On July 2, Massachusetts’ Department of Public Health issued an advisory warning that “pregnant women, nursing mothers, and infants should not drink certain brands of spring water bottled by Spring Hill Farm Dairy,” a Haverhill company.

But while the state’s Bottled Water Consumption Advisorywas made public on the agency's website, it was not broadly publicized.

Spring Hill Farm Dairy, which has since shut down, estimated six to seven percent of the state's population was impacted by the advisory.

Prompted by listener questions, WGBH News asked the state, the bottled water company and retailers what efforts they made to inform the relevant population.

Getting the Word Out

The advisory was initially issued because testing done by the state of New Hampshire showed elevated levels of toxic chemicals known as per- and polyfluoroalkyl substances, or PFAS, in Spring Hill Farm Dairy’s spring water. PFAS have been linked to a variety of health concerns, including immune system function and metabolic disorders.

While the advisory was posted on the Massachusetts Department of Public Health (DPH) website, WGBH News found no evidence of an effort by the state to contact pediatricians, obstetricians or the media to help inform the affected population. WGBH News did not receive a press release from DPH, and the agency would not confirm whether a release was sent to any news organization.

Read more: State Officials Warn Infants, Pregnant And Breastfeeding Women To Avoid Some Bottled Water Brands

Ann Scales, a DPH spokesperson, wrote in an email that "when DPH sent out the water advisory we requested that Spring Hill send the advisory to all of its customers and we confirmed with the company that this had been done."

Scales also emphasized that "although test results from Spring Hill did not indicate an acute threat to the public health, DPH issued the advisory out of an abundance of caution."

But Is It Safe?

The federal government does not set an enforceable limit for PFAS in drinking water — only a health advisory level that is not legally binding. It is up to each state to determine their own limits.

Scales said, "drinking water containing PFAS at these levels [found in Spring Hill spring water] does not necessarily lead to adverse health effects. Health advisories are developed to be protective and to offer a margin of safety to the public, including sensitive populations such as children and the elderly."

New Hampshire health officials clearly disagree. Last month, the state passed some of the strictest limits for PFAS chemical contamination in drinking water in the country, which require lower levels of PFAS in tap water for it to be considered safe.

“Given our new health-based standards for drinking water, we wouldn’t recommend that anyone in the public drink this water,” a spokesman for the New Hampshire Department of Environmental Services told The Boston Globe.

On Or Off the Shelves

Scales confirmed that the state asked Spring Hill Farm Dairy to send the advisory to all of its retailers, who sold the water under various brand names. A company spokeswoman, Nancy Sterling, said in a statement that they “notified their customers immediately.”

Andy Tan, a professor of social sciences at the Harvard T.H. Chan School of Public Health, said states' communication strategy is often calibrated by the severity of the threat to the population. However, he recommended a multi-pronged effort to get information out, including contacting media outlets.

“What’s the point of an advisory if it’s kept under wraps and nobody knows about it?” Tan said.

Weeks after the advisory was issued, the bottled spring water was still on grocery store shelves across New England, without any indication of an advisory. Just one retailer, CVS, told WGBH News in an email that they halted shipments and “suspended further distribution to our stores after July 2.”

The Roche Bros. supermarket chain says it was not notified by Spring Hill or the state. Roche Bros. spokeswoman Dena Kowaloff said they learned about the advisory through media reports on July 30, weeks after the advisory was posted.

“As soon as we learned of the advisory, Roche Bros. removed all of the product subject to DPH advisory from our shelves,” wrote Kowaloff in an email. At Roche Bros., the water from Spring Hill Farm Dairy was sold under the brand Roche Brothers Spring Water.

Sterling said Spring Hill notified Dean Foods, which distributes the water to Roche Bros. Sterling emphasized in an email that, "since this was merely an advisory, Spring Hill was under no obligation to notify anyone, but of course, let their direct customers know right away."

Other customers, including Cumberland Farms and Stop & Shop, declined to comment on whether they were informed by the company. Whole Foods, Market Basket and Garelick Farms did not respond to requests for comment.

“There could have been more proactive efforts from the retailers to either provide an advisory on the shelves or even to potentially pull these products from the shelves,” said Tan, who also expressed surprise that the state asked Spring Hill Farm Dairy to contact their customers instead of directly reaching out to the retailers. “That strikes me as not typical of what I would expect.”