Brewster Health Dept., APCC Clash Over Testing; Town Dropped From Cyanobacteria Map

BREWSTER – A battle over who is responsible for issuing health advisories about possible cyanobacteria contamination in ponds has resulted in the town being dropped from a regional map depicting pond health.

The Association to Preserve Cape Cod contracted with multiple groups across Cape Cod, municipalities and Barnstable County to create a cyanobacteria monitoring program. Volunteers or staff collect water samples from 134 or so ponds around the Cape, including 20 in Brewster. Some samples are sent to the Barnstable County Lab for further testing and a report is also sent to the Massachusetts Department of Public Health. 

Using APCC and Barnstable County Lab data combined with guidance from the Department of Public Health, the APCC classifies the ponds risk levels as acceptable (blue), potential for concern (yellow) and restriction warranted (red). This summer all of Brewster’s 20 ponds were consistently blue except for Upper and Lower Mill Ponds. Now they are all gray.

“A couple of weeks ago the town of Brewster requested the state Department of Public Health not reply to inquiries the APCC was making about that scum and the DPH is no longer making recommendations and deferring to local health departments,” APCC Executive Director Andrew Gottlieb said. “Because our map reflected Mass DPH recommendations we are no longer able to make a determination on the condition of Brewster ponds on the map except if the concentration (of microcystin) is determined to be over eight micrograms per liter from a reliable source (such as the Barnstable County Lab).”

As a result, Brewster’s Ponds are all slated gray despite the sampling work of volunteers from the Brewster Ponds Coalition. The origins of this issue date back to the days in the heart of the COVID-19 pandemic when the APCC began its cyanobacteria program.

“This started during COVID where APCC developed this program here on the Cape utilizing an established program through the University of New Hampshire back in 2018,” recalled Brewster Health Director Amy Van Hone as she spoke to the board of health Aug. 7. “They were collaborating with the Barnstable County Health Department as far as potential laboratory capacity to do some testing. APCC was building up their clientele as far as what ponds in what towns are going to be tested. This program that was established by UNH was created to help indicate the trends of cyanobacteria and its growth in water bodies.”

As the town’s health director, Van Hone is in charge of monitoring cyanobacteria blooms if they occur in local ponds and has the sole responsibility to post advisories or warnings on site and communicate with the public about any health concerns. 

The Brewster Ponds Coalition became a participant in collecting water samples, eventually monitoring 20 ponds in Brewster.

“There started to be some conflicts of the testing and the reporting that was being done by the APCC that was blindsiding us because we weren’t closely involved in that process,” Van Hone said. “Now all of a sudden we were dealing with information coming out of this private organization saying we had major issues in some of our water bodies. That’s our purview as the public health department to determine what the messaging needs to be and what kind of advisories or closures we should be posting.”

She met with the APCC, which reaffirmed that restrictions and advisories are solely the province of the local health departments. While municipalities may have different criteria, the APCC uses World Health Organization, Environmental Protection Agency, Mass. Department of Public Health guidance, local health agencies and APCC and Barnstable County Lab data to create the risk levels. 

“They’ve created their own program and created these risk categories,” Van Hone said. 

The state has no regulations on cyanobacteria, as it does with E. coli, just guidance from the DPH.

“APCC was going to consult with the health directors before they made their postings,” she said of the results from the meeting. “Last year was a quiet year. We didn’t have any hits at all that were an issue. This year with the heat we have had a couple of ponds that have shown sporadic cyanobacteria blooms. They haven’t been consistent.”

She made the decision to post an advisory at the two locations they were seeing the blooms, not the entire pond. 

“A couple weeks ago conditions hadn’t changed and APCC decided to go against my advisory that was still in place and I wanted to keep in place because it didn’t fit into their categories that they had created,” Van Hone said.

The APCC wanted a “red alert” and posted the ponds as red.

Van Hone said the health department is responsible for advisories and the public health messaging, and the differing evaluations was creating confusion.

