Forever chemicals exposure: What you need to know

Forever chemicals, also known as PFAS (per- and polyfluoroalkyl substances), have indeed woven themselves into the fabric of our modern world. These human-made compounds are aptly named “forever chemicals” because they persist in the environment and the human body for an exceptionally long time.

Sources of PFAS

PFAS, or per- and polyfluoroalkyl substances, are a group of man-made chemicals that are found in a wide range of products we use every day. Here are some of the most common sources of PFAS:

1. Industrial Sites:
• PFAS are used in various industrial applications, including electronics manufacturing, oil recovery, and chrome plating¹.
• Chemical plants that produce PFAS or use them in manufacturing processes can release these chemicals into the air and water.
2. Consumer Products:
• Many consumer goods contain PFAS due to their water, stain, and grease-resistant properties.
• Products include non-stick cookware, waterproof clothing, stain-resistant fabrics and carpets, and some cosmetics².
3. Food Packaging:
• PFAS are often used in food packaging materials, such as pizza boxes, popcorn bags, and fast-food wrappers, to prevent grease from leaking through.
4. Firefighting Foams:
• Aqueous film-forming foams (AFFF), which are used for firefighting, especially at airports and military bases, are a significant source of PFAS contamination².
5. Drinking Water:
• PFAS can contaminate drinking water supplies near areas with specific industrial facilities or where AFFF has been used extensively².
6. Household Dust:
• PFAS can accumulate in household dust from various sources, including carpeting, furniture, and household cleaning products.
7. Waste Treatment Plants:
• Wastewater treatment plants and landfills can be sources of PFAS, as these chemicals can leach from products disposed of in these facilities¹.
8. Environmental Contamination:
• PFAS can be found in soil, air, and water due to their widespread use and persistence in the environment³.
9. Occupational Exposure:
• Workers in industries that manufacture or use PFAS, such as chemical production or firefighting, may be exposed to higher levels of these substances⁴.

The widespread use of PFAS and their resistance to degradation mean that they can be found almost everywhere in the environment, leading to widespread human exposure. Efforts are ongoing to understand the full extent of PFAS contamination and to develop strategies to reduce their presence in the environment and minimize exposure.

 

Are PFAS found in LMICs?

Yes, PFAS (per- and polyfluoroalkyl substances) are found in low- and middle-income countries (LMICs) as well. The presence of PFAS in LMICs is a growing concern due to the potential health risks and the lack of resources for adequate monitoring and regulation.

1. Industrial Activities:
• LMICs often host various industrial activities, including manufacturing plants that may use PFAS in their processes.
• Due to less stringent environmental regulations, these substances can be released into the environment more freely.
2. Imported Goods:
• LMICs import consumer goods that may contain PFAS, such as textiles, electronics, and other products with water or stain-resistant properties.
3. Agricultural Practices:
• PFAS can enter the food chain through contaminated soil and water used in agriculture, which is a significant concern for food safety.
4. Limited Monitoring:
• Many LMICs lack the infrastructure and resources to monitor and regulate the presence of PFAS in the environment and consumer products effectively.
5. Healthcare Implications:
• The potential health impacts of PFAS, such as cancer and immune system effects, can be more severe in LMICs where healthcare systems may be less equipped to handle chronic diseases.
6. Global Trade and Waste:
• LMICs may also be recipients of waste products from high-income countries that contain PFAS, contributing to environmental contamination.

The global nature of PFAS production and use means that these chemicals are a concern for all countries, including LMICs. Efforts to understand the extent of PFAS contamination and to mitigate its impacts are essential worldwide.

 

What is the impact of PFAS on our health?

1. Ubiquitous Presence:
• PFAS are found nearly everywhere — in air, water, soil, and even Arctic ice.
• They have been used since the 1940s in various products due to their versatility. From non-stick cookware to food packaging, cosmetics, and pharmaceuticals, PFAS are part of our daily lives.
2. Health Effects:
• Accumulation: Even at low doses, PFAS can build up in the body over time. More than 95% of Americans have detectable levels of PFAS in their blood.
• Toxicity: Research shows that exposure to certain levels of PFAS may lead to a range of health issues, including:
• Reproductive problems: Decreased fertility, developmental delays in children, and low birth weight.
• Suppressed immune system.
• Increased cholesterol levels.
• Cardiovascular system impacts.
• Certain types of cancer, such as kidney and testicular cancer.
• Liver damage, hormonal disruption, and compromised immune function.
• No Safe Level: The EPA has stated that there is no safe level of exposure to PFAS without risk of health impacts.

