It’s been more than two decades since scientists first recognized that perfluoroalkyl and polyfluoroalkyl substances (PFAS), compounds used in the manufacturing of a myriad everyday products, could be bad for our health. Still, researchers are barely scratching the surface of what these more than 12,000 different chemicals can do. Experts from the National Academy of Sciences, Engineering and Medicine released a report last week describing what we do know and making recommendations for clinicians to conduct a blood test for PFAS exposure and provide guidance to lowering the levels of the chemicals in their bodies.
Here’s what you need to know.
What Is PFAS?
PFAS is a class of over 12,000 different compounds. Manufacturers started using them in products in the 1940s, because they repel water, resist heat, and reduce friction. Unfortunately, these chemicals don’t break down easily, and when they do, they often form new PFAS. Most of the 12,000 compounds have not been studied thoroughly, but some of the best known PFAS such as bisphenol-A (BPA) are known to be endocrine disrupters—chemicals that interfere with hormones in your body and can raise your risk for a variety of diseases and conditions such as kidney cancer and reproductive disorders. Some research suggests that PFAS can cause developmental issues such as language delays.
Where Is PFAS Exposure Found?
In short, almost everywhere and almost everyone is at risk for PFAS exposure. Over the years, PFAS have leached out of manufacturing plants and waste in landfills into the water, ground, and even air.
“They’re widely used, and they can enter the environment in a number of ways,” said Jane Hoppin, ScD, a biologist at North Carolina State University and one of the members of NASEM’s team, in a virtual presentation of the guidelines
Some people are exposed as a result of their professions. In addition to working in factories that use or produce PFAS, for example, firefighters are at higher risk because the foam they use and protective clothing they wear contain the chemicals to protect them from heat.
However, while certain areas, such as those located close to military bases and factories that use PFAS have higher levels, almost all environments now have some level of PFAS. In those areas with higher levels of PFAS, residents may have higher exposures due to drinking contaminated water or consuming local fish, meat, and dairy products.
What Is a High Level on a Test of PFAS Exposure? What Does It Mean for My Health?
Scientists still have a lot to learn about PFAS. We don’t have a precise measurement beyond which a person is at risk of health complications and under which they can be considered safe from PFAS harm. As a part of the project, the NAS team reviewed what we do know, and created three broad categories.
Category 1:
Those who have less than 2 nanograms per milliliter (ng/mL) of PFAS in their blood. These individuals have very low level exposure and are not considered to be at risk for adverse health effects.
Category 2:
Those who have between 2 and 20 ng/mL of PFAS in their blood. The team believes most of us likely fall into this category, and that, over time, we’ll need more research to understand different levels of exposure that fall under this umbrella. Ned Colange, MD, MPH, a professor at the University of Colorado School of Medicine, called this the “gray area,” adding that “we know it’s a wide range.”
The team recommended that clinicians encourage these people to try to reduce their exposure to PFAS, and regularly screen for conditions such as high cholesterol, hypertensive disorder in pregnancy, and breast cancer in these individuals.
Category 3:
Those with more than 20 ng/mL of PFAS in their blood are more likely to face adverse health effects. The team recommended that clinicians advise ways for these patients to reduce their exposure to PFAS, and along with screening for high cholesterol, hypertensive disorders in pregnancy, and breast cancer, doctors should monitor these patients for thyroid dysfunction, kidney or testicular cancer, and ulcerative colitis.
Not all of the health effects of PFAS exposure all well understood. The scientists explained that there is substantial evidence that PFAS can reduce the strength of the immune system, contribute to high cholesterol, and raise risk for kidney cancer in adults. It can also reduce infant and fetal growth.
There’s some, but not as much, evidence that PFAS raises the risk of breast cancer, pregnancy-induced hypertension, testicular cancer, thyroid dysfunction and ulcerative colitis.
What If I’m Pregnant or Breastfeeding?
There’s still a lot to learn about PFAS and infant development. The chemicals do pass from mother to baby through breastmilk, but the report’s authors warned, there are many benefits to breastfeeding, and PFAS can also be found in the water used to reconstitute baby formula or in the packaged baby foods sold in stores. The report noted that, while more research is clearly required, clinicians should help counsel pregnant and postpartum people to reduce their PFAS exposure when possible.
What Can I Do If My PFAS Levels Are High? or If I’m Worried About My PFAS Exposure?
PFAS can stay in your body a long time, but if you reduce your exposure, the level in your body can lower over time. One way to reduce your exposure to PFAS is to use a water filter that can capture the compounds. You can find a list of filters certified to remove PFAS from your water here.
Mark Andre-Verner, PhD, associate professor of public health at the University of Montreal, added that there’s some data that “getting rid of some of your blood” may reduce your level of PFAS since they’re mostly concentrated in the serum. But, make sure not to donate blood more often than once every 56-84 days.
MedShadow has also previously published two articles with tips on how to avoid PFAS exposures. These are not extensive lists, but include suggestions to minimize exposure to certain types of plastics and products with treatments such as anti-fog coatings on glasses.
In the next five to ten years, we’ll likely learn a lot more about PFAS exposure, their effects on our health, and how to avoid them. MedShadow is dedicated to keeping you informed.
