PFAS: Health Risks and Regulation of “Forever Chemicals”

As scientists uncover more about the health dangers linked to PFAS, which occur in products ranging from non-stick cookware and carpets to ski wax, these “forever chemicals” appear ever more troubling.

The U.S. Environmental Protection Agency now considers that no level of two widespread PFAS – PFOA and PFOS – is safe in drinking water. It also recognises that extremely low concentrations of other PFAS can endanger human health. On 10 April 2024, the agency introduced the first legally enforceable national standards for drinking water covering five common PFAS chemicals and PFAS mixtures.

As an environmental health scientist who researches PFAS, I can outline the risks associated with these chemicals and the attempts to control them.

What exactly are PFAS?

PFAS is short for per- and polyfluoroalkyl substances. It describes a broad class of manufactured chemicals – now thought to include almost 15,000 separate chemical compounds – used extensively in industrial applications and consumer goods. They can give products resistance to water, grease and staining, as well as fire protection.

PFAS are often present in waterproof outdoor clothing and cosmetics, as well as stain-resistant carpets and upholstery. They are also used in food packaging intended to stop liquids or grease soaking through, and in some firefighting equipment.

Indeed, research has found PFAS in most items marketed as stain- or water-resistant. Another study showed this was also the case for products described as “nontoxic” or “green”. PFAS also turn up in less obvious products, including high-performance ski and snowboard waxes, floor waxes and medical devices.

At first, PFAS may seem highly practical, so it is reasonable to ask why they are a problem.

In brief, PFAS damage both human health and the environment.

The chemical features that make PFAS useful in products are also responsible for their ability to remain in the environment for generations. Their widespread use means that they are now found in water, soil and living things across almost every region of the world, including Arctic glaciers, marine mammals and remote communities that rely on subsistence diets. They are also present in 98% of the American public.

The U.S. Geological Survey estimates that common PFAS types are present in at least 45% of the nation’s tap water. In June 2023, PFAS manufacturer 3M, which was facing lawsuits, announced a settlement valued at no less than US$10.3 billion, intended to help public water systems cover PFAS testing and treatment.

What are the health risks from PFAS exposure?

After exposure, PFAS can stay in the body for a lengthy period – from months to years, depending on the particular compound – and may build up over time.

Studies repeatedly link PFAS with a range of harmful health outcomes. An expert panel reviewing evidence on PFAS toxicity concluded, with a high degree of certainty, that these chemicals contribute to thyroid disease, raised cholesterol, liver damage, and kidney and testicular cancer.

The panel also determined with a high degree of certainty that PFAS affect babies exposed before birth. Such exposure increases the chance of lower birth weight and a less effective response to vaccines. PFAS can also interfere with mammary gland development in women, potentially harming a mother’s ability to breastfeed.

The review identified evidence that PFAS may play a role in several further conditions, although more research is required to confirm the current findings. These include inflammatory bowel disease, reduced fertility, breast cancer, a greater likelihood of miscarriage, and the development of high blood pressure and pre-eclampsia during pregnancy. In addition, existing research indicates that babies exposed before birth face a higher risk of obesity, early puberty and lower fertility later in life.

Taken together, this represents a daunting range of diseases and disorders.

Who's regulating PFAS?

PFAS chemicals date back to the late 1930s, when a DuPont scientist accidentally created one during a laboratory experiment. DuPont named it Teflon, which later became a household name because of its use on non-stick pans.

Several decades afterwards, in 1998, Scotchgard manufacturer 3M informed the Environmental Protection Agency that a PFAS chemical was appearing in human blood samples. At that point, 3M said low levels of the manufactured chemical had been detected in people’s blood as far back as the 1970s.

The Agency for Toxic Substances and Disease Registry provides a toxicological profile for PFAS, while the EPA had previously issued advisories and health-based guidance. Yet, despite the long list of serious health hazards associated with PFAS and substantial federal spending on PFAS research in recent years, the United States had not regulated PFAS at federal level until now.

The new drinking water rules establish limits for five individual PFAS – PFOA, PFOS, PFNA, PFHxS and HFPO-DA – along with mixtures containing these chemicals. They form part of the EPA’s PFAS regulation road map.

The EPA has additionally proposed designating nine PFAS as hazardous substances under the Resource Conservation and Recovery Act. Utilities and firms that use products or processes containing PFAS are concerned about this proposal because of cleanup costs.

While federal measures were pending, individual states introduced their own protections for residents facing the risks of PFAS exposure.

At least 28 states have enacted laws directed at PFAS in different applications, including food packaging and carpets. Around 12 have set PFAS standards for drinking water. Depending on state legislation, however, creates a patchwork of rules that requires businesses and consumers to manage regulatory differences across state boundaries.

How can you reduce your PFAS exposure?

According to current scientific knowledge, food is the main route through which most people encounter PFAS. However, drinking water and airborne exposure can be important for certain people, particularly those living close to known PFAS-related industry or contamination.

The most effective way to safeguard yourself and your family from PFAS-related risks is to learn about possible exposure sources.

Items labelled water- or stain-resistant are quite likely to contain PFAS. Where possible, inspect the ingredients of products you purchase and look out for chemical names that include “fluor-”. Particular brand names, including Teflon and Gore-Tex, are also likely to involve PFAS.

Find out whether contamination sources exist nearby, such as contaminated drinking water or local PFAS-related industries. Approaches to monitoring and reporting PFAS pollution differ according to location and source, so a lack of easily accessible information does not automatically mean an area has no PFAS concerns.

For more information on PFAS, consult the websites of the Agency for Toxic Substances and Disease Registry, the EPA and the U.S. Centers for Disease Control and Prevention, or speak to your state or local public health department.

If you think you have been exposed to PFAS and are worried about your health, contact your healthcare provider. The National Academies of Sciences, Engineering, and Medicine have issued guidance on PFAS exposure, testing and clinical follow-up. It includes material to help healthcare professionals understand the monitoring and clinical consequences of PFAS exposure.

This article updates one originally published on 21 June 2022.

Kathryn Crawford, Assistant Professor of Environmental Health, Middlebury

This article is republished from The Conversation under a Creative Commons licence. Read the original article.