Poisoning the Well: How Forever Chemicals Contaminated America 

By Sharon Udasin and Rachel Frazin 

Island Press, 2025 

Hardcover: $32.00 

Genre: Nonfiction, Environmental Policy, Nature Conservation  

Reviewed by Stephen W. Russell  

Cover of POISONING THE WELL by Sharon Udasin and Rachel Frazen. Title is shown in red ink on a background image of a metal can styled to look like the American flag with a tree growing out of it on a yellow background.

For those who call Alabama home, state pride runs deep. Even when Alabama folk cannot agree on their football affiliations or their favorite barbecue, the Southern sense of home binds those born here. But in the new book, Poisoning the Well: How Forever Chemicals Contaminated America, investigative reporters Sharon Udasin and Rachel Frazin uncover a more sinister connection among Alabama natives: disease-causing toxic chemicals. Using rural Alabama towns along the Tennessee River as a backdrop, Udasin and Frazin expose a link between corporate river pollution and the downstream medical effects. The result is a tragedy of epic proportions.  

Like most tragedies, the response to these events, more than the initial events themselves, caused the present problems. The cover-up, it seems, was worse than the crime. The story begins in the 1930s as scientists sought solutions to the practical problem of creating a more effective refrigerator coolant. One chemical discovered was a polymer with a nine-syllable name, now more commonly known as Teflon. Other polymers soon followed. This class of compounds became known collectively as PFAS—an abbreviation for an even longer class of chemicals. While these compounds offered chemical solutions to common problems (such as how to create non-stick cooking surfaces and water-resistant clothing), Udasin and Frazin demonstrate their toxic health effects.     

Within two decades of the discovery of PFAS chemicals, reports surfaced of exposed factory workers having “polymer fume fever.”  A decade later, evidence of PFAS toxicity was more widespread. “The companies knew since the 1970s the chemicals were in the blood of the entire U.S. population,” Udasin and Frazin write, “and they didn’t tell anyone.” So the toxic runoff continued.  

Alabama silently suffered the side effects of these compounds. Companies that relied on PFAS products in manufacturing dumped toxic waste into the Tennessee River, the critical water supply that flows through northern Alabama. Downstream from the factories, “tests from the early 2000s detected PFAS” and “the water and fish collected there had higher concentrations than those upstream.” By 2009, “very high levels of PFAS” were detected in the agricultural soil near Alabama cities such as Courtland, where this story starts, and larger cities such as Decatur. The medical consequences soon followed.  

To date, PFAS chemicals have been implicated in causing liver and immune issues. PFAS have been associated with causing several different types of cancers. And for expectant mothers exposed to high levels of PFAS runoff, babies can be born with birth defects.   

The scope of Poisoning the Well also demonstrates the health effects of PFAS chemicals on communities in Colorado and along the East Coast. Similar PFAS exposures have resulted in similar medial stories across the country. But this story is more than a tragedy. Udasin and Frazin also illuminate a path forward, starting with environmental clean up. Recent billion-dollar settlements with the responsible companies have helped fund water treatment plants. Toxic waste can be removed using modern methods of reverse osmosis, ion exchange, or granular charcoal filtration. These hopeful steps should offer cleaner water to twenty-first-century children—but they do little to help those already affected.  

For justice to come to the Alabama patients already affected by PFAS, laws will have to change, too. “Alabama plaintiffs can sue [the responsible companies] within two years of becoming ill,” they write, “rather than two years of becoming aware of the illness cause.” The story told in Poisoning the Well may just be the answer to bringing awareness while linking the cause-and-effect of PFAS chemicals to chronic illness. And for those who call Alabama home, that is one more thing we can all agree on.    

Stephen W. Russell, MD, a native of Alabama, is a Professor of Medicine and a Primary Care Physician at the University of Alabama at Birmingham (UAB). He is the author of medical thrillers, including Blood Money and Command and Control, both of which were previous Amazon bestsellers.