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One State’s War on Forever Chemicals in Milk

News Feed
Friday, December 20, 2024

In late December 2022, a rancher in Johnson County, Texas, called the constable’s office to complain about his neighbor. The neighbor had recently spread a kind of waste-derived fertilizer, known as biosolids, over his land, the caller said, and the piles were smoking. The caller and his wife were struggling to breathe, the fish in his pond had died, and he thought the biosolids were making him, his wife, and their animals sick.Dana Ames, the county’s environmental crimes investigator, had gotten complaints about biosolids before—the human waste product also known as sewage sludge has a particularly noxious smell—but this felt different. She did some research and found news articles about a dairy farmer in the state of Maine who had used biosolids on his land and whose milk showed sky-high levels of per- and polyfluoroalkyl substances, or PFAS.Known as “forever chemicals” because of how long they persist in our environment, PFAS have been linked to a wide variety of human health concerns—and are also present in a range of industrial and consumer products, from firefighting foam to nonstick frying pans. While industry has known about the harms of these chemicals for decades, the government is just catching up: In April of this year, the Environmental Protection Agency set a first-ever drinking water standard for some of the most common forever chemicals, setting a maximum enforceable level of just four parts per trillion for PFOA and PFOS, the two most studied compounds. Some states, meanwhile, have taken regulation into their own hands. Because sludge can accumulate high levels of forever chemicals from municipal sewage, Maine banned the use of biosolids on farmlands entirely in 2022.After the rancher made his complaint, Johnson County tested his property and animals. A drinking water well tested at 268.2 parts per trillion of PFAS, more than 65 times over the new EPA standards. The flesh of a fish taken from the property tested at 74,000 parts per trillion of PFAS. (One 2023 study found that eating just one serving of fish with 11,800 parts per trillion of PFAS would be the equivalent of drinking water contaminated with more than 10 times the new EPA levels of PFAS for a whole month.) The liver of a stillborn calf, meanwhile, tested with more than 610,000 parts per trillion of PFOA, indicating that its mother was routinely exposed to the chemicals in her environment.The company that produced the biosolids applied to the neighbor’s land, Synagro, had recently distributed samples of sludge at the grand opening of its Fort Worth location. Ames was able to get a jar to test. The biosolids tested at 35,610 parts per trillion of total PFAS. “You can make a scary movie out of this,” Ames says.For years, farmers around the country have used biosolids on their fields, a practice touted by industry interests and the government as a safe, environmentally friendly use of waste. But recently, a handful of farmers in different states hundreds of miles apart have seen products from their farm—and even their own bodies—test positive for worrying levels of forever chemicals. Biosolids, a growing number of experts say, are likely to blame, endangering these farmers’ livelihoods and health.Regulators in Maine are some of the only ones in the country to take aggressive action, but those closest to the issue say it’s time for the federal government and other states to follow suit. Earlier this year, a group of Johnson County residents, including those who originally called Ames in 2022, filed a lawsuit against Synagro, North America’s largest biosolids producer, alleging that the PFAS seeping into their land may have caused serious medical issues and the deaths of multiple animals. (A company spokesperson said in an email to The New Republic that Synagro denies the “unproven and unprecedented” allegations, that the biosolids applied to the land in Johnson County “met all USEPA and Texas Commission on Environmental Quality (TCEQ) requirements,” and that subsequent test results showing lower PFAS levels on the farm with the biosolids “strongly suggest that the farm where biosolids were used cannot be a source for the PFAS allegedly found on the plaintiffs’ farms.”) Johnson County, meanwhile, has teamed up with a farmers’ advocate group in Maine to sue the EPA for its lack of regulation on PFAS in biosolids. And in Congress, Maine legislators in both houses are trying to pass national legislation to make sure farmers affected by PFAS can access funds for support. The question now is whether anyone will listen.One of the first phone calls that Nancy McBrady got when she joined Maine’s Department of Agriculture in 2019 was from the commissioner of the Department of Environmental Protection. “She said, ‘Do you know about PFAS?’” McBrady recalls. “I really had to jump in and get smart.”McBrady found herself in the middle of a mounting agricultural crisis that had begun just a few years before. In late 2016, Maine regulators had found PFAS contaminating water wells on the property of dairy farmer Fred Stone in Arundel, Maine. Stone voluntarily tested his milk, finding PFAS levels so high that his purchaser, Oakhurst Dairy, stopped buying his product. In early 2019, as Stone was losing hundreds of dollars a day and dumping dozens of gallons of milk in an attempt to fix the problem, Maine’s new governor formed a task force to investigate the larger issue of PFAS pollution in the state—an effort McBrady was pulled into.In order to see if Stone’s farm was an anomaly, regulators designed a sampling scheme for milk available for sale in Maine. The tests traced PFAS pollution back to another farm—this time in Fairfield, about 100 miles north of Stone’s property. This farm, like Stone’s, had a history of using biosolids on its land.“We did the testing with the expectation that we wouldn’t find much,” McBrady says. “In hindsight, that was incorrect thinking.”McBrady and her colleagues were facing a peculiar vacuum of information when it came to PFAS. While the government has been aware of the potential harms of forever chemicals since the 1990s, there are few definitive federal standards in place for safe human consumption. What’s more, PFAS is not just one chemical but rather a class of thousands; many of the lesser-studied PFAS have been almost totally ignored by regulators.In 2016, the same year that Stone’s farm was tested, the federal government had just set a standard for drinking water for the two most studied types of PFAS at 70 parts per trillion. The new four parts per trillion level set in April tightens this dramatically. But to this day, the EPA does not set any official limits for PFAS levels in sewage sludge applied to farms, nor does it regulate the presence of PFAS in sludge in any way.When McBrady started her job, no states required that products from farms that used biosolids be tested for PFAS. On the federal side, the nation’s milk supply is regulated by the Food and Drug Administration, while meat is regulated by the U.S. Department of Agriculture. Both agencies regularly test samples of food products for PFAS and other contaminants, but those tests are designed in such a way that they may miss intense spots of pollution at the local level. (When it comes to the FDA’s food testing of products grown in areas with known PFAS pollution, for instance, the agency says on its website that “technical support generally occurs at the request of states and before the food enters the market”—meaning that states have to raise the alarm first.) Each agency has intervened in instances where high PFAS levels have shown up in food products, but neither the FDA nor the USDA maintains specific standards for how much PFAS in milk, beef, or any kind of food is safe for human consumption. In an email to The New Republic, an FDA spokesperson said that “understanding PFAS exposure from food is an evolving area of science and more data are needed.”McBrady and her colleagues began working with Maine’s Center for Disease Control and Prevention to create action levels for PFAS in beef and milk in the state. “We just had to start building this program on the fly,” McBrady says.Maine’s environmental agencies found allies in the statehouse. In 2021, the legislature created a fund to enable the Department of Environmental Protection to test land and water at farms that had spread sewage sludge before 2019. Thus far, the investigation has found more than 60 farms where PFAS contamination was high enough that action needed to be taken. At one vegetable farm in Unity, Maine, the owners’ blood levels tested with PFAS levels hundreds of times over the safe limit. In 2022, Maine banned biosolids application altogether. That same year, Mills’s administration created a $60 million support fund for farmers whose land was contaminated; the first payouts from that fund were distributed earlier this year. “We cannot be in the position of telling people that something is contaminated and then just not be able to help them,” McBrady says.When Representative Chellie Pingree, who represents the first of Maine’s two congressional districts, talks to other politicians in Washington about PFAS on farms, her warnings often fall on deaf ears. “There’s a sense of, well, that’s too bad, but it’s not my problem,” she tells me. “If you don’t have a constituent in your district who’s got a huge problem on their farm, you may not have heard about it, or you think it’s only happening somewhere else.”In 2023, Maine’s representatives in Washington joined together to introduce dual legislation in the House and Senate to provide the same kind of support Maine offers farmers on a national level. The Relief for Farmers Hit with PFAS Act, which is designed to be included in the Farm Bill, would allow states to allocate money for PFAS testing and supporting farmers whose farms have been contaminated.