US EPA Drinking Water Health Advisories for Cyanotoxins

1. US EPA Drinking WaterHealth Advisories for Cyanotoxins Lesley V. D’Anglada, Dr.P.H. US Environmental Protection Agency Office of Water/Office of Science and Technology IAFP 2016 August 1st, 2016 St. Louis, Missouri

2. What are cyanobacterial harmful algal blooms • Routes of exposure and adverse health effects • Discuss the adverse effects in animals and plants • Overview of the current public health Federal and US States Regulations and Guidelines for cyanotoxins in drinking and recreational waters • Describe the EPA drinking water health advisories • Opportunity for Questions Presentation Overview

3. The prevalence of HABs in freshwater is increasingly reported in the U.S. and worldwide • Algal blooms can cause: • Hypoxia, leading to fish kills • Taste and odor problems in treated drinking water • Toxins at levels that may be of concern for human health • Loss of drinking water, recreational/fishing uses, contributing to economic losses • Presence in source water and finished drinking water • 2014: City of Toledo, OH (population ~500,000) issued a “do not drink” advisory, > 1 µg/L total microcystins detected in finished water in a drinking water system on western Lake Erie • 2015: Ohio River HAB affected 3 States • 2016: Florida issued a State of Emergency for four counties due to HABs in surface water Why are we talking about HABs?

4. What are HABs and cyanoHABs?

5. Algal blooms are natural components of marine and freshwater flora. • When an algae specie multiply and forms a bloom, they can affect aquatic life and water quality leading to scum formation, fish kills, and/or unpleasant odors. These are known as Harmful Algal Blooms (HABs). • HABs tend to occur in late summer and fall in temperate zones and potentially year-round in tropical and subtropical zones • Under the right conditions, all type of algae can cause harmful algal blooms. Overview of Harmful Algal Blooms (HABs)

6. In freshwater, cyanobacteria or blue-green algae, are the most common “algae”, some of which produce highly potent cyanotoxins. • One species can make multiple toxins and different toxins can be produced by a number of different species making visual monitoring difficult. • Toxins can either reside inside the cell (intracellular) or be released into the water (extracellular). • Microcystins • Group of at least 100 variants • Primarily affect the liver (hepatotoxin) • Most studied and widespread cyanobacterial toxin (Microcystin-LR) Cyanobacterial Blooms

7. Microcystins were found throughout the United States especially in the upper Midwest. • 32% overall detections (401/1238) • (Reference Lakes/Resampled lakes) 2007 EPA National Lakes Assessment Microcystin Sampling Source: http://ks.water.usgs.gov/cyanobacteria NLA link: http://water.epa.gov/type/lakes/upload/nla_newlowres_fullrpt.pdf

8. Adverse Effects to Humans and Animals

9. Potential routes of exposure: • Consumption in drinking water and food • Ingestion during recreational activities • Dermal contact • Inhalation of aerosolized toxins • Health effects related to exposure to cyanotoxins: • Hepatotoxic (affects the liver) • Microcystins and Cylindrospermopsin • Neurotoxic (affects the nervous system) • Anatoxin-a and Saxitoxin • Dermatoxic (affects the skin) • Lipopolysaccharides and Lyngbyatoxin • Symptoms of acute exposure are irritation to eyes, ears, throat, rashes, and skin lesions. • Toxicity data (needed to determine thresholds) are not available for many cyanotoxins. Exposure and Health Effects

10. Pets and livestock can be impacted by cyanotoxins • Animals are exposed by drinking water and/or eating algal biomass (surface mats or fur grooming) • Can have rapid onset of symptoms and mortality • Cyanobacterial cells and toxins can contaminate spray irrigation water and subsequently be associated with crop plants. • Low levels of cyanotoxins could be absorbed by roots, migrate to shoots, and then be translocated to grains and or fruits. • Cyanotoxins concentration in grains and fruits are very low. • Generally, roots accumulated more than the leaves. • Cyanotoxins inhibit plant growth causing visible toxic effects on the plant such as leaf discoloration. • Further investigation is needed to understand the uptake and fate of microcystins and other cyanobacterial toxins by food plants. Effects of Cyanotoxins in Animals and Plants

11. Cyanotoxins levels in edible fish and shellfish are highly variable depending on trophic level and fish organ or tissues. • Concentrations are higher in liver > gut > kidneys and gonads > muscle tissue • Concentrations are higher >phytoplanktivorous > omnivorous > carnivorous fish • More research is needed to quantify the toxicity in fish caused by cyanotoxins and the bioaccumulation in aquatic food webs. • Rather than biomagnification, biodilution seems to occur in the foodweb with toxins being subject to degradation and excretion at every level. • One of research needs identified is the need to quantify the total toxicity in fish caused by MCs variants and other secondary metabolites. Cyanotoxins and Fish

12. Current Public Health Guidelines for Cyanotoxins in Drinking and Recreational Waters

13. Guidelines and Regulations in Drinking Water • No US Federal regulations for cyanobacteria or cyanotoxins in drinking water in the U.S. • Safe Drinking Water Act Requirements (SDWA Section 1412(b)(1)) • Contaminant Candidate List • List of unregulated contaminants that are known or anticipated to occur in public water systems and may require a drinking water regulation. • EPA publishes the list every five years. • Cyanobacteria and their toxins included in CCL (1 , 2, 3 and draft 4) • Unregulated Contaminant Monitoring Rule (UCMR) • Collect data from selected public water systems. • EPA included 10 cyanotoxins in UCMR 4 for monitoring (2018-2021). • Regulatory Determination (RD) • Determine whether or not to regulate; EPA publishes determinations every on a five year cycle. • RD 1, 2 and 3 – No Regulatory Decision - not sufficient information

15. No federal regulations for cyanobacteria or cyanotoxins in recreational water in the U.S. • World Health Organization (WHO) Guidelines: Guidelines and Regulations in Recreational Water • Guidance values for recreational water have been adopted by many countries and some states based on WHO guidelines.

