States are continuing to allow sewage sludge to be spread on cropland as fertilizer and in some cases increasing the amount spread, even as the PFAS-tainted substance has ruined farmers’ livelihoods, poisoned water supplies, contaminated food and put the public’s health at risk.

Michigan and Maine are the only two states in the US to widely test sludge, and regulators in each say contamination was found in all tested samples. Still, in recent months, officials in Virginia increased the amount of sludge permitted to be spread on farmland without testing for PFAS, while Alabama regulators have rejected residents’ and environmental groups’ pleas to test sludge for the chemicals.

Similar fights are playing out in other states, including Georgia and Oklahoma, and public health advocates fear regulators are ignoring the dangers to appease the waste management industry.

“We’re in an absolute mess, and the government knows we’re in a mess, but it seems like they don’t know what to do,” said Julie Lay, an Alabama agricultural worker who has organized residents to try to stop sludge from being spread in the state. “It’s terrible.”

Sewage sludge is a byproduct of the water treatment process that’s left over when water is separated from human and industrial waste discharged into the nation’s sewer systems. The Sierra Club has characterized sludge as “the most pollutant-rich manmade substance on Earth”.

The biosolid treatment process doesn’t remove PFAS, or “forever chemicals”, a widely used toxic compound – typically used to make thousands of products resist water, stain and heat – that experts say contaminates all sludge. The chemicals can easily move from sludge into soil, crops, cattle, and nearby drinking water sources. Regulators in Michigan and Maine’s testing programs have identified widespread contamination in fields where the substance was spread, as well as in crops, beef, groundwater and even farmers’ blood.

Maine last year became the first state to ban the practice after contamination harmed its agricultural industry. Similarly, Michigan officials and environmental groups have uncovered PFAS contamination on dozens of farms, forcing one to shut down and raising questions about safety of the state’s farmland. The state enacted a plan to identify farms at risk for the highest levels of contamination, prohibited some wastewater treatment plants from selling sludge, and forced polluters to stop discharging PFAS into sewers.

But other states are taking a different approach. In July, the Virginia Department of Environmental Quality (DEQ) gave the green light to a permit request by waste management giant Synagro to spread sludge across nearly 5,400 acres of farmland in King William county, just north of Richmond. The request followed a 2013 permit allowing the company to spread on 7,155 acres in the county, and the DEQ is now considering a new permit request for a further 1,900 acres, said Tyla Matteson, chair of the York River Group of the Sierra Club.

About 80 local residents and environmental groups objected to the most recent Synagro permit, and called for a public hearing. Among other concerns, they say sludge spread on neighboring fields has sickened them, emits a noxious stench, and contaminates their drinking water, soil and food with PFAS.

But state regulators said Synagro is complying with all state and federal laws, denied the request for a public hearing, and ignored demands for PFAS testing. Synagro did not immediately respond to requests for comment.

“We are disgusted, because we are slowly being poisoned,” Matteson said. “Virginia needs to have a backbone and do what other states are doing.”

In a statement to the Guardian, the Virginia DEQ said it was waiting for the Environmental Protection Agency to finish analyzing the risk of PFAS contamination in biosolids before it will consider testing for the chemicals. No limits on PFAS in sludge or food have been established at the state or federal level.

A spokesperson cited a study that suggested PFAS does not build up on farmland at high levels, and said the discovery of widespread contamination in Michigan and Maine may be an “outlier”. The Virginia DEQ’s claim contradicts Michigan regulators’ study that found a direct correlation between biosolid use and PFAS buildup on farms.

In response to several years of resident complaints about odor, pollution, PFAS contamination and other issues, regulators with the Alabama Department of Environmental Management in June tightened some rules around how sludge and other waste products spread on agricultural land are applied and stored.

But the state ignored calls for sludge to be tested for PFAS, and did not respond to a request for comment from the Guardian. A refusal to test amid ongoing crises in Michigan and Maine is “worrying”, said Jack West, policy and advocacy director for Alabama Rivers Alliance, which has petitioned the state to test for PFAS.

“We want to eat food grown in our state, but it’s concerning to go to grocery stores or farmers markets and not know if the food that we’re buying was grown in soils that had sludge applied to them when nobody is testing the sludge for PFAS,” he said.

Absent meaningful help from state regulators, public health advocates plan to push legislators to take up the issue in the next session, West said.

In northern Alabama, Julie Lay and her neighbors have asked a judge to order a nearby farm to stop spreading sludge, and are attempting to educate farmers about the risks. Sludge spread on a nearby field may be poisoning an aquifer from which at least 30,000 residents draw water, Lay said. She equated the sludge’s stench to that of decomposing bodies, and said the substance has sickened her neighbors.

Unwitting farmers are the victim of industry players like Synagro that push the cheap biosolids, Lay added.

“What they’re doing is evil,” Lay said. “[Synagro has] no clue what’s in sludge as long as toilets are flushed into the sewers and industry waste is coming down, too.”

In Virginia, Matteson said farmers and residents don’t have any good options for stopping sludge permits from being approved, but added they will continue to oppose new permit requests and raise awareness.

“I’m a believer in people speaking out,” she said. “I’m a believer in never quitting.”