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{{Short description|Class of perfluorinated chemical compounds}} {{Short description|Class of perfluorinated chemical compounds}}
{{redirect|PFAS}}
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'''Per- and polyfluoroalkyl substances''' ('''PFAS'''<ref>{{cite web | url=https://www.epa.gov/pfas | title=Per- and Polyfluoroalkyl Substances (PFAS) | date=30 March 2016}}</ref> or '''PFASs'''<ref name=Terminology/>) are a group of synthetic ] ]s that have multiple ] atoms attached to an ] chain; there are 7 million such chemicals according to ].<ref name=7m>{{Cite journal | title=Per- and Polyfluoroalkyl Substances (PFAS) in PubChem: 7 Million and Growing | first1=Emma L. | last1=Schymanski | first2=Jian | last2=Zhang | first3=Paul A. | last3=Thiessen | first4=Parviel | last4=Chirsir | first5=Todor | last5=Kondic | first6=Evan E. | last6=Bolton | journal=Environmental Science & Technology | publisher=] | date=October 23, 2023| volume=57 | issue=44 | pages=16918–16928 | doi=10.1021/acs.est.3c04855 | pmid=37871188 | pmc=10634333 | bibcode=2023EnST...5716918S}}</ref> PFAS came into use after the invention of ] in 1938 to make fluoropolymer coatings and products that resist heat, oil, stains, grease, and water. They are now used in products including ] such as ], ], carpets, shampoo, ] products, mobile phone screens, wall paint, furniture, adhesives, ], heat-resistant non-stick cooking surfaces such as ],<ref>{{Cite news | url=https://www.usatoday.com/story/news/2022/03/07/pfas-guide-chemicals/6652847001/ | title=What are PFAS? A guide to understanding chemicals behind nonstick pans, cancer fears | first=Kyle | last=Bagenstose | work=] | date=March 7, 2022}}</ref> ], and the insulation of electrical wire.<ref name=Explained/><ref name=stuff/><ref name="whatare">{{Cite web |date=17 January 2024 |title=PFAS and Your Health |url=https://www.atsdr.cdc.gov/pfas/about/?CDC_AAref_Val=https://www.atsdr.cdc.gov/pfas/health-effects/overview.html |access-date=12 December 2024 |publisher=]}}</ref> PFAS are also used by the ] in most ] and ], including ], ], ], ], ], ], ], and ].<ref name=widespread>{{Cite news | url=https://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals | title=Toxic 'forever chemicals' widespread in top makeup brands, study finds | first=Tom | last=Perkins | work=] | date=June 15, 2021 | archive-date=July 7, 2021 | archive-url=https://web.archive.org/web/20210707070534/https://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals | url-status=live}}</ref><ref>{{cite journal | vauthors=Whitehead HD, Venier M, Wu Y, Eastman E, Urbanik S, ], Shalin A, Schwartz-Narbonne H, Bruton TA, ], Wang Z | display-authors=6 | title=Fluorinated Compounds in North American Cosmetics |journal=Environmental Science & Technology Letters |date=15 June 2021 | volume=8 | issue=7 | pages=538–544 |doi=10.1021/acs.estlett.1c00240 | bibcode=2021EnSTL...8..538W | hdl=20.500.11850/495857 | s2cid=236284279| hdl-access=free}}</ref>


Many PFAS such as ] and ] pose health and environmental concerns because they are ]s; they were branded as "'''forever chemicals'''" in an article in '']'' in 2018.<ref>{{cite news |url=https://www.washingtonpost.com/opinions/these-toxic-chemicals-are-everywhere-and-they-wont-ever-go-away/2018/01/02/82e7e48a-e4ee-11e7-a65d-1ac0fd7f097e_story.html |title=Opinion: These toxic chemicals are everywhere — even in your body. And they won't ever go away |newspaper=] |date=January 2, 2018 |issn=0190-8286 |archive-date=May 9, 2019 |archive-url=https://web.archive.org/web/20190509013619/https://www.washingtonpost.com/opinions/these-toxic-chemicals-are-everywhere-and-they-wont-ever-go-away/2018/01/02/82e7e48a-e4ee-11e7-a65d-1ac0fd7f097e_story.html |url-status=live}}</ref> Some have ] of over eight years due to a ], one of the strongest in ].<ref name=Factsheet>{{Cite web | title=Per- and Polyfluorinated Substances (PFAS) Factsheet |date=18 January 2024 |url=https://www.atsdr.cdc.gov/pfas/resources/pfas-information-for-clinicians-factsheet.html | publisher=]}}</ref><ref name=Buck2011>{{cite journal | vauthors=Buck RC, Franklin J, Berger U, Conder JM, Cousins IT, de Voogt P, Jensen AA, Kannan K, Mabury SA, van Leeuwen SP | display-authors=6 | title=Perfluoroalkyl and polyfluoroalkyl substances in the environment: terminology, classification, and origins | journal=Integrated Environmental Assessment and Management | volume=7 | issue=4 | pages=513–541 | date=October 2011 | pmid=21793199 | pmc=3214619 | doi=10.1002/ieam.258 | bibcode=2011IEAM....7..513B}}</ref><ref>{{cite news | url=https://www.nytimes.com/2019/02/22/us/military-water-toxic-chemicals.html | title=Toxic 'Forever Chemicals' in Drinking Water Leave Military Families Reeling| vauthors=Turkewitz J |work=] | date=February 22, 2019 | url-access=limited |issn=0362-4331 | archive-date=June 8, 2019 | archive-url=https://web.archive.org/web/20190608111323/https://www.nytimes.com/2019/02/22/us/military-water-toxic-chemicals.html | url-status=live}}</ref><ref>{{cite news | url=https://www.cnn.com/2019/06/03/health/pfas-food-supply-fda/index.html |title=FDA confirms PFAS chemicals are in the US food supply | first=Nadia | last=Kounang | work=] |date=June 3, 2019 | archive-date=June 8, 2019 | archive-url=https://web.archive.org/web/20190608124826/https://www.cnn.com/2019/06/03/health/pfas-food-supply-fda/index.html | url-status=live}}</ref><ref>{{cite web | url=https://www.theguardian.com/us-news/2019/sep/11/pfas-toxic-forever-chemicals-hearing-3m-dupont-chemours | title=Companies deny responsibility for toxic 'forever chemicals' contamination | archive-url=https://web.archive.org/web/20190911233533/https://www.theguardian.com/us-news/2019/sep/11/pfas-toxic-forever-chemicals-hearing-3m-dupont-chemours | archive-date=September 11, 2019 | work=The Guardian | date=September 11, 2019}}</ref> They move through soils and ] in fish and wildlife, which are then eaten by humans. ] are now commonly found in ], ], and wastewater.<ref name=Factsheet/><ref name=Evidence>{{cite journal | vauthors=Munoz G, Budzinski H, Babut M, Drouineau H, Lauzent M, Menach KL, Lobry J, Selleslagh J, Simonnet-Laprade C, Labadie P | display-authors=6 | title=Evidence for the Trophic Transfer of Perfluoroalkylated Substances in a Temperate Macrotidal Estuary | journal=Environmental Science & Technology | volume=51 | issue=15 | pages=8450–8459 | date=August 2017 | pmid=28679050 | doi=10.1021/acs.est.7b02399 | bibcode=2017EnST...51.8450M | url=https://hal.archives-ouvertes.fr/hal-02067250/file/Main%20text_R1_2017-06-27.pdf}}</ref><ref>{{Cite web | first=Charlotte | last=Elton | title='Frightening' scale of Europe's forever chemical pollution revealed | url=https://www.euronews.com/green/2023/02/24/exposed-17000-european-sites-contaminated-by-forever-chemicals-where-are-the-worst-spots | work=] | date=February 24, 2023}}</ref><ref name=stuff>{{Cite magazine | url=https://time.com/6281242/pfas-forever-chemicals-home-beauty-body-products/ | title=All The Stuff in Your Home That Might Contain PFAS 'Forever Chemicals' | first=JEFFREY | last=KLUGER | magazine=] | date=May 19, 2023}}</ref> Since PFAS compounds are highly mobile, they are readily absorbed through ] and through ]s, and such products on ]s are often unwittingly ingested.<ref>{{cite web | work=The Guardian | location=UK | date=15 June 2021 | url=https://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals | title=Toxic 'Forever Chemicals' Widespread in Top Makeup Brands, Study Finds; Researchers Find Signs of PFAS in over Half of 231 Samples of Products Including Lipstick, Mascara and Foundation | archive-url=https://web.archive.org/web/20210626211117/https://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals | archive-date=June 26, 2021}}</ref> Due to the large number of PFAS, it is challenging to study and assess the potential human health and environmental risks; more research is necessary and is ongoing.<ref name=Understanding/><ref name=Factsheet/><ref name=Emerging/><ref name=Explained>{{Cite web |title=PFAS Explained | date=30 March 2016 | url=https://www.epa.gov/pfas/pfas-explained | publisher=]}}</ref>
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Exposure to PFAS, some of which have been classified as ]ic and/or as ]s, has been linked to ]s such as ], ] and ], ], ], suboptimal ] / decreased immunity, decreased fertility, hypertensive disorders in pregnancy, reduced infant and fetal growth and developmental issues in children, obesity, ] (abnormally high ]), and higher rates of ] interference.<ref name=Explained/><ref>{{Cite press release | title=New Report Calls for Expanded PFAS Testing for People With History of Elevated Exposure, Offers Advice for Clinical Treatment | url=https://www.nationalacademies.org/news/2022/07/new-report-calls-for-expanded-pfas-testing-for-people-with-history-of-elevated-exposure-offers-advice-for-clinical-treatment | publisher=] | date=July 28, 2022}}</ref><ref name=Carcinogenicity/>
'''Per- and polyfluoroalkyl substances''' ('''PFAS'''<ref>https://www.epa.gov/pfas</ref> or '''PFASs''') are a group of synthetic ] ]s that have multiple ] atoms attached to an ] chain. An early definition, from 2011, required that they contain at least one ] ], –C<sub>n</sub>F<sub>2n+1</sub>–.<ref name=":3">{{cite journal |vauthors = Buck RC, Franklin J, Berger U, Conder JM, Cousins IT, de Voogt P, Jensen AA, Kannan K, Mabury SA, van Leeuwen SP |display-authors = 6 |title = Perfluoroalkyl and polyfluoroalkyl substances in the environment: terminology, classification, and origins |journal = Integrated Environmental Assessment and Management |volume = 7 |issue = 4 |pages = 513–41 |date = October 2011 |pmid = 21793199 |pmc = 3214619 |doi = 10.1002/ieam.258 }}</ref><ref>{{cite journal |vauthors = Ritscher A, Wang Z, Scheringer M, Boucher JM, Ahrens L, Berger U, Bintein S, Bopp SK, Borg D, Buser AM, Cousins I, DeWitt J, Fletcher T, Green C, Herzke D, Higgins C, Huang J, Hung H, Knepper T, Lau CS, Leinala E, Lindstrom AB, Liu J, Miller M, Ohno K, Perkola N, Shi Y, Småstuen Haug L, Trier X, Valsecchi S, van der Jagt K, Vierke L |display-authors = 6 |title = Zürich Statement on Future Actions on Per- and Polyfluoroalkyl Substances (PFASs) |journal = Environmental Health Perspectives |volume = 126 |issue = 8 |pages = 84502 |date = August 2018 |pmid = 30235423 |pmc = 6375385 |doi = 10.1289/EHP4158}}</ref> Beginning in 2021, the ] (OECD) expanded their terminology, stating that "PFASs are defined as fluorinated substances that contain at least one fully fluorinated methyl or methylene ] atom (without any H/Cl/Br/I atom attached to it), i.e. with a few noted exceptions, any chemical with at least a ] ] (–CF<sub>3</sub>) or a perfluorinated ] (–CF<sub>2</sub>–) is a PFAS."<ref>{{cite web |author = OECD |url = https://www.oecd.org/chemicalsafety/portal-perfluorinated-chemicals/terminology-per-and-polyfluoroalkyl-substances.pdf |title = Reconciling Terminology of the Universe of Per- and Polyfluoroalkyl Substances: Recommendations and Practical Guidance |archive-url = https://web.archive.org/web/20210713155205/https://www.oecd.org/chemicalsafety/portal-perfluorinated-chemicals/terminology-per-and-polyfluoroalkyl-substances.pdf |archive-date = 13 July 2021 |series = OECD Series on Risk Management |issue = 61 |publisher = OECD Publishing |location = Paris |date = 2021 |page = 23 }}</ref><ref>{{cite journal |vauthors = Wang Z, Buser AM, Cousins IT, Demattio S, Drost W, Johansson O, Ohno K, Patlewicz G, Richard AM, Walker GW, White GS, Leinala E |display-authors = 6 |title = A New OECD Definition for Per- and Polyfluoroalkyl Substances |journal = Environmental Science & Technology |volume = 55 |issue = 23 |pages = 15575–15578 |date = December 2021 | pmid = 34751569 |doi = 10.1021/acs.est.1c06896 |s2cid = 243861839 |bibcode = 2021EnST...5515575W }}</ref>


The use of PFAS has been regulated internationally by the ] since 2009, with some jurisdictions, such as China and the ], planning further reductions and phase-outs. However, major producers and users such as the United States, Israel, and Malaysia have not ratified the agreement and the ] has lobbied governments to reduce regulations<ref name=bills/> or has moved production to countries such as Thailand, where there is less regulation.<ref name="Zürich">{{Cite journal |last1=DeWitt |first1=Jamie C. |last2=Glüge |first2=Juliane |last3=Cousins |first3=Ian T. |last4=Goldenman |first4=Gretta |last5=Herzke |first5=Dorte |last6=Lohmann |first6=Rainer |last7=Miller |first7=Mark |last8=Ng |first8=Carla A. |last9=Patton |first9=Sharyle |last10=Trier |first10=Xenia |last11=Vierke |first11=Lena |last12=Wang |first12=Zhanyun |last13=Adu-Kumi |first13=Sam |last14=Balan |first14=Simona |last15=Buser |first15=Andreas M. |date=April 22, 2024 |title=Zürich II Statement on Per- and Polyfluoroalkyl Substances (PFASs): Scientific and Regulatory Needs |journal=] |volume=11 |issue=8 |pages=786–797 |bibcode=2024EnSTL..11..786D |doi=10.1021/acs.estlett.4c00147 |pmc=11325642 |pmid=39156923 |doi-access=free |hdl-access=free |last16=Fletcher |first16=Tony |last17=Haug |first17=Line Småstuen |last18=Huang |first18=Jun |last19=Kaserzon |first19=Sarit |last20=Leonel |first20=Juliana |last21=Sheriff |first21=Ishmail |last22=Shi |first22=Ya-Li |last23=Valsecchi |first23=Sara |last24=Scheringer |first24=Martin |hdl=20.500.11850/679165}}</ref><ref name=across>{{Cite web | url=https://ipen.org/sites/default/files/documents/pfas_pollution_across_the_middle_east_and_asia.pdf | title=PFAS POLLUTION ACROSS THE MIDDLE EAST AND ASIA | work=] | date=April 2019}}</ref> In the United States, the ] has ]ed bills regulating the chemicals.<ref name=bills/> Cover-ups and the suppression of studies in 2018 by the ] led to bipartisan outrage.<ref name=outrage/><ref name=headed/>
According to the OECD, at least 4,730 distinct PFASs that contain at least three perfluorinated carbon atoms are known.<ref>{{cite report |title=Toward a New Comprehensive Global Database of Per- and Polyfluoroalkyl Substances (PFASs): Summary Report on Updating the OECD 2007 List of Per- and Polyfluoroalkyl Substances (PFASs) |url=http://www.oecd.org/officialdocuments/publicdisplaydocumentpdf/?cote=ENV-JM-MONO(2018)7&doclanguage=en |publisher=] |series=Series on Risk Management No. 39 |date= |access-date=9 December 2019 |archive-date=17 January 2020 |archive-url=https://web.archive.org/web/20200117231946/http://www.oecd.org/officialdocuments/publicdisplaydocumentpdf/?cote=ENV-JM-MONO(2018)7&doclanguage=en |url-status=live }}</ref> The ]'s (EPA) toxicity database, DSSTox, lists 14,735 unique PFAS chemical compounds,<ref>{{cite web |title=PFAS structures in DSSTox (update August 2022) |url=https://comptox.epa.gov/dashboard/chemical_lists/PFASSTRUCT |url-status=live |access-date=2022-10-21 |website=] |publisher=U.S. Environmental Protection Agency (EPA) |location=Washington, D.C.}} "List consists of all DTXSID records with a structure assigned, and using a set of substructural filters based on community input."</ref> while ] lists approximately 6 million.<ref>{{Cite web |title=PubChem Classification Browser – PFAS and Fluorinated Compounds in PubChem Tree |url=https://pubchem.ncbi.nlm.nih.gov/classification/#hid=120 |access-date=2022-10-21 |website=pubchem.ncbi.nlm.nih.gov |publisher=]}}</ref> The ''fluorinated surfactants'' or ''fluorosurfactants'' subgroup has a fluorinated "tail" and a ] "head" and are thus considered ]. These are more effective at reducing the ] of water than comparable ] surfactants. They include the ], such as ] (PFOS), and the ]s like ] (PFOA).


The market for PFAS was estimated to be $28 billion in 2023 and the majority are produced by 12 companies: ], ], Archroma, ], ], ], ], ], ], ], Shandong Dongyue Chemical, and ].<ref>{{Cite news | url=https://chemsec.org/reports/the-top-12-pfas-producers-in-the-world-and-the-staggering-societal-costs-of-pfas-pollution/ | title=The top 12 PFAS producers in the world and the staggering societal costs of PFAS pollution | work=] | date=May 25, 2023}}</ref> Sales of PFAS, which cost approximately $20 per kilogram, generate a total industry profit of $4 billion per year on 16% ]s.<ref name=cost/> Due to health concerns, several companies have ended or plan to end the sale of PFAS or products that contain them; these include ] (the maker of ]), ], ], ], and ].<ref>{{Cite news | url=https://www.patagonia.com/stories/say-goodbye-to-forever-chemicals/story-133800.html | title=Say Goodbye to "Forever Chemicals" | first=Archana | last=Ram | work=] | date=March 22, 2023}}</ref><ref>{{Cite news | url=https://www.usatoday.com/story/money/shopping/2023/02/22/rei-stores-forever-chemicals-products/11321761002/ | title=REI announces plan to remove 'forever chemicals' from its products by 2026 | first=Mike | last=Snider | work=] | date=February 22, 2023}}</ref><ref>{{Cite news | url=https://hmgroup.com/our-stories/phasing-out-pfas/ | title=Phasing out PFAS | work=] | date=February 27, 2019}}</ref><ref>{{cite magazine | url=https://cen.acs.org/environment/persistent-pollutants/3M-says-end-PFAS-production/101/i1 | first=Alexander H. | last=Tullo | title=3M says it will end PFAS production by 2025 | magazine=] | volume=101 | issue=1 | page=4 | doi=10.1021/cen-10101-leadcon | date=December 29, 2022 | url-access=limited}}</ref><ref>{{cite press release | url=https://news.3m.com/2022-12-20-3M-to-Exit-PFAS-Manufacturing-by-the-End-of-2025 |title=3M to Exit PFAS Manufacturing by the End of 2025 | publisher=] | date=December 20, 2022}}</ref><ref>{{Cite news | url=https://www.spokesman.com/stories/2024/feb/15/amid-pollution-investigation-maker-of-gore-tex-cut/ | title=Amid pollution investigation, maker of Gore-Tex cuts PFAS from outdoor clothing | first=Christine | last=Condon | agency=] | work=] | date=February 15, 2024}}</ref> PFAS producers have paid billions of dollars to settle litigation claims, the largest being a $10.3 billion settlement paid by 3M for water contamination in 2023.<ref name=settle/> Studies have shown that companies have known of the health dangers since the 1970s – DuPont and 3M were aware that PFAS was "highly toxic when inhaled and moderately toxic when ingested".<ref name=Devil/> ], including those associated with remediation of PFAS from soil and water contamination, treatment of related diseases, and monitoring of PFAS pollution, may be as high as US$17.5 trillion annually, according to ].<ref name=cost>{{cite news | url=https://www.theguardian.com/environment/2023/may/12/pfas-forever-chemicals-societal-cost-new-report | title=Societal cost of 'Forever Chemicals' About $17.5tn Across Global Economy—Report | first=Tom | last=Perkins | work=] | date=May 12, 2023}}</ref> The ] estimated health costs to be at least €52–84 billion in the ].<ref name=Nordic>{{Cite web | url=http://norden.diva-portal.org/smash/get/diva2:1295959/FULLTEXT01.pdf | title=Nordic Council of Ministers (2019). The cost of inaction. A socioeconomic analysis of environmental and health impacts linked to exposure | archive-url=https://web.archive.org/web/20191001215048/http://norden.diva-portal.org/smash/get/diva2:1295959/FULLTEXT01.pdf | archive-date=1 October 2019 | url-status=live}}</ref> In the United States, PFAS-attributable disease costs are estimated to be US$6–62 billion.<ref>{{Cite journal | vauthors=Obsekov V, Kahn LG, Trasande L |date=July 26, 2022 |title=Leveraging Systematic Reviews to Explore Disease Burden and Costs of Per- and Polyfluoroalkyl Substance Exposures in the United States | journal=Exposure and Health | volume=15 |issue=2 |pages=373–394 | doi=10.1007/s12403-022-00496-y | pmid=37213870 | pmc=10198842 |s2cid=251072281 | issn=2451-9766}}</ref><ref>{{Cite press release | url=https://nyulangone.org/news/daily-exposure-forever-chemicals-costs-united-states-billions-health-costs | title=Daily Exposure to 'Forever Chemicals' Costs United States Billions in Health Costs | publisher=] | date=July 26, 2022}}</ref>
Many PFASs were used in the mid-20th century in products and on materials due to their enhanced water-resistant properties, such as within ] or ]. Only since the start of the 21st century has the environmental impact and toxicity to human and mammalian life been studied in depth. PFOS, PFOA and other PFASs are commonly described as ]s or "forever chemicals" because they remain in the environment for long periods of time. ] have been detected in humans and wildlife, prompting concern about impacts to health.<ref name="Houde_200606">{{cite journal |vauthors = Houde M, Martin JW, Letcher RJ, Solomon KR, Muir DC |title = Biological monitoring of polyfluoroalkyl substances: A review |journal = Environmental Science & Technology |volume = 40 |issue = 11 |pages = 3463–73 |date = June 2006 |pmid = 16786681 |doi = 10.1021/es052580b |bibcode = 2006EnST...40.3463H }} {{cite journal |url = http://pubs.acs.org/doi/suppl/10.1021/es052580b/suppl_file/es052580bsi20060303_021408.pdf |title = Supporting Information |year = 2006 |doi = 10.1021/es052580b |pmid = 16786681 |archive-url = https://web.archive.org/web/20191014154012/http://pubs.acs.org/doi/suppl/10.1021/es052580b/suppl_file/es052580bsi20060303_021408.pdf |archive-date=October 14, 2019 |vauthors = Houde M, Martin JW, Letcher RJ, Solomon KR, Muir DC |journal = Environmental Science & Technology |volume = 40 |issue = 11 |pages = 3463–3473 |bibcode = 2006EnST...40.3463H }}</ref><ref>{{cite web |title=Per- and Polyfluorinated Substances (PFAS) Factsheet |url=https://www.cdc.gov/biomonitoring/PFAS_FactSheet.html |website=National Biomonitoring Program |date=2 September 2021 |publisher=] |access-date=10 October 2021}}</ref><ref>{{Cite web |last=Elton |first=Charlotte |date=2023-02-24 |title='Frightening' scale of Europe's forever chemical pollution revealed |url=https://www.euronews.com/green/2023/02/24/exposed-17000-european-sites-contaminated-by-forever-chemicals-where-are-the-worst-spots |access-date=2023-02-25 |website=euronews |language=en}}</ref> According to the ], PFAS exposure is linked to increased risk of ] (abnormally high cholesterol), suboptimal ], reduced infant and fetal growth, and higher rates of ].<ref>{{Cite web |date=2022-07-28 |title=New Report Calls for Expanded PFAS Testing for People With History of Elevated Exposure, Offers Advice for Clinical Treatment |url=https://www.nationalacademies.org/news/2022/07/new-report-calls-for-expanded-pfas-testing-for-people-with-history-of-elevated-exposure-offers-advice-for-clinical-treatment |access-date=2022-08-04 |website=National Academies of Sciences, Engineering, and Medicine (NASEM)}}</ref>


==Definition==
Health concerns related to PFASs have resulted in numerous litigations (see '']''). In 2023, the American multinational ] reached a US$10.3 ] settlement with a host of US public water systems to resolve water pollution claims tied to PFAS.<ref name=":21">{{Cite news |last= |date=2023-06-22 |title=3M pays $10.3bn to settle water pollution suit over 'forever chemicals' |language=en-GB |work=The Guardian |url=https://www.theguardian.com/environment/2023/jun/22/3m-settlement-municipal-water-systems-pfas-contamination |access-date=2023-06-24 |issn=0261-3077}}</ref> Three other major chemicals companies – ], ] and ] – have reached an agreement in principle for US$1.19 bn to settle claims they contaminated US public water systems with PFAS.<ref name=":21" /> In 2021, ] became the first U.S. state to ban these compounds in all products by 2030, except for instances deemed "currently unavoidable".<ref>{{cite web |vauthors = Perkins T |date = 16 July 2021 |url = https://www.theguardian.com/us-news/2021/jul/15/maine-law-pfas-forever-chemicals-ban |title = Maine bans toxic 'forever chemicals' under groundbreaking new law |archive-url = https://web.archive.org/web/20210716071833/https://www.theguardian.com/us-news/2021/jul/15/maine-law-pfas-forever-chemicals-ban |archive-date=July 16, 2021 |work = The Guardian }}</ref><ref>{{Cite journal |vauthors = Lim XZ |title=Maine's ban on 'forever chemicals' marks a big win for some scientists|url=https://www.science.org/news/2021/08/maine-s-ban-forever-chemicals-marks-big-win-some-scientists |journal=Science |doi=10.1126/science.abm1382 |date=2021-08-27 |access-date=31 August 2021 |archive-date=31 August 2021 |archive-url=https://web.archive.org/web/20210831164644/https://www.science.org/news/2021/08/maine-s-ban-forever-chemicals-marks-big-win-some-scientists |url-status=live}}</ref>
]
]
Per- and polyfluoroalkyl substances are a group of synthetic ] ]s that have multiple ] atoms attached to an ] chain. Different organizations use different definitions for PFAS, leading to estimates of between 8,000 and 7 million chemicals within the group. The EPA toxicity database, DSSTox, lists 14,735 unique PFAS chemical compounds.<ref>{{cite web | url=https://comptox.epa.gov/dashboard/chemical-lists/PFASSTRUCT | title=PFAS structures in DSSTox | website=] | publisher=]}} "List consists of all DTXSID records with a structure assigned, and using a set of substructural filters based on community input."</ref><ref name="Gaines2023">{{cite journal | last1=Gaines | first1=Linda G. T. | last2=Sinclair | first2=Gabriel | last3=Williams | first3=Antony J. | title=A proposed approach to defining per- and polyfluoroalkyl substances (PFAS) based on molecular structure and formula | journal=Integrated Environmental Assessment and Management | volume=19 | issue=5 | date=2023 | issn=1551-3777 | pmid=36628931 | pmc=10827356 | doi=10.1002/ieam.4735 | pages=1333–1347| bibcode=2023IEAM...19.1333G }}</ref>


An early definition required that they contain at least one ] ], {{chem2|\sC_{''n''}F_{2''n''+1}|}}.<ref name=Buck2011/> Beginning in 2021, the OECD expanded its terminology, stating that "PFAS are defined as fluorinated substances that contain at least one fully fluorinated methyl or methylene ] atom (without any H/Cl/Br/I atom attached to it), i.e., with a few noted exceptions, any chemical with at least a ] ] (''{{chem2|\sCF3|}}'') or a perfluorinated ] ({{chem2|\sCF2\s|}}) is a PFAS."<ref name=Terminology>{{Cite book |last= |title=Reconciling Terminology of the Universe of Per- and Polyfluoroalkyl Substances: Recommendations and Practical Guidance |date=2021 |publisher=OECD |isbn=978-92-64-51128-6 |series=OECD Series on Risk Management of Chemicals |pages=23 |language=en |doi=10.1787/e458e796-en}}</ref><ref>{{cite journal |display-authors=6 | vauthors=Wang Z, Buser AM, Cousins IT, Demattio S, Drost W, Johansson O, Ohno K, Patlewicz G, Richard AM, Walker GW, White GS, Leinala E | date=December 2021 |title=A New OECD Definition for Per- and Polyfluoroalkyl Substances | journal=Environmental Science & Technology |volume=55 |issue=23 |pages=15575–15578 | bibcode=2021EnST...5515575W | doi=10.1021/acs.est.1c06896 |pmid=34751569 | s2cid=243861839 | doi-access=free}}</ref> This definition notably includes ].
]
]


The ] defines PFAS in the ''Drinking Water Contaminant Candidate List 5'' as substances that contain "at least one of the following three structures: {{chem2|R\sCF2\sCF(R')R"}}, where both the {{chem2|\sCF2\s|}} and {{chem2|\sCF\s|}} moieties are saturated carbons, and none of the R groups can be hydrogen; {{chem2|R\sCF2\sO\sCF2\s(R')}}, where both the {{chem2|\sCF2\s|}} moieties are saturated carbons, and none of the R groups can be hydrogen; or {{chem2|CF3\sC\s(CF3)RR'}}, where all the carbons are saturated, and none of the R groups can be hydrogen.<ref>{{Cite web |date=2022-11-14 |title=Drinking Water Contaminant Candidate List 5-Final |url=https://www.federalregister.gov/documents/2022/11/14/2022-23963/drinking-water-contaminant-candidate-list-5-final#p-105 |access-date=2024-09-21 |website=Federal Register |language=en}}</ref>
==Fluorosurfactants==
] makes a fabric water-resistant.]]