“We’ve set up this model, and we know it can work—but unfortunately, we’re the only state that has this safety net in place,” Sarah Alexander, the executive director of the Maine Farmers and Gardeners Association, or MOFGA, says. “More farms are going to keep finding contamination. We need a federal safety net.”It’s not just Maine and Texas with a toxic sludge problem. In 2022, Michigan officials shut down a 400-acre cattle farm after biosolids applied on that farm—and, subsequently, the meat, which was sold directly to farmers’ markets and schools—tested with high levels of PFAS. While Michigan routinely tests sludge from its wastewater treatment plants that it sends out for application, it only banned the application of biosolids with high levels of PFAS in 2021. It also does not test farms with a previous history of sludge applications like Maine does; there’s no way of knowing if other farms that spread biosolids in the past also have contamination. Earlier this year, Harvest Public Media surveyed 13 states across the Midwest, finding that only Michigan had any limits on the allowable amount of PFAS in biosolids. “Commissioners of agriculture would rather not have this seen as a big problem, because nobody wants to be the state where people say, ‘Oh, you can’t buy soybeans from Kansas now, they’re all contaminated,’” Pingree says. “Nobody wants to be tagged with the PFAS label.”To its credit, the Biden administration made significant strides on PFAS. In addition to tightening the new drinking water standards, the EPA this spring designated two of the most common PFAS chemicals as hazardous substances under the Superfund program, meaning that companies, not taxpayers, would be on the hook for cleaning up major spills.The new federal movement on PFAS, especially the drinking water standards, may help raise the bar for gauging safe consumption of other substances, like milk. In April, Consumer Reports conducted its own PFAS testing of milk available for sale in five states. While only six of the 50 samples tested positive for PFAS, those samples all tested several times over the new EPA standards for drinking water, and all tested high enough that they would trigger an investigation in the European Union. One of the samples, Kirkland Signature milk from California, tested with 84 parts per trillion of PFOA.Most experts agree that any additional action or information at the federal level on PFAS would help shed some light on just how much of a problem sewage sludge is. Biosolids, after all, aren’t the only potential source of PFAS pollution on farms: In 2018, water well testing of a dairy farm in New Mexico found that firefighting foam from a nearby Air Force base had polluted the water supply. The FDA determined that the milk from the dairy tested with high enough PFAS levels to be a human health concern, and the farm subsequently went out of business.But while the EPA may be making progress on some PFAS research, advocates say it’s lagging when it comes to biosolids, and putting farms at risk in the process. The agency says on its website that it is currently conducting a risk assessment for PFAS in biosolids—due at the end of this year—and suggests that states monitor sludge for contamination. In June, the farmers in Johnson County in Texas, represented by Public Employees for Environmental Responsibility, or PEER, an advocacy group, filed a lawsuit against the EPA, alleging that the agency is neglecting its duty under the Clean Water Act to regulate PFAS in biosolids. (Maine’s MOFGA later joined the suit.) In a response filed in September, the agency pushed to dismiss the lawsuit, arguing that it actually has no current responsibility to regulate biosolids at all. “That’s not our understanding of the Environmental Protection Agency,” Alexander says.There are some good signs. Only five of the more than 60 farms that Maine has found contaminated with PFAS have had to shut down. The rest have, with significant help, been able to find a way to survive: to shift crops, clean up their water and soil, and protect their families and animals from further contamination.Through trial and error, Maine regulators are figuring out how PFAS works. Leafy greens, for instance, tend to be more vulnerable to contamination; McBrady says that fruit plants, by contrast, seem to store PFAS in the plant material, while the fruit remains relatively PFAS-free. One Maine farm with PFAS-contaminated soil successfully switched from growing foraging grasses for cattle to growing grains, whose stalks seem to protect the harvestable material from PFAS contamination. The farm now raises pigs who eat the safe grains.But Maine is still the only state doing regular testing of farms that applied biosolids. Without widespread local testing like the kind Maine is providing, it’s difficult to get a grasp on how pervasive the problem is. “It’s not like it makes your food taste funny,” Pingree says.How the Trump administration will handle PFAS remains an open question. The EPA has told advocates that its risk assessment on PFOA and PFOS in biosolids—the required first step to create more regulations—is due at the end of this year, but any further regulations will be out of Biden bureaucrats’ hands. Lee Zeldin, Trump’s pick to lead the EPA, has a history of voting in favor of PFAS protections. Project 2025, meanwhile, explicitly calls for the EPA to reverse its designation of PFAS as hazardous chemicals under the Superfund law. Environmental advocates worry that the administration could prolong the implementation of the new drinking water standards, even if it ultimately decides not to roll them back. One waste management executive told the trade publication WasteDive that he foresees a “patchwork quilt” of regulations cropping up as states continue to regulate PFAS without federal input.For an agency that seems to just now be finding its stride on regulating PFAS, an industry-friendly administration could spell trouble for the crucial early work.“If I were EPA right now, I would be very worried that [the work on the PFAS risk assessment] would all be scrapped,” says Laura Dumais, an attorney at PEER involved in its lawsuit against the EPA. “I cannot imagine this next administration, based on the positions that it took last time around, would go against industry and for public health.”Even with an agency committed to regulating the chemicals in our environment, the problems posed by PFAS seem to just keep getting bigger. Public awareness of PFAS, until recently, has mostly focused on large-scale pollution from industrial facilities or military bases making it into the water supply. But removing PFAS from biosolids isn’t as simple as removing a single point of industrial pollution. Because biosolids are made from municipal waste—what we flush down the toilet—they serve as a terrifying indicator of just how pervasive forever chemicals really are in our everyday life. We, ourselves, now shed a chemical that doesn’t degrade, that intensifies in our wastewater, and then is spread on our food. Even if all states banned biosolids use tomorrow, it wouldn’t solve the problem of eliminating PFAS within our waste system—or even help us to understand basic facts about how these chemicals contaminate our environment and affect our bodies.“You start legislating one thing, and it’s going to have effects on another thing—that’s the case with biosolids,” McBrady says. “There’s hesitancy on the parts of some states because it’s such an intractable, big problem—where do you begin?”

In late December 2022, a rancher in Johnson County, Texas, called the constable’s office to complain about his neighbor. The neighbor had recently spread a kind of waste-derived fertilizer, known as biosolids, over his land, the caller said, and the piles were smoking. The caller and his wife were struggling to breathe, the fish in his pond had died, and he thought the biosolids were making him, his wife, and their animals sick.Dana Ames, the county’s environmental crimes investigator, had gotten complaints about biosolids before—the human waste product also known as sewage sludge has a particularly noxious smell—but this felt different. She did some research and found news articles about a dairy farmer in the state of Maine who had used biosolids on his land and whose milk showed sky-high levels of per- and polyfluoroalkyl substances, or PFAS.Known as “forever chemicals” because of how long they persist in our environment, PFAS have been linked to a wide variety of human health concerns—and are also present in a range of industrial and consumer products, from firefighting foam to nonstick frying pans. While industry has known about the harms of these chemicals for decades, the government is just catching up: In April of this year, the Environmental Protection Agency set a first-ever drinking water standard for some of the most common forever chemicals, setting a maximum enforceable level of just four parts per trillion for PFOA and PFOS, the two most studied compounds. Some states, meanwhile, have taken regulation into their own hands. Because sludge can accumulate high levels of forever chemicals from municipal sewage, Maine banned the use of biosolids on farmlands entirely in 2022.After the rancher made his complaint, Johnson County tested his property and animals. A drinking water well tested at 268.2 parts per trillion of PFAS, more than 65 times over the new EPA standards. The flesh of a fish taken from the property tested at 74,000 parts per trillion of PFAS. (One 2023 study found that eating just one serving of fish with 11,800 parts per trillion of PFAS would be the equivalent of drinking water contaminated with more than 10 times the new EPA levels of PFAS for a whole month.) The liver of a stillborn calf, meanwhile, tested with more than 610,000 parts per trillion of PFOA, indicating that its mother was routinely exposed to the chemicals in her environment.The company that produced the biosolids applied to the neighbor’s land, Synagro, had recently distributed samples of sludge at the grand opening of its Fort Worth location. Ames was able to get a jar to test. The biosolids tested at 35,610 parts per trillion of total PFAS. “You can make a scary movie out of this,” Ames says.For years, farmers around the country have used biosolids on their fields, a practice touted by industry interests and the government as a safe, environmentally friendly use of waste. But recently, a handful of farmers in different states hundreds of miles apart have seen products from their farm—and even their own bodies—test positive for worrying levels of forever chemicals. Biosolids, a growing number of experts say, are likely to blame, endangering these farmers’ livelihoods and health.Regulators in Maine are some of the only ones in the country to take aggressive action, but those closest to the issue say it’s time for the federal government and other states to follow suit. Earlier this year, a group of Johnson County residents, including those who originally called Ames in 2022, filed a lawsuit against Synagro, North America’s largest biosolids producer, alleging that the PFAS seeping into their land may have caused serious medical issues and the deaths of multiple animals. (A company spokesperson said in an email to The New Republic that Synagro denies the “unproven and unprecedented” allegations, that the biosolids applied to the land in Johnson County “met all USEPA and Texas Commission on Environmental Quality (TCEQ) requirements,” and that subsequent test results showing lower PFAS levels on the farm with the biosolids “strongly suggest that the farm where biosolids were used cannot be a source for the PFAS allegedly found on the plaintiffs’ farms.”) Johnson County, meanwhile, has teamed up with a farmers’ advocate group in Maine to sue the EPA for its lack of regulation on PFAS in biosolids. And in Congress, Maine legislators in both houses are trying to pass national legislation to make sure farmers affected by PFAS can access funds for support. The question now is whether anyone will listen.One of the first phone calls that Nancy McBrady got when she joined Maine’s Department of Agriculture in 2019 was from the commissioner of the Department of Environmental Protection. “She said, ‘Do you know about PFAS?’” McBrady recalls. “I really had to jump in and get smart.”McBrady found herself in the middle of a mounting agricultural crisis that had begun just a few years before. In late 2016, Maine regulators had found PFAS contaminating water wells on the property of dairy farmer Fred Stone in Arundel, Maine. Stone voluntarily tested his milk, finding PFAS levels so high that his purchaser, Oakhurst Dairy, stopped buying his product. In early 2019, as Stone was losing hundreds of dollars a day and dumping dozens of gallons of milk in an attempt to fix the problem, Maine’s new governor formed a task force to investigate the larger issue of PFAS pollution in the state—an effort McBrady was pulled into.In order to see if Stone’s farm was an anomaly, regulators designed a sampling scheme for milk available for sale in Maine. The tests traced PFAS pollution back to another farm—this time in Fairfield, about 100 miles north of Stone’s property. This farm, like Stone’s, had a history of using biosolids on its land.“We did the testing with the expectation that we wouldn’t find much,” McBrady says. “In hindsight, that was incorrect thinking.”McBrady and her colleagues were facing a peculiar vacuum of information when it came to PFAS. While the government has been aware of the potential harms of forever chemicals since the 1990s, there are few definitive federal standards in place for safe human consumption. What’s more, PFAS is not just one chemical but rather a class of thousands; many of the lesser-studied PFAS have been almost totally ignored by regulators.In 2016, the same year that Stone’s farm was tested, the federal government had just set a standard for drinking water for the two most studied types of PFAS at 70 parts per trillion. The new four parts per trillion level set in April tightens this dramatically. But to this day, the EPA does not set any official limits for PFAS levels in sewage sludge applied to farms, nor does it regulate the presence of PFAS in sludge in any way.When McBrady started her job, no states required that products from farms that used biosolids be tested for PFAS. On the federal side, the nation’s milk supply is regulated by the Food and Drug Administration, while meat is regulated by the U.S. Department of Agriculture. Both agencies regularly test samples of food products for PFAS and other contaminants, but those tests are designed in such a way that they may miss intense spots of pollution at the local level. (When it comes to the FDA’s food testing of products grown in areas with known PFAS pollution, for instance, the agency says on its website that “technical support generally occurs at the request of states and before the food enters the market”—meaning that states have to raise the alarm first.) Each agency has intervened in instances where high PFAS levels have shown up in food products, but neither the FDA nor the USDA maintains specific standards for how much PFAS in milk, beef, or any kind of food is safe for human consumption. In an email to The New Republic, an FDA spokesperson said that “understanding PFAS exposure from food is an evolving area of science and more data are needed.”McBrady and her colleagues began working with Maine’s Center for Disease Control and Prevention to create action levels for PFAS in beef and milk in the state. “We just had to start building this program on the fly,” McBrady says.Maine’s environmental agencies found allies in the statehouse. In 2021, the legislature created a fund to enable the Department of Environmental Protection to test land and water at farms that had spread sewage sludge before 2019. Thus far, the investigation has found more than 60 farms where PFAS contamination was high enough that action needed to be taken. At one vegetable farm in Unity, Maine, the owners’ blood levels tested with PFAS levels hundreds of times over the safe limit. In 2022, Maine banned biosolids application altogether. That same year, Mills’s administration created a $60 million support fund for farmers whose land was contaminated; the first payouts from that fund were distributed earlier this year. “We cannot be in the position of telling people that something is contaminated and then just not be able to help them,” McBrady says.When Representative Chellie Pingree, who represents the first of Maine’s two congressional districts, talks to other politicians in Washington about PFAS on farms, her warnings often fall on deaf ears. “There’s a sense of, well, that’s too bad, but it’s not my problem,” she tells me. “If you don’t have a constituent in your district who’s got a huge problem on their farm, you may not have heard about it, or you think it’s only happening somewhere else.”In 2023, Maine’s representatives in Washington joined together to introduce dual legislation in the House and Senate to provide the same kind of support Maine offers farmers on a national level. The Relief for Farmers Hit with PFAS Act, which is designed to be included in the Farm Bill, would allow states to allocate money for PFAS testing and supporting farmers whose farms have been contaminated.