17. Overview of USEPA’s Drinking Water Health Advisories for Cyanotoxins

18. Informal technical guidance for unregulated drinking water contaminants to assist federal, state and local officials, and managers of public or community water systems in protecting public health during emergency situations. • HAs are non-regulatory concentrations in drinking water that is not expected to cause adverse non carcinogenic effects for a specific exposure period. • Short term exposures: one-day and ten-day (children) • Chronic Exposures: lifetime (for adults) • Carcinogenic Reference: Calabrase, E. (1989). Safe Drinking Water Act. CRC Press, ISBN 0873711386. 240 pages. EPA Drinking Water Health Advisories (HA)

19. As of 2016, Drinking Water Health Advisories for 200 chemicals (and toxins). • 162 One-day HA • 162 Ten-day HA • 119 lifetime advisories for adults. • Only one HA (Nitrate and Nitrite) targeted a different age subgroup (4 months old). Infants less than 4 months old are most sensitives for methemoglobinemia following exposure to nitrates and nitrites. • They are subject to change as new information becomes available. US EPA Health Advisories http://water.epa.gov/action/advisories/drinking/upload/dwstandards2012.pdf

20. 2012 - Joint effort with Health Canada • HC: Update the 2002 DW Guideline for microcystins • USEPA: Develop Health Advisories (HAs) for Cyanotoxins • 2013 - Literature Review • 2013 - Development of Health Effects Support Documents (HESD) for microcystins, cylindrospermopsin and anatoxin-a • Comprehensive review of the health effects information • Provides the health effects basis for the development of HAs • 2014/15 - External Peer Reviews HESDs for microcystins, cylindrospermopsin and anatoxin-a • Peer reviewers affirmed data are inadequate to develop an HA for anatoxin-a • EPA will continue evaluating health effects data on anatoxin-a as new information becomes available. • Peer reviewers confirmed data are adequate to develop HAs for microcystins and cylindrospermopsin HESD Development https://www.epa.gov/nutrient-policy-data/health-effects-support-documents

21. 2015 – Development of Health Advisories for microcystins and cylindrospermopsin • June 17th, 2015 – HAs Published • EPA’s Office of Ground Water and Drinking Water (OGWDW) published the Recommendations for Public Water Systems to Manage Cyanotoxins in Drinking Water https://www.epa.gov/nutrient-policy-data/drinking-water-health-advisory-documents HAs Development • Companion to the HAs to assist public drinking water systems (PWSs) that choose to develop system-specific plans for evaluating their source waters for vulnerability to contamination by microcystins and cylindrospermopsin.) https://www.epa.gov/nutrient-policy-data/recommendations-public-water-systems-manage-cyanotoxins-drinking-water

22. EPA published Drinking Water Health Advisories (HA) for microcystins and cylindrospermopsin in 2015 • MC-LR is considered a surrogate for all microcystins. • Exposure duration: 10-day value • Short term exposure is more consistent with expected exposure pattern. • No lifetime or carcinogenic value derived. • http://water.epa.gov/drink/standards/hascience.cfm#micro HAs for Microcystins and Cylindrospermopsin

23. Bottle-fed infants consume large amounts of water compared to their body weight. • At 6 years and older, exposure on a body-weight basis is similar to that of an adult. • HAs for Microcystins HAs for Cylindrospermopsin Mean Drinking Water Ingestion Rates by Age Groups

24. Male reproductive system toxicity following sub-acute to chronic oral exposure. • Toxicity of microcystin during pregnancy and effects on offspring following oral exposure. • The potencies of other microcystin congeners relative to microcystin-LR. • Effects of inhalation and/or dermal exposures to microcystins, cylindrospermopsin, and anatoxin-a. • Acute and chronic toxicity of anatoxin-a. • Chronic toxicity of cylindrospermopsin. • Carcinogenic potential of cyanotoxins. • Health risks from exposure to mixtures of cyanotoxins. • Bioaccumulation of cyanotoxins in aquatic food webs. Toxicity Research Needs Identified

25. Clean Water Act  §304(a) recommends recreational Ambient Water Quality Criteria (AWQC) values protective of human health given a primary contact recreational exposure scenario. • EPA is developing recreational AWQC recommendations for the cyanotoxins microcystin toxins and cylindrospermopsin. • The AWQC will focus on exposure as a result of primary contact recreation activities such as swimming where immersion and incidental ingestion of ambient water are likely. • Dermal and inhalation exposures associated with primary contact recreation will be considered if data are sufficient. • Consumption of fish and shellfish will not be considered in the assessments. • Expected Draft: 2016 Next: Recreational AWQC for cyanotoxins

26. The views expressed in this presentation are those of the author and do not necessarily represent the views or policies of the U.S. Environmental Protection Agency. Disclaimer

27. Lesley V. D’Anglada, Dr.PH U.S. Environmental Protection Agency Office of Water / Office of Science and Technology 202-566-1125 Danglada.lesley@epa.gov EPA’s CyanoHABs Website www.epa.gov/cyanohabs Contact Information