A summary table of some PFAS definitions is provided in Hammel et al (2022).<ref>{{Cite journal |last1=Hammel |first1=Emily |last2=Webster |first2=Thomas F. |last3=Gurney |first3=Rich |last4=Heiger-Bernays |first4=Wendy |date=April 2022 |title=Implications of PFAS definitions using fluorinated pharmaceuticals |journal=iScience |volume=25 |issue=4 |pages=104020 |doi=10.1016/j.isci.2022.104020 |issn=2589-0042 |pmc=8933701 |pmid=35313699|bibcode=2022iSci...25j4020H }}</ref>
Fluorosurfactants are ] containing ] chains such as those in PFASs. Their ] nature can reduce the surface tension of water below what is attainable by using ] surfactants,<ref name=Salager2002>{{cite web | vauthors = Salager JL |title=Surfactants-Types and Uses |version=FIRP Booklet # 300-A |pages=45 |publisher=Universidad de los Andes Laboratory of Formulation, Interfaces Rheology, and Processes |year=2002 |url=http://nanoparticles.org/pdf/Salager-E300A.pdf |access-date=2008-09-07 |journal= |archive-date=July 31, 2020 |archive-url=https://web.archive.org/web/20200731194249/http://nanoparticles.org/pdf/Salager-E300A.pdf |url-status=live }}</ref> so fluorosurfactants tend to concentrate at the liquid-air ].<ref>{{cite web|url=http://www.masonsurfactants.com/Products/Fluorosurfactant.htm|title=Fluorosurfactant &mdash; Structure / Function|date=2007|work=Mason Chemical Company|url-status=dead|archive-url=https://web.archive.org/web/20080705074650/http://www.masonsurfactants.com/Products/Fluorosurfactant.htm|archive-date=2008-07-05|access-date=2008-11-01}}</ref> Fluorocarbons are both ] and hydrophobic, which allows them to repel both oil and water. Their lipophobicity results from the relative lack of ]s when compared to hydrocarbons, a consequence of fluorine's large ] and small bond length, which reduce the ] of the surfactants' fluorinated molecular surface. Fluorosurfactants are more stable and fit for harsher conditions than hydrocarbon surfactants because of the stability of the ]. Perfluorinated surfactants persist in the environment for the same reason.<ref name="Houde_200606"/>


===Fluorosurfactants===
==Economic role==
] makes a fabric water-resistant.]]
PFASs play a key economic role for companies such as ], ], and ] because they are used in ] to produce ]s. They have two main markets: a $1 billion annual market for use in stain repellents, and a $100 million annual market for use in polishes, paints, and coatings.<ref name=long>{{cite journal | vauthors = Renner R | title = The long and the short of perfluorinated replacements | journal = Environmental Science & Technology | volume = 40 | issue = 1 | pages = 12–3 | date = January 2006 | pmid = 16433328 | doi = 10.1021/es062612a | bibcode = 2006EnST...40...12R }}</ref> In 2022, 3M announced that it will end PFAS production by 2025.<ref>{{cite magazine |last1=Tullo |first1=Alexander H. |title=3M says it will end PFAS production by 2025 |magazine=] |date=December 29, 2022 |volume=101 |issue=1 |page=4 |doi=10.1021/cen-10101-leadcon |url=https://cen.acs.org/environment/persistent-pollutants/3M-says-end-PFAS-production/101/i1 |access-date=2 April 2023}}</ref><ref>{{cite press release |title=3M to Exit PFAS Manufacturing by the End of 2025 |url=https://news.3m.com/2022-12-20-3M-to-Exit-PFAS-Manufacturing-by-the-End-of-2025 |access-date=2 April 2023 |work=3M News Center |date=December 20, 2022}}</ref>


''Fluorinated surfactants'' or ''fluorosurfactants'' are a subgroup of PFAS characterized by a ] fluorinated "tail" and a ] "head" that behave as ]. These are more effective at reducing the ] of water than comparable ] surfactants.<ref>{{cite journal | pmid=24814169 | title=Fluoro- vs hydrocarbon surfactants: why do they differ in wetting performance? | first1=N M | last1=Kovalchuk | first2=A |last2=Trybala | first3=V | last3=Starov | first4=O | last4=Matar | first5=N | last5=Ivanova | journal=Advances in Colloid and Interface Science | date=August 2014| volume=210 | pages=65–71 | doi=10.1016/j.cis.2014.04.003 | hdl=10044/1/26321 | hdl-access=free }}</ref> They include the ], such as ] (PFOS), and the ]s like ] (PFOA).
==Health and environmental concerns==
{{Pollution sidebar}}


As with other surfactants, fluorosurfactants tend to concentrate at the phase ].<ref>{{Cite journal |last1=Schaefer |first1=Charles E. |last2=Culina |first2=Veronika |last3=Nguyen |first3=Dung |last4=Field |first4=Jennifer |date=2019-11-05 |title=Uptake of Poly- and Perfluoroalkyl Substances at the Air–Water Interface |url=https://pubs.acs.org/doi/10.1021/acs.est.9b04008 |journal=Environmental Science & Technology |language=en |volume=53 |issue=21 |pages=12442–12448 |doi=10.1021/acs.est.9b04008 |pmid=31577432 |bibcode=2019EnST...5312442S |issn=0013-936X}}</ref> Fluorocarbons are both ] and hydrophobic, repelling both oil and water. Their lipophobicity results from the relative lack of ]s compared to hydrocarbons, a consequence of fluorine's large ] and small bond length, which reduce the ] of the surfactants' fluorinated molecular surface. Fluorosurfactants are more stable than hydrocarbon surfactants due to the stability of the ]. Perfluorinated surfactants persist in the environment for the same reason.<ref name=Evidence/>
=== Human health concerns associated with PFASs ===

On their introduction in the 1940s, PFASs were considered ].<ref name=":1">{{cite journal|date=2019-05-27|title=Guide to PFAS in our environment debuts|journal=C&EN Global Enterprise|volume=97|issue=21|pages=12|doi=10.1021/cen-09721-polcon2|s2cid=199655540|issn=2474-7408}}</ref><ref>{{cite journal|date=2006-10-25|title=Preliminary Lists of PFOS, PFAS, PFOA and Related Compounds and Chemicals that May Degrade to PFCA|journal=OECD Papers|volume=6|issue=11|pages=1–194|doi=10.1787/oecd_papers-v6-art38-en|issn=1609-1914}}</ref> Early occupational studies revealed elevated levels of fluorochemicals, including ] (PFOS) and ] (PFOA, C8), in the blood of exposed industrial workers, but cited no ill health effects.<ref name=":13">{{cite journal | vauthors = Ubel FA, Sorenson SD, Roach DE | title = Health status of plant workers exposed to fluorochemicals—a preliminary report | journal = American Industrial Hygiene Association Journal | volume = 41 | issue = 8 | pages = 584–9 | date = August 1980 | pmid = 7405826 | doi = 10.1080/15298668091425310 }}</ref><ref name=":2">{{cite journal | vauthors = Olsen GW, Burris JM, Burlew MM, Mandel JH | title = Epidemiologic assessment of worker serum perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) concentrations and medical surveillance examinations | journal = Journal of Occupational and Environmental Medicine | volume = 45 | issue = 3 | pages = 260–70 | date = March 2003 | pmid = 12661183 | doi = 10.1097/01.jom.0000052958.59271.10 | s2cid = 11648767 }}</ref> These results were consistent with the measured serum concentrations of PFOS and PFOA in 3M plant workers ranging from 0.04 to 10.06 ppm and 0.01 to 12.70&nbsp;ppm, respectively, well below toxic and ]ic levels cited in animal studies.<ref name=":2" /> Given, however, the "forever chemical" property of PFASs (serum elimination ] of 4–5 years) and widespread environmental contamination, molecules have been shown to accumulate in humans to such a degree that adverse health outcomes have resulted.<ref name=":1" />
Fluorosurfactants such as PFOS, PFOA, and ] (PFNA) have caught the attention of regulatory agencies because of their persistence, toxicity, and widespread occurrence in the blood of general populations.<ref>{{cite journal | vauthors=Calafat AM, Wong LY, Kuklenyik Z, Reidy JA, Needham LL | title=Polyfluoroalkyl chemicals in the U.S. population: data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and comparisons with NHANES 1999-2000 | journal=Environmental Health Perspectives | volume=115 | issue=11 | pages=1596–1602 | date=November 2007 | pmid=18007991 | pmc=2072821 | doi=10.1289/ehp.10598}}</ref><ref>{{cite journal | vauthors=Wang Z, Cousins IT, Berger U, Hungerbühler K, Scheringer M | title=Comparative assessment of the environmental hazards of and exposure to perfluoroalkyl phosphonic and phosphinic acids (PFPAs and PFPiAs): Current knowledge, gaps, challenges and research needs | journal=Environment International | volume=89-90 | pages=235–247 | year=2016 | pmid=26922149 | doi=10.1016/j.envint.2016.01.023| bibcode=2016EnInt..89..235W}}</ref>

PFASs are used in ] to produce ]s, used in stain repellents, polishes, paints, and ]s.<ref name=long>{{cite journal | vauthors=Renner R | title=The long and the short of perfluorinated replacements | journal=Environmental Science & Technology | volume=40 | issue=1 | pages=12–13 | date=January 2006 | pmid=16433328 | doi=10.1021/es062612a | bibcode=2006EnST...40...12R | doi-access=free}}</ref>

==Health and environmental effects==
{{Pollution sidebar}}
PFASs were originally considered to be ].<ref name=guide>{{cite journal | url=https://cen.acs.org/sections/pfas.html | date=May 27, 2019 | title=A guide to the PFAS found in our environment | journal=] | volume=97 | issue=21 | pages=12 | doi=10.1021/cen-09721-polcon2 | s2cid=199655540 | issn=2474-7408 | last=Hogue | first=Cheryl}}</ref><ref>{{cite journal |date=October 25, 2006 | title=Preliminary Lists of PFOS, PFAS, PFOA and Related Compounds and Chemicals that May Degrade to PFCA|journal=OECD Papers| volume=6 | issue=11 | pages=1–194 | doi=10.1787/oecd_papers-v6-art38-en |issn=1609-1914}}</ref> Early occupational studies revealed elevated levels of fluorochemicals, including ] (PFOS) and ] (PFOA, C8), in the blood of exposed industrial workers, but cited no ill health effects.<ref name=status>{{cite journal | vauthors=Ubel FA, Sorenson SD, Roach DE | title=Health status of plant workers exposed to fluorochemicals—a preliminary report | journal=American Industrial Hygiene Association Journal | volume=41 | issue=8 | pages=584–589 | date=August 1980 | pmid=7405826 | doi=10.1080/15298668091425310}}</ref><ref name=assessment>{{cite journal | vauthors=Olsen GW, Burris JM, Burlew MM, Mandel JH | title=Epidemiologic assessment of worker serum perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) concentrations and medical surveillance examinations | journal=Journal of Occupational and Environmental Medicine | volume=45 | issue=3 | pages=260–270 | date=March 2003 | pmid=12661183 | doi=10.1097/01.jom.0000052958.59271.10 | s2cid=11648767}}</ref> These results were consistent with the measured serum concentrations of PFOS and PFOA in ] plant workers ranging from 0.04 to 10.06 ppm and 0.01 to 12.70&nbsp;ppm, respectively, well below toxic and ]ic levels cited in animal studies.<ref name=assessment/> Given, however, the serum elimination ] of four to five years and widespread environmental contamination, molecules have been shown to accumulate in humans sufficiently to cause adverse health outcomes.<ref name=guide/>


] | date = 2019 }}</ref><ref name=":12">{{cite web | url = https://wwwn.cdc.gov/TSP/ToxProfiles/ToxProfiles.aspx?id=1117&tid=237 | title = Toxicological profile for Perfluoroalkyls | archive-url = https://web.archive.org/web/20210512154522/https://wwwn.cdc.gov/TSP/ToxProfiles/ToxProfiles.aspx?id=1117&tid=237 | archive-date=May 12, 2021 | work = ] | date = 2018 }}</ref><ref>{{cite book | chapter-url = https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Some-Chemicals-Used-As-Solvents-And-In-Polymer-Manufacture-2016 | chapter = Some Chemicals Used as Solvents and in Polymer Manufacture | archive-url = https://web.archive.org/web/20200324104056/https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Some-Chemicals-Used-As-Solvents-And-In-Polymer-Manufacture-2016 | archive-date=March 24, 2020 | title = IARC Monographs on the Evaluation of Carcinogenic Risks to Humans | volume = 110| date = 2016}}</ref><ref>{{cite journal | vauthors = Barry V, Winquist A, Steenland K | title = Perfluorooctanoic acid (PFOA) exposures and incident cancers among adults living near a chemical plant | journal = Environmental Health Perspectives | volume = 121 | issue = 11–12 | pages = 1313–8 | year = 2013 | pmid = 24007715 | pmc = 3855514 | doi = 10.1289/ehp.1306615 }}</ref><ref>{{cite journal | vauthors = Fenton SE, Reiner JL, Nakayama SF, Delinsky AD, Stanko JP, Hines EP, White SS, Lindstrom AB, Strynar MJ, Petropoulou SE | display-authors = 6 | title = Analysis of PFOA in dosed CD-1 mice. Part 2. Disposition of PFOA in tissues and fluids from pregnant and lactating mice and their pups | journal = Reproductive Toxicology | volume = 27 | issue = 3–4 | pages = 365–372 | date = June 2009 | pmid = 19429407 | pmc = 3446208 | doi = 10.1016/j.reprotox.2009.02.012 }}</ref><ref>{{cite journal | vauthors = White SS, Stanko JP, Kato K, Calafat AM, Hines EP, Fenton SE | title = Gestational and chronic low-dose PFOA exposures and mammary gland growth and differentiation in three generations of CD-1 mice | journal = Environmental Health Perspectives | volume = 119 | issue = 8 | pages = 1070–6 | date = August 2011 | pmid = 21501981 | pmc = 3237341 | doi = 10.1289/ehp.1002741 }}</ref>]] ]|date=December 12, 2019}}</ref><ref>{{cite book | chapter-url=https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Some-Chemicals-Used-As-Solvents-And-In-Polymer-Manufacture-2016 | chapter=Some Chemicals Used as Solvents and in Polymer Manufacture | archive-url=https://web.archive.org/web/20200324104056/https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Some-Chemicals-Used-As-Solvents-And-In-Polymer-Manufacture-2016 | archive-date=March 24, 2020 | title=IARC Monographs on the Evaluation of Carcinogenic Risks to Humans | volume=110| date=2016}}</ref><ref>{{cite journal | vauthors=Fenton SE, Reiner JL, Nakayama SF, Delinsky AD, Stanko JP, Hines EP, White SS, Lindstrom AB, Strynar MJ, Petropoulou SE | display-authors=6 | title=Analysis of PFOA in dosed CD-1 mice. Part 2. Disposition of PFOA in tissues and fluids from pregnant and lactating mice and their pups | journal=Reproductive Toxicology | volume=27 | issue=3–4 | pages=365–372 | date=June 2009 | pmid=19429407 | pmc=3446208 | doi=10.1016/j.reprotox.2009.02.012 | bibcode=2009RepTx..27..365F}}</ref>]]


===Prevalence in rain, soil, water bodies, and air===
], including PFASs, are linked with ].<ref name="swan-and-colino-2021">
In 2022, levels of at least four perfluoroalkyl acids (PFAAs) in ] water worldwide greatly exceeded the EPA's lifetime ] health advisories as well as comparable Danish, Dutch, and ] safety standards, leading to the conclusion that "the global spread of these four PFAAs in the atmosphere has led to the ] for chemical pollution being exceeded".<ref>{{cite journal | vauthors=Cousins IT, Johansson JH, Salter ME, Sha B, Scheringer M | title=Outside the Safe Operating Space of a New Planetary Boundary for Per- and Polyfluoroalkyl Substances (PFAS) | journal=] | volume=56 | issue=16 | pages=11172–11179 |date=August 2022 | pmid=35916421 | doi=10.1021/acs.est.2c02765 | publisher=] | pmc=9387091 | bibcode=2022EnST...5611172C}}</ref>
{{cite book
| vauthors = Swan SH, Colino S
| title = Count down: how our modern world is threatening sperm counts, altering male and female reproductive development, and imperiling the future of the human race
| date = February 2021
| publisher = Scribner
| location = New York, USA
| isbn = 978-1-9821-1366-7
}}
</ref> In a ] for associations between PFASs and human clinical ]s for liver injury, authors considered both PFAS effects on liver biomarkers and histological data from rodent experimental studies and concluded that evidence exists showing that PFOA, ] (PFHxS), and ] (PFNA) are hepatotoxic to humans.<ref>{{cite journal | vauthors = Costello E, Rock S, Stratakis N, Eckel SP, Walker DI, Valvi D, Cserbik D, Jenkins T, Xanthakos SA, Kohli R, Sisley S, Vasiliou V, La Merrill MA, Rosen H, Conti DV, McConnell R, Chatzi L | display-authors = 6 | title = Exposure to per- and Polyfluoroalkyl Substances and Markers of Liver Injury: A Systematic Review and Meta-Analysis | journal = Environmental Health Perspectives | volume = 130 | issue = 4 | pages = 46001 | date = April 2022 | pmid = 35475652 | pmc = 9044977 | doi = 10.1289/EHP10092 }}</ref>


It had been thought that PFAAs would eventually end up in the oceans, where they would be diluted over decades, but a field study published in 2021 by researchers at ] found that they are often transferred from water to air when waves reach land, are a significant source of ], and eventually get into rain. The researchers concluded that pollution may impact large areas.<ref>{{Cite news |last=Perkins |first=Tom |date=18 December 2021 |title=PFAS 'forever chemicals' constantly cycle through ground, air and water, study finds |url=https://www.theguardian.com/environment/2021/dec/17/pfas-forever-chemicals-constantly-cycle-through-ground-air-and-water-study-finds |newspaper=]}}</ref><ref>{{cite journal |vauthors=Sha B, Johansson JH, Tunved P, Bohlin-Nizzetto P, Cousins IT, Salter ME |date=January 2022 |title=Sea Spray Aerosol (SSA) as a Source of Perfluoroalkyl Acids (PFAAs) to the Atmosphere: Field Evidence from Long-Term Air Monitoring |journal=] |publisher=] |volume=56 |issue=1 |pages=228–238 |bibcode=2022EnST...56..228S |doi=10.1021/acs.est.1c04277 |pmc=8733926 |pmid=34907779}}</ref><ref>{{Cite journal |last1=Sha |first1=Bo |last2=Johansson |first2=Jana H. |last3=Salter |first3=Matthew E. |last4=Blichner |first4=Sara M. |last5=Cousins |first5=Ian T. |date=2024 |title=Constraining global transport of perfluoroalkyl acids on sea spray aerosol using field measurements |journal=] |volume=10 |issue=14 |pages=eadl1026 |doi=10.1126/sciadv.adl1026 |pmc=10997204 |pmid=38579007|bibcode=2024SciA...10L1026S }}</ref>
Many comprehensive epidemiological studies linking adverse human health effects to PFASs, particularly PFOA, come from the C8 Science Panel.<ref name="c8sciencepanel">{{cite web |url=http://www.c8sciencepanel.org |title=C8 Science Panel |website=www.c8sciencepanel.org |access-date=June 8, 2019 |archive-date=June 18, 2019 |archive-url=https://web.archive.org/web/20190618160631/http://www.c8sciencepanel.org/ |url-status=live }}</ref> The panel was formed as part of a contingency to a class action lawsuit brought by communities in the ] against DuPont in response to landfill and wastewater dumping of PFAS-laden material from DuPont's West Virginia ].<ref name="c8sciencepanel" /> The panel measured PFOA (also known as C8) serum concentrations in 69,000 individuals from around DuPont's Washington Works Plant and found a mean concentration of 83.0&nbsp;ng/mL, compared to 4&nbsp;ng/mL in a standard population of Americans.<ref>{{cite journal | vauthors = Steenland K, Jin C, MacNeil J, Lally C, Ducatman A, Vieira V, Fletcher T | title = Predictors of PFOA levels in a community surrounding a chemical plant | journal = Environmental Health Perspectives | volume = 117 | issue = 7 | pages = 1083–8 | date = July 2009 | pmid = 19654917 | pmc = 2717134 | doi = 10.1289/ehp.0800294 }}</ref> This panel reported probable links between elevated PFOA blood concentration and ], ], ], ], ] as well as pregnancy-induced ] and ].<ref name="c8sciencepanel.org">{{cite web | title = Probable Link Evaluation for heart disease (including high blood pressure, high cholesterol, coronary artery disease) | date = 29 October 2012 | work = C8 Science Panel | url = http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Heart_Disease_29Oct2012.pdf }}</ref><ref>{{cite web | date = 30 July 2012 | work = C8 Science Panel | title = Probable Link Evaluation of Autoimmune Disease | url = http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Autoimmune_Disease_30Jul2012.pdf }}</ref><ref>{{cite web | title = Probable Link Evaluation of Thyroid disease | date = 30 July 2012 | work = C8 Science Panel | url = http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Thyroid_30Jul2012.pdf }}</ref><ref>{{cite web | title = Probable Link Evaluation of Cancer | date = 15 April 2012 | work = C8 Science Panel | url = http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Cancer_16April2012_v2.pdf }}</ref><ref>{{cite web | title = Probable Link Evaluation of Pregnancy Induced Hypertension and Preeclampsia | date = 5 December 2011 | work = C8 Science Panel | url = http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_PIH_5Dec2011.pdf }}</ref>


In 2024, a worldwide study of 45,000 groundwater samples found that 31% of samples contained levels of PFAS that were harmful to human health; these samples were taken from areas not near any obvious source of contamination.<ref>{{Cite news |last=Erdenesanaa |first=Delger |date=April 8, 2024 |title=PFAS 'Forever Chemicals' Are Pervasive in Water Worldwide |url=https://www.nytimes.com/2024/04/08/climate/pfas-forever-chemicals-water.html |url-access=limited |work=]}}</ref>
=== Prevalence in rainwater ===
In 2022, it was found that levels of at least four perfluoroalkyl acids (PFAAs) in ] worldwide ubiquitously and often greatly exceeded the EPA's lifetime ] health advisories as well as comparable Danish, Dutch, and ] safety standards, leading to the conclusion that "the global spread of these four PFAAs in the atmosphere has led to the ] for chemical pollution being exceeded".<ref name="Cousins Johansson Salter Sha Scheringer">{{cite journal |vauthors = Cousins IT, Johansson JH, Salter ME, Sha B, Scheringer M |title = Outside the Safe Operating Space of a New Planetary Boundary for Per- and Polyfluoroalkyl Substances (PFAS) |journal = Environmental Science & Technology |volume = 56 |issue = 16 |pages = 11172–11179 |date = August 2022 |pmid = 35916421 |doi = 10.1021/acs.est.2c02765 |publisher = ] |pmc = 9387091 |bibcode = 2022EnST...5611172C }}</ref> There are some moves to restrict and replace their use.<ref name="bbc62391069">{{cite news |title=Pollution: 'Forever chemicals' in rainwater exceed safe levels |url=https://www.bbc.com/news/science-environment-62391069 |access-date=14 September 2022 |work=BBC News |date=2 August 2022}}</ref>


Soil is also contaminated and the chemicals have been found in remote areas such as ].<ref>{{cite news | url=https://www.bbc.com/news/science-environment-62391069 | title=Pollution: 'Forever chemicals' in rainwater exceed safe levels | first=Matt | last=McGrath | work=] | date=August 2, 2022}}</ref> ] can result in higher levels of PFAs found in foods such as white rice, coffee, and animals reared on contaminated ground.<ref>{{Cite news |last=Perkins |first=Tom |date=2022-03-22 |title='I don't know how we'll survive': the farmers facing ruin in America's 'forever chemicals' crisis |url=https://www.theguardian.com/environment/2022/mar/22/i-dont-know-how-well-survive-the-farmers-facing-ruin-in-americas-forever-chemicals-crisis |access-date=2024-07-04 |work=The Guardian |language=en-GB |issn=0261-3077}}</ref><ref name=":0">{{Cite journal |last1=Wang |first1=Yuting |last2=Gui |first2=Jiang |last3=Howe |first3=Caitlin G. |last4=Emond |first4=Jennifer A. |last5=Criswell |first5=Rachel L. |last6=Gallagher |first6=Lisa G. |last7=Huset |first7=Carin A. |last8=Peterson |first8=Lisa A. |last9=Botelho |first9=Julianne Cook |last10=Calafat |first10=Antonia M. |last11=Christensen |first11=Brock |last12=Karagas |first12=Margaret R. |last13=Romano |first13=Megan E. |date=July 2024 |title=Association of diet with per- and polyfluoroalkyl substances in plasma and human milk in the New Hampshire Birth Cohort Study |url=https://doi.org/10.1016/j.scitotenv.2024.173157 |journal=Science of the Total Environment |volume=933 |pages=173157 |doi=10.1016/j.scitotenv.2024.173157 |pmid=38740209 |pmc=11247473 |pmc-embargo-date=July 10, 2025 |bibcode=2024ScTEn.93373157W |issn=0048-9697}}</ref><ref>{{Cite news |last=Perkins |first=Tom |date=2024-07-04 |title=Coffee, eggs and white rice linked to higher levels of PFAS in human body |url=https://www.theguardian.com/environment/article/2024/jul/04/pfas-toxic-forever-chemicals-food |access-date=2024-07-04 |work=The Guardian |language=en-GB |issn=0261-3077}}</ref>
=== Estimated contemporary costs ===
{{See also|Externality}}
Chemical corporations that produce PFAS generate approximately US$4 billion in annual profits from the production of this chemical but they impose monumental costs on tax payers and the health of the planet's population. Of these costs, remediation efforts fighting PFAS soil and water contamination are the most expensive, followed by the healthcare costs of treating people who develop cancer, thyroid disease, kidney dysfunction, ]s, and other major medical conditions that have been linked to even low levels of exposure to PFAS, and the costs of monitoring of PFAS pollution in human and other life forms. Such costs to society have been estimated to amount to approximately US$17.5 ] annually (which would be almost one fifth of the US$96 trillion global GDP in 2021<ref>World Bank </ref>), according to a press release by The International Chemical Secretariat (]), a Sweden-based ] that works with industry and policymakers to limit the use of toxic chemicals.<ref>The Guardian (UK), 12 May 2023 </ref>


====Costs by region==== ===Adverse health outcomes===
From 2005 to 2013, three epidemiologists known as the C8 Science Panel conducted health studies in the Mid-Ohio Valley as part of a contingency to a class action lawsuit brought by communities in the ] Valley against DuPont in response to landfill and wastewater dumping of PFAS-laden material from DuPont's West Virginia ] plant.<ref name=c8>{{cite web | title=C8 Science Panel | url=http://www.c8sciencepanel.org/ | website=c8sciencepanel.org | archive-date=June 18, 2019 | archive-url=https://web.archive.org/web/20190618160631/http://www.c8sciencepanel.org/ |url-status=live}}</ref> The panel measured PFOA (also known as C8) serum concentrations in 69,000 individuals from around DuPont's Washington Works Plant and found a mean concentration of 83&nbsp;ng/mL, compared to 4&nbsp;ng/mL in a standard population of Americans.<ref>{{cite journal | vauthors=Steenland K, Jin C, MacNeil J, Lally C, Ducatman A, Vieira V, Fletcher T | title=Predictors of PFOA levels in a community surrounding a chemical plant | journal=Environmental Health Perspectives | volume=117 | issue=7 | pages=1083–1088 | date=July 2009 | pmid=19654917 | pmc=2717134 | doi=10.1289/ehp.0800294}}</ref> This panel reported probable links between elevated PFOA blood concentration and ], ], ], ], ] as well as pregnancy-induced ] and ].<ref>{{cite web | title=Probable Link Evaluation for heart disease (including high blood pressure, high cholesterol, coronary artery disease) | date=October 29, 2012 | work=C8 Science Panel | url=http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Heart_Disease_29Oct2012.pdf}}</ref><ref>{{cite web | date=30 July 2012 | work=C8 Science Panel | title=Probable Link Evaluation of Autoimmune Disease | url=http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Autoimmune_Disease_30Jul2012.pdf}}</ref><ref>{{cite web | title=Probable Link Evaluation of Thyroid disease | date=30 July 2012 | work=C8 Science Panel | url=http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Thyroid_30Jul2012.pdf}}</ref><ref>{{cite web | title=Probable Link Evaluation of Cancer | date=15 April 2012 | work=C8 Science Panel | url=http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_Cancer_16April2012_v2.pdf}}</ref><ref>{{cite web | title=Probable Link Evaluation of Pregnancy Induced Hypertension and Preeclampsia | date=5 December 2011 | work=C8 Science Panel | url=http://www.c8sciencepanel.org/pdfs/Probable_Link_C8_PIH_5Dec2011.pdf}}</ref>
In a report by the ] the total annual health-related costs associated with human exposure to PFASs were estimated to be at least €52-€84 billion in the ] (EEA) countries.<ref name=":0">{{Cite web |url=http://norden.diva-portal.org/smash/get/diva2:1295959/FULLTEXT01.pdf |title=Nordic Council of Ministers (2019). The cost of inaction. A socioeconomic analysis of environmental and health impacts linked to exposure |access-date=1 October 2019 |archive-date=1 October 2019 |archive-url=https://web.archive.org/web/20191001215048/http://norden.diva-portal.org/smash/get/diva2:1295959/FULLTEXT01.pdf |url-status=live }}</ref> Aggregated annual costs covering environmental screening, monitoring where contamination is found, water treatment, soil remediation and health assessment total €821 million-€170 billion in the EEA plus Switzerland.<ref name=":0" />


The severity of PFAS-associated health effects can vary based on the length of exposure, level of exposure, and health status.<ref name=profile/>
In the United States, estimated PFAS-attributable disease costs amount to 6–62 billion US$.<ref>{{Cite journal |vauthors = Obsekov V, Kahn LG, Trasande L |date=2022-07-26 |title=Leveraging Systematic Reviews to Explore Disease Burden and Costs of Per- and Polyfluoroalkyl Substance Exposures in the United States |journal=Exposure and Health |volume=15 |issue=2 |pages=373–394 |language=en |doi=10.1007/s12403-022-00496-y |pmid=37213870 |pmc=10198842 |s2cid=251072281 |issn=2451-9766}}</ref> Studies have estimated the annual healthcare costs in the United States of each of some of the major diseases attributed to PFAS.<ref>NYU Langone NewsHub, 26 Jul. 2022, </ref>


====Pregnancy and lactation issues====
=== Proposed mechanisms of PFAS-related adverse health outcomes ===
Exposure to PFAS is a risk factor for various hypertensive disorders in pregnancy, including ] and ]. It is not clear whether PFAS exposure is associated with wider cardiovascular disorders during pregnancy.<ref>{{cite journal | vauthors=Erinc A, Davis MB, Padmanabhan V, Langen E, Goodrich JM |title=Considering environmental exposures to per- and polyfluoroalkyl substances (PFAS) as risk factors for hypertensive disorders of pregnancy | journal=Environ Res |volume=197 | pages=111113 | date=June 2021 | pmid=33823190 | pmc=8187287 | doi=10.1016/j.envres.2021.111113 | bibcode=2021ER....19711113E | type=Review}}</ref> Human breast milk can harbor PFASs, which can be transferred from mother to infant via breastfeeding.<ref>{{Cite web | url=https://www.atsdr.cdc.gov/pfas/health-effects/pfas-breastfeeding.html |title=PFAS and Breastfeeding |date=17 January 2024 | publisher=]}}</ref><ref name=":0" />


Use of various personal care products, such as nail care products, fragrances, makeup, hair dyes and hair sprays, by pregnant women and ] mothers has been shown to be associated with significantly higher levels of PFAS in the blood and breastmilk of the mothers. For example, PFOS levels of women who ] at least twice during pregnancy were more than a third higher than those who did not. PFOS is one of the most common and most dangerous of the PFAS compounds.<ref name=":1">{{Cite news |last=Perkins |first=Tom |date=2024-11-23 |title=Makeup, fragrance and hair dye use in pregnancy leads to more PFAS in breast milk – study |url=https://www.theguardian.com/environment/2024/nov/23/personal-care-products-pfas-pregnancy |access-date=2024-12-15 |work=The Guardian}}</ref>
==== Hypercholesterolemia ====
Animal studies in the 1990s and early 2000s primarily aimed to investigate the effect of two widely used long-chain PFASs, perfluorooctanoic acid (PFOA, C8) and perfluorooctane sulphonic acid (PFOS, C8), on peroxisome proliferation in rat livers.<ref name=":4">{{cite journal | vauthors = Hosokawa M, Satoh T | title = Differences in the induction of carboxylesterase isozymes in rat liver microsomes by perfluorinated fatty acids | journal = Xenobiotica; the Fate of Foreign Compounds in Biological Systems | volume = 23 | issue = 10 | pages = 1125–33 | date = October 1993 | pmid = 8259694 | doi = 10.3109/00498259309059427 }}</ref> The studies determined that PFOA and PFOS acted as ] (PPAR) agonists and increased lipid metabolism.<ref name=":4" /> A paradoxical response is observed in humans where elevated PFOS levels were significantly associated with{{vague|date=January 2021}} elevated total cholesterol and LDL cholesterol, highlighting significantly reduced PPAR expression and alluding to PPAR independent pathways predominating over ] in humans compared to rodents.<ref>{{cite journal | vauthors = DeWitt JC, Shnyra A, Badr MZ, Loveless SE, Hoban D, Frame SR, Cunard R, Anderson SE, Meade BJ, Peden-Adams MM, Luebke RW, Luster MI | display-authors = 6 | title = Immunotoxicity of perfluorooctanoic acid and perfluorooctane sulfonate and the role of peroxisome proliferator-activated receptor alpha | journal = ] | volume = 39 | issue = 1 | pages = 76–94 | date = 8 January 2009 | pmid = 18802816 | doi = 10.1080/10408440802209804 | s2cid = 96896603 }}</ref>


==== Ulcerative colitis ==== ====Fertility issues====
]s, including PFASs, are linked with the ].<ref>{{cite book | url=https://books.google.com/books?id=kjUXEAAAQBAJ | first1=Shanna H. | last1=Swan | first2=Stacey | last2=Colino | title=Count down: how our modern world is threatening sperm counts, altering male and female reproductive development, and imperiling the future of the human race | date=February 23, 2021 | publisher=] | isbn=978-1-9821-1366-7}}</ref>
PFOA and PFOS have been shown to significantly alter immune and inflammatory responses in human and animal species. In particular, ], ] (in females only) and ] have been shown to decrease whereas ] increase as PFOA serum concentrations increase.<ref>{{cite journal | vauthors = DeWitt JC, Peden-Adams MM, Keller JM, Germolec DR | title = Immunotoxicity of perfluorinated compounds: recent developments | journal = Toxicologic Pathology | volume = 40 | issue = 2 | pages = 300–11 | date = 22 November 2011 | pmid = 22109712 | doi = 10.1177/0192623311428473 | s2cid = 35549835 }}</ref> These ] variations allude to immune response aberrations resulting in ]. One proposed mechanism is a shift towards anti-inflammatory M2 ]s and/or {{nowrap|]}} (TH2) response in intestinal ] which allows ] to flourish. Elevated levels of ] result, which reduce ] and nutrient production, leading to a breakdown of the colonic epithelial barrier.<ref>{{cite journal | vauthors = Steenland K, Zhao L, Winquist A, Parks C | title = Ulcerative colitis and perfluorooctanoic acid (PFOA) in a highly exposed population of community residents and workers in the mid-Ohio valley | journal = Environmental Health Perspectives | volume = 121 | issue = 8 | pages = 900–5 | date = August 2013 | pmid = 23735465 | pmc = 3734500 | doi = 10.1289/ehp.1206449 }}</ref>


A report in 2023 by the ] linked high exposure to PFAS with a 40% decrease in the ability for a woman to have a successful pregnancy as well as hormone disruption and delayed ] onset.<ref>{{Cite news | url=https://www.euronews.com/health/2023/03/24/infertility-pfas-forever-chemicals-may-slash-pregnancy-odds-by-40-per-cent-study-finds | title=Can't get pregnant? PFAS chemicals in household products may be slashing women's fertility by 40% | first=Natalie | last=Huet | work=] | date=March 24, 2023}}</ref><ref>{{Cite press release | url=https://www.mountsinai.org/about/newsroom/2023/exposure-to-chemicals-found-in-everyday-products-is-linked-to-significantly-reduced-fertility | title=Exposure to Chemicals Found in Everyday Products Is Linked to Significantly Reduced Fertility | work=] | date=March 17, 2023}}</ref>
==== Thyroid disease ====
] is the most common thyroid abnormality associated with PFAS exposure.<ref name=":5">{{cite journal | vauthors = Lee JE, Choi K | title = Perfluoroalkyl substances exposure and thyroid hormones in humans: epidemiological observations and implications | journal = Annals of Pediatric Endocrinology & Metabolism | volume = 22 | issue = 1 | pages = 6–14 | date = March 2017 | pmid = 28443254 | pmc = 5401824 | doi = 10.6065/apem.2017.22.1.6 }}</ref> PFASs have been shown to decrease ], resulting in decreased production and activation of ] in vivo.<ref name=":6">{{cite journal | vauthors = Song M, Kim YJ, Park YK, Ryu JC | title = Changes in thyroid peroxidase activity in response to various chemicals | journal = Journal of Environmental Monitoring | volume = 14 | issue = 8 | pages = 2121–6 | date = August 2012 | pmid = 22699773 | doi = 10.1039/c2em30106g}}</ref> Other proposed mechanisms include alterations in thyroid hormone signaling, metabolism and excretion as well as function of ].<ref name=":5" />


==== Cancer ==== ====Human developmental issues====
Fetuses and children are especially vulnerable to the harms of PFAS chemicals because they have been shown to be linked to major adverse health conditions, including ] in newborns, ], shorter ] periods, breastmilk of diminished nutritional content, one or more ], and decreased response to childhood ]s.<ref name=":1" />
Rat studies investigating the ]icity of PFASs reported significant correlation with ], ] of the testis, and ] and dietary PFOA consumption.<ref name=":6" /> The C8 Science Panel investigated the potential relationship between PFAS exposure and these three cancer types as well as 18 other cancer types in their epidemiological studies. Contrary to the animal studies, the C8 studies did not find a probable link between elevated C8 exposure and liver adenomas or pancreatic acinar cell tumors; however, a probable link was found with regards to testis and kidney cancer.<ref>{{cite journal |vauthors = Barry V, Winquist A, Steenland K |title = Perfluorooctanoic acid (PFOA) exposures and incident cancers among adults living near a chemical plant |journal = Environmental Health Perspectives |volume = 121 |issue = 11–12 |pages = 1313–8 |date = 2013 |pmid = 24007715 |pmc = 3855514 |doi = 10.1289/ehp.1306615}}</ref>


====Liver issues====
Two mechanisms have been proposed by which PFOA could cause Leydig cell tumors. Both mechanisms propose that PROA exposure results in increased ] activation in the liver which increases ] concentration and subsequent serum ] levels. The mechanisms diverge at this point, with one pathway suggesting elevated estradiol levels increase ], which prompts Leydig cell proliferation, while the other pathway suggests that the aromatization of ] to ] reduces serum testosterone levels, resulting in increased release of ] from the ] which directly results in Leydig Cell tumorgenesis.<ref>{{cite journal |vauthors = Klaunig JE, Hocevar BA, Kamendulis LM |title = Mode of Action analysis of perfluorooctanoic acid (PFOA) tumorigenicity and Human Relevance |journal = Reproductive Toxicology |volume = 33 |issue = 4 |pages = 410–418 |date = July 2012 |pmid = 22120428 |doi = 10.1016/j.reprotox.2011.10.014}}</ref> A mechanism has not yet been proposed to explain how ] could be caused by C8 exposure as no in vivo animal studies have been able to model this epidemiological outcome.<ref>{{cite journal |vauthors = Li K, Gao P, Xiang P, Zhang X, Cui X, Ma LQ |title = Molecular mechanisms of PFOA-induced toxicity in animals and humans: Implications for health risks |journal = Environment International |volume = 99 |pages = 43–54 |date = February 2017 |pmid = 27871799 |doi = 10.1016/j.envint.2016.11.014 }}</ref>
A ] for associations between PFASs and human clinical ]s for liver injury, analyzing PFAS effects on liver biomarkers and histological data from rodent experimental studies, concluded that evidence exists that PFOA, ] (PFHxS), and ] (PFNA) caused ] in humans.<ref>{{cite journal | vauthors=Costello E, Rock S, Stratakis N, Eckel SP, Walker DI, Valvi D, Cserbik D, Jenkins T, Xanthakos SA, Kohli R, Sisley S, Vasiliou V, La Merrill MA, Rosen H, Conti DV, McConnell R, Chatzi L | display-authors=6 | title=Exposure to per- and Polyfluoroalkyl Substances and Markers of Liver Injury: A Systematic Review and Meta-Analysis | journal=] | volume=130 | issue=4 | pages=46001 | date=April 2022 | pmid=35475652 | pmc=9044977 | doi=10.1289/EHP10092}}</ref>


====Cancer====
==== Pregnancy-induced hypertension and pre-eclampsia ====
PFOA is classified as carcinogenic to humans (Group 1) by the ] (IARC) based on "sufficient" evidence for cancer in animals and "strong" mechanistic evidence in exposed humans. IARC also classified PFOS as possibly carcinogenic to humans (Group 2b) based on "strong" mechanistic evidence.<ref name=Carcinogenicity>{{cite journal | vauthors=Zahm S, Bonde JP, Chiu WA, Hoppin J, Kanno J, Abdallah M, Blystone CR, Calkins MM, Dong GH, Dorman DC, Fry R, Guo H, Haug LS, Hofmann JN, Iwasaki M, Machala M, Mancini FR, Maria-Engler SS, Møller P, Ng JC, Pallardy M, Post GB, Salihovic S, Schlezinger J, Soshilov A, Steenland K, Steffensen IL, Tryndyak V, White A, Woskie S, Fletcher T, Ahmadi A, Ahmadi N, Benbrahim-Tallaa L, Bijoux W, Chittiboyina S, de Conti A, Facchin C, Madia F, Mattock H, Merdas M, Pasqual E, Suonio E, Viegas S, Zupunski L, Wedekind R, Schubauer-Berigan MK | display-authors=6 | title=Carcinogenicity of perfluorooctanoic acid and perfluorooctanesulfonic acid | journal=] | date=November 2023 | volume=25 | issue=1 | pages=16–17 | pmid=38043561 | doi=10.1016/S1470-2045(23)00622-8 | s2cid=265571186}}</ref> There is a lack of high-quality epidemiological data on the associations between many specific PFAS chemicals and specific cancer types, and research is ongoing.<ref>{{cite journal | vauthors=Steenland K, Winquist A | title=PFAS and cancer, a scoping review of the epidemiologic evidence | journal=Environmental Research | volume=194 | pages=110690 | date=March 2021 | pmid=33385391 | pmc=7946751 | doi=10.1016/j.envres.2020.110690 | type=Review | bibcode=2021ER....19410690S}}</ref>
] is diagnosed when maternal systolic ] exceeds 140&nbsp;mmHg or ] exceeds 90 mmHg after 20 weeks ].<ref>{{cite journal| vauthors = Tonks DL |date=September 1994|title=Percolation wave propagation, and void link-up effects in ductile fracture|journal=Le Journal de Physique IV|volume=04|issue=C8|pages=C8–665-C8-670|doi=10.1051/jp4:19948101|bibcode=1994STIN...9511209T|issn=1155-4339|url=https://digital.library.unt.edu/ark:/67531/metadc1275549/|access-date=December 2, 2019|archive-date=June 25, 2021|archive-url=https://web.archive.org/web/20210625163519/https://digital.library.unt.edu/ark:/67531/metadc1275549/|url-status=live}}</ref> Diagnostic criteria are the same for ] as pregnancy-induced hypertension, but it also confers ]. Mechanisms by which pregnancy-induced hypertension and preeclampsia could be caused by PFAS exposure have remained elusive and are largely speculative to date. One proposed mechanism highlights alterations in immune function leading to disruption of ], specifically as it pertains to ] infiltration of the placenta to facilitate ]ic integration with placental blood supply.<ref name=":7">{{cite thesis| vauthors = Starling AP |date=2013|title=Perflourylalkyl substances in pregnancy and the risk of preeclampsia|journal=University of North Carolina at Chapel Hill|pages=1–215|doi=10.17615/qhqh-4265}}</ref> Another mechanism refers to agonism of PPARs contributing to alterations in ], ] and ] levels, all of which may lead to vascular inflammation and elevated blood pressure.<ref name=":7" />


====Hypercholesterolemia====
Other adverse health outcomes that have been attributed to elevated PFAS exposure but were not found to be probable links in the C8 studies are decreased antibody response to vaccines, ], decreased ] development, low birth weight (-0.7oz per 1&nbsp;ng/mL increase in blood PFOA or PFOS level), decreased ], and ] abnormalities.<ref name="CQ Press">{{Citation|chapter=Agency for Toxic Substances and Disease Registry (ATSDR)|publisher=CQ Press|isbn=9780872897762|doi=10.4135/9781452240121.n18|title=Health Care Policy and Politics a to Z|year=2009}}</ref><ref>{{cite journal | vauthors = Hu Y, Liu G, Rood J, Liang L, Bray GA, de Jonge L, Coull B, Furtado JD, Qi L, Grandjean P, Sun Q | display-authors = 6 | title = Perfluoroalkyl substances and changes in bone mineral density: A prospective analysis in the POUNDS-LOST study | journal = Environmental Research | volume = 179 | issue = Pt A | pages = 108775 | date = December 2019 | pmid = 31593837 | pmc = 6905427 | doi = 10.1016/j.envres.2019.108775 | bibcode = 2019ER....179j8775H }}</ref><ref>{{cite journal | vauthors = Donauer S, Chen A, Xu Y, Calafat AM, Sjodin A, Yolton K | title = Prenatal exposure to polybrominated diphenyl ethers and polyfluoroalkyl chemicals and infant neurobehavior | journal = The Journal of Pediatrics | volume = 166 | issue = 3 | pages = 736–42 | date = March 2015 | pmid = 25524317 | pmc = 4344877 | doi = 10.1016/j.jpeds.2014.11.021 }}</ref>
A response is observed in humans where elevated PFOS levels were significantly associated with elevated total cholesterol and LDL cholesterol, highlighting significantly reduced ] expression and alluding to PPAR independent pathways predominating over ] in humans compared to rodents.<ref>{{cite journal | vauthors=DeWitt JC, Shnyra A, Badr MZ, Loveless SE, Hoban D, Frame SR, Cunard R, Anderson SE, Meade BJ, Peden-Adams MM, Luebke RW, Luster MI | display-authors=6 | title=Immunotoxicity of perfluorooctanoic acid and perfluorooctane sulfonate and the role of peroxisome proliferator-activated receptor alpha | journal=] | volume=39 | issue=1 | pages=76–94 | date=8 January 2009 | pmid=18802816 | doi=10.1080/10408440802209804 | s2cid=96896603}}</ref>


====Ulcerative colitis====
=== "Forever chemicals" ===
PFOA and PFOS have been shown to significantly alter immune and inflammatory responses in human and animal species. In particular, ], ] (in females only) and ] have been shown to decrease whereas ] increase as PFOA serum concentrations increase.<ref>{{cite journal | vauthors=DeWitt JC, Peden-Adams MM, Keller JM, Germolec DR | title=Immunotoxicity of perfluorinated compounds: recent developments | journal=Toxicologic Pathology | volume=40 | issue=2 | pages=300–311 | date=November 22, 2011 | pmid=22109712 | doi=10.1177/0192623311428473 | s2cid=35549835 | doi-access=free}}</ref> These ] variations allude to immune response aberrations resulting in ]. One proposed mechanism is a shift towards anti-inflammatory M2 ]s and/or {{nowrap|]}} (TH2) response in intestinal ] which allows ] to flourish. Elevated levels of ] result, which reduce ] and nutrient production, leading to a breakdown of the colonic epithelial barrier.<ref>{{cite journal | vauthors=Steenland K, Zhao L, Winquist A, Parks C | title=Ulcerative colitis and perfluorooctanoic acid (PFOA) in a highly exposed population of community residents and workers in the mid-Ohio valley | journal=Environmental Health Perspectives | volume=121 | issue=8 | pages=900–905 | date=August 2013 | pmid=23735465 | pmc=3734500 | doi=10.1289/ehp.1206449}}</ref>
Fluorosurfactants such as PFOS, PFOA, and PFNA have caught the attention of regulatory agencies because of their persistence, toxicity, and widespread occurrence in the blood of general populations<ref name="Calafat2007">{{cite journal | vauthors = Calafat AM, Wong LY, Kuklenyik Z, Reidy JA, Needham LL | title = Polyfluoroalkyl chemicals in the U.S. population: data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and comparisons with NHANES 1999-2000 | journal = Environmental Health Perspectives | volume = 115 | issue = 11 | pages = 1596–602 | date = November 2007 | pmid = 18007991 | pmc = 2072821 | doi = 10.1289/ehp.10598 }}</ref><ref name="WangCousins2016">{{cite journal | vauthors = Wang Z, Cousins IT, Berger U, Hungerbühler K, Scheringer M | title = Comparative assessment of the environmental hazards of and exposure to perfluoroalkyl phosphonic and phosphinic acids (PFPAs and PFPiAs): Current knowledge, gaps, challenges and research needs | journal = Environment International | volume = 89-90 | pages = 235–47 | year = 2016 | pmid = 26922149 | doi = 10.1016/j.envint.2016.01.023 | url = https://doaj.org/article/3d577b314186485aaacd374747b3a3c3 }}{{Dead link|date=October 2021 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> and wildlife. In 2009, PFOS, its salts, and ] were listed as ]s under the ] due to their ubiquitous, ] nature.<ref>{{cite journal | vauthors = Blum A, Balan SA, Scheringer M, Trier X, Goldenman G, Cousins IT, Diamond M, Fletcher T, Higgins C, Lindeman AE, Peaslee G, de Voogt P, Wang Z, Weber R | display-authors = 6 | title = The Madrid Statement on Poly- and Perfluoroalkyl Substances (PFASs) | journal = Environmental Health Perspectives | volume = 123 | issue = 5 | pages = A107-11 | date = May 2015 | pmid = 25932614 | pmc = 4421777 | doi = 10.1289/ehp.1509934 }}</ref><ref>{{cite web|url=http://chm.pops.int/|title=Stockholm Convention Clearing|website=chm.pops.int|publisher=Secretariat of the Stockholm Convention|access-date=2016-10-26|archive-date=April 10, 2011|archive-url=https://web.archive.org/web/20110410085157/http://chm.pops.int/|url-status=live}}</ref> PFAS chemicals were dubbed the "forever chemicals" following a 2018 op-ed in the '']''.<ref>{{cite news|url=https://www.washingtonpost.com/opinions/these-toxic-chemicals-are-everywhere-and-they-wont-ever-go-away/2018/01/02/82e7e48a-e4ee-11e7-a65d-1ac0fd7f097e_story.html|title=Opinion {{!}} These toxic chemicals are everywhere — even in your body. And they won't ever go away.|newspaper=Washington Post|access-date=2019-06-08|archive-date=May 9, 2019|archive-url=https://web.archive.org/web/20190509013619/https://www.washingtonpost.com/opinions/these-toxic-chemicals-are-everywhere-and-they-wont-ever-go-away/2018/01/02/82e7e48a-e4ee-11e7-a65d-1ac0fd7f097e_story.html|url-status=live}}</ref> The nickname was derived by combining the two dominant attributes of this class of chemicals: PFAS chemicals are characterized by a carbon-fluorine backbone (the "F-C" in "forever chemicals"), and the carbon-fluorine bond is one of the strongest bonds in organic chemistry, which gives these chemicals an extremely long environmental half-life. The term ''forever chemicals'' is commonly used in media outlets in addition to the more technical name of per- and polyfluorinated alkyl substances.<ref>{{cite news|url=https://www.nytimes.com/2019/02/22/us/military-water-toxic-chemicals.html|title=Toxic 'Forever Chemicals' in Drinking Water Leave Military Families Reeling| vauthors = Turkewitz J |date=2019-02-22|work=The New York Times|access-date=2019-06-08|issn=0362-4331|archive-date=June 8, 2019|archive-url=https://web.archive.org/web/20190608111323/https://www.nytimes.com/2019/02/22/us/military-water-toxic-chemicals.html|url-status=live}}</ref><ref>{{cite web|url=https://www.cnn.com/2019/06/03/health/pfas-food-supply-fda/index.html|title=FDA confirms PFAS chemicals are in the US food supply| vauthors = Kounang N |website=CNN|date=June 3, 2019|access-date=2019-06-08|archive-date=June 8, 2019|archive-url=https://web.archive.org/web/20190608124826/https://www.cnn.com/2019/06/03/health/pfas-food-supply-fda/index.html|url-status=live}}</ref><ref>{{cite news|url=https://www.washingtonpost.com/climate-environment/2019/02/14/epa-vows-national-action-toxic-forever-chemicals/|title=Critics say EPA action plan on toxic 'forever chemicals' falls short|date=February 14, 2019|newspaper=The Washington Post|access-date=June 8, 2019|archive-date=June 8, 2019|archive-url=https://web.archive.org/web/20190608111339/https://www.washingtonpost.com/climate-environment/2019/02/14/epa-vows-national-action-toxic-forever-chemicals/|url-status=live}}</ref><ref>{{cite web | url = https://www.theguardian.com/us-news/2019/sep/11/pfas-toxic-forever-chemicals-hearing-3m-dupont-chemours | title = Companies deny responsibility for toxic 'forever chemicals' contamination | archive-url = https://web.archive.org/web/20190911233533/https://www.theguardian.com/us-news/2019/sep/11/pfas-toxic-forever-chemicals-hearing-3m-dupont-chemours | archive-date=September 11, 2019 | work = The Guardian | date = 2019 }}</ref> Their production has been regulated or phased out by manufacturers, such as 3M, DuPont, Daikin, and Miteni in the U.S., Japan, and Europe. In 2006 3M replaced PFOS and PFOA with short-chain PFASs,<ref name="long" /> such as ] (PFHxA) and ] (PFBS). Shorter fluorosurfactants may be less prone to accumulating in mammals;<ref name="long" /> there is still concern that they may be harmful to both humans<ref>{{cite journal | vauthors = Wang Z, Cousins IT, Scheringer M, Hungerbuehler K | title = Hazard assessment of fluorinated alternatives to long-chain perfluoroalkyl acids (PFAAs) and their precursors: status quo, ongoing challenges and possible solutions | journal = Environment International | volume = 75 | pages = 172–179 | date = February 2015 | pmid = 25461427 | doi = 10.1016/j.envint.2014.11.013}}</ref><ref>{{cite journal | vauthors = Birnbaum LS, Grandjean P | title = Alternatives to PFASs: perspectives on the science | journal = Environmental Health Perspectives | volume = 123 | issue = 5 | pages = A104-5 | date = May 2015 | pmid = 25932670 | pmc = 4421778 | doi = 10.1289/ehp.1509944 }}</ref><ref>{{cite journal|vauthors=Perry MJ, Nguyen GN, Porter ND|year=2016|title=The Current Epidemiologic Evidence on Exposures to Poly- and Perfluoroalkyl Substances (PFASs) and Male Reproductive Health|journal=Current Epidemiology Reports|volume=3|issue=1|pages=19–26|doi=10.1007/s40471-016-0071-y|s2cid=88276945|issn=2196-2995}}</ref> and the environment.<ref>{{cite journal | vauthors = Scheringer M, Trier X, Cousins IT, de Voogt P, Fletcher T, Wang Z, Webster TF | title = Helsingør statement on poly- and perfluorinated alkyl substances (PFASs) | journal = Chemosphere | volume = 114 | pages = 337–9 | date = November 2014 | pmid = 24938172 | doi = 10.1016/j.chemosphere.2014.05.044 | bibcode = 2014Chmsp.114..337S }}</ref> Many PFASs are either not covered by European legislation or are excluded from registration obligations under the EU ] chemical regulation.<ref>{{cite web|url=https://www.env-health.org/the-forever-chemicals-that-are-harming-our-health-pfas/|title=The "forever chemicals" that are harming our health: PFAS|date=2020-02-04|website=Health and Environment Alliance|language=en-GB|url-status=live|archive-url=https://web.archive.org/web/20200206122946/https://www.env-health.org/the-forever-chemicals-that-are-harming-our-health-pfas/|archive-date=2020-02-06|access-date=2020-03-06}}</ref> Several PFASs have been detected in drinking water,<ref>{{cite journal | vauthors = Thomaidi VS, Tsahouridou A, Matsoukas C, Stasinakis AS, Petreas M, Kalantzi OI | title = Risk assessment of PFASs in drinking water using a probabilistic risk quotient methodology | journal = The Science of the Total Environment | volume = 712 | pages = 136485 | date = April 2020 | pmid = 31927447 | doi = 10.1016/j.scitotenv.2019.136485 | bibcode = 2020ScTEn.712m6485T | s2cid = 210167277 }}</ref> municipal wastewater,<ref>{{cite journal | vauthors = Arvaniti OS, Stasinakis AS | title = Review on the occurrence, fate and removal of perfluorinated compounds during wastewater treatment | journal = The Science of the Total Environment | volume = 524-525 | pages = 81–92 | date = August 2015 | pmid = 25889547 | doi = 10.1016/j.scitotenv.2015.04.023 | bibcode = 2015ScTEn.524...81A }}</ref> and landfill leachates<ref>{{cite journal | vauthors = Nika MC, Ntaiou K, Elytis K, Thomaidi VS, Gatidou G, Kalantzi OI, Thomaidis NS, Stasinakis AS | display-authors = 6 | title = Wide-scope target analysis of emerging contaminants in landfill leachates and risk assessment using Risk Quotient methodology | journal = Journal of Hazardous Materials | volume = 394 | pages = 122493 | date = July 2020 | pmid = 32240898 | doi = 10.1016/j.jhazmat.2020.122493 | s2cid = 214766390 }}</ref> worldwide.