“We’ve set up this model, and we know it can work—but unfortunately, we’re the only state that has this safety net in place,” Sarah Alexander, the executive director of the Maine Farmers and Gardeners Association, or MOFGA, says. “More farms are going to keep finding contamination. We need a federal safety net.”It’s not just Maine and Texas with a toxic sludge problem. In 2022, Michigan officials shut down a 400-acre cattle farm after biosolids applied on that farm—and, subsequently, the meat, which was sold directly to farmers’ markets and schools—tested with high levels of PFAS. While Michigan routinely tests sludge from its wastewater treatment plants that it sends out for application, it only banned the application of biosolids with high levels of PFAS in 2021. It also does not test farms with a previous history of sludge applications like Maine does; there’s no way of knowing if other farms that spread biosolids in the past also have contamination. Earlier this year, Harvest Public Media surveyed 13 states across the Midwest, finding that only Michigan had any limits on the allowable amount of PFAS in biosolids. “Commissioners of agriculture would rather not have this seen as a big problem, because nobody wants to be the state where people say, ‘Oh, you can’t buy soybeans from Kansas now, they’re all contaminated,’” Pingree says. “Nobody wants to be tagged with the PFAS label.”To its credit, the Biden administration made significant strides on PFAS. In addition to tightening the new drinking water standards, the EPA this spring designated two of the most common PFAS chemicals as hazardous substances under the Superfund program, meaning that companies, not taxpayers, would be on the hook for cleaning up major spills.The new federal movement on PFAS, especially the drinking water standards, may help raise the bar for gauging safe consumption of other substances, like milk. In April, Consumer Reports conducted its own PFAS testing of milk available for sale in five states. While only six of the 50 samples tested positive for PFAS, those samples all tested several times over the new EPA standards for drinking water, and all tested high enough that they would trigger an investigation in the European Union. One of the samples, Kirkland Signature milk from California, tested with 84 parts per trillion of PFOA.Most experts agree that any additional action or information at the federal level on PFAS would help shed some light on just how much of a problem sewage sludge is. Biosolids, after all, aren’t the only potential source of PFAS pollution on farms: In 2018, water well testing of a dairy farm in New Mexico found that firefighting foam from a nearby Air Force base had polluted the water supply. The FDA determined that the milk from the dairy tested with high enough PFAS levels to be a human health concern, and the farm subsequently went out of business.But while the EPA may be making progress on some PFAS research, advocates say it’s lagging when it comes to biosolids, and putting farms at risk in the process. The agency says on its website that it is currently conducting a risk assessment for PFAS in biosolids—due at the end of this year—and suggests that states monitor sludge for contamination. In June, the farmers in Johnson County in Texas, represented by Public Employees for Environmental Responsibility, or PEER, an advocacy group, filed a lawsuit against the EPA, alleging that the agency is neglecting its duty under the Clean Water Act to regulate PFAS in biosolids. (Maine’s MOFGA later joined the suit.) In a response filed in September, the agency pushed to dismiss the lawsuit, arguing that it actually has no current responsibility to regulate biosolids at all. “That’s not our understanding of the Environmental Protection Agency,” Alexander says.There are some good signs. Only five of the more than 60 farms that Maine has found contaminated with PFAS have had to shut down. The rest have, with significant help, been able to find a way to survive: to shift crops, clean up their water and soil, and protect their families and animals from further contamination.Through trial and error, Maine regulators are figuring out how PFAS works. Leafy greens, for instance, tend to be more vulnerable to contamination; McBrady says that fruit plants, by contrast, seem to store PFAS in the plant material, while the fruit remains relatively PFAS-free. One Maine farm with PFAS-contaminated soil successfully switched from growing foraging grasses for cattle to growing grains, whose stalks seem to protect the harvestable material from PFAS contamination. The farm now raises pigs who eat the safe grains.But Maine is still the only state doing regular testing of farms that applied biosolids. Without widespread local testing like the kind Maine is providing, it’s difficult to get a grasp on how pervasive the problem is. “It’s not like it makes your food taste funny,” Pingree says.How the Trump administration will handle PFAS remains an open question. The EPA has told advocates that its risk assessment on PFOA and PFOS in biosolids—the required first step to create more regulations—is due at the end of this year, but any further regulations will be out of Biden bureaucrats’ hands. Lee Zeldin, Trump’s pick to lead the EPA, has a history of voting in favor of PFAS protections. Project 2025, meanwhile, explicitly calls for the EPA to reverse its designation of PFAS as hazardous chemicals under the Superfund law. Environmental advocates worry that the administration could prolong the implementation of the new drinking water standards, even if it ultimately decides not to roll them back. One waste management executive told the trade publication WasteDive that he foresees a “patchwork quilt” of regulations cropping up as states continue to regulate PFAS without federal input.For an agency that seems to just now be finding its stride on regulating PFAS, an industry-friendly administration could spell trouble for the crucial early work.“If I were EPA right now, I would be very worried that [the work on the PFAS risk assessment] would all be scrapped,” says Laura Dumais, an attorney at PEER involved in its lawsuit against the EPA. “I cannot imagine this next administration, based on the positions that it took last time around, would go against industry and for public health.”Even with an agency committed to regulating the chemicals in our environment, the problems posed by PFAS seem to just keep getting bigger. Public awareness of PFAS, until recently, has mostly focused on large-scale pollution from industrial facilities or military bases making it into the water supply. But removing PFAS from biosolids isn’t as simple as removing a single point of industrial pollution. Because biosolids are made from municipal waste—what we flush down the toilet—they serve as a terrifying indicator of just how pervasive forever chemicals really are in our everyday life. We, ourselves, now shed a chemical that doesn’t degrade, that intensifies in our wastewater, and then is spread on our food. Even if all states banned biosolids use tomorrow, it wouldn’t solve the problem of eliminating PFAS within our waste system—or even help us to understand basic facts about how these chemicals contaminate our environment and affect our bodies.“You start legislating one thing, and it’s going to have effects on another thing—that’s the case with biosolids,” McBrady says. “There’s hesitancy on the parts of some states because it’s such an intractable, big problem—where do you begin?”