 

1. Decreased Fertility:
• PFAS exposure has been linked to reduced fertility in both men and women.
• In men, studies have found a correlation between high levels of PFAS in the blood and decreased sperm quality, including reduced sperm count, motility, and morphology¹.
• In women, exposure to these chemicals can cause menstrual irregularities and a diminished ovarian reserve, increasing the risk of infertility¹.
2. Developmental Delays in Children:
• PFAS can cross the placenta, exposing the fetus to these chemicals during crucial developmental stages.
• Exposure to PFAS is associated with developmental effects or delays in children, such as accelerated puberty, bone variations, or behavioral changes².
3. Low Birth Weight:
• PFAS exposure during pregnancy is linked to lower birth weight in newborns.
• Studies have shown that PFOA and PFOS levels in maternal serum during pregnancy were associated with lower birth weight³.
• The EPA has estimated that 1,232.7 annual birth-weight-related deaths could be avoided if proposed maximum contaminant levels for PFAS in drinking water were adopted³.
4. Breastfeeding and PFAS:
• PFAS are also detected in breast milk, posing another potential source of infant exposure.
• There is some evidence of shorter duration of breastfeeding in mothers with higher PFAS exposure, which may deprive infants of the full benefits of breastfeeding³.

The evidence suggests that PFAS exposure poses significant risks to reproductive health and early childhood development. It underscores the importance of continued research, regulation, and public awareness to mitigate these risks.

PFAS chemicals have been shown to have a significant impact on the immune system, affecting its ability to function properly.

 

1. Antibody Production:
• PFAS exposure has been linked to suppressed production of antibodies. This can reduce the body’s ability to fight off infections and diminish the effectiveness of vaccines¹.
• For example, children with higher blood levels of PFAS had lower levels of diphtheria and tetanus antibodies two years after receiving their DTaP vaccination¹.
2. Vulnerability to Diseases:
• Studies suggest that communities with higher exposures to PFAS may be more vulnerable to infectious diseases, including COVID-19¹.
• A study of US children found those with higher levels of PFOS also had lower levels of antibodies to rubella and mumps¹.
3. Immune Cell Activity:
• Research indicates that immune cells previously exposed to PFAS show significantly lower activity than untreated cells².
• This is particularly true for T-cells, which are crucial for the immune response. T-cells exposed to PFAS produced less of the messenger substances they normally use to communicate with each other and to recruit other immune cells or to trigger inflammation².
4. Increased Rates of Hypersensitivity:
• There is evidence, although weaker, that suggests an association between PFAS exposure and increased rates of hypersensitivity-related outcomes. This can include conditions like asthma, allergic responses, and rhinitis (runny nose, sneezing, and stuffiness)¹.
5. Long-Term Effects:
• The long-term effects of PFAS on the immune system are still being studied, but the evidence points to a range of immune system effects, from suppressed antibody production to increased rates of hypersensitivity-related outcomes¹.

The suppression of the immune system by PFAS is a serious concern, especially considering the widespread presence of these chemicals in the environment and their persistence in the human body. Ongoing research and increased awareness are essential to understand the full extent of these effects and to protect public health.

 

 

PFAS exposure has been associated with increased cholesterol levels, which is a significant concern given the prevalence of these chemicals in the environment and their persistence in the human body.

1. Blood Lipid Levels:
• A study led by Harvard T.H. Chan School of Public Health found that exposure to certain types of PFAS, particularly PFOA and PFOS, is associated with increased blood lipid levels in adults¹.
• The study, which was a meta-analysis of 29 studies, showed that these PFAS were significantly associated with higher levels of total cholesterol, triacylglycerols, and low-density lipoprotein cholesterol (LDL-C), commonly known as “bad” cholesterol¹.
2. Cardiovascular Disease Risk:
• Elevated cholesterol levels are a well-known risk factor for cardiovascular disease (CVD).
• The findings from the Harvard study suggest that higher levels of exposure to PFAS could lead to an elevated risk of CVD, although further studies are needed to clarify this risk¹.
3. Cholesterol Management Challenges:
• Unlike cholesterol levels that can be managed through diet and lifestyle changes, the cholesterol issues caused by PFAS exposure are more challenging to control.
• This is because PFAS can induce hormonal changes that affect the metabolism and the body’s ability to control plaque in arteries, leading to stubbornly high and dangerous levels of cholesterol².
4. Global Health Implications:
• The implications of increased cholesterol due to PFAS exposure are global, as these chemicals are used widely and persist in the environment.
• Efforts to limit PFAS exposure and mitigate its health impacts are crucial to prevent potential increases in CVD and related health issues worldwide.