====Thyroid disease====
It had been thought that PFAAs would eventually end up in the oceans, where they would be diluted over decades, but a field study published in 2021 by researchers at Stockholm University found that they are significantly transferred from water to air when waves break on land, and are a significant source of air pollution, and eventually get into the rain. The researchers concluded that pollution "may impact large areas of inland Europe and other continents, in addition to coastal areas".<ref>{{Cite news |title=PFAS 'forever chemicals' constantly cycle through ground, air and water, study finds | vauthors = Perkins T |newspaper=The Guardian |date=18 December 2021 |url= https://www.theguardian.com/environment/2021/dec/17/pfas-forever-chemicals-constantly-cycle-through-ground-air-and-water-study-finds}}</ref><ref name="Sha Johansson Tunved Bohlin-Nizzetto p.">{{cite journal | vauthors = Sha B, Johansson JH, Tunved P, Bohlin-Nizzetto P, Cousins IT, Salter ME | title = Sea Spray Aerosol (SSA) as a Source of Perfluoroalkyl Acids (PFAAs) to the Atmosphere: Field Evidence from Long-Term Air Monitoring | journal = Environmental Science & Technology | volume = 56 | issue = 1 | pages = 228–238 | date = January 2022 | pmid = 34907779 | pmc = 8733926 | doi = 10.1021/acs.est.1c04277 | publisher = American Chemical Society (ACS) | bibcode = 2022EnST...56..228S }}</ref>
] is the most common thyroid abnormality associated with PFAS exposure.<ref name=hormones>{{cite journal | vauthors=Lee JE, Choi K | title=Perfluoroalkyl substances exposure and thyroid hormones in humans: epidemiological observations and implications | journal=Annals of Pediatric Endocrinology & Metabolism | volume=22 | issue=1 | pages=6–14 | date=March 2017 | pmid=28443254 | pmc=5401824 | doi=10.6065/apem.2017.22.1.6}}</ref> PFASs have been shown to decrease ], resulting in decreased production and activation of ] in vivo.<ref>{{cite journal | vauthors=Song M, Kim YJ, Park YK, Ryu JC | title=Changes in thyroid peroxidase activity in response to various chemicals | journal=Journal of Environmental Monitoring | volume=14 | issue=8 | pages=2121–2126 | date=August 2012 | pmid=22699773 | doi=10.1039/c2em30106g}}</ref> Other proposed mechanisms include alterations in thyroid hormone signaling, metabolism and excretion as well as function of ].<ref name=hormones/>


=== Bioaccumulation and biomagnification === ===Bioaccumulation and biomagnification===
] of PFAS:''' PFASs from sediments and water can accumulate in marine organisms. Animals higher up the food chain accumulate more PFAS because they absorb PFAS in prey they consume.]] ] of PFAS:''' PFASs from sediments and water can accumulate in marine organisms. Animals higher up the food chain accumulate more PFAS because they absorb PFAS in the prey they consume.]]
] is the process by which PFASs are transferred into the tissue of any exposed organisms where PFASs accumulate over time since organisms lack natural excretion mechanisms. PFASs can accumulate in marine species by a variety of pathways. They can be absorbed from the environment, such as contaminated sediments or PFASs dissolved in water. PFASs can partition into the organs and tissues of marine organisms from these environmental compartments. They have been shown to bind to blood proteins and accumulate in the livers of marine animals.<ref name="Jones">{{cite journal | vauthors = Jones PD, Hu W, De Coen W, Newsted JL, Giesy JP | title = Binding of perfluorinated fatty acids to serum proteins | journal = Environmental Toxicology and Chemistry | volume = 22 | issue = 11 | pages = 2639–2649 | date = November 2003 | pmid = 14587903 | doi = 10.1897/02-553 | s2cid = 15768654 }}</ref>
]''' is the build up of toxins in a food chain. As the trophic level increases in a food chain, the amount of toxic build up increases. The x's represent the amount of toxic build up accumulating as the trophic level increases. Toxins build up in organism's fat and tissue. Predators accumulate higher toxins than prey as a result of bioaccumulation. ]]
] is the process by which the amount of PFAS contamination increases with increasing ], due to predation by the species higher in the food web. Top predators have higher levels of PFASs than species lower down the food chain. Seabirds that feed on fish have among the highest levels of PFAS contamination.<ref name="Jones" />


;In marine species of the food web ;In marine species of the food web
Bioaccumulation controls internal concentrations of pollutants, including PFAS, in individual organisms. When bioaccumulation is looked at in the perspective of the entire food web, it is called biomagnification, which is important to track because lower concentrations of pollutants in environmental matrices such as seawater or sediments, can very quickly grow to harmful concentrations in organisms at higher trophic levels, including humans. Notably, concentrations in biota can even be greater than 5000 times those present in water for PFOS and C<sub>10</sub>–C<sub>14</sub> ]s.<ref>{{cite journal | vauthors=Munoz G, Budinski H, Babut M, Drouineau H, Lauzent M, Menach KL| title=Evidence for the trophic transfer of perfluoroalkylated substances in a temperate macrotidal estuary| journal=Environ. Sci. Technol.| volume=51 | issue=15 | pages=8450–8459 | date=July 2017 | doi=10.1021/acs.est.7b02399 | pmid=28679050| bibcode=2017EnST...51.8450M| url=https://hal.archives-ouvertes.fr/hal-02067250/file/Main%20text_R1_2017-06-27.pdf}}</ref> PFAS can enter an organism by ingestion of sediment, through the water, or directly via their diet. It accumulates namely in areas with high protein content, in the blood and liver, but it is also found to a lesser extent in tissues.<ref>{{cite journal | vauthors=Ballutaud M, Drouineau H, Carassou L, Munoz G, Chevillot X, Labadie P, Budzinski H, Lobry J | display-authors=6 | title=EStimating Contaminants tRansfers Over Complex food webs (ESCROC): An innovative Bayesian method for estimating POP's biomagnification in aquatic food webs | journal=The Science of the Total Environment | volume=658 | pages=638–649 | date=March 2019 | pmid=30580218 | doi=10.1016/j.scitotenv.2018.12.058 | s2cid=58660816 | bibcode=2019ScTEn.658..638B | url=https://hal.archives-ouvertes.fr/hal-02289120}}</ref>
PFOS, a long chain sulfonic acid, was found at the highest concentrations relative to other PFASs measured in fish and birds in Northern seas such as the Barents Sea and the Canadian Arctic.<ref>{{cite journal | vauthors = Martin JW, Mabury SA, Solomon KR, Muir DC | title = Bioconcentration and tissue distribution of perfluorinated acids in rainbow trout (Oncorhynchus mykiss) | journal = Environmental Toxicology and Chemistry | volume = 22 | issue = 1 | pages = 196–204 | date = January 2003 | pmid = 12503765 | doi = 10.1002/etc.5620220126 | s2cid = 12659454 }}</ref> A study and an interactive map by the ] using its results showed ] in the U.S.{{globalize inline|date=February 2023}} ubiquitously contain high levels of harmful PFAS, with a single serving typically significantly increasing the blood ] level.<ref>{{cite news |last1=LaMotte |first1=Sandee |title=Locally caught fish are full of dangerous chemicals called PFAS, study finds |url=https://edition.cnn.com/2023/01/17/health/freshwater-fish-pfas-contamination-wellness/index.html |access-date=15 February 2023 |work=CNN |date=17 January 2023 |language=en |archive-date=14 February 2023 |archive-url=https://web.archive.org/web/20230214213701/https://edition.cnn.com/2023/01/17/health/freshwater-fish-pfas-contamination-wellness/index.html |url-status=live }}</ref><ref>{{cite journal |last1=Barbo |first1=Nadia |last2=Stoiber |first2=Tasha |last3=Naidenko |first3=Olga V. |last4=Andrews |first4=David Q. |title=Locally caught freshwater fish across the United States are likely a significant source of exposure to PFOS and other perfluorinated compounds |journal=Environmental Research |date=1 March 2023 |volume=220 |pages=115165 |doi=10.1016/j.envres.2022.115165 |pmid=36584847 |bibcode=2023ER....220k5165B |s2cid=255248441 |language=en |issn=0013-9351}}</ref>


Biomagnification can be described using the estimation of the trophic magnification factor (TMF), which describes the relationship between the contamination levels in a species and their trophic level in the food web. TMFs are determined by graphing the log-transformed concentrations of PFAS against the assigned trophic level and taking the antilog of the regression slope (10<sup>slope</sup>).<ref name=Evidence/>
Bioaccumulation and biomagnification of PFASs in marine species throughout the food web, particularly frequently consumed fish and shellfish, can have important impacts on human populations.<ref>{{cite journal | vauthors = Choi S, Kim JJ, Kim MH, Joo YS, Chung MS, Kho Y, Lee KW | title = Origin and organ-specific bioaccumulation pattern of perfluorinated alkyl substances in crabs | journal = Environmental Pollution | volume = 261 | pages = 114185 | date = June 2020 | pmid = 32114125 | doi = 10.1016/j.envpol.2020.114185 | s2cid = 211727091 }}</ref> PFASs have been frequently documented in both fish and shellfish that are commonly consumed by human populations,<ref name="Perfluoroalkyl substances PFASs i">{{cite journal | vauthors = Fair PA, Wolf B, White ND, Arnott SA, Kannan K, Karthikraj R, Vena JE | title = Perfluoroalkyl substances (PFASs) in edible fish species from Charleston Harbor and tributaries, South Carolina, United States: Exposure and risk assessment | journal = Environmental Research | volume = 171 | pages = 266–277 | date = April 2019 | pmid = 30703622 | pmc = 6943835 | doi = 10.1016/j.envres.2019.01.021 | bibcode = 2019ER....171..266F }}</ref> which poses health risks to humans and studies on the bioaccumulation in certain species are important to determine daily tolerable limits for human consumption, and where those limits may be exceeded causing potential health risks.<ref>{{Cite journal | vauthors = Teunen L, Bervoets L, Belpaire C, De Jonge M, Groffen T |date=2021-03-29 |title=PFAS accumulation in indigenous and translocated aquatic organisms from Belgium, with translation to human and ecological health risk |journal=Environmental Sciences Europe |volume=33 |issue=1 |pages=39 |doi=10.1186/s12302-021-00477-z |s2cid=232414650 |issn=2190-4715}}</ref> This has particular implications for populations that consume larger numbers of wild fish and shellfish species.<ref name="Perfluoroalkyl substances PFASs i"/> In addition to health risks, populations may be impacted by advisories, limits of fishing closures for certain species that are put in place to help mitigate health risks from potential consumption of species with higher levels of accumulated PFASs, but result in a loss of food sources and important subsistence species depended on by local communities. There is research being done in this area, including into spatial patterns of PFAS bioaccumulation in fish and crustaceans.<ref>{{cite journal | vauthors = Taylor MD, Beyer-Robson J, Johnson DD, Knott NA, Bowles KC | title = Bioaccumulation of perfluoroalkyl substances in exploited fish and crustaceans: Spatial trends across two estuarine systems | journal = Marine Pollution Bulletin | volume = 131 | issue = Pt A | pages = 303–313 | date = June 2018 | pmid = 29886951 | doi = 10.1016/j.marpolbul.2018.04.029 | bibcode = 2018MarPB.131..303T | s2cid = 47009972 }}</ref> There is a need for more research on membrane transport mechanisms, which transfer PFASs into marine organisms, and the biological behavior of shorter chain PFASs.<ref>{{cite journal | vauthors = Sun JM, Kelly BC, Gobas FA, Sunderland EM | title = A food web bioaccumulation model for the accumulation of per- and polyfluoroalkyl substances (PFAS) in fish: how important is renal elimination? | journal = Environmental Science. Processes & Impacts | volume = 24 | issue = 8 | pages = 1152–1164 | date = August 2022 | pmid = 35678632 | doi = 10.1039/D2EM00047D | pmc = 9384792 }}</ref>


In a study done on a macrotidal estuary in Gironde, SW France, TMFs exceeded one for nearly all 19 PFAS compounds considered in the study and were particularly high for PFOA and PFNA (6.0 and 3.1 respectively).<ref name=Evidence/> A TMF greater than one signifies that accumulation in the organism is greater than that of the medium, with the medium being seawater in this case.
===Corporate and federal government suppression of information===
Since the 1970s, 3M scientists learned that PFOS and PFOA were toxic to humans, and documented damage to the human ]. They also found that these substances accumulate over time in the human body, but the company suppressed dissemination of these facts to the public or to regulators.<ref>{{cite web |date=2018-07-31 |title=3M Knew about The Dangers of PFOA and PFOS Decades Ago, Internal Documents Show |url=https://theintercept.com/2018/07/31/3m-pfas-minnesota-pfoa-pfos/ |url-status=live |archive-url=https://web.archive.org/web/20210623152116/https://theintercept.com/2018/07/31/3m-pfas-minnesota-pfoa-pfos/ |archive-date=June 23, 2021 |access-date=May 2, 2020 |website=The Intercept |publisher=First Look Media Works, Inc. |vauthors=Lerner S}}</ref>


PFOS, a long-chain sulfonic acid, was found at the highest concentrations relative to other PFASs measured in fish and birds in northern seas such as the Barents Sea and the Canadian Arctic.<ref>{{cite journal | vauthors=Martin JW, Mabury SA, Solomon KR, Muir DC | title=Bioconcentration and tissue distribution of perfluorinated acids in rainbow trout (Oncorhynchus mykiss) | journal=Environmental Toxicology and Chemistry | volume=22 | issue=1 | pages=196–204 | date=January 2003 | pmid=12503765 | doi=10.1002/etc.5620220126 | s2cid=12659454}}</ref>
In 2018 ] staff and the EPA pressured the U.S. ] to suppress a study that showed PFASs to be even more dangerous than previously thought.<ref>{{cite web |date=2018-05-16 |title=Bipartisan Outrage as EPA, White House Try to Cover Up Chemical Health Assessment |url=https://blog.ucsusa.org/michael-halpern/bipartisan-outrage-as-epa-white-house-try-to-cover-up-chemical-health-assessment |url-status=live |archive-url=https://web.archive.org/web/20200305211354/https://blog.ucsusa.org/michael-halpern/bipartisan-outrage-as-epa-white-house-try-to-cover-up-chemical-health-assessment |archive-date=March 5, 2020 |access-date=May 2, 2020 |publisher=Union of Concerned Scientists |vauthors=Halpern M |location=Cambridge, MA}}</ref><ref>{{cite news |date=2018-05-14 |title=White House, EPA headed off chemical pollution study |work=Politico |url=https://www.politico.com/story/2018/05/14/emails-white-house-interfered-with-science-study-536950 |url-status=live |access-date=May 2, 2020 |archive-url=https://web.archive.org/web/20180516023718/https://www.politico.com/story/2018/05/14/emails-white-house-interfered-with-science-study-536950 |archive-date=May 16, 2018 |vauthors=Snider A}}</ref>


A study published in 2023 analyzing 500 composite samples of fish fillets collected across the United States from 2013 to 2015 under the EPA's monitoring programs showed ] ubiquitously contain high levels of harmful PFAS, with a single serving typically significantly increasing the blood ] level.<ref>{{cite news | url=https://edition.cnn.com/2023/01/17/health/freshwater-fish-pfas-contamination-wellness/index.html | last=LaMotte | first=Sandee |title=Locally caught fish are full of dangerous chemicals called PFAS, study finds | work=] |date=January 17, 2023 |archive-date=14 February 2023 |archive-url=https://web.archive.org/web/20230214213701/https://edition.cnn.com/2023/01/17/health/freshwater-fish-pfas-contamination-wellness/index.html |url-status=live}}</ref><ref>{{cite journal | vauthors=Barbo N, Stoiber T, Naidenko OV, Andrews DQ | title=Locally caught freshwater fish across the United States are likely a significant source of exposure to PFOS and other perfluorinated compounds | journal=Environmental Research | volume=220 | pages=115165 | date=March 2023 | pmid=36584847 | doi=10.1016/j.envres.2022.115165 | s2cid=255248441 | doi-access=free | bibcode=2023ER....22015165B}}</ref>
== Concerns in specific countries and regions ==


Bioaccumulation and biomagnification of PFASs in marine species throughout the food web, particularly frequently consumed fish and shellfish, can have important impacts on human populations.<ref>{{cite journal | vauthors=Choi S, Kim JJ, Kim MH, Joo YS, Chung MS, Kho Y, Lee KW | title=Origin and organ-specific bioaccumulation pattern of perfluorinated alkyl substances in crabs | journal=Environmental Pollution | volume=261 | pages=114185 | date=June 2020 | pmid=32114125 | doi=10.1016/j.envpol.2020.114185 | bibcode=2020EPoll.26114185C | s2cid=211727091}}</ref> PFASs have been frequently documented in both fish and shellfish that are commonly consumed by human populations,<ref name=edible>{{cite journal | vauthors=Fair PA, Wolf B, White ND, Arnott SA, Kannan K, Karthikraj R, Vena JE | title=Perfluoroalkyl substances (PFASs) in edible fish species from Charleston Harbor and tributaries, South Carolina, United States: Exposure and risk assessment | journal=Environmental Research | volume=171 | pages=266–277 | date=April 2019 | pmid=30703622 | pmc=6943835 | doi=10.1016/j.envres.2019.01.021 | bibcode=2019ER....171..266F}}</ref> which poses health risks to humans and studies on the bioaccumulation in certain species are important to determine daily tolerable limits for human consumption, and where those limits may be exceeded causing potential health risks.<ref>{{Cite journal | vauthors=Teunen L, Bervoets L, Belpaire C, De Jonge M, Groffen T | date=March 29, 2021 | title=PFAS accumulation in indigenous and translocated aquatic organisms from Belgium, with translation to human and ecological health risk | journal=] | volume=33 | issue=1 |pages=39 | doi=10.1186/s12302-021-00477-z | s2cid=232414650 | issn=2190-4715 | doi-access=free | hdl=10067/1769070151162165141 | hdl-access=free}}</ref> This has particular implications for populations that consume larger numbers of wild fish and shellfish species.<ref name=edible/> PFAS contamination has also resulted in disruptions to the food supply, such as closures and limits on fishing.<ref>{{Cite web | url=https://www.epa.gov/system/files/documents/2023-06/2023proceedings.pdf | title=Proceedings of the 2023 National Forum on Contaminants in Fish | publisher=] | date=June 2023}}</ref>
=== Australia ===
In 2017, the ]'s current affairs program ] reported that the storage and use of firefighting foams containing perfluorinated surfactants at ] facilities around Australia had contaminated nearby water resources.<ref>{{cite news|url=http://www.abc.net.au/news/2017-10-10/pfas-chemicals-katherine-residents-shocked-demand-action/9034504|title='Shocked and disgusted' Katherine residents demand action on PFAS contamination|date=2017-10-10|work=ABC News|access-date=2017-10-10|archive-date=October 10, 2017|archive-url=https://web.archive.org/web/20171010073127/http://www.abc.net.au/news/2017-10-10/pfas-chemicals-katherine-residents-shocked-demand-action/9034504|url-status=live}}</ref> In 2019, remediation efforts at ] and the adjacent town of Katherine were ongoing.<ref>{{cite web|url=https://www.katherinetimes.com.au/story/6527835/tindals-pfas-hot-spots-record-startling-results/|title=Tindal's PFAS hot spots record startling results| vauthors = McLennan C |date=2019-12-05|website=Katherine Times|language=en|access-date=2020-02-21|archive-date=February 21, 2020|archive-url=https://web.archive.org/web/20200221111934/https://www.katherinetimes.com.au/story/6527835/tindals-pfas-hot-spots-record-startling-results/|url-status=live}}</ref> In the 2022 ] $428{{nbsp}}million was allocated for works at ], ], ] and ] including funding to remediate PFAS contamination.<ref>{{Cite web | vauthors = Curtis K |date=2022-04-21 |title=Airbases to get $428 million upgrade as government switches back to national security |url=https://www.smh.com.au/politics/federal/airbases-to-get-428-million-upgrade-as-government-switches-back-to-national-security-20220421-p5af77.html |access-date=2022-04-22 |website=The Sydney Morning Herald |language=en}}</ref>


Fluorosurfactants with shorter carbon chains may be less prone to accumulating in mammals;<ref name=long/> there is still some concern that they may be harmful to both humans<ref>{{cite journal | vauthors=Wang Z, Cousins IT, Scheringer M, Hungerbuehler K | title=Hazard assessment of fluorinated alternatives to long-chain perfluoroalkyl acids (PFAAs) and their precursors: status quo, ongoing challenges and possible solutions | journal=Environment International | volume=75 | pages=172–179 | date=February 2015 | pmid=25461427 | doi=10.1016/j.envint.2014.11.013 | bibcode=2015EnInt..75..172W}}</ref><ref>{{cite journal | vauthors=Birnbaum LS, Grandjean P | title=Alternatives to PFASs: perspectives on the science | journal=Environmental Health Perspectives | volume=123 | issue=5 | pages=A104–105 | date=May 2015 | pmid=25932670 | pmc=4421778 | doi=10.1289/ehp.1509944}}</ref><ref>{{cite journal | vauthors=Perry MJ, Nguyen GN, Porter ND | year=2016| title=The Current Epidemiologic Evidence on Exposures to Poly- and Perfluoroalkyl Substances (PFASs) and Male Reproductive Health |journal=Current Epidemiology Reports |volume=3 |issue=1 | pages=19–26 | doi=10.1007/s40471-016-0071-y | s2cid=88276945 | issn=2196-2995}}</ref> and the environment.<ref>{{cite journal | vauthors=Scheringer M, Trier X, Cousins IT, de Voogt P, Fletcher T, Wang Z, Webster TF | title=Helsingør statement on poly- and perfluorinated alkyl substances (PFASs) | journal=Chemosphere | volume=114 | pages=337–339 | date=November 2014 | pmid=24938172 | doi=10.1016/j.chemosphere.2014.05.044 | bibcode=2014Chmsp.114..337S | s2cid=249995685 | doi-access=free | hdl=20.500.11850/84912 | hdl-access=free}}</ref><ref name=Understanding>{{Cite web | url=https://www.epa.gov/pfas/our-current-understanding-human-health-and-environmental-risks-pfas | title=Our Current Understanding of the Human Health and Environmental Risks of PFAS |date=June 7, 2023}}</ref>
=== Canada ===
Although PFASs are not manufactured in Canada, they may be present in imported goods and products. In 2008, Canada prohibited the import, sale, or use of PFOS or PFOS-containing products, with some exceptions for products used in firefighting, the military, and some forms of ink and photo media.<ref name="nceh">{{cite web | vauthors = O'Keeffe J |title=Keeping Drinking Water Safe: New Guidelines for PFASs in Canada |url=https://ncceh.ca/content/blog/keeping-drinking-water-safe-new-guidelines-pfas-canada |website=National Collaborating Centre for Environmental Health |access-date=22 July 2020 |archive-date=August 7, 2020 |archive-url=https://web.archive.org/web/20200807233146/https://ncceh.ca/content/blog/keeping-drinking-water-safe-new-guidelines-pfas-canada |url-status=live }}</ref>


===Suppression of information on health effects===
Health Canada has published drinking water guidelines for maximum concentrations of PFOS and PFOA to protect the health of Canadians, including children, over a lifetime's exposure to these substances. The maximum allowable concentration for PFOS under the guidelines is 0.0002 milligrams per litre. The maximum allowable concentration for PFOA is 0.0006 milligrams per litre.<ref>{{cite web |title=Perfluoroalkylated substances in drinking water |website=canada.ca |publisher=Government of Canada |access-date=22 July 2020 |date=April 2019 |url=https://www.canada.ca/en/services/health/publications/healthy-living/water-talk-drinking-water-screening-values-perfluoroalkylated-substances.html |archive-date=August 15, 2020 |archive-url=https://web.archive.org/web/20200815112519/https://www.canada.ca/en/services/health/publications/healthy-living/water-talk-drinking-water-screening-values-perfluoroalkylated-substances.html |url-status=live }}</ref>
Since the 1970s, DuPont and 3M were aware that PFAS was "highly toxic when inhaled and moderately toxic when ingested".<ref name=Devil>{{cite journal | vauthors=Gaber N, Bero L, Woodruff TJ | title=The Devil they Knew: Chemical Documents Analysis of Industry Influence on PFAS Science | journal=Annals of Global Health | volume=89 | issue=1 | pages=37 | date=June 1, 2023 | pmid=37273487 | pmc=10237242 | doi=10.5334/aogh.4013 | doi-access=free}}</ref> Producers used several strategies to influence science and regulation – most notably, suppressing unfavorable research and distorting public discourse.<ref name=Devil/>


In 2018, under the ], ] staff and the ] pressured the U.S. ] to suppress a study that showed PFASs to be even more dangerous than previously thought.<ref name=outrage>{{cite web |date=May 16, 2018 | title=Bipartisan Outrage as EPA, White House Try to Cover Up Chemical Health Assessment |url=https://blog.ucsusa.org/michael-halpern/bipartisan-outrage-as-epa-white-house-try-to-cover-up-chemical-health-assessment |publisher=] | last=Halpern | first=Michael | location=] |archive-url=https://web.archive.org/web/20200305211354/https://blog.ucsusa.org/michael-halpern/bipartisan-outrage-as-epa-white-house-try-to-cover-up-chemical-health-assessment |archive-date=March 5, 2020 | url-status=live}}</ref><ref name=headed>{{cite news |title=White House, EPA headed off chemical pollution study |work=] | url=https://www.politico.com/story/2018/05/14/emails-white-house-interfered-with-science-study-536950 | first=ANNIE | last=SNIDER | date=May 14, 2018 |archive-url=https://web.archive.org/web/20180516023718/https://www.politico.com/story/2018/05/14/emails-white-house-interfered-with-science-study-536950 |archive-date=May 16, 2018| url-status=live}}</ref>
=== United Kingdom ===
The environmental consequences of PFAS, especially from fire fighting activities, has been recognized since the mid-1990s and came to prominence after the ] on 11 December 2005. In recent years the Environment Agency has undertaken a series of projects to understand the scale and nature of PFAS in the environment. The Drinking Water Inspectorate requires water companies to report concentrations of 47 PFAS.<ref>, DWI Information Letter 05/2021.</ref>


==Concerns, litigation, and regulations in specific countries and regions==
=== European Union ===
In 2019, the ] requested the ] to develop an action plan to eliminate all non-essential uses of PFAS due to the growing evidence of adverse effects caused by exposure to these substances; the evidence for the widespread occurrence of PFAS in water, soil, articles, and waste; and the threat it can pose to drinking water.<ref>{{cite web|website= European Council|title= Council Conclusions on Chemicals|url= https://www.consilium.europa.eu/en/press/press-releases/2019/06/26/council-conclusions-on-chemicals/}}</ref> Germany, the Netherlands, Denmark, Norway, and Sweden submitted a so-called restriction proposal based on the REACH regulation to achieve a European ban on the production, use, sale and import of PFAS.<ref>{{cite web|website= RIVM|title= PFAS|url= https://www.rivm.nl/pfas}}</ref> The proposal states that a ban is necessary for all use of PFAS, with different periods for different applications when the ban takes effect (immediately after the restriction comes into force, 5 years afterwards, or 12 years afterwards), depending on the function and the availability of alternatives. The proposal has not assessed the use of PFAS in medicines, plant protection products and biocides because specific regulations apply to those substances (Biocidal Products Regulation, ], Medicinal Products Regulation) that have an explicit authorization procedure that focuses on risk for health and the environment.