In late December 2022, a rancher in Johnson County, Texas, called the constable’s office to complain about his neighbor. The neighbor had recently spread a kind of waste-derived fertilizer, known as biosolids, over his land, the caller said, and the piles were smoking. The caller and his wife were struggling to breathe, the fish in his pond had died, and he thought the biosolids were making him, his wife, and their animals sick.

Dana Ames, the county’s environmental crimes investigator, had gotten complaints about biosolids before—the human waste product also known as sewage sludge has a particularly noxious smell—but this felt different. She did some research and found news articles about a dairy farmer in the state of Maine who had used biosolids on his land and whose milk showed sky-high levels of per- and polyfluoroalkyl substances, or PFAS.

Known as “forever chemicals” because of how long they persist in our environment, PFAS have been linked to a wide variety of human health concerns—and are also present in a range of industrial and consumer products, from firefighting foam to nonstick frying pans. While industry has known about the harms of these chemicals for decades, the government is just catching up: In April of this year, the Environmental Protection Agency set a first-ever drinking water standard for some of the most common forever chemicals, setting a maximum enforceable level of just four parts per trillion for PFOA and PFOS, the two most studied compounds. Some states, meanwhile, have taken regulation into their own hands. Because sludge can accumulate high levels of forever chemicals from municipal sewage, Maine banned the use of biosolids on farmlands entirely in 2022.

After the rancher made his complaint, Johnson County tested his property and animals. A drinking water well tested at 268.2 parts per trillion of PFAS, more than 65 times over the new EPA standards. The flesh of a fish taken from the property tested at 74,000 parts per trillion of PFAS. (One 2023 study found that eating just one serving of fish with 11,800 parts per trillion of PFAS would be the equivalent of drinking water contaminated with more than 10 times the new EPA levels of PFAS for a whole month.) The liver of a stillborn calf, meanwhile, tested with more than 610,000 parts per trillion of PFOA, indicating that its mother was routinely exposed to the chemicals in her environment.

The company that produced the biosolids applied to the neighbor’s land, Synagro, had recently distributed samples of sludge at the grand opening of its Fort Worth location. Ames was able to get a jar to test. The biosolids tested at 35,610 parts per trillion of total PFAS. “You can make a scary movie out of this,” Ames says.

For years, farmers around the country have used biosolids on their fields, a practice touted by industry interests and the government as a safe, environmentally friendly use of waste. But recently, a handful of farmers in different states hundreds of miles apart have seen products from their farm—and even their own bodies—test positive for worrying levels of forever chemicals. Biosolids, a growing number of experts say, are likely to blame, endangering these farmers’ livelihoods and health.

Regulators in Maine are some of the only ones in the country to take aggressive action, but those closest to the issue say it’s time for the federal government and other states to follow suit. Earlier this year, a group of Johnson County residents, including those who originally called Ames in 2022, filed a lawsuit against Synagro, North America’s largest biosolids producer, alleging that the PFAS seeping into their land may have caused serious medical issues and the deaths of multiple animals. (A company spokesperson said in an email to The New Republic that Synagro denies the “unproven and unprecedented” allegations, that the biosolids applied to the land in Johnson County “met all USEPA and Texas Commission on Environmental Quality (TCEQ) requirements,” and that subsequent test results showing lower PFAS levels on the farm with the biosolids “strongly suggest that the farm where biosolids were used cannot be a source for the PFAS allegedly found on the plaintiffs’ farms.”) Johnson County, meanwhile, has teamed up with a farmers’ advocate group in Maine to sue the EPA for its lack of regulation on PFAS in biosolids. And in Congress, Maine legislators in both houses are trying to pass national legislation to make sure farmers affected by PFAS can access funds for support. The question now is whether anyone will listen.


One of the first phone calls that Nancy McBrady got when she joined Maine’s Department of Agriculture in 2019 was from the commissioner of the Department of Environmental Protection. “She said, ‘Do you know about PFAS?’” McBrady recalls. “I really had to jump in and get smart.”

McBrady found herself in the middle of a mounting agricultural crisis that had begun just a few years before. In late 2016, Maine regulators had found PFAS contaminating water wells on the property of dairy farmer Fred Stone in Arundel, Maine. Stone voluntarily tested his milk, finding PFAS levels so high that his purchaser, Oakhurst Dairy, stopped buying his product. In early 2019, as Stone was losing hundreds of dollars a day and dumping dozens of gallons of milk in an attempt to fix the problem, Maine’s new governor formed a task force to investigate the larger issue of PFAS pollution in the state—an effort McBrady was pulled into.

In order to see if Stone’s farm was an anomaly, regulators designed a sampling scheme for milk available for sale in Maine. The tests traced PFAS pollution back to another farm—this time in Fairfield, about 100 miles north of Stone’s property. This farm, like Stone’s, had a history of using biosolids on its land.

“We did the testing with the expectation that we wouldn’t find much,” McBrady says. “In hindsight, that was incorrect thinking.”

McBrady and her colleagues were facing a peculiar vacuum of information when it came to PFAS. While the government has been aware of the potential harms of forever chemicals since the 1990s, there are few definitive federal standards in place for safe human consumption. What’s more, PFAS is not just one chemical but rather a class of thousands; many of the lesser-studied PFAS have been almost totally ignored by regulators.

In 2016, the same year that Stone’s farm was tested, the federal government had just set a standard for drinking water for the two most studied types of PFAS at 70 parts per trillion. The new four parts per trillion level set in April tightens this dramatically. But to this day, the EPA does not set any official limits for PFAS levels in sewage sludge applied to farms, nor does it regulate the presence of PFAS in sludge in any way.

When McBrady started her job, no states required that products from farms that used biosolids be tested for PFAS. On the federal side, the nation’s milk supply is regulated by the Food and Drug Administration, while meat is regulated by the U.S. Department of Agriculture. Both agencies regularly test samples of food products for PFAS and other contaminants, but those tests are designed in such a way that they may miss intense spots of pollution at the local level. (When it comes to the FDA’s food testing of products grown in areas with known PFAS pollution, for instance, the agency says on its website that “technical support generally occurs at the request of states and before the food enters the market”—meaning that states have to raise the alarm first.) Each agency has intervened in instances where high PFAS levels have shown up in food products, but neither the FDA nor the USDA maintains specific standards for how much PFAS in milk, beef, or any kind of food is safe for human consumption. In an email to The New Republic, an FDA spokesperson said that “understanding PFAS exposure from food is an evolving area of science and more data are needed.”

