PFAS
What are Per- and Polyfluorinated Substances (PFAS)?
Per- and polyfluoroalkyl (polyfluorinated) substances (PFAS) are man-made chemicals that have been used in industry and consumer products worldwide since the 1940s. Because of their ability to resist oil and water and reduce friction, they are useful for commercial and industrial purposes. They can be found in nonstick cookware, stain resistant upholstery and carpets, water repellant clothing, cleaning products, paints, varnishes and sealants, cosmetics, personal care products, as well as in industrial processes and some firefighting foams.
There are thousands of PFAS chemicals but only a few have been studied in humans. The most widely studied PFAS so far are perfluorooctanoic acid (PFOA) and perflouorooctane sulfonic acid (PFOS) followed by perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA). PFOA and PFOS have been phased out of production and use in the United States, but other countries may still manufacture and use them.
PFAS in Humans
PFAS molecules have strong carbon-fluorine bonds which keep them from fully breaking down in the environment which lets them move through soil, water, and air. The things that make them useful for commercial purposes may also affect how the human body works. Some examples are:
Absorption PFAS may be absorbed by the intestines and lungs but is less absorbed through the skin
Distribution PFAS can be carried through the body on proteins in blood serum
Metabolism the body doesn't fully break down PFAS, or only partially breaks down PFAS
Elimination PFAS leaves the body through urination but can be passed through breast feeding and to a fetus through the placenta
Half-life of the PFAS chemicals studied can be from a few days to 8 years or more.
Exposure to PFAS
Almost everyone in the U.S. has some levels of PFAS in their bodies. You can be exposed through:
- Drinking contaminated municipal or private well water
- Eating food produced near places where PFAS were used or made
- Eating fish caught from water contaminated by PFAS (PFOS, in particular)
- Swallowing or breathing contaminated soil or dust
- Eating food packaged in material that contains PFAS
- Swallowing residue or dust from consumer products containing PFAS such as stain resistant carpeting and water repellent clothing
Exposure concerns for children
Young children may be more likely to get PFAS in their bodies because they tend to chew on plastic toys and fabrics and tend to put their hands into their mouths. They can also be exposed by:
- Drinking formula mixed with PFAS-contaminated water
- Drinking breastmilk from persons exposed to PFAS. Clinicians can assist patients in deciding whether to breastfeed based on factors specific to the patient and the child. Due to the many benefits of breastfeeding, the CDC and American Academy of Pediatrics recommend that breast milk is best. For more information, please see link below in Downloads and Resources.
Exposure concerns for workers
People employed in industries that make, process, or use PFAS and PFAS-containing materials are more likely to be exposed than the general population. Exposure can occur by touching or swallowing PFAS or by breathing in PFAS containing dust, aerosols, or fumes. For more information on worker exposures, please visit the National Institute for Occupational Safety and Health in Downloads and Resources below.
How to lower your risk for exposure
If your drinking water is contaminated above levels specified by the EPA or your state government, use an alternate water source for drinking, preparing food, cooking, brushing teeth, and any other activity when you might swallow water. Current information on maximum contaminant levels in New Mexico can be found in the Downloads and Resources section below.
- Avoid eating contaminated fish or game. Look for health advisories from your local state health and environment departments for advisories
- Follow applicable advisories or warning about agricultural products in your area that may be contaminated with PFAS
- Because PFAS are at low levels in some foods and in the environment (air, water, soil, etc.) completely eliminating exposure is unlikely.
Even though recent efforts to remove PFAS have reduced the likelihood of exposure, some products may still contain them. For questions or concerns, contact the Consumer Product Safety Commission https://www.cpsc.gov/ at (800) 638-2772.
Potential Health Effects of PFAS
Research to understand how PFAS harms humans is ongoing. The epidemiological evidence suggest associations between increases in exposure to (specific) PFAS and certain health effects.
- Increases in cholesterol levels (PFOA, PFOS, PFNA, PFDA)
- Changes in liver enzymes (PFOA, PFOS, PFHxS)
- Decreases in birth weight (PFOA, PFOS)
- Lower antibody response to some vaccines (PFOA, PFOS, PFHxS, PFDA)
- Pregnancy-induced hypertension and preeclampsia (PFOA, PFOS)
- Kidney and testicular cancer (PFOA)
The risk of health effects associated with PFAS depends on exposure factors (e.g., dose, frequency, route, and duration), individual factors (e.g., sensitivity and disease burden), and other determinants of health (e.g., access to safe water and quality healthcare).
PFAS Information for Clinicians/Physicians
If you are a physician treating a patient with a concern about PFAS, the first response should focus on minimizing exposures and treating symptoms.
These resources are available to medical professionals: