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Per- and Polyfluoroalkyl Substances (PFAS)

Written by Dr. Tomotaroh Granzier-Nakajima
Published on October 3, 2022
Research Highlights

PFAS are used to make everyday products that resist heat, water, oil, grease, and other stains.

Because they do not break down easily, PFAS levels in humans can build up over time.

Human PFAS exposure can have negative health impacts, such as high cholesterol and cancer.

  • However, additional research is needed to understand the connections between PFAS exposure and human health.

Poly- and per-fluoroalkyl substances (PFAS) are commonly used chemicals that can build up in human bodies.

PFAS are a group of over 9,000 chemicals commonly used to (ATSDR, 2019; EPA 2022):

  • prevent sticking in food packaging and non-stick cookware
  • make carpets, sofas, clothes, and mat-tresses more stain resistant
  • control and put out fires as a component of firefighting foam

They are also used in the aerospace, auto-motive, and construction industries.

PFAS in landfills can leak into the soil and enter groundwater. These chemicals are not filtered out by traditional water treatments (EPA, 2021). PFAS can also be released into the air when burned (DOH, 2022).

PFAS are often called ‘forever chemicals’ because they break down very slowly over time, which allows them to build up in people’s bodies and the environment (AAAS, 2022).

Certain levels of PFAS exposure can have negative health consequences.

Human Exposure to PFAS: Most Americans have measurable PFAS levels in their blood, but these levels are not necessarily associated with negative health effects (Lewis, 2015). Most people are exposed to PFAS by (ATSDR, 2019):

  • drinking contaminated water
  • eating food in PFAS-containing packaging
  • inhaling dust or airborne particles from PFAS-treated products like stain resistant clothing, carpets, and contaminated soil
  • eating food grown or raised near places that use or manufacture PFAS

Showering poses no significant exposure risk unless contaminated water is ingested (ATSDR, 2019).

Workers who are exposed to PFAS at their workplace may be at a higher risk of PFAS exposure than the general public. Occupations that are known to expose workers to higher levels of PFAS include (CDC, 2022):

  • Firefighters (see our Science Note)
  • Chemical manufacturing workers
  • Ski wax technicians

Health Effects of PFAS Exposure: Some PFAS can take years to leave the body, allowing PFAS to build up (ATSDR, 2019). High levels of exposure to certain types of PFAS may lead to (ATSDR, 2022):

  • high cholesterol
  • increased risk of testicular or kidney cancer
  • increased risk of pre-eclampsia
  • increased risk of high blood pressure
  • changes in liver enzymes
  • decreased receptiveness to vaccines in children

Difficulties in PFAS research: Researchers are still investigating the health effects of PFAS. It is difficult to track how PFAS exposure occurs and how it leads to disease because:

  • people are exposed to PFAS in different ways and at different stages of their life (EPA, 2022).
  • thousands of different types of PFAS exist, each with their own properties and ability to build up in the body (ATSDR, 2019).
  • PFAS use changes over time (EPA, 2022).

For example, two of the most common and well-studied PFAS chemicals—perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA)—have recently been phased out in the U.S. and replaced with other PFAS which have been researched less (ASTDR 2022).

Individuals can test their water for PFAS exposure.

Environmental Protection Agency (EPA) Actions: In June 2022, the EPA released new health advisories for the maximum level of safe exposure for four PFAS chemicals in drinking water (Table 1) (AAAS, 2022). These advisories serve as a guide to assist government officials and are not enforceable.

The EPA has taken several steps to address PFAS including:

  • Creating a strategic roadmap
  • Developing a strategy for testing and categorizing PFAS to identify harmful properties
  • Expanding the monitoring of PFAS in drinking water

Reducing Individual PFAS Exposure: Individuals concerned about PFAS exposure should reach out to their local water utility or get their water tested in a state-certified laboratory using EPA-developed tests (EPA 2, 2022). When PFAS are present above advisory levels, individuals can consider installing a filter, or changing water sources for drinking, cooking, and brushing teeth (ATSDR 2019).

  • The cost of testing and installing a filter or changing water sources can disproportionately affect low-income households.


Table 1. EPA health advisories in part per trillion (ppt). (AAAS, 2022)

PFAS Chemical 2016 Health Advisories 2022 Health Advisories
PFOA 70 ppt 0.004 ppt
PFAS 70 ppt 0.02 ppt
hexafluoropropylene oxide (HFPO) compounds (“GenX chemicals”) N/A 10 ppt
perfluorobutane sulfonic acid and potassium perfluorobutane sulfonate (“PFBS”) N/A 2,000 ppt
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