McBrady and her colleagues began working with Maine’s Center for Disease Control and Prevention to create action levels for PFAS in beef and milk in the state. “We just had to start building this program on the fly,” McBrady says.

Maine’s environmental agencies found allies in the statehouse. In 2021, the legislature created a fund to enable the Department of Environmental Protection to test land and water at farms that had spread sewage sludge before 2019. Thus far, the investigation has found more than 60 farms where PFAS contamination was high enough that action needed to be taken. At one vegetable farm in Unity, Maine, the owners’ blood levels tested with PFAS levels hundreds of times over the safe limit.

In 2022, Maine banned biosolids application altogether. That same year, Mills’s administration created a $60 million support fund for farmers whose land was contaminated; the first payouts from that fund were distributed earlier this year. “We cannot be in the position of telling people that something is contaminated and then just not be able to help them,” McBrady says.


When Representative Chellie Pingree, who represents the first of Maine’s two congressional districts, talks to other politicians in Washington about PFAS on farms, her warnings often fall on deaf ears. “There’s a sense of, well, that’s too bad, but it’s not my problem,” she tells me. “If you don’t have a constituent in your district who’s got a huge problem on their farm, you may not have heard about it, or you think it’s only happening somewhere else.”

In 2023, Maine’s representatives in Washington joined together to introduce dual legislation in the House and Senate to provide the same kind of support Maine offers farmers on a national level. The Relief for Farmers Hit with PFAS Act, which is designed to be included in the Farm Bill, would allow states to allocate money for PFAS testing and supporting farmers whose farms have been contaminated.

“We’ve set up this model, and we know it can work—but unfortunately, we’re the only state that has this safety net in place,” Sarah Alexander, the executive director of the Maine Farmers and Gardeners Association, or MOFGA, says. “More farms are going to keep finding contamination. We need a federal safety net.”

It’s not just Maine and Texas with a toxic sludge problem. In 2022, Michigan officials shut down a 400-acre cattle farm after biosolids applied on that farm—and, subsequently, the meat, which was sold directly to farmers’ markets and schools—tested with high levels of PFAS. While Michigan routinely tests sludge from its wastewater treatment plants that it sends out for application, it only banned the application of biosolids with high levels of PFAS in 2021. It also does not test farms with a previous history of sludge applications like Maine does; there’s no way of knowing if other farms that spread biosolids in the past also have contamination. Earlier this year, Harvest Public Media surveyed 13 states across the Midwest, finding that only Michigan had any limits on the allowable amount of PFAS in biosolids.

“Commissioners of agriculture would rather not have this seen as a big problem, because nobody wants to be the state where people say, ‘Oh, you can’t buy soybeans from Kansas now, they’re all contaminated,’” Pingree says. “Nobody wants to be tagged with the PFAS label.”

To its credit, the Biden administration made significant strides on PFAS. In addition to tightening the new drinking water standards, the EPA this spring designated two of the most common PFAS chemicals as hazardous substances under the Superfund program, meaning that companies, not taxpayers, would be on the hook for cleaning up major spills.

The new federal movement on PFAS, especially the drinking water standards, may help raise the bar for gauging safe consumption of other substances, like milk. In April, Consumer Reports conducted its own PFAS testing of milk available for sale in five states. While only six of the 50 samples tested positive for PFAS, those samples all tested several times over the new EPA standards for drinking water, and all tested high enough that they would trigger an investigation in the European Union. One of the samples, Kirkland Signature milk from California, tested with 84 parts per trillion of PFOA.

Most experts agree that any additional action or information at the federal level on PFAS would help shed some light on just how much of a problem sewage sludge is. Biosolids, after all, aren’t the only potential source of PFAS pollution on farms: In 2018, water well testing of a dairy farm in New Mexico found that firefighting foam from a nearby Air Force base had polluted the water supply. The FDA determined that the milk from the dairy tested with high enough PFAS levels to be a human health concern, and the farm subsequently went out of business.

But while the EPA may be making progress on some PFAS research, advocates say it’s lagging when it comes to biosolids, and putting farms at risk in the process. The agency says on its website that it is currently conducting a risk assessment for PFAS in biosolids—due at the end of this year—and suggests that states monitor sludge for contamination. In June, the farmers in Johnson County in Texas, represented by Public Employees for Environmental Responsibility, or PEER, an advocacy group, filed a lawsuit against the EPA, alleging that the agency is neglecting its duty under the Clean Water Act to regulate PFAS in biosolids. (Maine’s MOFGA later joined the suit.) In a response filed in September, the agency pushed to dismiss the lawsuit, arguing that it actually has no current responsibility to regulate biosolids at all. “That’s not our understanding of the Environmental Protection Agency,” Alexander says.


There are some good signs. Only five of the more than 60 farms that Maine has found contaminated with PFAS have had to shut down. The rest have, with significant help, been able to find a way to survive: to shift crops, clean up their water and soil, and protect their families and animals from further contamination.

Through trial and error, Maine regulators are figuring out how PFAS works. Leafy greens, for instance, tend to be more vulnerable to contamination; McBrady says that fruit plants, by contrast, seem to store PFAS in the plant material, while the fruit remains relatively PFAS-free. One Maine farm with PFAS-contaminated soil successfully switched from growing foraging grasses for cattle to growing grains, whose stalks seem to protect the harvestable material from PFAS contamination. The farm now raises pigs who eat the safe grains.

But Maine is still the only state doing regular testing of farms that applied biosolids. Without widespread local testing like the kind Maine is providing, it’s difficult to get a grasp on how pervasive the problem is. “It’s not like it makes your food taste funny,” Pingree says.

How the Trump administration will handle PFAS remains an open question. The EPA has told advocates that its risk assessment on PFOA and PFOS in biosolids—the required first step to create more regulations—is due at the end of this year, but any further regulations will be out of Biden bureaucrats’ hands. Lee Zeldin, Trump’s pick to lead the EPA, has a history of voting in favor of PFAS protections. Project 2025, meanwhile, explicitly calls for the EPA to reverse its designation of PFAS as hazardous chemicals under the Superfund law. Environmental advocates worry that the administration could prolong the implementation of the new drinking water standards, even if it ultimately decides not to roll them back. One waste management executive told the trade publication WasteDive that he foresees a “patchwork quilt” of regulations cropping up as states continue to regulate PFAS without federal input.

For an agency that seems to just now be finding its stride on regulating PFAS, an industry-friendly administration could spell trouble for the crucial early work.