The association between PFAS and increased cholesterol levels adds another layer of complexity to the already concerning health effects of these chemicals. It emphasizes the need for ongoing research, public health initiatives, and policy changes to address the challenges posed by PFAS exposure.

The impact of PFAS on the cardiovascular system is a significant health concern. Recent studies have provided more insight into how these chemicals affect heart health:

1. Increased Risk of Cardiovascular Disease:
• A groundbreaking study has shown for the first time that exposure to PFAS increases the likelihood of death by cardiovascular disease¹.
• The study, conducted in the Veneto region of Italy, compared death records of people who drank water contaminated with PFAS to those who did not, revealing a clear association with cardiovascular mortality¹.
2. Cholesterol and Arterial Health:
• PFAS are known to cause stubbornly high levels of cholesterol, which are difficult to manage because they result from hormonal changes rather than dietary or lifestyle choices¹.
• This can lead to the development of plaque in arteries, increasing the risk of heart attacks and strokes¹.
3. Blood Lipid Levels:
• Research indicates that exposure to PFAS is associated with increased blood lipid levels, including total cholesterol, triacylglycerols, and low-density lipoprotein cholesterol (LDL-C)².
• These unfavorable lipid profiles contribute to an increased risk of developing cardiovascular diseases³.
4. Cardiac Toxicity and Hypertension:
• Accumulated serum levels of PFAS may contribute to cardiac toxicity, vascular disorders, hypertension, and dyslipidemia⁴.
• These conditions can lead to a subclinical course of cardiovascular disease, potentially resulting in severe health outcomes⁴.
5. Global Health Implications:
• The evidence of PFAS’s impact on cardiovascular health is not limited to one region or population; it is a global concern due to the widespread use of these chemicals³.
• The findings underscore the need for international efforts to limit PFAS exposure and protect public health.

The research on PFAS and cardiovascular health is evolving, but the current evidence points to a clear need for action to reduce exposure to these harmful chemicals.

 

The link between PFAS exposure and certain types of cancer, particularly kidney and testicular cancer, has been a subject of increasing concern.

 

1. Kidney Cancer:
• Studies have found that exposure to PFAS, especially PFOA, is associated with an increased risk of kidney cancer¹.
• A meta-analysis found that the average relative increase in cancer risk per 10 ng/mL increase in serum PFOA is 16% for kidney cancer².
• The kidneys are particularly vulnerable because they are involved in filtering blood and excreting waste products, which includes PFAS.
2. Testicular Cancer:
• PFAS, and specifically PFOS, have been linked to a higher risk of developing testicular cancer³.
• A study among U.S. Air Force servicemen found that elevated blood levels of PFOS were associated with an increased risk of testicular cancer³.
• Testicular cancer is the most frequently diagnosed cancer among U.S. active-duty servicemen and among young adult men in general³.
3. Mechanisms of Carcinogenicity:
• PFAS are believed to cause cancer by disrupting endocrine function, inducing oxidative stress, and promoting inflammation, which can lead to cellular damage and tumor growth.
• Animal studies have shown that exposure to PFOA increases the risk of certain tumors of the liver, testicles, mammary glands (breasts), and pancreas.
4. Epidemiological Evidence:
• Epidemiological studies have suggested an increased risk of testicular and kidney cancer with increased PFOA exposure¹.
• The strongest epidemiological evidence shows that kidney and testicular cancers are associated with higher levels of PFAS⁴.
5. Regulatory Response:
• These findings have prompted regulatory agencies to consider stricter controls on PFAS to reduce exposure and the associated health risks.
• Ongoing research is essential to further understand the relationship between PFAS and cancer risk, and to develop strategies for prevention and early detection.