=== Arctic ===
The proposal was submitted on 13 January 2023 and published by the ] (ECHA) on 7 February. From 22 March to 21 September, citizens, companies and other organizations can comment on the proposal during a public consultation.<ref name="PRP">{{cite web|website= ECHA|title= ECHA publishes PFAS restriction proposal|url= https://echa.europa.eu/-/echa-publishes-pfas-restriction-proposal|access-date= 2023-02-08}}</ref> Based on the information in the restriction proposal and the consultation, two committees from ECHA formulate an opinion on the risk and socio-economic aspects of the proposed restriction. Within a year of publication, the opinions are sent to the European Commission, which makes a final proposal that is submitted to the EU Member States for discussion and decision.<ref>{{cite web|website= ECHA|title= Restriction procedure|url= https://echa.europa.eu/regulations/reach/restrictions/restriction-procedure|access-date= 2023-02-08}}</ref> Eighteen months after the publication of the restriction decision (which may differ from the original proposal), it will enter the ban.<ref name="PRP" />
In 2024, research at ] in Quebec,<ref>{{cite journal | url=https://pubs.acs.org/doi/abs/10.1021/acs.est.4c02661 | doi=10.1021/acs.est.4c02661 | title=Winter Tracking Data Suggest that Migratory Seabirds Transport Per- and Polyfluoroalkyl Substances to Their Arctic Nesting Site | date=2024 | last1=Léandri-Breton | first1=Don-Jean | last2=Jouanneau | first2=William | last3=Legagneux | first3=Pierre | last4=Tarroux | first4=Arnaud | last5=Moe | first5=Bo̷rge | last6=Angelier | first6=Frédéric | last7=Blévin | first7=Pierre | last8=Bråthen | first8=Vegard S. | last9=Fauchald | first9=Per | last10=Gabrielsen | first10=Geir W. | last11=Herzke | first11=Dorte | last12=Nikiforov | first12=Vladimir A. | last13=Elliott | first13=Kyle H. | last14=Chastel | first14=Olivier | journal=Environmental Science & Technology | volume=58 | issue=29 | pages=12909–12920 | pmid=38991194 }}</ref> indicated that PFASs were being brought to the Arctic from polluted southern waters by migrating birds.<ref>von Herff, William, '''', ], October 4, 2024</ref> Although it is much less than compared to the introduction by wind and the oceans, the birds become vectors, transmitting the toxic chemicals. Rainer Lohmann, an oceanographer at the ], noted that this has a significant localized affect that is devastating for Arctic predators who accumulate toxins in their bodies because the contaminants from the birds often enter the food chain directly since the birds are the prey of many species.


=== Italy === ===Australia===
In 2017, the ]'s current affairs program ] reported that the storage and use of firefighting foams containing perfluorinated surfactants at ] facilities around Australia had contaminated nearby water resources.<ref>{{cite news |url=https://www.abc.net.au/news/2017-10-10/pfas-chemicals-katherine-residents-shocked-demand-action/9034504 |title='Shocked and disgusted' Katherine residents demand action on PFAS contamination | work=] |date=October 10, 2017 |archive-date=October 10, 2017|archive-url=https://web.archive.org/web/20171010073127/http://www.abc.net.au/news/2017-10-10/pfas-chemicals-katherine-residents-shocked-demand-action/9034504|url-status=live}}</ref> In 2019, remediation efforts at ] and the adjacent town of Katherine were ongoing.<ref>{{cite news |url=https://www.katherinetimes.com.au/story/6527835/tindals-pfas-hot-spots-record-startling-results/ |title=Tindal's PFAS hot spots record startling results | first=Chris | last=McLennan | work=Katherine Times | date=December 4, 2019 | archive-date=February 21, 2020 | archive-url=https://web.archive.org/web/20200221111934/https://www.katherinetimes.com.au/story/6527835/tindals-pfas-hot-spots-record-startling-results/ | url-status=live}}</ref> In the 2022 ] $428{{nbsp}}million was allocated for works at ], ], ] and ] including funding to remediate PFAS contamination.<ref>{{Cite news | url=https://www.smh.com.au/politics/federal/airbases-to-get-428-million-upgrade-as-government-switches-back-to-national-security-20220421-p5af77.html | first=Katina | last=Curtis | title=Airbases to get $428 million upgrade as government switches back to national security | work=] | date=April 21, 2022}}</ref>
Over 350,000 residents in the ] region are estimated to have been exposed to contamination through tap water, and it is thought to be Europe's biggest PFAS-related environmental disaster.{{Who|date=May 2023}} While Italy's National Health Institute (ISS, ''Istituto Superiore di Sanità'') set the threshold limit of PFOA in the bloodstream at 8 nanograms per milliliter (ng/mL), some residents had reached 262 and some industrial employees reach 91,900&nbsp;ng/mL. In 2021 some data was disclosed by ] and local citizens after a long legal battle against the Veneto Region and ISS, which for years has denied access to data, despite values known since or even before 2017. The Veneto region has not carried out further monitoring or taken resolutive actions to eliminate pollution and reduce, at least gradually, the contamination of non-potable water. Although in 2020 the ] (EFSA) has reduced by more than four times the maximum tolerable limit of PSAS that can be taken through the diet, the region has not carried out new assessments or implemented concrete actions to protect the population and the agri-food and livestock sectors. Some limits were added to monitoring the geographical area, which does not include the orange zone and other areas affected by contamination, as well as the insufficiency of analysis on important productions widespread in the areas concerned: eggs (up to 37,100&nbsp;ng/kg), fish (18,600&nbsp;ng/kg) spinach and ] (only one sampling carried out), kiwis, melons, watermelons, cereals (only one sample was analyzed), soy, wines and apples.<ref>, Greenpeace.</ref>


=== United States === ===Canada===
Although PFASs are not manufactured in Canada, they may be present in imported goods and products. In 2008, products containing PFOS as well as PFOA were banned in Canada, with exceptions for products used in firefighting, the military, and some forms of ink and photo media.<ref>{{cite web | url=https://ncceh.ca/resources/blog/keeping-drinking-water-safe-new-guidelines-pfas-canada | first=Juliette | last=O'Keeffe |title=Keeping Drinking Water Safe: New Guidelines for PFASs in Canada | website=National Collaborating Centre for Environmental Health | archive-date=August 7, 2020 | archive-url=https://web.archive.org/web/20200807233146/https://ncceh.ca/content/blog/keeping-drinking-water-safe-new-guidelines-pfas-canada | url-status=live}}</ref>


Health Canada has published drinking water guidelines for maximum concentrations of PFOS and PFOA to protect the health of Canadians, including children, over a lifetime's exposure to these substances. The maximum allowable concentration for PFOS under the guidelines is 0.0002 milligrams per liter. The maximum allowable concentration for PFOA is 0.0006 milligrams per liter.<ref>{{cite web | url=https://www.canada.ca/en/services/health/publications/healthy-living/water-talk-drinking-water-screening-values-perfluoroalkylated-substances.html | title=Perfluoroalkylated substances in drinking water | publisher=] | date=April 2019 | archive-date=August 15, 2020 | archive-url=https://web.archive.org/web/20200815112519/https://www.canada.ca/en/services/health/publications/healthy-living/water-talk-drinking-water-screening-values-perfluoroalkylated-substances.html | url-status=live}}</ref> In August 2024, Health Canada established an objective of 30 ng/L for the sum of the concentration of 25 PFASs<ref>]: ]–C<sub>12</sub>; ]: ]–]; PFECAs: ], ], ], ], ]; PFESAs: ], ], ]; FTSs: ], ], ]</ref> detected in drinking water.<ref>{{Cite web |last= |first= |date=2024-08-09 |title=Objective for Canadian drinking water quality per- and polyfluoroalkyl substances |url=https://www.canada.ca/en/health-canada/services/publications/healthy-living/objective-drinking-water-quality-per-polyfluoroalkyl-substances.html |access-date=2024-08-18 |website=www.canada.ca |publisher=Health Canada}}</ref>
==== In products ====
]
Certain PFASs are no longer manufactured in the United States as a result of phase-outs including the PFOA Stewardship Program (2010-2015), in which eight major chemical manufacturers agreed to eliminate the use of PFOA and PFOA-related chemicals in their products and emissions from their facilities.<ref>{{cite web |url=https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/fact-sheet-20102015-pfoa-stewardship-program |title=Fact Sheet: 2010/2015 PFOA Stewardship Program |date=2018-08-09 |website=Assessing and Managing Chemicals under TSCA |publisher=EPA |archive-date=December 8, 2018 |archive-url=https://web.archive.org/web/20181208160450/https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/fact-sheet-20102015-pfoa-stewardship-program |url-status=live }}</ref> Although PFOA and PFOS are no longer manufactured in the United States, they are still produced internationally and are imported into the U.S. in consumer goods such as carpet, leather and apparel, textiles, paper and packaging, coatings, rubber, and plastics.<ref>{{cite web |url=https://www.epa.gov/pfas/basic-information-pfas |title=Basic Information on PFAS |publisher=EPA |date=2018-12-06 |archive-date=December 23, 2018 |archive-url=https://web.archive.org/web/20181223025822/https://www.epa.gov/pfas/basic-information-pfas |url-status=live }}</ref>


===New Zealand===
In 2020, manufacturers and the ] announced an agreement to phase out some types of PFAS that are used in food packaging by 2024.<ref>{{cite web | vauthors = Hahn SM |title=FDA Announces Voluntary Agreement with Manufacturers to Phase Out Certain Short-Chain PFAS Used in Food Packaging |url=https://www.fda.gov/news-events/press-announcements/fda-announces-voluntary-agreement-manufacturers-phase-out-certain-short-chain-pfas-used-food |publisher=FDA |access-date=1 August 2020 |date=31 July 2020 |archive-date=August 2, 2020 |archive-url=https://web.archive.org/web/20200802044359/https://www.fda.gov/news-events/press-announcements/fda-announces-voluntary-agreement-manufacturers-phase-out-certain-short-chain-pfas-used-food |url-status=live}}</ref>
The New Zealand Environmental Protection Agency (EPA) has banned the use of per- and polyfluoroalkyl substances (PFAS) in cosmetic products starting from 31 December 2026. This will make the country one of the first in the world to take this step on PFAS to protect people and the environment.<ref>{{cite press release | url=https://www.epa.govt.nz/news-and-alerts/latest-news/epa-bans-forever-chemicals-in-cosmetic-products/ | title=EPA bans 'forever chemicals' in cosmetic products |publisher=] | date=30 January 2024}}</ref>


===United Kingdom===
PFASs are also used by major companies of the ] in a wide range of ], including ], ], ], ], ], ], ], and ]. A 2021 study tested 231 makeup and ]s and found organic fluorine, an indicator of PFASs, in more than half of the samples. High levels of fluorine were most commonly identified in waterproof mascara (82% of brands tested), foundations (63%), and liquid lipstick (62%).<ref name=":20">{{Cite web|date=2021-06-15|title=Toxic 'forever chemicals' widespread in top makeup brands, study finds|url=http://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals|access-date=2021-07-07|website=The Guardian|language=en|archive-date=July 7, 2021|archive-url=https://web.archive.org/web/20210707070534/https://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals|url-status=live}}</ref><ref name="10.1021/acs.estlett.1c00240">{{cite journal | vauthors = Whitehead HD, Venier M, Wu Y, Eastman E, Urbanik S, ], Shalin A, Schwartz-Narbonne H, Bruton TA, ], Wang Z | display-authors = 6 |title= Fluorinated Compounds in North American Cosmetics |journal=Environmental Science & Technology Letters |date=15 June 2021 |volume=8 |issue=7 |pages=538–544 |doi=10.1021/acs.estlett.1c00240 |hdl=20.500.11850/495857 |s2cid=236284279}}</ref> As many as 13 types of individual PFAS compounds were found in each product.<ref name=":20" /> Since PFAS compounds are highly mobile, they are readily absorbed through ] and through ]s, and such products on ]s are often unwittingly ingested. Manufacturers often fail to label their products as containing PFASs, which makes it difficult for cosmetics consumers to avoid products containing PFASs.<ref>{{cite web | work = The Guardian | location = UK | date = 15 June 2021 | url = https://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals?CMP=Share_iOSApp_Other | title = Toxic 'Forever Chemicals' Widespread in Top Makeup Brands, Study Finds; Researchers Find Signs of PFAS in over Half of 231 Samples of Products Including Lipstick, Mascara and Foundation | archive-url = https://web.archive.org/web/20210626211117/https://www.theguardian.com/fashion/2021/jun/15/pfas-makeup-forever-chemicals?CMP=Share_iOSApp_Other | archive-date=June 26, 2021 }}</ref> In response, Senators ] of Maine and ] of Connecticut proposed the No PFAS in Cosmetics Act in the ].<ref>{{cite news |url=https://www.washingtonpost.com/climate-environment/2021/06/15/toxic-pfas-makeup/ |title=Senate bill would ban toxic 'forever chemicals' in makeup, which new study found are often unlabeled | vauthors = Root T |newspaper=] |date=15 June 2021 |access-date=July 2, 2021 |archive-date=June 16, 2021 |archive-url=https://web.archive.org/web/20210616161229/https://www.washingtonpost.com/climate-environment/2021/06/15/toxic-pfas-makeup/ |url-status=live }}</ref> It was also introduced in the ] by Michigan Representative ],<ref>{{Cite web| vauthors = LaMotte S |title=Makeup may contain potentially toxic chemicals called PFAS, study finds|url=https://www.cnn.com/2021/06/15/health/makeup-toxic-chemicals-wellness/index.html|access-date=2021-07-07|website=CNN|date=June 15, 2021 |archive-date=June 29, 2021|archive-url=https://web.archive.org/web/20210629021146/https://www.cnn.com/2021/06/15/health/makeup-toxic-chemicals-wellness/index.html|url-status=live}}</ref> but the U.S. chemical industry lobby has killed efforts to regulate this.<ref>{{Cite news |last=Perkins |first=Tom |date=2023-01-13 |title=Bills to regulate toxic 'forever chemicals' died in Congress – with Republican help |language=en-GB |work=The Guardian |url=https://www.theguardian.com/environment/2023/jan/13/pfas-toxic-forever-chemicals-republican-house |access-date=2023-02-15 |issn=0261-3077}}</ref>
The environmental consequences of PFAS, especially from firefighting activities, have been recognized since the mid-1990s and came to prominence after the ] on 11 December 2005. The Environment Agency has undertaken a series of projects to understand the scale and nature of PFAS in the environment. The Drinking Water Inspectorate requires water companies to report concentrations of 47 PFAS.<ref>{{Cite web | url=https://dwi-content.s3.eu-west-2.amazonaws.com/wp-content/uploads/2021/10/04203217/Information-Letter-PFAS-Monitoring.pdf | title=Requirements for PFAS monitoring by water companies in England and Wales | work=] | date=1 October 2021}}</ref>


===European Union===
==== Contaminated sites, drinking water and wastewater ====
Many PFASs are either not covered by European legislation or are excluded from registration obligations under the EU ] (REACH) chemical regulation.<ref>{{cite web | url=https://www.env-health.org/the-forever-chemicals-that-are-harming-our-health-pfas/ |title=The "forever chemicals" that are harming our health: PFAS |date=February 4, 2020 |website=Health and Environment Alliance | archive-url=https://web.archive.org/web/20200206122946/https://www.env-health.org/the-forever-chemicals-that-are-harming-our-health-pfas/ | archive-date=February 6, 2020 | url-status=live}}</ref> Several PFASs have been detected in drinking water,<ref>{{cite journal | vauthors=Thomaidi VS, Tsahouridou A, Matsoukas C, Stasinakis AS, Petreas M, Kalantzi OI | title=Risk assessment of PFASs in drinking water using a probabilistic risk quotient methodology | journal=The Science of the Total Environment | volume=712 | pages=136485 | date=April 2020 | pmid=31927447 | doi=10.1016/j.scitotenv.2019.136485 | bibcode=2020ScTEn.71236485T | s2cid=210167277}}</ref> municipal wastewater,<ref>{{cite journal | vauthors=Arvaniti OS, Stasinakis AS | title=Review on the occurrence, fate and removal of perfluorinated compounds during wastewater treatment | journal=The Science of the Total Environment | volume=524-525 | pages=81–92 | date=August 2015 | pmid=25889547 | doi=10.1016/j.scitotenv.2015.04.023 | bibcode=2015ScTEn.524...81A}}</ref> and landfill leachates<ref>{{cite journal | vauthors=Nika MC, Ntaiou K, Elytis K, Thomaidi VS, Gatidou G, Kalantzi OI, Thomaidis NS, Stasinakis AS | display-authors=6 | title=Wide-scope target analysis of emerging contaminants in landfill leachates and risk assessment using Risk Quotient methodology | journal=Journal of Hazardous Materials | volume=394 | pages=122493 | date=July 2020 | pmid=32240898 | doi=10.1016/j.jhazmat.2020.122493 | bibcode=2020JHzM..39422493N | s2cid=214766390}}</ref> worldwide.
An estimated 26,000 U.S. sites are contaminated with PFASs. At least six million Americans are estimated to have drinking water containing PFASs above the safe limit published prior to 2022 by the ] (EPA).<ref name="Timmis_201801">{{cite journal |vauthors=Timmis A |title=Using Dredged Materials to Improve a Salt Marsh |journal=The Military Engineer |date=January 2018 |volume=110 |issue=712 |page=61 |url=http://online.fliphtml5.com/fedq/bohi/#p=63 |access-date=December 18, 2018 |archive-date=November 7, 2018 |archive-url=https://web.archive.org/web/20181107202305/http://online.fliphtml5.com/fedq/bohi/#p=63 |url-status=live }}</ref><ref name="Hu_20161011">{{cite journal |vauthors=Hu XC, Andrews DQ, Lindstrom AB, Bruton TA, Schaider LA, Grandjean P, Lohmann R, Carignan CC, Blum A, Balan SA, Higgins CP, Sunderland EM |display-authors=6 |title=Detection of Poly- and Perfluoroalkyl Substances (PFASs) in U.S. Drinking Water Linked to Industrial Sites, Military Fire Training Areas, and Wastewater Treatment Plants |journal=Environmental Science & Technology Letters |volume=3 |issue=10 |pages=344–350 |date=October 2016 |pmid=27752509 |pmc=5062567 |doi=10.1021/acs.estlett.6b00260}}</ref> More than 200 million Americans are estimated to live in places where the tap water PFAS level (a combination of ] and ] levels) exceeds the 1 ppt (part per trillion) limit set in 2022 by the EPA.<ref>{{Cite web |last=Sneed |first=Annie |date=2021-01-22 |title=Forever Chemicals Are Widespread in U.S. Drinking Water: Experts hope that with the incoming Biden administration, the federal government will finally regulate a class of chemicals known as PFASs |url=https://www.scientificamerican.com/article/forever-chemicals-are-widespread-in-u-s-drinking-water/ |access-date=2023-04-13 |website=] |language=en}}</ref>


In 2019, the ] requested the ] to develop an action plan to eliminate all non-essential uses of PFAS due to the growing evidence of adverse effects caused by exposure to these substances; the evidence for the widespread occurrence of PFAS in water, soil, articles, and waste; and the threat it can pose to drinking water.<ref>{{cite press release | website=] | title=Council Conclusions on Chemicals | url=https://www.consilium.europa.eu/en/press/press-releases/2019/06/26/council-conclusions-on-chemicals/}}</ref> Germany, the Netherlands, Denmark, Norway, and Sweden submitted a so-called restriction proposal based on the REACH regulation to achieve a European ban on the production, use, sale and import of PFAS.<ref>{{cite web | website=RIVM | title=PFAS | url=https://www.rivm.nl/pfas}}</ref> The proposal states that a ban is necessary for all use of PFAS, with different periods for different applications when the ban takes effect (immediately after the restriction comes into force, five years afterward, or 12 years afterward), depending on the function and the availability of alternatives. The proposal has not assessed the use of PFAS in medicines, plant protection products, and biocides because specific regulations apply to those substances (Biocidal Products Regulation, ], Medicinal Products Regulation) that have an explicit authorization procedure that focuses on risk for health and the environment.
{{As of|October 2020}}, the states of California, Connecticut, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Vermont, and Wisconsin had enforceable drinking water standards for between two and six types of PFAS. The six chemicals (termed by the ] as PFAS6) are measured either individually or summed as a group depending on the standard; they are:<ref>{{cite web |url=https://mecc.memberclicks.net/assets/Presentations/I-495%20PFAS6%20MCL%2010-21-2020.pdf |title=MassDEP's PFAS6 Drinking Water Standard |date=October 21, 2020 |author=]}}</ref>
* ] (PFOS)
* ] (PFOA)
* ] (PFHxS)
* ] (PFNA)
* ] (PFHpA)
* ] (PFDA)


The proposal was submitted on 13 January 2023 and published by the ] (ECHA) on 7 February. From 22 March to 21 September, citizens, companies, and other organizations commented on the proposal during a public consultation.<ref name=ECHA>{{cite web | url=https://echa.europa.eu/-/echa-publishes-pfas-restriction-proposal | title=ECHA publishes PFAS restriction proposal | publisher=]}}</ref> Based on the information in the restriction proposal and the consultation, two committees from ECHA formulate an opinion on the risk and socio-economic aspects of the proposed restriction. Within a year of publication, the opinions are sent to the European Commission, which makes a final proposal that is submitted to the EU Member States for discussion and decision.<ref>{{cite web | url=https://echa.europa.eu/regulations/reach/restrictions/restriction-procedure | title=Restriction procedure | publisher=]}}</ref> Eighteen months after the publication of the restriction decision (which may differ from the original proposal), it will enter into force.<ref name=ECHA/>
EPA published non-enforceable ] for PFOA and PFOS in 2016.<ref>{{cite web |title=Drinking Water Health Advisories for PFOA and PFOS |url=https://www.epa.gov/ground-water-and-drinking-water/drinking-water-health-advisories-pfoa-and-pfos |date=2020-12-09 |publisher=EPA |access-date=December 27, 2020 |archive-date=December 28, 2020 |archive-url=https://web.archive.org/web/20201228004056/https://www.epa.gov/ground-water-and-drinking-water/drinking-water-health-advisories-pfoa-and-pfos |url-status=live}}</ref><ref>{{cite web |title=Fact Sheet; PFOA & PFOS Drinking Water Health Advisories |url=https://www.epa.gov/ground-water-and-drinking-water/supporting-documents-drinking-water-health-advisories-pfoa-and-pfos |date=November 2016 |id=EPA 800-F-16-003 |access-date=December 27, 2020 |archive-date=December 26, 2020 |archive-url=https://web.archive.org/web/20201226125900/https://www.epa.gov/ground-water-and-drinking-water/supporting-documents-drinking-water-health-advisories-pfoa-and-pfos |url-status=live}}</ref> In March 2021 EPA announced that it would develop national drinking water standards for PFOA and PFOS.<ref name="CCL4-final">EPA (2021-03-03). "Announcement of Final Regulatory Determinations for Contaminants on the Fourth Drinking Water Contaminant Candidate List." ''Federal Register,'' {{usfr|86|12272}}</ref> On December 27, 2021, EPA published a regulation requiring drinking water utilities to conduct monitoring for 29 compounds. The data are to be collected during 2023 to 2025. EPA will pay for the monitoring costs for small drinking water systems (those serving a population of 10,000 or fewer). The agency may use the monitoring data to develop additional regulations.<ref>EPA (2021-12-27). "Revisions to the Unregulated Contaminant Monitoring Rule (UCMR 5) for Public Water Systems and Announcement of Public Meetings." ''Federal Register,'' {{USFR|86|73131}}</ref><ref>{{cite web |title=Fifth Unregulated Contaminant Monitoring Rule |url=https://www.epa.gov/dwucmr/fifth-unregulated-contaminant-monitoring-rule |date=2022-02-22 |publisher=EPA}}</ref>


===Italy===
In mid-2021 EPA announced plans to revise federal wastewater regulations (]) for several industries that manufacture PFASs or use PFASs in fabricating various products.<ref>{{cite web |title=Organic Chemicals, Plastics and Synthetic Fibers Effluent Guidelines |url=https://www.epa.gov/eg/organic-chemicals-plastics-and-synthetic-fibers-effluent-guidelines |date=2021-07-13 |publisher=EPA}}</ref><ref>{{cite web |title=Metal Finishing Effluent Guidelines |url=https://www.epa.gov/eg/metal-finishing-effluent-guidelines |date=2021-09-24 |publisher=EPA}}</ref>
127,000 residents in the ] region are estimated to have been exposed to contamination through tap water, and it is thought to be Europe's biggest PFAS-related environmental disaster.<ref name=Emerging/><ref>{{Cite web |url=https://www.who.int/europe/publications/i/item/9789289052467 |title=Keeping our water clean: the case of water contamination in the Veneto Region, Italy | website=www.who.int}}</ref> While Italy's National Health Institute (ISS, ''Istituto Superiore di Sanità'') set the threshold limit of PFOA in the bloodstream at 8 nanograms per milliliter (ng/mL), some residents had reached 262 and some industrial employees reach 91,900&nbsp;ng/mL. In 2021 some data was disclosed by ] and local citizens after a long legal battle against the Veneto Region and ISS, which for years has denied access to data, despite values known since or even before 2017. The Veneto region has not carried out further monitoring or taken resolutive actions to eliminate pollution and reduce, at least gradually, the contamination of non-potable water. Although in 2020 the ] (EFSA) has reduced by more than four times the maximum tolerable limit of PFAS that can be taken through the diet, the region has not carried out new assessments or implemented concrete actions to protect the population and the agri-food and livestock sectors. Some limits were added to monitoring the geographical area, which does not include the orange zone and other areas affected by contamination, as well as the insufficiency of analysis on important productions widespread in the areas concerned: eggs (up to 37,100&nbsp;ng/kg), fish (18,600&nbsp;ng/kg) spinach and ] (only one sampling carried out), kiwis, melons, watermelons, cereals (only one sample was analyzed), soy, wines and apples.<ref>, Greenpeace.</ref>


