of extending the water supply of a public water system to an impacted
property.
Allocate funds for PFAS remediation and response activities, laboratory equipment and
support, community water supply sampling, grants to local public health departments
engaged in PFAS response activities (to include local education and prevention
efforts). https://www.legislature.mi.gov/(S(3b2lm5a1ndbxg21p2ht20j4t))/milegPrint.aspx?
page=BillStatus&objectname=2017-HB-4320
Federal Support
Understanding of the bioaccumulative effects of these compounds. Additional research is
necessary.