The association between PFAS exposure and the increased risk of certain cancers underscores the importance of continued vigilance and research in this area.

 

PFAS exposure has been linked to a range of adverse health effects, including liver damage, hormonal disruption, and compromised immune function.

1. Liver Damage:
• Research has established a connection between PFAS exposure and biomarkers of liver damage, suggesting that these chemicals may be associated with non-alcoholic fatty liver disease (NAFLD)¹.
• NAFLD is characterized by a build-up of fat in the liver and affects about a quarter of the world’s population².
• The increase in liver enzymes, such as alanine aminotransferase (ALT), indicates liver disease and has been correlated with PFAS exposure².
2. Hormonal Disruption:
• PFAS can disrupt the endocrine system, impacting hormonal balance even at low concentrations³.
• They can mimic or block natural hormones, affecting major bodily processes like fertility, hormone metabolism, and steroid hormone production³.
• Exposure to PFAS has been linked to thyroid disease, with studies suggesting that PFASs may disrupt the thyroid hormone system, potentially affecting pregnancy outcomes and child development⁴.
3. Compromised Immune Function:
• There is mounting evidence that PFAS interfere with immune system function, potentially diminishing the ability to fight infectious diseases, including COVID-19⁵.
• Studies have shown that children with higher blood levels of PFAS had lower levels of antibodies to diseases like diphtheria, tetanus, rubella, and mumps⁶.
• PFAS exposure may prevent the body from effectively responding to infections and reduce the efficacy of vaccinations⁵.

The evidence of PFAS’s impact on liver health, hormonal systems, and immune function is a serious concern, highlighting the need for continued research and regulatory efforts to limit exposure and protect public health.

The U.S. Environmental Protection Agency (EPA) has taken a firm stance on the safety levels of PFAS exposure, emphasizing that there is effectively no safe level of exposure to these chemicals without the risk of health impacts.

1. Zero Tolerance Policy:
• The EPA has set the Maximum Contaminant Level Goals (MCLGs) for PFOA and PFOS at zero, indicating that no amount of these substances in drinking water is considered safe¹.
• This is based on scientific evidence that even very low levels of PFAS can lead to adverse health effects.
2. New Regulations:
• As part of the new regulations, the EPA has established legally enforceable Maximum Contaminant Levels (MCLs) for six PFAS in drinking water¹.
• For PFOA and PFOS, the enforceable levels have been set at 4.0 parts per trillion (ppt), which is close to the level of detection².
3. Health Advisory Levels:
• Prior to setting the MCLs, the EPA had tightened its lifetime health advisory levels for PFOA and PFOS to 0.004 ppt and 0.02 ppt respectively, reflecting the agency’s commitment to minimizing exposure to these harmful chemicals³.
4. Public Health Protection:
• The EPA’s actions are expected to prevent PFAS exposure in drinking water for approximately 100 million people, prevent thousands of deaths, and reduce tens of thousands of serious PFAS-attributable illnesses¹.
5. Investment in Safety:
• Alongside the new standards, the EPA is investing nearly $1 billion through the Bipartisan Infrastructure Law to help states and territories implement PFAS testing and treatment at public water systems⁴.

The EPA’s position on PFAS reflects a growing understanding of the serious health risks posed by these chemicals and a commitment to protecting public health by enforcing strict standards and investing in water safety.

 

3. Regulation and Impact on Drinking Water:

The recent regulations by the U.S. Environmental Protection Agency (EPA) on PFAS in drinking water mark a significant step in public health protection.