===Japan===
In October 2021 EPA announced the PFAS Strategic Roadmap. It is a "whole-of-EPA" strategy and considers the full lifecycle of PFAS—including drinking water monitoring and risk assessment for PFOA and PFOS in ] (processed wastewater ] used as fertilizer).<ref>{{cite web |title=PFAS Strategic Roadmap: EPA's Commitments to Action 2021-2024 |date=2022-01-27 |url=https://www.epa.gov/pfas/pfas-strategic-roadmap-epas-commitments-action-2021-2024 |publisher=EPA}}</ref><ref>{{cite web |url=https://www.epa.gov/biosolids/risk-assessment-pollutants-biosolids |title=Risk Assessment of Pollutants in Biosolids |date=2022-05-03 |publisher=EPA}}</ref>
A study of public water bodies ending in March 2022 showed that the sum of PFOS and PFOA concentrations exceeded 50&nbsp;ng/L in 81 out of 1,133 test sites and in some cases are present at elevated levels in blood. This has led to pressure to increase regulations.<ref>{{Cite news | url=https://www.japantimes.co.jp/news/2023/05/28/national/japan-pfas-risks-growing-awareness/ | title=Japan slowly wakes up to health risks of PFAS 'forever chemicals' | first=TOMOKO | last=OTAKE | work=] | date=May 28, 2023}}</ref>


===Sweden===
The EPA issued health advisories for four specific PFASs in June 2022, significantly lowering their safe threshold levels for drinking water. PFOA was reduced from 70 ppt to 0.004 ppt, while PFOS was reduced from 70 ppt to 0.02 ppt. ]'s safe levels were set at 10 ppt, while ] were set to 2000 ppt. While not enforceable, these health advisories are intended to be acted on by states in setting their own drinking water standards.<ref>{{cite web | url = https://www.wsj.com/articles/epa-lowers-bar-for-pfas-contamination-11655318054 | title = EPA Lowers Bar for Toxic Chemicals Contamination | vauthors = Maher K | date = June 15, 2022 | accessdate = June 15, 2022 | work = ] }}</ref>
Highly contaminated drinking water has been detected at several locations in Sweden. Such locations include Arvidsjaur, Lulnäset, Uppsala and Visby.<ref>{{cite journal | vauthors=Gyllenhammar I, Berger U, Sundström M, McCleaf P, Eurén K, Eriksson S, Ahlgren S, Lignell S, Aune M, Kotova N, Glynn A | display-authors=6 | title=Influence of contaminated drinking water on perfluoroalkyl acid levels in human serum--A case study from Uppsala, Sweden | journal=Environmental Research | volume=140 | pages=673–683 | date=July 2015 | pmid=26079316 | doi=10.1016/j.envres.2015.05.019 | bibcode=2015ER....140..673G}}</ref><ref>{{cite journal | title=Quantitative relationships of perfluoroalkyl acids in drinking water associated with serum concentrations above background in adults living near contamination hotspots in Sweden | journal=Environmental Research | first1=Gunnar | last1=Johanson | first2=Irina | last2=Gyllenhammar | first3=Carl | last3=Ekstrand| first4=Andrei | last4=Pyko | first5=Yiyi | last5=Xu | first6=Ying | last6=Li | first7=Karin | last7=Norström | first8=Karl | last8=Lilja | first9=Christian | last9=Lindh | first10=Jonathan P | last10=Benskin | first11=Antonios | last11=Georgelis | first12=Karl | last12=Forsell | first13=Kristina | last13=Jakobsson | first14=Anders | last14=Glynn | first15=Carolina | last15=Vogs | volume=219 | pages=115024 | date=February 2023 | pmid=36535390 | doi=10.1016/j.envres.2022.115024 | doi-access=free | bibcode=2023ER....21915024J}}</ref> In 2013, PFAS were detected at high concentrations in one of the two municipality drinking water treatment plants in the town of Ronneby, in southern Sweden. Concentrations of ] and ] were found at 1700&nbsp;ng/L and 8000&nbsp;ng/L, respectively.<ref>{{Cite web |url=https://sodrasjukvardsregionen.se/download/exponering-for-perfluorerade-amnen-pfas-i-dricksvatten-i-ronneby-kommun/?wpdmdl=2485&refresh=5fc8b036ccf3e1606987830 | first1=Kristina | last1=Jakobsson | first2=Kerstin Kronholm | last2=Diab | first3=Christian | last3=Lindh | first4=Bodil | last4=Persson | first5=Bo | last5=Jönsson | title=Exponering för perfluorerade ämnen (PFAS) i dricksvatten i Ronneby kommun |date=June 12, 2014}}</ref> The source of contamination was later found to be a military fire-fighting exercise site in which PFAS containing fire-fighting foam had been used since the mid-1980s.<ref>{{cite journal | first1=Ying |last1=Li | first2=Axel | last2=Andersson | first3=Yiyi | last3=Xu | first4=Daniela | last4=Pineda | first5=Carina A | last5=Nilsson | first6=Christian H | last6=Lindh | first7=Kristina | last7=Jakobsson | first8=Tony | last8=Fletcher | title=Determinants of serum half-lives for linear and branched perfluoroalkyl substances after long-term high exposure-A study in Ronneby, Sweden | journal=Environment International | volume=163 | pages=107198 | date=May 2022 | pmid=35447437 | doi=10.1016/j.envint.2022.107198 | s2cid=248247530 | doi-access=free | bibcode=2022EnInt.16307198L}}</ref>


Additionally, low-level contaminated drinking water has also been shown to be a significant exposure source of ], ], ] and ] for Swedish adolescents (ages 10–21). Even though the median concentrations in the municipality drinking water were below one&nbsp;ng/L for each individual PFAS, positive associations were found between adolescent serum PFAS concentrations and PFAS concentrations in drinking water.<ref>{{cite journal | first1=Jennifer | last1=Nyström-Kandola | first2=Lutz | last2=Ahrens | first3=Anders | last3=Glynn | first4=Gunnar | last4=Johanson | first5=Jonathan P | last5=Benskin | first6=Irina | last6=Gyllenhammar |first7=Sanna | last7=Lignell | first8=Carolina | last8=Vogs | title=Low concentrations of perfluoroalkyl acids (PFAAs) in municipal drinking water associated with serum PFAA concentrations in Swedish adolescents | journal=Environment International | volume=180 | pages=108166 | date=October 2023 | pmid=37708812 | doi=10.1016/j.envint.2023.108166 | s2cid=261156749 | doi-access=free | bibcode=2023EnInt.18008166N}}</ref>
A formal EPA rule to add PFOA and PFAS as hazardous chemicals was first issued for comment on 26 August 2022, which would require anyone discharging waste to monitor and restrict the release of these PFAS to set levels, and report when the wastewater exceeds it. It would also make grounds affected by high levels of PFIA or PFAS to be considered Superfund cleanup sites.<ref>washingtonpost.com/climate-environment/2022/08/26/forever-chemicals-epa-cleanup-rule/</ref>


===United States===
EPA has listed recommended steps that consumers may take to reduce possible exposure to PFAS chemicals.<ref>{{cite web |title=Meaningful and Achievable Steps You Can Take to Reduce Your Risk |url=https://www.epa.gov/pfas/meaningful-and-achievable-steps-you-can-take-reduce-your-risk |date=2022-08-18 |website=PFOA, PFOS and Other PFAS |publisher=EPA}}</ref>
An estimated 26,000 U.S. sites are contaminated with PFASs.<ref>{{cite journal |url=http://online.fliphtml5.com/fedq/bohi/#p=63 | last=Timmis | first=Andrew | title=Using Dredged Materials to Improve a Salt Marsh | journal=] | volume=110 | issue=712 | page=61 | date=January 2018 |archive-date=November 7, 2018 | archive-url=https://web.archive.org/web/20181107202305/http://online.fliphtml5.com/fedq/bohi/#p=63 |url-status=live}}</ref><ref>{{cite journal | first1=Xindi C. | last1=Hu | first2=David Q. | last2=Andrews | first3=Andrew B. | last3=Lindstrom| first4=Thomas A. | last4=Bruton | first5=Laurel A. | last5=Schaider | first6=Philippe | last6=Grandjean | first7=Rainer | last7=Lohmann| first8=Courtney C. | last8=Carignan | first9=Arlene | last9=Blum | authorlink9=Arlene Blum | first10=Simona A. | last10=Balan | first11=Christopher P. | last11=Higgins○ | first12=Elsie M. | last12=Sunderland |title=Detection of Poly- and Perfluoroalkyl Substances (PFASs) in U.S. Drinking Water Linked to Industrial Sites, Military Fire Training Areas, and Wastewater Treatment Plants |journal=Environmental Science & Technology Letters |volume=3 |issue=10 |pages=344–350 |date=October 2016 |pmid=27752509 |pmc=5062567 | doi=10.1021/acs.estlett.6b00260|bibcode=2016EnSTL...3..344H}}</ref> More than 200 million Americans are estimated to live in places where the PFAS level in tap water, including ] and ] levels, exceeds the 1 ppt (part per trillion) limit set in 2022 by the EPA.<ref>{{Cite web |url=https://www.scientificamerican.com/article/forever-chemicals-are-widespread-in-u-s-drinking-water/ | author=Sneed A |title=Forever Chemicals Are Widespread in U.S. Drinking Water: Experts hope that with the incoming Biden administration, the federal government will finally regulate a class of chemicals known as PFASs | work=] | date=January 22, 2021}}</ref>


Based on tap water studies from 716 locations from 2016 and 2021, the ] (USGS) found that the PFAS levels exceeded the EPA advisories in approximately 75% of the samples from urban areas and in approximately 25% of the rural area samples.<ref>{{Cite press release |title=Tap water study detects PFAS 'forever chemicals' across the US |url=https://www.usgs.gov/news/national-news-release/tap-water-study-detects-pfas-forever-chemicals-across-us |publisher=] |id=National News Release |date=July 5, 2023}}</ref>
On 14 March 2023, EPA announced the proposed National Primary Drinking Water Regulation (NPDWR). This proposal includes new maximum contaminant levels (MCLs) in drinking water for six well-known PFAS: PFOA, PFOS, ], PFBS, PFNA, and PFHxS. While the proposal does not require any actions until its finalization, the EPA believes it will be implemented by late 2023. If these new restrictions are put into place, the EPA expects that they will prevent thousands of deaths and tens of thousands of PFAS-attributable illnesses. Along with legally enforceable MCLs, the EPA proposal will also require public water systems to actively monitor for the 6 PFAS, notify the public about the level of PFAS in the water supply, and take measures to reduce the level of PFAS in drinking water if they exceed the MCLs.<ref>{{Cite web |last=US EPA |first=OW |date=2021-11-16 |title=Per- and Polyfluoroalkyl Substances (PFAS) |url=https://www.epa.gov/sdwa/and-polyfluoroalkyl-substances-pfas |access-date=2023-04-20 |website=www.epa.gov |language=en}}</ref>


Certain PFASs are no longer manufactured in the United States as a result of phase-outs including the PFOA Stewardship Program (2010–2015), in which eight major chemical manufacturers agreed to eliminate the use of PFOA and PFOA-related chemicals in their products and emissions from their facilities. However, they are still produced internationally and are imported into the U.S. in consumer goods.<ref>{{cite web |url=https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/fact-sheet-20102015-pfoa-stewardship-program |title=Fact Sheet: 2010/2015 PFOA Stewardship Program |date=August 9, 2018 |website=Assessing and Managing Chemicals under TSCA |publisher=] |archive-date=December 8, 2018 |archive-url=https://web.archive.org/web/20181208160450/https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/fact-sheet-20102015-pfoa-stewardship-program |url-status=live}}</ref><ref>{{cite web | url=https://www.epa.gov/pfas/basic-information-pfas |title=Basic Information on PFAS |date=30 March 2016 | publisher=] | archive-date=December 23, 2018 |archive-url=https://web.archive.org/web/20181223025822/https://www.epa.gov/pfas/basic-information-pfas |url-status=live}}</ref> Some types of PFAS are voluntarily not included in ].<ref>{{cite web |url=https://www.fda.gov/news-events/press-announcements/fda-announces-voluntary-agreement-manufacturers-phase-out-certain-short-chain-pfas-used-food |publisher=] | last=Hahn | first=Stephen M. |title=FDA Announces Voluntary Agreement with Manufacturers to Phase Out Certain Short-Chain PFAS Used in Food Packaging |date=31 July 2020 | archive-date=August 2, 2020 |archive-url=https://web.archive.org/web/20200802044359/https://www.fda.gov/news-events/press-announcements/fda-announces-voluntary-agreement-manufacturers-phase-out-certain-short-chain-pfas-used-food |url-status=live}}</ref>
==== Water contamination by U.S. military bases ====
The water in and around at least 126 U.S. military bases has been contaminated by high levels of PFASs because of their use of firefighting foams since the 1970s, according to a study by the ]. Of these, 90 bases reported PFAS contamination that had spread to drinking water or groundwater off the base.<ref>{{cite web |date=26 April 2018 |title=DoD: At Least 126 Bases Report Water Contaminants Linked to Cancer, Birth Defects |url=https://www.militarytimes.com/news/your-military/2018/04/26/dod-126-bases-report-water-contaminants-harmful-to-infant-development-tied-to-cancers/ |archive-url=https://web.archive.org/web/20200506043631/https://www.militarytimes.com/news/your-military/2018/04/26/dod-126-bases-report-water-contaminants-harmful-to-infant-development-tied-to-cancers/ |archive-date=May 6, 2020 |work=Military Times}}</ref><ref>{{Cite web |date=March 2018 |title=Addressing Perfluorooctane Sulfonate (PFOS) and Perfluorooctanoic Acid (PFOA) |url=https://partner-mco-archive.s3.amazonaws.com/client_files/1524589484.pdf |vauthors=Sullivan M}}</ref> A 2022 Pentagon report acknowledged that approximately 175,000 U.S. military personnel at two dozen American military facilities drank water contaminated by PFAS that exceeded the U.S. EPA limit. However, according to an analysis of the Pentagon report by the non-partisan ], the Pentagon report downplayed the number of people exposed to PFAS, which was much higher, probably in excess of 640,000 at 116 military facilities, than the number advanced by the Pentagon report. The EWG found that the Pentagon also omitted from its report some types of diseases that are likely to be caused by PFAS exposure, such as ], kidney disease, and fetal abnormalities.<ref>The Guardian (UK), 23 Dec. 2022, </ref>


In 2021, Senators ] of Maine and ] of Connecticut proposed the No PFAS in Cosmetics Act in the ].<ref>{{cite news |title=Senate bill would ban toxic 'forever chemicals' in makeup, which new study found are often unlabeled | url=https://www.washingtonpost.com/climate-environment/2021/06/15/toxic-pfas-makeup/ | last=Root | first=Tik |newspaper=] |date=June 15, 2021 |archive-date=June 16, 2021 |archive-url=https://web.archive.org/web/20210616161229/https://www.washingtonpost.com/climate-environment/2021/06/15/toxic-pfas-makeup/ |url-status=live}}</ref> It was also introduced in the ] by Michigan Representative ],<ref>{{Cite web | url=https://www.cnn.com/2021/06/15/health/makeup-toxic-chemicals-wellness/index.html | author=LaMotte S |title=Makeup may contain potentially toxic chemicals called PFAS, study finds | work=CNN | date=June 15, 2021 |archive-date=June 29, 2021 |archive-url=https://web.archive.org/web/20210629021146/https://www.cnn.com/2021/06/15/health/makeup-toxic-chemicals-wellness/index.html |url-status=live}}</ref> but the ], supported by the U.S. chemical industry ]ed the bill.<ref name=bills>{{Cite news |url=https://www.theguardian.com/environment/2023/jan/13/pfas-toxic-forever-chemicals-republican-house | last=Perkins | first=Tom | title=Bills to regulate toxic 'forever chemicals' died in Congress – with Republican help | work=] | date=January 13, 2023 |issn=0261-3077}}</ref>
==== Class action lawsuits ====
In February 2017, DuPont and ] (a DuPont ]) agreed to pay $671 million to settle lawsuits arising from 3,550 personal injury claims related to releasing of PFASs from their ], plant into the drinking water of several thousand residents.<ref>{{cite news |date=2017-02-13 |title=DuPont settles lawsuits over leak of chemical used to make Teflon |work=Reuters |url=https://www.reuters.com/article/us-du-pont-lawsuit-west-virginia-idUSKBN15S18U |url-status=live |access-date=2019-06-08 |archive-url=https://web.archive.org/web/20190608111323/https://www.reuters.com/article/us-du-pont-lawsuit-west-virginia-idUSKBN15S18U |archive-date=June 8, 2019}}</ref> This was after a court-created independent scientific panel—the C8 Science Panel—found a "probable link" between C8 exposure and six illnesses: kidney and testicular cancer, ulcerative colitis, thyroid disease, pregnancy-induced hypertension and high cholesterol.<ref name="c8sciencepanel" /><ref>{{cite web |title=C8 Science Panel Website |url=http://www.c8sciencepanel.org/prob_link.html |url-status=live |archive-url=https://www.webcitation.org/6FsXZ1Gua?url=http://www.c8sciencepanel.org/prob_link.html |archive-date=April 14, 2013 |access-date=2019-06-08 |website=www.c8sciencepanel.org}}</ref>


====Military bases====
In October 2018, a ] was filed by an Ohio firefighter against several producers of fluorosurfactants, including the 3M and DuPont corporations, on behalf of all U.S. residents who may have adverse health effects from exposure to PFASs.<ref>{{cite web |date=October 6, 2018 |title=Nationwide class action lawsuit targets Dupont, Chemours, 3M, and other makers of PFAS chemicals |url=https://theintercept.com/2018/10/06/dupont-pfas-chemicals-lawsuit/ |url-status=live |archive-url=https://web.archive.org/web/20181007111157/https://theintercept.com/2018/10/06/dupont-pfas-chemicals-lawsuit/ |archive-date=October 7, 2018 |access-date=October 8, 2018 |website=] |vauthors=Lerner S}}</ref> The story is told in the film '']''.<ref>{{cite web |date=30 November 2019 |title='Dark Waters': 7 of the Film's Stars and Their Real-Life Inspirations |url=https://www.hollywoodreporter.com/lists/true-story-dark-waters-how-accurate-are-characters-1254811/ |access-date=10 May 2022 |website=The Hollywood Reporter |vauthors=Piña C}}</ref>
The water in and around at least 126 U.S. military bases has been contaminated by high levels of PFASs because of their use of firefighting foams since the 1970s, according to a study by the ]. Of these, 90 bases reported PFAS contamination that had spread to drinking water or groundwater off the base.<ref>{{cite web | title=DoD: At Least 126 Bases Report Water Contaminants Linked to Cancer, Birth Defects | url=https://www.militarytimes.com/news/your-military/2018/04/26/dod-126-bases-report-water-contaminants-harmful-to-infant-development-tied-to-cancers/ |work=] |date=April 26, 2018 | archive-url=https://web.archive.org/web/20200506043631/https://www.militarytimes.com/news/your-military/2018/04/26/dod-126-bases-report-water-contaminants-harmful-to-infant-development-tied-to-cancers/ | archive-date=May 6, 2020 | url-status=live}}</ref>


In 2022, a report by the Pentagon acknowledged that approximately 175,000 U.S. military personnel at two dozen American military facilities drank water contaminated by PFAS that exceeded the U.S. EPA limit. However, according to the ], the Pentagon report downplayed the number of people exposed to PFAS, which was probably over 640,000 at 116 military facilities. The EWG found that the Pentagon also omitted from its report some types of diseases that are likely to be caused by PFAS exposure, such as ], kidney disease, and fetal abnormalities.<ref>{{Cite news | url=https://www.theguardian.com/us-news/2022/dec/23/us-soldiers-pfas-forever-chemicals-higher-rate-pentagon-military | title=US Military 'Downplayed' The Number of Soldiers Exposed to 'Forever Chemicals'—Analysis of Pentagon Report Reveals that Soldiers Exposed to PFAS Pollution at Much Higher Rate than Military Claims | work=] | date=23 December 2022}}</ref>
==== California ====
In 2021 California banned PFASs for use in food packaging and from infant and children's products and also required PFAS cookware in the state to carry a warning label.<ref>{{cite news | vauthors = Duggan T |url= https://www.sfchronicle.com/bayarea/article/California-bans-PFAS-chemicals-from-baby-products-16512091.php |title=California bans PFAS chemicals from baby products and food packaging |date=2021-10-05 |work=San Francisco Chronicle}}</ref>


==== Maine ==== ====Environmental Protection Agency actions====
The ] has published non-enforceable ] for PFOA and PFOS.<ref>{{cite web |url=https://www.epa.gov/ground-water-and-drinking-water/drinking-water-health-advisories-pfoa-and-pfos |title=Drinking Water Health Advisories for PFOA and PFOS | publisher=] |date=December 9, 2020 | archive-date=December 28, 2020 |archive-url=https://web.archive.org/web/20201228004056/https://www.epa.gov/ground-water-and-drinking-water/drinking-water-health-advisories-pfoa-and-pfos |url-status=live}}</ref><ref>{{cite web | title=Fact Sheet; PFOA & PFOS Drinking Water Health Advisories |url=https://www.epa.gov/ground-water-and-drinking-water/supporting-documents-drinking-water-health-advisories-pfoa-and-pfos | date=November 2016 |id=EPA 800-F-16-003 |archive-date=December 26, 2020 |archive-url=https://web.archive.org/web/20201226125900/https://www.epa.gov/ground-water-and-drinking-water/supporting-documents-drinking-water-health-advisories-pfoa-and-pfos |url-status=live}}</ref> In March 2021 EPA announced that it would develop national drinking water standards for PFOA and PFOS.<ref>EPA (2021-03-03). "Announcement of Final Regulatory Determinations for Contaminants on the Fourth Drinking Water Contaminant Candidate List." ''Federal Register,'' {{usfr|86|12272}}</ref> Drinking water utilities are required to monitor PFAS levels and may receive subsidies to do so.<ref>EPA (2021-12-27). "Revisions to the Unregulated Contaminant Monitoring Rule (UCMR 5) for Public Water Systems and Announcement of Public Meetings." ''Federal Register,'' {{USFR|86|73131}}</ref><ref>{{cite web |title=Fifth Unregulated Contaminant Monitoring Rule | url=https://www.epa.gov/dwucmr/fifth-unregulated-contaminant-monitoring-rule | date=February 22, 2022 | publisher=]}}</ref> There are also regulations regarding wastewater (]) for industries that use PFASs in the manufacturing process as well as ] (processed wastewater ] used as fertilizer).<ref>{{cite web |title=Organic Chemicals, Plastics and Synthetic Fibers Effluent Guidelines | url=https://www.epa.gov/eg/organic-chemicals-plastics-and-synthetic-fibers-effluent-guidelines |publisher=] | date=July 13, 2021}}</ref><ref>{{cite web |title=Metal Finishing Effluent Guidelines |url=https://www.epa.gov/eg/metal-finishing-effluent-guidelines |publisher=] |date=September 24, 2021}}</ref><ref>{{cite web | url=https://www.epa.gov/pfas/pfas-strategic-roadmap-epas-commitments-action-2021-2024 | title=PFAS Strategic Roadmap: EPA's Commitments to Action 2021-2024 | publisher=] | date=January 27, 2022}}</ref><ref>{{cite web | url=https://www.epa.gov/biosolids/risk-assessment-pollutants-biosolids |title=Risk Assessment of Pollutants in Biosolids | publisher=] | date=May 3, 2022}}</ref><ref>{{cite web | title=Meaningful and Achievable Steps You Can Take to Reduce Your Risk |url=https://www.epa.gov/pfas/meaningful-and-achievable-steps-you-can-take-reduce-your-risk | publisher=] | date=August 18, 2022}}</ref>
A program licensed and promoted by the Maine Department of Environmental Protection that provided free municipal wastewater ] (]) to farmers as fertilizer has resulted in PFAS contamination of local drinking water and farm-grown produce.<ref name="guardian">{{cite web |url=https://www.theguardian.com/environment/2022/mar/22/i-dont-know-how-well-survive-the-farmers-facing-ruin-in-americas-forever-chemicals-crisis |title='I don't know how we'll survive': the farmers facing ruin in America's 'forever chemicals' crisis |website=The Guardian |date=March 22, 2022 |publisher=Guardian News & Media Limited |access-date=28 March 2022 }}</ref><ref>{{Cite web|url=https://www.mainepublic.org/environment-and-outdoors/2022-02-07/complete-crisis-as-pfas-discovery-upends-life-and-livelihood-of-young-maine-farming-family|title=‘Complete crisis’ as PFAS discovery upends life and livelihood of young Maine farming family|date=7 February 2022|website=Maine Public}}</ref>


The EPA issued health advisories for four specific PFASs in June 2022, significantly lowering their safe threshold levels for drinking water. PFOA was reduced from 70 ppt to 0.004 ppt, while PFOS was reduced from 70 ppt to 0.02 ppt. A safe level for the compound ] was set at 10 ppt, while that for ] was set at 2000 ppt. While not enforceable, these health advisories are intended to be acted on by states in setting their own drinking water standards.<ref>{{cite news | url=https://www.wsj.com/articles/epa-lowers-bar-for-pfas-contamination-11655318054 |title=EPA Lowers Bar for Toxic Chemicals Contamination | last=Maher | first=Kris | work=] | date=June 15, 2022 | url-access=subscription}}</ref>
==== Michigan ====
The ] PFAS Action Response Team (MPART) was launched in 2017 and is the first multi-agency action team of its kind in the nation. Agencies representing health, environment, and other branches of state government have joined together to investigate sources and locations of PFAS contamination in the state, take action to protect people's drinking water, and keep the public informed.<ref name="FAS_Response">{{cite web |url=https://www.michigan.gov/pfasresponse/ |title=FY 2020 Fast Facts |website=Michigan PFAS Action Response Team |publisher=Michigan Department of Environment, Great Lakes, and Energy |location=Lansing, MI |access-date=2021-03-27 |archive-date=December 18, 2018 |archive-url=https://web.archive.org/web/20181218193515/https://www.michigan.gov/pfasresponse/ |url-status=live }}</ref>


In August 2022, the EPA proposed to add PFOA and PFOS to its list of hazardous substances under the ] law.<ref>{{cite news | last=Grandoni | first=Dino | title=EPA finally moves to label some 'forever chemicals' as hazardous | url=https://washingtonpost.com/climate-environment/2022/08/26/forever-chemicals-epa-cleanup-rule/ | newspaper=] | date=August 26, 2022 | url-access=limited}}</ref> EPA issued a final rule in April 2024, which requires that polluters pay for investigations and cleanup of these substances.<ref>{{cite web |title=Designation of Perfluorooctanoic Acid (PFOA) and Perfluorooctanesulfonic Acid (PFOS) as CERCLA Hazardous Substances | url=https://www.epa.gov/superfund/designation-perfluorooctanoic-acid-pfoa-and-perfluorooctanesulfonic-acid-pfos-cercla | date=May 8, 2024 | website=] |publisher=]}}</ref><ref>{{cite news | url=https://www.nytimes.com/2024/04/19/climate/epa-pfas-superfund-cleanup.html | title=E.P.A. Will Make Polluters Pay to Clean Up Two 'Forever Chemicals' | first=Coral | last=Davenport | newspaper=] | date=April 19, 2024 | url-access=limited}}</ref>
Groundwater is tested at locations throughout the state by various parties to ensure safety, compliance with regulations, and proactively detect and remedy potential problems. In 2010, the ] (MDEQ) discovered levels of PFASs in groundwater monitoring wells at the former ]. As additional information became available from other national testing, Michigan expanded its investigations into other locations where PFAS compounds were potentially used.<ref name="FAS_Response" />