“If I were EPA right now, I would be very worried that [the work on the PFAS risk assessment] would all be scrapped,” says Laura Dumais, an attorney at PEER involved in its lawsuit against the EPA. “I cannot imagine this next administration, based on the positions that it took last time around, would go against industry and for public health.”

Even with an agency committed to regulating the chemicals in our environment, the problems posed by PFAS seem to just keep getting bigger. Public awareness of PFAS, until recently, has mostly focused on large-scale pollution from industrial facilities or military bases making it into the water supply. But removing PFAS from biosolids isn’t as simple as removing a single point of industrial pollution. Because biosolids are made from municipal waste—what we flush down the toilet—they serve as a terrifying indicator of just how pervasive forever chemicals really are in our everyday life. We, ourselves, now shed a chemical that doesn’t degrade, that intensifies in our wastewater, and then is spread on our food. Even if all states banned biosolids use tomorrow, it wouldn’t solve the problem of eliminating PFAS within our waste system—or even help us to understand basic facts about how these chemicals contaminate our environment and affect our bodies.

“You start legislating one thing, and it’s going to have effects on another thing—that’s the case with biosolids,” McBrady says. “There’s hesitancy on the parts of some states because it’s such an intractable, big problem—where do you begin?”

Read the full story here.
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Rachel Feltman: For Scientific American’s Science Quickly, I’m Rachel Feltman.Lung cancer is the deadliest cancer among women in the United States, surpassing the mortality numbers of breast and ovarian cancer combined. And surprisingly, younger women who have never smoked are increasingly being diagnosed with the disease.Here to explain what could be driving this trend—and why early screening can make all the difference—is Johnathan Villena, a thoracic surgeon at NewYork-Presbyterian and Weill Cornell.On supporting science journalismIf you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.Thank you so much for joining us.Johnathan Villena: Thank you for having me.Feltman: So our viewers and listeners might be surprised to hear that lung cancer [deaths] in women now tops breast cancer, ovarian cancer combined. Can you tell us more about what’s going on there?Villena: Yeah, definitely. So in general lung cancer is the number-one cancer [killing]people in the U.S., both men and women. If you look at the American Cancer Society, around 226 new—226,000 new cases of lung cancer are projected to be diagnosed in 2025. Of those about 50 percent are cancer-related deaths, meaning [roughly] 120,000 people die every year from lung cancer. Now, what’s—the good news is that the incidence has actually been decreasing in the last few years.Feltman: Mm.Villena: If you look at the American Cancer Society’s statistics, in the last 10 years [ of data, which goes through 2021], the, the incidence of lung cancer has decreased in men around 3 percent per year. And it’s about half of that in women, meaning it’s decreasing [roughly] 1.5 percent per year. So one of the reasons that they think that this might be happening is that there was an uptick in smoking in women around the ’60s and ’70s, and that’s why we’re seeing a slight, you know, decrease in the incidence in men but not so much in the women.What’s more interesting and very surprising is the fact that when you look at younger people, meaning less than 65 years old—especially younger never-smoking people—there’s actually an increase of women in that subgroup. They’re overrepresented, and that’s something very surprising.Feltman: Does the research offer us any clues about what’s going on in this demographic of younger women?Villena: Yeah, so there’s been a lot of research. So, you know, in general—and something that people don’t know is that about 20 percent of lung cancers actually occur in people that have never smoked in their entire lives.Feltman: Mm.Villena: This is something that we don’t really understand why this happens to this one in five people, but there are some risk factors associated with it. Number one is exposure to radon, which is a natural gas that sometimes people are exposed to for a prolonged time. Number two is secondhand smoking ...Feltman: Mm.Villena: So they don’t smoke directly, but they live in a household where they smoke. And number three are kind of other environmental factors, things such as working in a specific, you know, manufacturing plant that deals with specific chemicals. And then lastly, the one that has had, actually, had a lot of research into it are genetic factors. There’s definitely a preponderance of certain mutations in somebody’s genes that can cause lung cancer, and that is overrepresented in women.Feltman: Do women face any unique challenges in getting diagnosed or treated when it comes to lung cancer?Villena: So, yes. First of all, you know, how do we treat or catch lung cancer? So the newest and, and latest way of catching this disease is actually through lung cancer screening.That’s something that’s relatively new; it’s only happened in the last 10 years. And that’s in certain demographics, meaning that if someone is over 50 years old and they have smoked more than one pack per day for 20 years, they meet the criteria for lung cancer screening, which is basically a radiograph or a CAT scan of their lungs. That’s the way that we pick up lung cancer.That’s the—almost the exact same thing that people have for breast cancer, such as mammography, or colonoscopy. So that’s before any symptoms come in. That’s really just to try to capture it when it’s in very nascent stages, right?Feltman: Mm-hmm.Villena: Where it’s very small or not symptomatic. And that’s the way we diagnose a, a lot of lung cancer.Now, that being said, there’s a couple of things. So first of all, [roughly] 60 to 70 percent of people, like, in general get mammographies.Feltman: Mm-hmm.Villena: [About] 60 to 70 percent of people get colonoscopies. Only 6 percent of people actually get lung cancer screening. So it’s dismally low.Feltman: Yeah.Villena: The reason being that sometimes people don’t know about it; it’s relatively new. Sometimes even doctors don’t know about it. There’s also a little bit of guilt involved, where people, you know, they think they did it to themselves by smoking ...Feltman: Hmm.Villena: So they don’t wanna go do it. The second thing is that, as you could imagine, this is only for high-risk individuals or people that have a history of smoking, all right? So it misses these never-smoking one in five patients. So that’s one of the things that we’re actively working on.Feltman: Yeah, how else does the, you know, the stigma associated with lung cancer because of its association with smoking, how does that impact people’s ability to get diagnosed and treated?Villena: I think there’s a lot of hesitancy between patients. There’s, you know, a recent study that showed that people are more—have more tendency to downplay their smoking history, meaning that if they quit, let’s say 10 years ago, you tell your doctor that you never smoked.Feltman: Mm.Villena: And that’s something very common. Or if you smoked, you know, one pack a day, maybe you say you smoked half a pack a day because you feel that guilt. So then you don’t give your doctor or your caretaker the full picture. And sometimes that prevents you from getting these tests, right? So there’s definitely that attitude.There’s also a bit of a fatalistic attitude, sort of like, “I did it to myself. I’d rather not know. You know, this is something that—you know, I made that choice, and if I get cancer, that’s my choice.” Right? So that’s, that’s also another attitude that we’re constantly trying to change in patients. You know, the treatment, once you capture it, is all the same, but really it’s about getting screening and it’s about finding the lung cancer.Feltman: So with smoking no longer necessarily being the driving factor, at least in this younger demographic, what kinds of risk factors should we be talking about more?Villena: So I think, you know—so smoking is always number one.Feltman: Sure.Villena: In the never-smoking people it’s