1. Historic Regulation:
• The EPA’s regulation is historic as it’s the first-ever national standard aimed at limiting PFAS in drinking water.
• This move is part of the agency’s broader strategy to tackle the widespread issue of PFAS contamination.
2. Testing for Multiple PFAS:
• Public water systems are now required to test for six different PFAS compounds, including PFOA and PFOS, which are among the most studied and have been linked to serious health issues.
• The testing is designed to monitor levels of these chemicals and ensure they do not exceed the set maximum contaminant levels (MCLs).
3. Reducing Exposure:
• The new standards are expected to significantly reduce PFAS exposure in the population.
• By setting MCLs for PFAS, the EPA aims to lower the concentration of these chemicals in drinking water to levels that are protective of human health, including sensitive populations like infants and pregnant women.
4. Preventing Health Issues:
• The EPA estimates that the new PFAS standards could prevent thousands of deaths and reduce tens of thousands of serious illnesses related to PFAS exposure.
• The health benefits include a decrease in the risk of developmental effects, cancer, liver damage, immune system effects, thyroid disease, and other health issues associated with PFAS.
5. Impact on Public Water Utilities:
• Public water utilities will play a crucial role in implementing these regulations.
• They will be responsible for regular testing, reporting, and taking corrective actions if PFAS levels exceed the standards.
6. Public Awareness and Action:
• The regulations also serve to increase public awareness about the presence of PFAS in drinking water and the associated risks.
• It encourages consumers to be more informed and proactive about the quality of their drinking water.
7. Future Implications:
• These regulations may pave the way for further actions to address other environmental contaminants.
• They also highlight the need for continued research and development of technologies to remove PFAS from water effectively.

The EPA’s regulations on PFAS in drinking water are a landmark effort to safeguard public health from these persistent environmental pollutants.

4. Global Concern:

The global concern over PFAS-related health risks has indeed led to a significant shift in regulatory approaches, particularly within the European Union, and has had implications for the UK and Ireland.

 

1. Stricter EU Regulations:
• The European Chemicals Agency (ECHA) has been actively working on a universal PFAS restriction proposal¹.
• In 2023, five member countries of the European Union submitted a restriction report proposing a substantial restriction under the REACH regulation for the use of all PFAS variants².
• The EU’s current legislation includes restrictions on PFOS and PFOA, and PFHxS has been added to the Stockholm Convention, marking a proactive step³.
2. Impact on Consumer Products and Industrial Processes:
• In the UK and Ireland, PFAS are pervasive in consumer products and industrial processes⁴.
• The UK Environment Agency’s screening in 2019 found PFAS, specifically PFOA and PFOS, in surface water samples at 96% of the sites surveyed⁴.
• This widespread contamination raises concerns about the long-term health consequences and the need for regulatory measures to prevent further environmental and human exposure.
3. Global Response and Future Actions:
• The mounting evidence and increased regulations reflect a global response to the PFAS crisis.
• Organizations like the Stockholm Convention on Persistent Organic Pollutants are pushing for stricter regulations on PFAS use within the European Union.
• The ongoing efforts aim to mitigate the risks associated with PFAS and protect public health and the environment from their harmful effects.

The response to PFAS contamination is evolving, with a clear trend towards stricter regulations and a more comprehensive approach to managing these “forever chemicals” to safeguard health and the environment.

In summary, these “forever chemicals” silently erode our quality of life, affecting our health and the environment. It’s crucial to raise awareness, regulate their use, and find safer alternatives.

 

Recommended further reading

1. ECHA - European Chemicals Agency:
1. Offers detailed information on PFAS, their environmental and health impacts, and regulatory measures within the EU. It also includes updates on the universal PFAS restriction proposal
2. PFAS — Per- and Polyfluoroalkyl Substances:
1. A resource with a collection of references related to PFAS, including scientific studies, regulatory documents, and historical data on the use and distribution of PFAS
3. ITRC Fact Sheets:
1. The Interstate Technology & Regulatory Council (ITRC) provides fact sheets on PFAS, covering topics like regulations, history and use, fate and transport, and sampling precautions
4. Recent Progress and Challenges on the Removal of PFAS:
1. This paper reviews emerging technologies for the degradation or sorption of PFAS to treat contaminated soil and water. It discusses the mechanisms involved in removing these persistent contaminants at a molecular level
5. A Critical Review on PFAS Removal from Water:
1. This review focuses on the efficiency of different removal techniques for eliminating different types of short- and long-chain PFAS from water. It also covers the removal mechanisms and future challenges
6. NIEHS-Supported Publications on PFAS:
1. The National Institute of Environmental Health Sciences provides a comprehensive, searchable database of peer-reviewed scientific papers on PFAS. This resource is useful for both the research community and the public³.
7. Compilation of Research on PFAS in the Environment:
1. A special issue dedicated to PFAS, providing a summarization of risk assessment approaches for PFAS, which are needed for environmental managers and regulatory bodies