]
In 2018, the MDEQ's Remediation and Redevelopment Division (RRD) established cleanup criteria for groundwater used as drinking water of 70 ppt of PFOA and PFOS, individually or combined. The RRD staff are responsible for implementing these criteria as part of their ongoing efforts to clean up sites of environmental contamination. The RRD staff are the lead investigators at most of the PFAS sites on the MPART website and also conduct interim response activities, such as coordinating bottled water or filter installations with local health departments at sites under investigation or with known PFAS concerns. Most of the groundwater sampling at PFAS sites under RRD's lead is conducted by contractors familiar with PFAS sampling techniques. The RRD also has a Geologic Services Unit, with staff who install monitoring wells and are also well versed with PFAS sampling techniques.<ref name="FAS_Response" />
In April 2024, the EPA issued a final drinking water rule for PFOA, PFOS, ], PFBS, PFNA, and PFHxS. Within three years, ]s must remove these six PFAS to near-zero levels. States may be awarded grants up to $1 billion in aid to help with the initial testing and treatment of water for this purpose.<ref>] (April 26, 2024). "PFAS National Primary Drinking Water Regulation." ''Federal Register,'' {{USFR|89|32532}}</ref><ref>{{cite web |title=Final PFAS National Primary Drinking Water Regulation |url=https://www.epa.gov/sdwa/and-polyfluoroalkyl-substances-pfas |date=May 22, 2024 |publisher=]}}</ref><ref name=BannedUS>{{cite news | url=https://www.nytimes.com/2024/04/10/climate/epa-pfas-drinking-water.html | title=E.P.A. Says 'Forever Chemicals' Must Be Removed From Tap Water | first=Lisa | last=Friedman | newspaper=] | date=April 10, 2024 | url-access=limited}}</ref><ref>{{Cite news | url=https://www.nbcnews.com/health/health-news/epa-limits-pfas-chemicals-drinking-water-first-time-rcna147000 | title=EPA imposes first national limits on 'forever chemicals' in drinking water | first=Aria | last=Bendix | work=] | date=April 10, 2024}}</ref><ref>{{Cite press release | url=https://www.epa.gov/newsreleases/biden-harris-administration-finalizes-first-ever-national-drinking-water-standard | title=Biden-Harris Administration Finalizes First-Ever National Drinking Water Standard to Protect 100M People from PFAS Pollution | publisher=] | date=April 10, 2024}}</ref>


====Legal actions====
The MDEQ has been conducting environmental clean-up of regulated contaminants for decades. Due to the evolving nature of PFAS regulations as new science becomes available, the RRD is evaluating the need for regular PFAS sampling at ] sites and is including an evaluation of PFAS sampling needs as part of a Baseline Environmental Assessment review.<ref name="FAS_Response" />
In February 2017, DuPont and ] (a DuPont ]) agreed to pay $671 million to settle lawsuits arising from 3,550 personal injury claims related to the releasing of PFASs from their ], plant into the drinking water of several thousand residents.<ref>{{cite news | url=https://www.reuters.com/article/us-du-pont-lawsuit-west-virginia-idUSKBN15S18U | title=DuPont settles lawsuits over leak of chemical used to make Teflon | first=Arathy S. | last=Nair | work=] | date=February 13, 2017 | archive-url=https://web.archive.org/web/20190608111323/https://www.reuters.com/article/us-du-pont-lawsuit-west-virginia-idUSKBN15S18U | archive-date=June 8, 2019 | url-status=live}}</ref> This was after a court-created independent scientific panel—the C8 Science Panel—found a "probable link" between C8 exposure and six illnesses: kidney and testicular cancer, ulcerative colitis, thyroid disease, pregnancy-induced hypertension and high cholesterol.<ref name=c8/>


In October 2018, a ] was filed by an Ohio firefighter against several producers of fluorosurfactants, including 3M and DuPont, on behalf of all U.S. residents who may have adverse health effects from exposure to PFASs.<ref>{{cite web | date=October 6, 2018 |title=Nationwide class action lawsuit targets Dupont, Chemours, 3M, and other makers of PFAS chemicals |url=https://theintercept.com/2018/10/06/dupont-pfas-chemicals-lawsuit/ | website=] |author=Lerner S |archive-url=https://web.archive.org/web/20181007111157/https://theintercept.com/2018/10/06/dupont-pfas-chemicals-lawsuit/ | archive-date=October 7, 2018 |url-status=live }}</ref> The story is told in the film '']''.<ref>{{cite news |title='Dark Waters': 7 of the Film's Stars and Their Real-Life Inspirations |url=https://www.hollywoodreporter.com/lists/true-story-dark-waters-how-accurate-are-characters-1254811/ |last=Piña | first=Christy |work=] | date=30 November 2019}}</ref>
Earlier in 2018, the RRD purchased lab equipment that will allow the MDEQ Environmental Lab to conduct analyses of certain PFAS samples. (Currently, most samples are shipped to one of the few labs in the country that conduct PFAS analysis, in California, although private labs in other parts of the country, including Michigan, are starting to offer these services.) As of August 2018, RRD has hired additional staff to work on developing the methodology and conducting PFAS analyses.<ref name="FAS_Response" />


In June 2023, ] reached a US$10.3 ] settlement with several US public water providers to resolve water pollution claims tied to PFAS, while ], ] and ] settled similar claims for $1.19 billion.<ref name=settle>{{Cite news | url=https://www.theguardian.com/environment/2023/jun/22/3m-settlement-municipal-water-systems-pfas-contamination | title=3M pays $10.3bn to settle water pollution suit over 'forever chemicals' |work=] | date=June 22, 2023 | issn=0261-3077}}</ref>
In 2020 Michigan Attorney General ] filed a lawsuit against 17 companies, including 3M, Chemours, and DuPont, for hiding known health and environmental risks from the state and its residents. Nessel's complaint identifies 37 sites with known contamination.<ref>{{Cite web |title=Dana Nessel sues 3M, DuPont over 'unconscionable' PFAS pollution in Michigan {{!}} Bridge Michigan |url=https://www.bridgemi.com/michigan-government/dana-nessel-sues-3m-dupont-over-unconscionable-pfas-pollution-michigan |access-date=2022-03-28 |website=www.bridgemi.com |language=en}}</ref> The ] introduced some of the strictest drinking water standards in the country for PFAS, setting ]s (MCLs) for PFOA and PFOS to 8 and 16 ppt respectively (down from previous existing groundwater cleanup standards of 70 ppt for both), and introducing MCLs for 5 other previously unregulated PFAS compounds, limiting PFNA to 6 ppt, PFHxA to 400,000 ppt, PFHxS to 51 ppt, PFBS to 420 ppt and ] to 370 ppt.<ref>{{Cite web |title=EGLE - Michigan adopts strict PFAS in drinking water standards |url=https://www.michigan.gov/egle/0,9429,7-135--534660--,00.html | archive-url=https://web.archive.org/web/20220310020229/https://www.michigan.gov/egle/0,9429,7-135--534660--,00.html |access-date=2022-03-10 |website=www.michigan.gov|archive-date=March 10, 2022 }}</ref> The change adds 38 additional sites to the state's list of known PFAS contaminated areas, bringing the total number of known sites to 137. About half of these sites are ]s and 13 are former ].<ref>{{Cite web | vauthors = Matheny K |title=Michigan's drinking water standards for these chemicals now among toughest in nation |url= https://www.freep.com/story/news/local/michigan/2020/08/03/tougher-pfas-standards-drinking-water-michigan/5574268002/ |access-date=2022-03-31 |website=Detroit Free Press |language=en-US}}</ref>


In December 2023, as part of a four-year legal battle, the EPA banned Inhance, a Houston, Texas-based manufacturer that produces an estimated 200 million containers annually with a process that creates PFOA, from using the manufacturing process.<ref>{{cite news | url=https://www.theguardian.com/us-news/2024/mar/30/pfas-ban-plastic-containers-court |last=Perkins | first=Tom | title=US appeals court kills ban on plastic containers contaminated with PFAS | work=] |date=March 30, 2024}}</ref><ref>{{cite news | url=https://www.theguardian.com/environment/2023/jun/01/pfas-lawsuit-epa-plastic-containers-health-danger | last=Perkins | first=Tom | title=Plastic containers still distributed across the US are a potential health disaster | work=] | date=June 1, 2023}}</ref> In March 2024, the ] overturned the ban. While the court did not deny the containers’ health risks, it said that the EPA could not regulate the manufactured containers under ], which only addresses "new" chemicals.<ref>{{Cite news | url=https://www.reuters.com/legal/litigation/us-appeals-court-curtails-epas-ability-regulate-pfas-under-toxic-substances-law-2024-03-22/ | title=US appeals court curtails EPA's ability to regulate PFAS under toxic substances law | first=Clark | last=Mindock | work=] | date=March 22, 2024}}</ref>
In 2022 PFOS was found in beef produced at a Michigan farm: the cattle had been fed crops fertilized with contaminated biosolids. State agencies issued a consumption advisory, but did not order a recall, because there currently is no PFOS contamination in beef government standards.<ref name="abcnews">{{cite web |url=https://abcnews.go.com/US/wireStory/toxic-forever-chemicals-found-michigan-farms-beef-82543453 |title=Toxic 'forever chemicals' found in Michigan farm's beef |website=abcNEWS |publisher=ABC News Internet Ventures |access-date=28 March 2022 }}</ref>


====Minnesota==== ====State actions====
In 2021, ] became the first U.S. state to ban these compounds in all products by 2030, except for instances deemed "currently unavoidable".<ref>{{cite news | last=Perkins | first=Tom |title=Maine bans toxic 'forever chemicals' under groundbreaking new law |url=https://www.theguardian.com/us-news/2021/jul/15/maine-law-pfas-forever-chemicals-ban |archive-url=https://web.archive.org/web/20210716071833/https://www.theguardian.com/us-news/2021/jul/15/maine-law-pfas-forever-chemicals-ban |archive-date=July 16, 2021 |work=] |date=July 16, 2021}}</ref><ref>{{Cite journal |url=https://www.science.org/content/article/maine-s-ban-forever-chemicals-marks-big-win-some-scientists | first=XIAOZHI | last=LIM |date=2021-08-27 |title=Maine's ban on 'forever chemicals' marks a big win for some scientists |journal=] |doi=10.1126/science.abm1382 |archive-url=https://web.archive.org/web/20210831164644/https://www.science.org/news/2021/08/maine-s-ban-forever-chemicals-marks-big-win-some-scientists |archive-date=31 August 2021 |url-status=live }}</ref>
In February 2018, 3M settled a lawsuit for $850 million related to contaminated drinking water in Minnesota.<ref>{{cite news |url=https://www.bloomberg.com/news/articles/2018-02-20/3m-is-said-to-settle-minnesota-lawsuit-for-up-to-1-billion |title=3M Settles Minnesota Lawsuit for $850 Million |date=2019-06-07 |publisher=Bloomberg |access-date=2019-06-08 |archive-date=June 8, 2019 |archive-url=https://web.archive.org/web/20190608111342/https://www.bloomberg.com/news/articles/2018-02-20/3m-is-said-to-settle-minnesota-lawsuit-for-up-to-1-billion |url-status=live }}</ref>


{{As of|October 2020}}, the states of California, Connecticut, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Vermont, and Wisconsin had enforceable drinking water standards for between two and six types of PFAS. The six chemicals (termed by the ] as PFAS6) are measured either individually or summed as a group depending on the standard; they are:<ref>{{cite web |url=https://mecc.memberclicks.net/assets/Presentations/I-495%20PFAS6%20MCL%2010-21-2020.pdf |title=MassDEP's PFAS6 Drinking Water Standard |date=October 21, 2020 |author=]}}</ref>
'''New York'''
* ] (PFOS)
* ] (PFOA)
* ] (PFHxS)
* ] (PFNA)
* ] (PFHpA)
* ] (PFDA)


=====California=====
In 2016, New York, along with Vermont and New Hampshire, acknowledged PFOA contamination by requesting the EPA to release water quality guidance measures. Contamination has been observed by the New York State Department of Environmental Conservation in Hoosick Falls, Newburgh, Petersburgh, Poestenkill, Mahopac, and Armonk.<ref>{{Cite web |title=Per- and Polyfluoroalkyl Substances (PFAS) - NYS Dept. of Environmental Conservation |url=https://www.dec.ny.gov/chemical/108831.html |access-date=2023-05-10 |website=www.dec.ny.gov}}</ref>
In 2021 California banned PFASs for use in food packaging and from infant and children's products and also required PFAS cookware in the state to carry a warning label.<ref>{{cite news | vauthors=Duggan T |url=https://www.sfchronicle.com/bayarea/article/California-bans-PFAS-chemicals-from-baby-products-16512091.php |title=California bans PFAS chemicals from baby products and food packaging |date=2021-10-05 |work=San Francisco Chronicle}}</ref>


=====Maine=====
The village of Hoosick Falls has received a $65.25 million dollar settlement from Saint-Gobain Performance Plastics, Honeywell, 3M, and DuPont companies through a class action lawsuit in 2021, due to the disposal of PFAS chemicals into the groundwater of the local water treatment plant.<ref>{{Cite web |last=Lyons |first=Brendan J. |date=2021-07-21 |title=$65M settlement filed in Hoosick Falls PFOA water contamination |url=https://www.timesunion.com/state/article/hoosick-falls-pfoa-settlement-16326755.php |access-date=2023-05-10 |website=Times Union |language=en-US}}</ref>
A program licensed and promoted by the Maine Department of Environmental Protection that provided free municipal wastewater ] (]) to farmers as fertilizer has resulted in PFAS contamination of local drinking water and farm-grown produce.<ref>{{cite news | title='I don't know how we'll survive': the farmers facing ruin in America's 'forever chemicals' crisis |url=https://www.theguardian.com/environment/2022/mar/22/i-dont-know-how-well-survive-the-farmers-facing-ruin-in-americas-forever-chemicals-crisis | first=Tom | last=Perkins | work=] | date=March 22, 2022}}</ref><ref>{{Cite web|url=https://www.mainepublic.org/environment-and-outdoors/2022-02-07/complete-crisis-as-pfas-discovery-upends-life-and-livelihood-of-young-maine-farming-family|title='Complete crisis' as PFAS discovery upends life and livelihood of young Maine farming family|date=7 February 2022|website=Maine Public}}</ref>


=====Michigan=====
'''New Jersey'''
The ] PFAS Action Response Team (MPART) was launched in 2017 and is the first multi-agency action team of its kind in the nation. Agencies representing health, environment, and other branches of state government have joined together to investigate sources and locations of PFAS contamination in the state, take action to protect people's drinking water, and keep the public informed. Groundwater is tested at locations throughout the state by various parties to ensure safety, compliance with regulations, and proactively detect and remedy potential problems. In 2010, the ] (MDEQ) discovered levels of PFASs in groundwater monitoring wells at the former ].<ref>{{Cite web | url=https://www.circleofblue.org/2018/world/fear-and-fury-in-michigan-town-where-air-force-contaminated-water/ |last=Walton |first=Brett | date=April 11, 2018 |title=Fear and Fury in Michigan Town Where Air Force Contaminated Water | website=Circle of Blue |language=en-US}}</ref> In 2024, citizen-led testing near the base in ] discovered high levels of PFAS in foam along the shore of ].<ref>{{Cite web |url=https://www.bridgemi.com/michigan-environment-watch/pfas-tainted-foam-lake-huron-prompts-citizen-outcry|title=PFAS-tainted foam in Lake Huron prompts citizen outcry | work=] |date=May 22, 2024}}</ref> As additional information became available from other national testing, Michigan expanded its investigations into other locations where PFAS compounds were potentially used. In 2018, the MDEQ's Remediation and Redevelopment Division (RRD) established cleanup criteria for groundwater used as drinking water of 70 ppt of PFOA and PFOS, individually or combined. The RRD staff are responsible for implementing these criteria as part of their ongoing efforts to clean up sites of environmental contamination. The RRD staff are the lead investigators at most of the PFAS sites on the MPART website and also conduct interim response activities, such as coordinating bottled water or filter installations with local health departments at sites under investigation or with known PFAS concerns. Most of the groundwater sampling at PFAS sites under RRD's lead is conducted by contractors familiar with PFAS sampling techniques. The RRD also has a Geologic Services Unit, with staff who install monitoring wells and are also well versed with PFAS sampling techniques. The MDEQ has been conducting environmental clean-up of regulated contaminants for decades. Due to the evolving nature of PFAS regulations as new science becomes available, the RRD is evaluating the need for regular PFAS sampling at ] sites and is including an evaluation of PFAS sampling needs as part of a Baseline Environmental Assessment review. Earlier in 2018, the RRD purchased lab equipment that will allow the MDEQ Environmental Lab to conduct analyses of certain PFAS samples. (Currently, most samples are shipped to one of the few labs in the country that conduct PFAS analysis, in California, although private labs in other parts of the country, including Michigan, are starting to offer these services.) As of August 2018, RRD has hired additional staff to work on developing the methodology and conducting PFAS analyses.<ref>{{cite web |title=Michigan PFAS Action Response Team (MPART) |url=https://www.michigan.gov/pfasresponse/ |publisher=Michigan Department of Environment, Great Lakes, and Energy |location=Lansing, MI | archive-date=December 18, 2018 |archive-url=https://web.archive.org/web/20181218193515/https://www.michigan.gov/pfasresponse/ |url-status=live}}</ref>


In 2020 Michigan Attorney General ] filed a lawsuit against 17 companies, including 3M, Chemours, and DuPont, for hiding known health and environmental risks from the state and its residents. Nessel's complaint identifies 37 sites with known contamination.<ref>{{Cite web |url=https://www.bridgemi.com/michigan-government/dana-nessel-sues-3m-dupont-over-unconscionable-pfas-pollution-michigan | title=Dana Nessel sues 3M, DuPont over 'unconscionable' PFAS pollution in Michigan | work=] | date=January 14, 2020}}</ref> The ] introduced some of the strictest drinking water standards in the country for PFAS, setting ]s (MCLs) for PFOA and PFOS to 8 and 16 ppt respectively (down from previous existing groundwater cleanup standards of 70 ppt for both), and introducing MCLs for five other previously unregulated PFAS compounds, limiting PFNA to six ppt, PFHxA to 400,000 ppt, PFHxS to 51 ppt, PFBS to 420 ppt and ] to 370 ppt.<ref>{{Cite web | url=https://www.michigan.gov/egle/0,9429,7-135--534660--,00.html | title=EGLE - Michigan adopts strict PFAS in drinking water standards | website=www.michigan.gov | archive-url=https://web.archive.org/web/20220310020229/https://www.michigan.gov/egle/0,9429,7-135--534660--,00.html | archive-date=March 10, 2022}}</ref> The change adds 38 additional sites to the state's list of known PFAS contaminated areas, bringing the total number of known sites to 137. About half of these sites are ]s and 13 are former ].<ref>{{Cite news | title=Michigan's drinking water standards for these chemicals now among toughest in nation | url=https://www.freep.com/story/news/local/michigan/2020/08/03/tougher-pfas-standards-drinking-water-michigan/5574268002/ | vauthors=Matheny K | website=Detroit Free Press | date=August 3, 2020}}</ref>
In 2018 the ] (NJDEP) published a drinking water standard for PFNA. ]s in New Jersey are required to meet an MCL standard of 13&nbsp;ppt.<ref>{{cite news | vauthors = Fallon S |title=New Jersey becomes first state to regulate dangerous chemical PFNA in drinking water |url=https://www.northjersey.com/story/news/environment/2018/09/06/new-jersey-first-state-regulate-dangerous-chemical-pfna-pfoa/1210328002/ |date=2018-09-06 |work=North Jersey Record |location=Woodland Park, NJ |access-date=December 27, 2020 |archive-date=November 29, 2020 |archive-url=https://web.archive.org/web/20201129081254/https://www.northjersey.com/story/news/environment/2018/09/06/new-jersey-first-state-regulate-dangerous-chemical-pfna-pfoa/1210328002/ |url-status=live }}</ref><ref>{{cite web |title=Maximum Contaminant Levels (MCLs) for Perfluorononanoic Acid and 1,2,3-Trichloropropane; Private Well Testing for Arsenic, Gross Alpha Particle Activity, and Certain Synthetic Organic Compounds |url=https://advance.lexis.com/api/document/collection/administrative-codes/id/5T61-TR60-01XC-F17T-00008-00?cite=50%20N.J.R.%201939(a)&context=1000516 |date=2018-09-04 |publisher=New Jersey Department of Environmental Protection (NJDEP) |location=Trenton, NJ |id=50 N.J.R. 1939(a) |access-date=December 27, 2020 |archive-date=October 6, 2021 |archive-url=https://web.archive.org/web/20211006204818/https://signin.lexisnexis.com/lnaccess/app/signin?back=https%3A%2F%2Fadvance.lexis.com%3A443%2Flaapi%2Fdocument%3Fcite%3D50%2BN.J.R.%2B1939%28a%29%26context%3D1000516%26collection%3Dadministrative-codes%26id%3D5T61-TR60-01XC-F17T-00008-00&aci=la |url-status=live }}</ref> In 2020 the state set a PFOA standard at 14&nbsp;ppt and a PFOS standard at 13&nbsp;ppt.<ref>{{cite web |title=Adoption of ground water quality standards and maximum contaminant levels for perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) |url=https://www.state.nj.us/dep/srp/srra/listserv_archives/2020/20200601_srra.html |date=2020-06-01 |publisher=NJDEP |access-date=December 27, 2020 |archive-date=June 25, 2021 |archive-url=https://web.archive.org/web/20210625164516/https://www.state.nj.us/dep/srp/srra/listserv_archives/2020/20200601_srra.html |url-status=live }}</ref>


In 2022 PFOS was found in beef produced at a Michigan farm: the cattle had been fed crops fertilized with contaminated biosolids. State agencies issued a consumption advisory, but did not order a recall, because there currently is no PFOS contamination in beef government standards.<ref>{{cite news | url=https://www.abc12.com/news/toxic-forever-chemicals-found-in-michigan-farms-beef/article_e7f880e2-8115-11ec-a9ab-738b364fb600.html | title=Toxic 'forever chemicals' found in Michigan farm's beef | first=Christine | last=Winter | agency=] | work=] | date=January 29, 2022}}</ref>
In 2019 NJDEP filed lawsuits against the owners of two plants that had manufactured PFASs, and two plants that were cited for water pollution from other chemicals. The companies cited are DuPont, ] and 3M.<ref>{{cite web |title=AG Grewal, DEP Commissioner Announce 4 New Environmental Lawsuits Focused on Contamination Allegedly Linked to DuPont, Chemours, 3M |url=https://www.nj.gov/oag/newsreleases19/pr20190327a.html |date=2019-03-27 |publisher=New Jersey Office of the Attorney General |location=Totowa, NJ |id=Press release |access-date=February 14, 2021 |archive-date=January 13, 2021 |archive-url=https://web.archive.org/web/20210113223236/https://www.nj.gov/oag/newsreleases19/pr20190327a.html |url-status=live }}</ref> NJDEP also declared five companies to be financially responsible for statewide remediation of the chemicals. Among the companies accused were ] and ] regarding a ] Facility in ], where Arkema manufactured PFASs, but Solvay claims to have never manufactured but only handled PFASs.<ref>{{cite letter | vauthors = Norton GP |recipient=Shawn LaTourette |subject=Re: Statewide PFAS Directive, Information Request and Notice to Insurers |date=2019-04-17|via=Internet Archive|url=https://archive.org/details/5999826-SolvayNJDEPLetter-4-17-2019/}}</ref> The companies denied liability and contested the directive.<ref name="NewJersey_Warren_20190513">{{cite news |url=https://www.nj.com/news/2019/05/state-ordered-chemical-companies-to-pay-for-pollution-clean-up-they-say-no-way.html |title=State ordered chemical companies to pay for pollution clean-up. They say, no way! | vauthors = Warren MS |date=May 13, 2019 |work=NJ.com |access-date=September 30, 2019 |publisher=NJ Advance Media |archive-date=October 19, 2019 |archive-url=https://web.archive.org/web/20191019015403/https://www.nj.com/news/2019/05/state-ordered-chemical-companies-to-pay-for-pollution-clean-up-they-say-no-way.html |url-status=live }}</ref> In June 2020, the U.S. Environmental Protection Agency and NJ Department of Environmental Protection published a paper reporting that a unique family of PFAS used by Solvay, chloroperfluoropolyether carboxylates (ClPFPECAs), were contaminating the soils of New Jersey as far from the Solvay facility as 150&nbsp;km.<ref name="pmid32499438">{{cite journal | vauthors = Washington JW, Rosal CG, McCord JP, Strynar MJ, Lindstrom AB, Bergman EL, Goodrow SM, Tadesse HK, Pilant AN, Washington BJ, Davis MJ, Stuart BG, Jenkins TM | display-authors = 6 | title = Nontargeted mass-spectral detection of chloroperfluoropolyether carboxylates in New Jersey soils | journal = Science | volume = 368 | issue = 6495 | pages = 1103–1107 | date = June 2020 | pmid = 32499438 | pmc = 7814412 | doi = 10.1126/science.aba7127 | bibcode = 2020Sci...368.1103W }}</ref> and the ClPFPECAs were found in water as well.<ref name="pmid33553465">{{cite journal | vauthors = McCord JP, Strynar MJ, Washington JW, Bergman EL, Goodrow SM | title = Emerging Chlorinated Polyfluorinated Polyether Compounds Impacting the Waters of Southwestern New Jersey Identified by Use of Nontargeted Analysis | journal = Environmental Science & Technology Letters | volume = 7 | issue = 12 | pages = 903–908 | date = December 2020 | pmid = 33553465 | pmc = 7863629 | doi = 10.1021/acs.estlett.0c00640 }}</ref>


A 2024 study found that "atmospheric deposition could be a significant environmental pathway, particularly for the Great Lakes."<ref>{{Cite journal |last1=Xia |first1=Chunjie |last2=Capozzi | first2=Staci L. | last3=Romanak | first3=Kevin A. | last4=Lehman | first4=Daniel C. | last5=Dove |first5=Alice | last6=Richardson | first6=Violeta | last7=Greenberg |first7=Tracie | last8=McGoldrick | first8=Daryl | last9=Venier | first9=Marta |date=2024-05-16 |title=The Ins and Outs of Per- and Polyfluoroalkyl Substances in the Great Lakes: The Role of Atmospheric Deposition | journal=Environmental Science & Technology | volume=58 | issue=21 | pages=9303–9313 | language=en |doi=10.1021/acs.est.3c10098 | issn=0013-936X | doi-access=free | pmid=38752648 | pmc=11137863 |bibcode=2024EnST...58.9303X}}</ref><ref>{{Cite web | url=https://www.greatlakesnow.org/2024/05/pfas-news-roundup-3m-scientist-exposes-50-years-of-pfas-deceit-just-as-the-forever-chemicals-are-found-in-great-lakes-precipitation/ | last=Litzenberg | first=Mia | title=PFAS News Roundup: 3M scientist exposes 50 years of PFAS deceit just as the 'forever chemicals' are found in Great Lakes precipitation | website=] | date=May 23, 2024}}</ref>
Later in 2020, the New Jersey state attorney general filed suit in the New Jersey Superior Court against Solvey regarding PFAS contamination of the state's environment.<ref>New Jersey DEP plaintiffs v. Solvay Specialty Chemicals USA and Arkema Inc. defendants. GLO-L-001239-20. Trans ID 20202023975</ref> In May 2021, Solvay issued a press release that the company is "discontinuing the use of fluorosurfactants in the U.S.".<ref>{{Cite web|url=https://www.solvay.com/en/press-release/solvay-launches-non-fluorosurfactant-technologies-in-us|title = Solvay Launches Non-Fluorosurfactant Technologies in the U.S.|date=2021-05-05}}</ref>


