For decades, chemicals that make life easier — your eggs slide out of the frying pan, stains don’t stick to your sofa, rain bounces off your jackets and boots — have been touted as game changers for our busy modern lives. “Better things for better living … through chemistry,” was the optimistic slogan coined by DuPont, the company that Teflon is a widely used chemical coating..
This better lifestyle comes at a price that is attracting new attention. These chemicals — dubbed forever chemicals for their ability to last in the environment — are proving to have a lasting impact on human health. Research is showing that PFAS (for per- and polyfluoroalkyl chemicals) can be linked to a variety of conditions, including cancer, pregnancy complications, and unhealthy blood lipid levels.
Recent U.S. regulatory and public health officials have taken swift action to address concerns about the potential health effects of these chemicals. The U.S. Environmental Protection Agency warned that PFAS present a greater risk to health than originally thought. This has dramatically decreased its safety levelsDrinking water contains chemicals.
“The updated advisory levels are based on new science, including more than 400 recent studies which indicate that negative health effects may occur at extremely low levels, much lower than previously understood,” Radhika Fox, assistant administrator of the EPA’s Office of Water, said in June at the Third National PFAS ConferenceThe event was held in Wilmington, N.C.
The National Academies of Sciences, Engineering, and Medicine soon released the report. First clinical guidelines for quantifying blood levels of PFAS that could put someone’s health at risk. The report, which is 300 pages long, urges doctors to perform regular blood tests on anyone who has been exposed to high levels of these chemicals. It also provides information about how to reduce exposure. installing special filtersIt has been shown to lower PFAS levels in drinking water.
Only in the United States, there is a one-measure measure for medical care costs, lost productivity, and PFAS exposure due to five medical conditions. This adds up to $5.5 billion per yearNew York University researchers reported July 26 in Exposure and Health. These conditions include low birth weight, child obesity, hypothyroidism, hypothyroidism for women, and kidney or testicular cancers.
“We only looked at two of the more than 9,000 chemicals in the PFAS family, so we’re just seeing the tip of an iceberg,” says Leonardo Trasande, a pediatrician and environmental health expert at NYU Langone Health.
Ubiquitous chemicals
Firefighters are the most vulnerable to exposure. PFAS make protective gear water-resistant and are used in common fire suppressant foams. According to the U.S. Centers for Disease Control and Prevention, most people have some measurable amount of PFAS in them. The most common source of exposure is Drinking PFAS-contaminated waterFood grown in soil containing fertilizers made from sewage contaminated by the chemicalsSN: 11/24/18, p. 18). There are an estimated 2,854 locations in the United States that have PFAS contamination.
“People and communities have had significant exposure to these chemicals. If they can ID that they are in an area of significant exposure, they should seek testing through their usual source of care,” says Ned Calonge, an epidemiologist at the Colorado School of Public Health in Aurora who chaired the committee that wrote the National Academies report. The committee linked PFAS exposure to a slightly different list of conditions than the NYU team, finding “sufficient evidence” linking PFAS to four conditions: poor antibody response to vaccination, abnormally high cholesterol levels, decreased infant and fetal growth, and kidney cancer. Evidence was “suggestive” for breast and testicular cancers, as well as thyroid problems and ulcerative colitis, an inflammatory bowel disease.
The report urges more research on the health effects PFAS. There are gaps in evidence on everything, from neurological issues to bone densities. Calonge claims that these chemicals can have many different effects on the human body. And they’re “ubiquitous in the environment.”
Safety is not a priority for the newer models
Since the 1940s, PFAS have been made in the United States. The chemicals are effective at repelling oil or water, holding up at high temperature and reducing friction. They have been used to make a variety of products such as carpeting, upholstery, food packaging, and dental floss. Although there are 9,000 versions of synthetic chemicals, only a few have been tested for toxicological effects.
Many PFAS have been identified as endocrine disruptors. This means that they are chemical compounds that affect the normal functioning and function of the endocrine system. But Other effects of PFAS can increase cancer riskThere are many other symptoms, including weakened immunity and excessive cell growth. One study Researchers found that kidney cancer risk increased by more than two-foldResearchers reported in 2021 that there was a significant difference in blood levels of PFASs, called perfluorooctanoic Acid (or PFOA), between individuals with the highest and lowest blood levels. Journal of the National Cancer Institute.