“Knowing the Department of Public Health was being used as part of the reasoning” Van Hone met with representatives from Brewster staff, APCC, Brewster Ponds Coalition and DPH on Aug. 7.

“The Department of Public Health reconfirmed it is not anybody’s responsibility but the health department’s to be making the final determination on advisories,” Van Hone said.

“The criteria that have been established [by APCC] are much more restrictive and inflammatory compared to what the reality is that we’re physically seeing when we do these investigations.”

Gottlieb disagreed.

“Our map reflected guidance from the state Department of Public Health for evaluating the significance of cyanobacteria scums,” he explained. “The map reflected DPH guidance and or restrictions by town authorities and or exceeding eight micrograms per liter of microcystin (the toxin produced by some cyanobacteria species) in a lab-confirmed sample by the Barnstable County Health Department.” Gottlieb said. “We have not made an independent determination whether a pond is restricted or not.”

The eight microgram per liter level is the number in the guidance put out by the DPH for advisories, along with a cell count of 70,000 per milliliter, and/or persistent pond scum made up of cyanobacteria colonies. 

Kim Pearson of the Brewster Board of Health told her fellow board members last week that the goals of the monitoring program were to identify the problem as soon as possible so it is early in the bacteria’s growth cycle and then to determine the appropriate health communication to the public.

“Not to underestimate but not to overestimate it,” she said, “and to then find a way to monitor the bloom until resolution.”

She said cyanobacteria blooms are becoming more prevalent across the world.

“Factors increasing their presence include temperature, nutrients to some degree, rainfall patterns,” Pearson said. “But what has changed most over the past 20 years is how much human activity has occurred. Some cyanobacteria produce chemicals that are toxic to humans and animals. These are metabolic byproducts of processes within the cyanobacteria.”

Microcystin is the toxin that is the focus of much of the monitoring on Cape Cod. Cyanobacteria take different forms, but some live in colonies that can be seen by the eye as scum on the surface of ponds. The number of individuals in these colonies can be difficult to count, noted Pearson. 

But they have a specific pigment, phycocyanin, that can be tested for the presence of phycocyanin, which indicates cyanobacteria are present in the environment. When conditions are proper, the bacteria, which reproduce by cloning, can reproduce exponentially, creating a bloom.

“The concern for public health is what are the outcomes of recreational exposure to cyanobacteria?” Pearson said. “There are not a lot of case reports in the medical literature of illnesses associated with cyanobacteria.”

While 76 people did die in Brazil when water contaminated with cyanobacteria was used in dialysis treatments, evidence of illness from ingestion of toxins or exposure while swimming, boating, etc. is nonexistent or scanty.

Pearson noted that a number of studies have been done in places using questionnaires asking people about symptoms associated with waters contaminated by cyanobacteria. The University of Toledo launched a new study on the effects of airborne microcystin from Lake Erie this year.

“The case reports are not out there,” Pearson said. “But it is a risk because they are toxins.”

There are no reports of human illness on Cape Cod, but there are anecdotal reports of dogs lapping at the water or their fur and becoming ill or dying, including at a pond in Brewster’s Nickerson State Park. 

“The Barnstable county lab doesn’t do cell counts; they do microcystin testing,” Pearson said. “In Brewster [we have] Dolichospermum (a genus of cyanobacteria) that produces other toxins but there are no standards and it is not tested for in the Barnstable county lab. Those chemicals (from Dolichospermum) are less stable and break down in sunlight. So the quandary is how to issue a public health advisory?”

The county lab is beginning a pilot program to test for toxins from Dolichospermum (anatoxin).

Without hard numbers to match with the DPH criteria, a judgment call has to be made based on experience and local history. The APCC was requesting guidance from the DPH after providing photos and what testing data they had. Now they won’t get a reply.

“Not having the basis for how the town was making a determination, we had no way to characterize what the ponds look like,” Gottlieb said. “We made the decision to provide no information.”

People with inquiries about a particular pond can now call the BPC for more information on what was reported to the BPC, Gottlieb said. The organization is the client and get the testing and monitoring results from APCC.