either radon, secondhand smoking or environmental factors, and then a little bit of genetics plays, plays a part.Radon is something that people can test for in their homes. It’s something that people should read up on. So that’s number one: if you have exposure to that, to get rid of that.If you are in, in an environment, let’s say you work with chemicals that you think, you know, are astringent or have caused—causes you to have coughs or, you know, affects you in any sort of way, to kind of try to talk to your employer to work in a more ventilated setting.Really important with genetic factors is understanding your family history.Feltman: Mm.Villena: If you have a mother, a grandmother, a grandfather who died of cancer or you have a lot of cancer in your family, sometimes understanding that and knowing that from your, you know, from your family perspective will actually clue a doctor in to doing further tests, to looking into that further, ’cause that sometimes is passed down and you can have the same genes.Feltman: Are there any big research questions that scientists need to answer about lung cancer, specifically in young women?Villena: So, you know, there’s so much to look at, all right? So if we think about just the genetic aspect of it, there’s one specific gene called the EGFR gene—or it’s a mutation that’s found in lung cancer that in, if you look at all people with lung cancer, it’s found in about 15 percent ...Feltman: Mm-hmm.Villena: Of the population with lung cancer. Now, if you look at never-smoking Asian women that get lung cancer, it’s about 60 percent of them ...Feltman: Mm.Villena: Have that mutation. So the important thing about that EGFR mutation is there’s a specific drug for that mutation, all right?So there’s definitely a lot of genetic kind of information that we’re still actively researching. But the important thing about this genetic information is that there’s drugs targeted specifically for those mutations. So the more we know, the more we understand, the better.Feltman: So for folks who are hearing this and are surprised and, and maybe concerned what is your advice for how they should proceed, how they should look into their risk factors?Villena: You know, I think one of the, the, the major aspects of health in general is understanding your own health.Feltman: Mm.Villena: I think that younger people tend to delay care, tend to not see their doctors, and because, one, they’re busy, right, at their very busy moment in their lives. But second is that, you know, you don’t wanna deal with it, and you think that you will not get cancer, that you will not get this disease because you’re young and you’ve never smoked and you’ve never done anything bad.Feltman: Mm.Villena: But, you know, you have to be very aware of your body, so what are the kind of top four symptoms? So number one, let’s say you have a cough, and that cough lasts for longer than two weeks, right?Feltman: Mm-hmm.Villena: A normal cold, things like that will go away after a couple of weeks. But if it’s there for a couple of months, and I’ve definitely seen patients that tell me in retrospect, you know, “I’ve had this cough for three months,” right, and it should have been checked up sooner. So understanding yourself, understanding your body, not, you know, waiting for things, not procrastinating, which is very hard to do, but you should definitely see your doctor ...Feltman: Yeah.Villena: Regularly.Second is, like I said before, understanding your family, right, and what your genetic makeup is, right? Knowing your family history, understanding if your parents, grandparents had cancer, etcetera, or other chronic diseases.Feltman: Mm-hmm.Villena: And that’s, that’s basically the, the major aspects of it. It’s really being in tune with yourself.Feltman: So once a patient is actually diagnosed, what does treatment look like?Villena: So treatment for lung cancer, actually, is heavily dependent on the stage. There’s everything from stage 1, in which it’s localized to one portion of a lung, to stage 4, where it actually has gone to other parts of the body.Now, stage 1 disease, you basically need a simple surgery, where that lung nodule, or that lung cancer, is surgically removed, and typically you don’t need any other treatments. So stage 1 is what we look for. Stage 1 is the reason that lung cancer screening works because stage 1 doesn’t really have any symptoms ...Feltman: Mm.Villena: So when you find it that early patients do very well.Stage 4, once it’s left the lung, you are no longer a surgical candidate, unless in, you know, sometimes very specific cases, but for the most part you’re no longer a surgical candidate. And there you need systemic treatments.Feltman: And how long does the treatment tend to take for a stage 1 patient, if it’s just a surgical procedure?Villena: So if it’s just a surgical procedure, look, I do these surgeries all the time: the patient comes in; we do the surgery; the patients usually go home the next day.Feltman: Wow.Villena: And then we follow the patient and get CAT scans every six months for a long time to make sure nothing comes back or nothing new comes. So it’s pretty straightforward, and we do this all the time. We do these surgeries robotically now. Patients recover incredibly well, and they’re out, you know, doing—living their lives in a couple of weeks. So it’s really something very, very, very efficient.Feltman: Yeah, so huge incentive to get checked early.Villena: Mm-hmm.Feltman: Are there any advances in treatment, you know, any new treatments that doctors are excited about?Villena: Yeah, so there’s two major steps forward that have changed lung cancer treatment. Number one is something called targeted therapy.Feltman: Mm-hmm.Villena: So that means that there’s a drug that targets a specific mutation. So just how I was speaking about earlier about the EGFR mutation in young, never-smoking Asian women, there is a drug that targets that mutation that has really shown amazing results at all stages now.And the second one is actually immunotherapy, which won the Nobel Prize, which is this idea that you can use your own body’s immune system to kill the cancer cell. So cancer is very smart—what it does is it evades your immune system; it pretends that it’s part of your own body. And what this drug does is that it basically reawakens your immune system to recognize that cancer again and kill it. And we’ve seen amazing results, even in the stage 4 patients, where they are potentially cured of cancer, which, which we’ve never seen before.Feltman: What motivated you to get into this specialty?Villena: You know, I do have a family history of this in an uncle that passed away from lung cancer ...Feltman: Mm.Villena: And he was a heavy smoker. And, you know, I saw how, basically, decimated his, he was—[his] life [was], basically. He was a very vibrant guy, he was very active, and in six months he was gone, right?And I think, you know, once I started getting into, you know, medical school and understanding things, one of the major things that I really got into was research. And I see that if my uncle had been treated 20 years ago, he potentially could have been saved ...Feltman: Mm.Villena: Because of these advances in research. And right now we are right at the cusp where we are learning all these new things, and we actually have the tools to change how patients are treated, you know? And this—every year there’s a new treatment, which prior to that, there was no new treatment; i t was basically just chemo, and that’s it, all right? So I think that that really motivated me—something that I can actually take part in and actually change the course for a lot of people.Feltman: Well, thank you so much for coming on to chat with us today. This has been great.Villena: Thank you.Feltman: That’s all for today’s episode. We’ll be back on Friday to unpack the shocking story of a missing meteorite.Science Quickly is produced by me, Rachel Feltman, along with Fonda Mwangi and Jeff DelViscio. This episode was edited by Alex Sugiura and Kylie Murphy. Shayna Posses and Aaron Shattuck fact-check our show. Our theme music was composed by Dominic Smith. Subscribe to Scientific American for more up-to-date and in-depth science news.For Scientific American, this is Rachel Feltman. See you next time.

Chemicals
Health
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