The chemicals in the newer PFAS were believed to be more safe. These are less likely than others to accumulate in your body. Trasande says that the newer compounds are just as dangerous to health as older compounds. These newer molecules “are increasingly being associated with diseases like gestational diabetes. We’re just starting to see the bigger problem that might be at play.”
The EPA’s new drinking water advisory aims to tackle both old and new PFAS. It targets two types of PFAS that are most common in the environment, namely perfluorooctane sulfuric acid (PFOA) and PFOA. The advisory reduces the amount of drinking water contamination below which adverse effects are not expected to occur from 70 parts/ trillion to 0.004 ppt and 0.02ppt respectively. These levels were calculated based on routine drinking water contamination over a lifetime.
The EPA’s health advisory also provided the first-ever recommendations on two of the newer kinds of PFAS: hexafluoropropylene oxide dimer acid and HFPO ammonium salt, collectively known as GenX chemicals, and perfluorobutane sulfonic acid, or PFBS. The agency established the drinking-water safety threshold at 10 ppt (GenX chemicals) and 2,000 ppt (PFBS). According to the agency, these chemicals have similar persistence in nature.
For information on PFAS testing in your area, consumers can contact their municipal water provider. Testing is becoming more common. Providers should be able identify the PFAS they test. Private wells can become contaminated with PFAS when they are close to manufacturers who produce or use these chemicals. Private well owners who live near these facilities can have their water tested. The EPA can be contacted at GrantsHelping small and disadvantaged communities, provide household water quality testing to ensure compliance with drinking water regulations.
Price tag of PFAS
Due to limited data regarding the health effects of newer chemicals on human health, the NYU reports and National Academies focused on older PFAS.
The NYU team first examined blood samples from approximately 5,000 children and adults who took part in the U.S. National Health and Nutrition Examination Survey. Based on previous studies that linked PFAS with certain diseases, and models that estimated medical costs and lost worker productivity, the NYU team then came up with a PFAS price tag.
According to the team, childhood obesity, which is the most significant contributor to the overall economic cost of PFAS exposure, amounts to $2.7 billion annually. The team also estimates that hypothyroidism among women costs $1.26 trillion. The economic impact of PFAS-related diseases that were not included in the top five was estimated at $63 billion per year by the researchers when they added in obesity in children and adults, endometriosis and pneumonia in children.
Assessing risk
The National Academies report aimed to curtail that toll. It provided guidelines for clinicians on how to test for high levels of PFAS and reduce exposure.
The report provides the first clinical guidelines on how to assess a person’s disease risk. A person with a PFAS blood concentration of less than 2 nanograms per milliliter doesn’t have to worry. However, patients with blood concentrations of between 2 and 10 ng/mL should be screened by clinicians for unhealthy levels or fat. These conditions can cause heart problems. Screening is important for patients who are more vulnerable to PFAS, such as pregnant women and those with immunocompromised. Anyone who has a PFAS test above 20 ng/mL should be screened for certain cancers, thyroid problems, and ulcerative colitis.
“For almost 20 years, we’ve been able to measure PFAS in people’s blood, but there was no guidance to say what [those measurements] mean,” says National Academies report coauthor Jane Hoppin, who heads the Center for Human Health and the Environment at North Carolina State University in Raleigh. “For the first time, this actually sets some ranges, some guidance for what could be levels of concern, and what kinds of health follow-up might be appropriate.”
She hopes that these recommendations will increase the availability of testing and raise awareness about these chemicals and their potential health effects for both patients and doctors. Doctors are encouraged to consult with patients about PFAS exposure and ways to reduce that risk by filtering water and reducing the use of PFAS-containing products.
Activated carbon filters, found in some countertop or pitcher filters, don’t remove PFAS as completely as reverse osmosis filters, researchers at Duke University and North Carolina State reported in 2020. National Academies reports provide a link to NSF (a testing organization that offers PFAS removal). technical detailsWhich filters filter out PFAS?
Reduced PFAS levels in drinking water may be an option. While EPA’s health advisories are recommendations and not enforceable, Trasande is pleased that the agency acted quickly, particularly on newer chemicals like GenX. However, he argues that PFAS should be tested more often in light of the ongoing research and what we know about the health effects of these chemicals. They should be regulated by classes, not what he calls “a whack a mole” approach.
“Our environmental policy still takes a wait-and-see approach that we should wait 20 to 30 years, which is the time that people take to develop diseases due to chemical exposures,” he says.