==== Washington ==== =====Minnesota=====
In February 2018, 3M settled a lawsuit for $850 million related to contaminated drinking water in Minnesota.<ref>{{cite news | url=https://www.bloomberg.com/news/articles/2018-02-20/3m-is-said-to-settle-minnesota-lawsuit-for-up-to-1-billion | title=3M Settles Minnesota Lawsuit for $850 Million | first=Tiffany | last=Kary | work=] | date=June 7, 2019 | url-access=subscription | archive-date=June 8, 2019 |archive-url=https://web.archive.org/web/20190608111342/https://www.bloomberg.com/news/articles/2018-02-20/3m-is-said-to-settle-minnesota-lawsuit-for-up-to-1-billion |url-status=live}}</ref>
] state has a history of PFAS releases to the environment.<ref name="pmid24262211">{{cite journal | vauthors = Joyce Dinglasan-Panlilio M, Prakash SS, Baker JE | title = Perfluorinated compounds in the surface waters of Puget Sound, Washington and Clayoquot and Barkley Sounds, British Columbia | journal = Marine Pollution Bulletin | volume = 78 | issue = 1–2 | pages = 173–80 | date = January 2014 | pmid = 24262211 | doi = 10.1016/j.marpolbul.2013.10.046 | bibcode = 2014MarPB..78..173J }}</ref><ref name="pmid28764109">{{cite journal | vauthors = Meador JP, Yeh A, Gallagher EP | title = Determining potential adverse effects in marine fish exposed to pharmaceuticals and personal care products with the fish plasma model and whole-body tissue concentrations | journal = Environmental Pollution | volume = 230 | issue = | pages = 1018–1029 | date = November 2017 | pmid = 28764109 | pmc = 5595653 | doi = 10.1016/j.envpol.2017.07.047 }}</ref><ref name="pmid33962256">{{cite journal | vauthors = Strivens JE, Kuo LJ, Liu Y, Noor KL | title = Spatial and temporal baseline of perfluorooctanesulfonic acid retained in sediment core samples from Puget Sound, Washington, USA | journal = Marine Pollution Bulletin | volume = 167 | issue = | pages = 112381 | date = June 2021 | pmid = 33962256 | doi = 10.1016/j.marpolbul.2021.112381 | bibcode = 2021MarPB.16712381S | s2cid = 233999063 }}</ref>


=====New Jersey=====
In addition, in Washington State have been identified by the ] as having PFAS contamination. Toward environmental and consumer protections, the ] published a in November 2021, and in June 2022 the governor tasked the Washington State Department of Ecology with . Initial steps taken by the ] to protect the public from exposure through drinking water have included setting for five PFASs (PFOA, PFOS, PFNA, PFHxS, and PFBS), which were implemented in November 2021.
In 2018 the ] (NJDEP) published a drinking water standard for PFNA. ]s in New Jersey are required to meet an MCL standard of 13&nbsp;ppt.<ref>{{cite news | url=https://www.northjersey.com/story/news/environment/2018/09/06/new-jersey-first-state-regulate-dangerous-chemical-pfna-pfoa/1210328002/ | last=Fallon | first=Scott | title=New Jersey becomes first state to regulate dangerous chemical PFNA in drinking water | work=] |date=September 6, 2018 | archive-date=November 29, 2020 | archive-url=https://web.archive.org/web/20201129081254/https://www.northjersey.com/story/news/environment/2018/09/06/new-jersey-first-state-regulate-dangerous-chemical-pfna-pfoa/1210328002/ | url-status=live}}</ref><ref>{{cite web | url=https://advance.lexis.com/api/document/collection/administrative-codes/id/5T61-TR60-01XC-F17T-00008-00?cite=50%20N.J.R.%201939(a)&context=1000516 | title=Maximum Contaminant Levels (MCLs) for Perfluorononanoic Acid and 1,2,3-Trichloropropane; Private Well Testing for Arsenic, Gross Alpha Particle Activity, and Certain Synthetic Organic Compounds |publisher=] | id=50 N.J.R. 1939(a) | date=September 4, 2018 | archive-date=October 6, 2021 | archive-url=https://web.archive.org/web/20211006204818/https://signin.lexisnexis.com/lnaccess/app/signin?back=https%3A%2F%2Fadvance.lexis.com%3A443%2Flaapi%2Fdocument%3Fcite%3D50%2BN.J.R.%2B1939%28a%29%26context%3D1000516%26collection%3Dadministrative-codes%26id%3D5T61-TR60-01XC-F17T-00008-00&aci=la | url-status=live}}</ref> In 2020 the state set a PFOA standard at 14&nbsp;ppt and a PFOS standard at 13&nbsp;ppt.<ref>{{cite web | url=https://www.state.nj.us/dep/srp/srra/listserv_archives/2020/20200601_srra.html | title=Adoption of ground water quality standards and maximum contaminant levels for perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) |publisher=] | date=June 1, 2020 | archive-date=June 25, 2021 |archive-url=https://web.archive.org/web/20210625164516/https://www.state.nj.us/dep/srp/srra/listserv_archives/2020/20200601_srra.html | url-status=live}}</ref>


In 2019 NJDEP filed lawsuits against the owners of two plants that had manufactured PFASs, and two plants that were cited for water pollution from other chemicals. The companies cited are DuPont, ], and 3M.<ref>{{cite press release | url=https://www.nj.gov/oag/newsreleases19/pr20190327a.html | title=AG Grewal, DEP Commissioner Announce 4 New Environmental Lawsuits Focused on Contamination Allegedly Linked to DuPont, Chemours, 3M |publisher=] | date=March 27, 2019 |archive-date=January 13, 2021 | archive-url=https://web.archive.org/web/20210113223236/https://www.nj.gov/oag/newsreleases19/pr20190327a.html | url-status=live}}</ref> NJDEP also declared five companies to be financially responsible for statewide remediation of the chemicals. Among the companies accused were ] and ] regarding a ] Facility in ], where Arkema manufactured PFASs, but Solvay claims to have never manufactured but only handled PFASs.<ref>{{cite letter | vauthors=Norton GP |recipient=Shawn LaTourette |subject=Re: Statewide PFAS Directive, Information Request and Notice to Insurers |date=April 17, 2019 |via=Internet Archive |url=https://archive.org/details/5999826-SolvayNJDEPLetter-4-17-2019/}}</ref> The companies denied liability and contested the directive.<ref>{{cite news | url=https://www.nj.com/news/2019/05/state-ordered-chemical-companies-to-pay-for-pollution-clean-up-they-say-no-way.html |title=State ordered chemical companies to pay for pollution clean-up. They say, no way! | first=Michael Sol | last=Warren |work=] |date=May 13, 2019 | archive-date=October 19, 2019 |archive-url=https://web.archive.org/web/20191019015403/https://www.nj.com/news/2019/05/state-ordered-chemical-companies-to-pay-for-pollution-clean-up-they-say-no-way.html |url-status=live}}</ref> In June 2020, the EPA and New Jersey Department of Environmental Protection published a paper reporting that a unique family of PFAS used by Solvay, chloroperfluoropolyether carboxylates (ClPFPECAs), were contaminating the soils of New Jersey as far from the Solvay facility as 150&nbsp;km.<ref>{{cite journal | vauthors=Washington JW, Rosal CG, McCord JP, Strynar MJ, Lindstrom AB, Bergman EL, Goodrow SM, Tadesse HK, Pilant AN, Washington BJ, Davis MJ, Stuart BG, Jenkins TM | display-authors=6 | title=Nontargeted mass-spectral detection of chloroperfluoropolyether carboxylates in New Jersey soils | journal=] | volume=368 | issue=6495 | pages=1103–1107 | date=June 2020 | pmid=32499438 | pmc=7814412 | doi=10.1126/science.aba7127 | bibcode=2020Sci...368.1103W}}</ref> and the ClPFPECAs were found in water as well.<ref>{{cite journal | vauthors=McCord JP, Strynar MJ, Washington JW, Bergman EL, Goodrow SM | title=Emerging Chlorinated Polyfluorinated Polyether Compounds Impacting the Waters of Southwestern New Jersey Identified by Use of Nontargeted Analysis | journal=Environmental Science & Technology Letters | volume=7 | issue=12 | pages=903–908 | date=December 2020 | pmid=33553465 | pmc=7863629 | doi=10.1021/acs.estlett.0c00640 | bibcode=2020EnSTL...7..903M}}</ref>
== Occupational exposure ==
Occupational exposure to PFASs occurs in numerous industries due to the widespread use of the chemicals in products and as an element of industrial process streams.<ref name=":12" /> PFASs are used in more than 200 different ways in industries as diverse as electronics and equipment manufacturing, plastic and rubber production, food and textile production, and building and construction.<ref>{{cite journal | vauthors = Glüge J, Scheringer M, Cousins IT, DeWitt JC, Goldenman G, Herzke D, Lohmann R, Ng CA, Trier X, Wang Z | display-authors = 6 | title = An overview of the uses of per- and polyfluoroalkyl substances (PFAS) | journal = Environmental Science. Processes & Impacts | date = October 2020 | volume = 22 | issue = 12 | pages = 2345–2373 | pmid = 33125022 | doi = 10.1039/D0EM00291G | pmc = 7784712 | url = }}</ref> Occupational exposure to PFASs can occur at fluorochemical facilities that produce them and other manufacturing facilities that use them for industrial processing like the chrome plating industry.<ref name=":12" /> Workers who handle PFAS-containing products can also be exposed during their work, such as people who install PFAS-containing carpets and leather furniture with PFAS coatings, professional ski-waxers using PFAS-based waxes, and fire-fighters using PFAS-containing foam and wear flame-resistant protective gear made with PFASs.<ref name=":12" /><ref>{{cite journal|vauthors=Peaslee GF, Wilkinson JT, McGuinness SR, Tighe M, Caterisano N, Lee S, Gonzales A, Roddy M, Mills S, Mitchell K|display-authors=6|date=2020-08-11|title=Another Pathway for Firefighter Exposure to Per- and Polyfluoroalkyl Substances: Firefighter Textiles|journal=Environmental Science & Technology Letters|language=en|volume=7|issue=8|pages=594–599|doi=10.1021/acs.estlett.0c00410|s2cid=220481982|issn=2328-8930|archive-date=October 20, 2020}}</ref><ref name=":8">{{cite journal | vauthors = Nilsson H, Kärrman A, Westberg H, Rotander A, van Bavel B, Lindström G | title = A time trend study of significantly elevated perfluorocarboxylate levels in humans after using fluorinated ski wax | journal = Environmental Science & Technology | volume = 44 | issue = 6 | pages = 2150–5 | date = March 2010 | pmid = 20158198 | doi = 10.1021/es9034733 | bibcode = 2010EnST...44.2150N }}</ref><ref name=":9">{{cite journal | vauthors = Rotander A, Toms LM, Aylward L, Kay M, Mueller JF | title = Elevated levels of PFOS and PFHxS in firefighters exposed to aqueous film forming foam (AFFF) | journal = Environment International | volume = 82 | pages = 28–34 | date = September 2015 | pmid = 26001497 | doi = 10.1016/j.envint.2015.05.005 }}</ref><ref>{{cite journal | vauthors = Trowbridge J, Gerona RR, Lin T, Rudel RA, Bessonneau V, Buren H, Morello-Frosch R | title = Exposure to Perfluoroalkyl Substances in a Cohort of Women Firefighters and Office Workers in San Francisco | journal = Environmental Science & Technology | volume = 54 | issue = 6 | pages = 3363–3374 | date = March 2020 | pmid = 32100527 | pmc = 7244264 | doi = 10.1021/acs.est.9b05490 | bibcode = 2020EnST...54.3363T | url = }}</ref>


Later in 2020, the New Jersey state attorney general filed suit in the New Jersey Superior Court against Solvay regarding PFAS contamination of the state's environment.<ref>New Jersey DEP plaintiffs v. Solvay Specialty Chemicals USA and Arkema Inc. defendants. GLO-L-001239-20. Trans ID 20202023975</ref> In May 2021, Solvay issued a press release that the company is "discontinuing the use of fluorosurfactants in the U.S.".<ref>{{Cite press release |url=https://www.solvay.com/en/press-release/solvay-launches-non-fluorosurfactant-technologies-in-us |title=Solvay Launches Non-Fluorosurfactant Technologies in the U.S. | publisher=] |date=May 5, 2021}}</ref>
=== Exposure pathways ===
People who are exposed to PFASs through their jobs typically have higher levels of PFASs in their blood than the general population.<ref name=":12" /><ref name=":8" /><ref name=":9" /><ref>{{cite journal | vauthors = Tanner EM, Bloom MS, Wu Q, Kannan K, Yucel RM, Shrestha S, Fitzgerald EF | title = Occupational exposure to perfluoroalkyl substances and serum levels of perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in an aging population from upstate New York: a retrospective cohort study | journal = International Archives of Occupational and Environmental Health | volume = 91 | issue = 2 | pages = 145–154 | date = February 2018 | pmid = 29027000 | doi = 10.1007/s00420-017-1267-2 | s2cid = 3950077}}</ref><ref>{{cite journal | vauthors = Fromme H, Tittlemier SA, Völkel W, Wilhelm M, Twardella D | title = Perfluorinated compounds—exposure assessment for the general population in Western countries | journal = International Journal of Hygiene and Environmental Health | volume = 212 | issue = 3 | pages = 239–70 | date = May 2009 | pmid = 18565792 | doi = 10.1016/j.ijheh.2008.04.007}}</ref> While the general population is exposed to PFASs through ingested food and water, occupational exposure includes accidental ingestion, inhalation exposure, and skin contact in settings where PFAS become volatile.<ref>{{cite journal | vauthors = Kärrman A, Harada KH, Inoue K, Takasuga T, Ohi E, Koizumi A | title = Relationship between dietary exposure and serum perfluorochemical (PFC) levels—a case study | journal = Environment International | volume = 35 | issue = 4 | pages = 712–7 | date = May 2009 | pmid = 19250678 | doi = 10.1016/j.envint.2009.01.010}}</ref><ref name=":3" /> There has been increased attention to the health risks associated with exposure to PFASs, which can affect the immune system and increase cholesterol and the risk of cancer.<ref name="CQ Press" /> The severity of PFAS-associated health effects can vary based on the length of exposure, level of exposure, and health status.<ref name=":12" />


=====New York=====
=== Professional ski wax technicians ===
In 2016, New York, along with Vermont and New Hampshire, acknowledged PFOA contamination by requesting the EPA to release water quality guidance measures. Contamination has been observed by the ] in Hoosick Falls, Newburgh, Petersburgh, Poestenkill, Mahopac, and Armonk.<ref>{{Cite web |url=https://www.dec.ny.gov/chemical/108831.html | title=Per- and Polyfluoroalkyl Substances (PFAS) | publisher=]}}</ref>
Professional ski wax technicians are disproportionately exposed to PFASs from the ] used to coat the bottom of skis to reduce the friction between the skis and snow. During this process, the wax is heated to 130–220&nbsp;°C, which releases fumes and airborne fluorinated compounds. Chronic exposure to aerosolized PFASs is associated with alveolic edema, polymer fume fever, severe dyspnea, decreased pulmonary function, and respiratory distress syndrome.<ref name=":8" /> In a 2010 study, blood serum levels of PFOA were significantly higher in ski wax technicians compared to levels of the general Swedish population. Serum levels of PFOA in ski wax technicians were positively correlated with years spent working, suggesting bioaccumulation of PFOA over time.<ref name=":8" />


After a class action lawsuit, in 2021, the village of Hoosick Falls received a $65.25 million settlement from Saint-Gobain Performance Plastics, Honeywell, 3M, and DuPont due to the disposal of PFAS chemicals into the groundwater of the local ] plant.<ref>{{Cite news | first=Brendan J. | last=Lyons |title=$65M settlement filed in Hoosick Falls PFOA water contamination | url=https://www.timesunion.com/state/article/hoosick-falls-pfoa-settlement-16326755.php | work=] | date=July 21, 2021}}</ref>
=== Manufacturing workers ===
People who work at fluorochemical production plants and in manufacturing industries that use PFASs in the industrial process can be exposed to PFASs in the workplace. Much of what we know about PFASs exposure and health effects began with medical surveillance studies of workers exposed to PFASs at fluorochemical production facilities. These studies began in the 1940s and were conducted primarily at U.S. and European manufacturing sites. Between the 1940s and 2000s, thousands of workers exposed to PFASs participated in research studies that advanced scientific understanding of exposure pathways, ] properties, and adverse health effects associated with exposure.<ref name=":13" /><ref name=":14">{{cite journal | vauthors = Costa G, Sartori S, Consonni D | title = Thirty years of medical surveillance in perfluooctanoic acid production workers | journal = Journal of Occupational and Environmental Medicine | volume = 51 | issue = 3 | pages = 364–72 | date = March 2009 | pmid = 19225424 | doi = 10.1097/JOM.0b013e3181965d80 | s2cid = 34813716}}</ref><ref>{{cite journal | vauthors = Olsen GW, Burris JM, Burlew MM, Mandel JH | title = Plasma cholecystokinin and hepatic enzymes, cholesterol and lipoproteins in ammonium perfluorooctanoate production workers | journal = Drug and Chemical Toxicology | volume = 23 | issue = 4 | pages = 603–20 | date = November 2000 | pmid = 11071397 | doi = 10.1081/DCT-100101973 | s2cid = 30289350}}</ref><ref name=":2" /><ref name=":15">{{cite journal | vauthors = Olsen GW, Burris JM, Ehresman DJ, Froehlich JW, Seacat AM, Butenhoff JL, Zobel LR | title = Half-life of serum elimination of perfluorooctanesulfonate,perfluorohexanesulfonate, and perfluorooctanoate in retired fluorochemical production workers | journal = Environmental Health Perspectives | volume = 115 | issue = 9 | pages = 1298–305 | date = September 2007 | pmid = 17805419 | pmc = 1964923 | doi = 10.1289/ehp.10009 }}</ref><ref>{{cite journal | vauthors = Olsen GW, Burris JM, Mandel JH, Zobel LR | title = Serum perfluorooctane sulfonate and hepatic and lipid clinical chemistry tests in fluorochemical production employees | journal = Journal of Occupational and Environmental Medicine | volume = 41 | issue = 9 | pages = 799–806 | date = September 1999 | pmid = 10491796 | doi = 10.1097/00043764-199909000-00012}}</ref><ref name=":16">{{cite journal | vauthors = Olsen GW, Chang SC, Noker PE, Gorman GS, Ehresman DJ, Lieder PH, Butenhoff JL | title = A comparison of the pharmacokinetics of perfluorobutanesulfonate (PFBS) in rats, monkeys, and humans | journal = Toxicology | volume = 256 | issue = 1–2 | pages = 65–74 | date = February 2009 | pmid = 19059455 | doi = 10.1016/j.tox.2008.11.008}}</ref><ref>{{cite journal | vauthors = Olsen GW, Ehresman DJ, Buehrer BD, Gibson BA, Butenhoff JL, Zobel LR | title = Longitudinal assessment of lipid and hepatic clinical parameters in workers involved with the demolition of perfluoroalkyl manufacturing facilities | journal = Journal of Occupational and Environmental Medicine | volume = 54 | issue = 8 | pages = 974–83 | date = August 2012 | pmid = 22842914 | doi = 10.1097/JOM.0b013e31825461d2 | s2cid = 11478469}}</ref><ref>{{cite journal | vauthors = Olsen GW, Zobel LR | title = Assessment of lipid, hepatic, and thyroid parameters with serum perfluorooctanoate (PFOA) concentrations in fluorochemical production workers | journal = International Archives of Occupational and Environmental Health | volume = 81 | issue = 2 | pages = 231–46 | date = November 2007 | pmid = 17605032 | doi = 10.1007/s00420-007-0213-0 | s2cid = 25537444}}</ref><ref name=":17">{{cite journal | vauthors = Sakr CJ, Kreckmann KH, Green JW, Gillies PJ, Reynolds JL, Leonard RC | title = Cross-sectional study of lipids and liver enzymes related to a serum biomarker of exposure (ammonium perfluorooctanoate or APFO) as part of a general health survey in a cohort of occupationally exposed workers | journal = Journal of Occupational and Environmental Medicine | volume = 49 | issue = 10 | pages = 1086–96 | date = October 2007 | pmid = 18000414 | doi = 10.1097/JOM.0b013e318156eca3 | s2cid = 20124680}}</ref><ref name=":18">{{cite journal | vauthors = Sakr CJ, Leonard RC, Kreckmann KH, Slade MD, Cullen MR | title = Longitudinal study of serum lipids and liver enzymes in workers with occupational exposure to ammonium perfluorooctanoate | journal = Journal of Occupational and Environmental Medicine | volume = 49 | issue = 8 | pages = 872–9 | date = August 2007 | pmid = 17693785 | doi = 10.1097/JOM.0b013e318124a93f | s2cid = 7339239}}</ref><ref>{{cite journal | vauthors = Sakr CJ, Symons JM, Kreckmann KH, Leonard RC | title = Ischaemic heart disease mortality study among workers with occupational exposure to ammonium perfluorooctanoate | journal = Occupational and Environmental Medicine | volume = 66 | issue = 10 | pages = 699–703 | date = October 2009 | pmid = 19553230 | doi = 10.1136/oem.2008.041582 | s2cid = 30652104}}</ref><ref name=":19">{{cite journal | vauthors = Steenland K, Zhao L, Winquist A | title = A cohort incidence study of workers exposed to perfluorooctanoic acid (PFOA) | journal = Occupational and Environmental Medicine | volume = 72 | issue = 5 | pages = 373–80 | date = May 2015 | pmid = 25601914 | doi = 10.1136/oemed-2014-102364 | s2cid = 28440634}}</ref>


=====Washington=====
The first research study to report elevated organic fluorine levels in the blood of fluorochemical workers was published in 1980.<ref name=":13" /> It established inhalation as a potential route of occupational PFAS exposure by reporting measurable levels of organic fluorine in air samples at the facility.<ref name=":13" /> Workers at fluorochemical production facilities have higher levels of PFOA and PFOS in their blood than the general population. Serum PFOA levels in fluorochemical workers are generally below 20,000&nbsp;ng/mL but have been reported as high as 100,000&nbsp;ng/mL, whereas the mean PFOA concentration among non-occupationally exposed cohorts in the same time frame was 4.9&nbsp;ng/mL.<ref name=":17" /><ref name=":2" /><ref>{{cite journal | vauthors = Olsen GW, Gilliland FD, Burlew MM, Burris JM, Mandel JS, Mandel JH | title = An epidemiologic investigation of reproductive hormones in men with occupational exposure to perfluorooctanoic acid | journal = Journal of Occupational and Environmental Medicine | volume = 40 | issue = 7 | pages = 614–22 | date = July 1998 | pmid = 9675720 | doi = 10.1097/00043764-199807000-00006}}</ref><ref>{{cite journal | vauthors = Olsen GW, Church TR, Miller JP, Burris JM, Hansen KJ, Lundberg JK, Armitage JB, Herron RM, Medhdizadehkashi Z, Nobiletti JB, O'Neill EM, Mandel JH, Zobel LR | display-authors = 6 | title = Perfluorooctanesulfonate and other fluorochemicals in the serum of American Red Cross adult blood donors | journal = Environmental Health Perspectives | volume = 111 | issue = 16 | pages = 1892–901 | date = December 2003 | pmid = 14644663 | pmc = 1241763 | doi = 10.1289/ehp.6316 }}</ref><ref>{{cite journal | vauthors = Olsen GW, Church TR, Larson EB, van Belle G, Lundberg JK, Hansen KJ, Burris JM, Mandel JH, Zobel LR | display-authors = 6 | title = Serum concentrations of perfluorooctanesulfonate and other fluorochemicals in an elderly population from Seattle, Washington | journal = Chemosphere | volume = 54 | issue = 11 | pages = 1599–611 | date = March 2004 | pmid = 14675839 | doi = 10.1016/j.chemosphere.2003.09.025 | bibcode = 2004Chmsp..54.1599O}}</ref><ref>{{cite journal| vauthors = Olsen GW, Church TR, Hansen KJ, Burris JM, Butenhoff JL, Mandel JH, Zobel LR |date=2004-01-01|title=Quantitative Evaluation of Perfluorooctanesulfonate (PFOS) and Other Fluorochemicals in the Serum of Children |journal=Journal of Children's Health|volume=2|issue=1|pages=53–76|doi=10.3109/15417060490447378|issn=1541-7069}}</ref><ref>{{cite journal | vauthors = Olsen GW, Huang HY, Helzlsouer KJ, Hansen KJ, Butenhoff JL, Mandel JH | title = Historical comparison of perfluorooctanesulfonate, perfluorooctanoate, and other fluorochemicals in human blood | journal = Environmental Health Perspectives | volume = 113 | issue = 5 | pages = 539–45 | date = May 2005 | pmid = 15866760 | pmc = 1257544 | doi = 10.1289/ehp.7544 }}</ref><ref>{{cite journal | vauthors = Kubwabo C, Vais N, Benoit FM | title = A pilot study on the determination of perfluorooctanesulfonate and other perfluorinated compounds in blood of Canadians | journal = Journal of Environmental Monitoring | volume = 6 | issue = 6 | pages = 540–5 | date = June 2004 | pmid = 15173906 | doi = 10.1039/b314085g}}</ref><ref>{{cite journal | vauthors = Kannan K, Corsolini S, Falandysz J, Fillmann G, Kumar KS, Loganathan BG, Mohd MA, Olivero J, Van Wouwe N, Yang JH, Aldoust KM | display-authors = 6 | title = Perfluorooctanesulfonate and related fluorochemicals in human blood from several countries | journal = Environmental Science & Technology | volume = 38 | issue = 17 | pages = 4489–95 | date = September 2004 | pmid = 15461154 | doi = 10.1021/es0493446 | bibcode = 2004EnST...38.4489K}}</ref><ref>{{cite journal | vauthors = Harada K, Saito N, Inoue K, Yoshinaga T, Watanabe T, Sasaki S, Kamiyama S, Koizumi A | display-authors = 6 | title = The influence of time, sex and geographic factors on levels of perfluorooctane sulfonate and perfluorooctanoate in human serum over the last 25 years | journal = Journal of Occupational Health | volume = 46 | issue = 2 | pages = 141–7 | date = March 2004 | pmid = 15090689 | doi = 10.1539/joh.46.141 | s2cid = 9418835}}</ref> Among fluorochemical workers, those with direct contact with PFASs have higher PFAS concentrations in their blood than those with intermittent contact or no direct PFAS contact.<ref name=":13" /><ref name=":14" /><ref name=":17" /> Blood PFAS levels have been shown to decline when direct contact ceases.<ref name=":17" /><ref name=":15" /><ref name=":16" /> PFOA and PFOS levels have declined in U.S. and European fluorochemical workers due to improved facilities, increased usage of personal protective equipment, and the discontinuation of these chemicals from production.<ref name=":14" /><ref name=":18" /><ref name=":19" /> Occupational exposure to PFASs in manufacturing continues to be an active area of study in China with numerous investigations linking worker exposure to various PFASs.<ref>{{cite journal | vauthors = Fu J, Gao Y, Cui L, Wang T, Liang Y, Qu G, Yuan B, Wang Y, Zhang A, Jiang G | display-authors = 6 | title = Occurrence, temporal trends, and half-lives of perfluoroalkyl acids (PFAAs) in occupational workers in China | journal = Scientific Reports | volume = 6 | issue = 1 | pages = 38039 | date = December 2016 | pmid = 27905562 | pmc = 5131319 | doi = 10.1038/srep38039 | bibcode = 2016NatSR...638039F }}</ref><ref>{{cite journal | vauthors = Fu J, Gao Y, Wang T, Liang Y, Zhang A, Wang Y, Jiang G | title = Elevated levels of perfluoroalkyl acids in family members of occupationally exposed workers: the importance of dust transfer | journal = Scientific Reports | volume = 5 | issue = 1 | pages = 9313 | date = March 2015 | pmid = 25791573 | pmc = 5380130 | doi = 10.1038/srep09313 | bibcode = 2015NatSR...5E9313F }}</ref><ref>{{cite journal | vauthors = Gao Y, Fu J, Cao H, Wang Y, Zhang A, Liang Y, Wang T, Zhao C, Jiang G | display-authors = 6 | title = Differential accumulation and elimination behavior of perfluoroalkyl Acid isomers in occupational workers in a manufactory in China | journal = Environmental Science & Technology | volume = 49 | issue = 11 | pages = 6953–62 | date = June 2015 | pmid = 25927957 | doi = 10.1021/acs.est.5b00778 | url = https://semanticscholar.org/paper/d0533dca0668696d00a8204f3a42347ca84e5018 | bibcode = 2015EnST...49.6953G | s2cid = 23947500 | access-date = December 2, 2019 | archive-date = October 6, 2021 | archive-url = https://web.archive.org/web/20211006204821/https://www.semanticscholar.org/paper/Differential-accumulation-and-elimination-behavior-Gao-Fu/d0533dca0668696d00a8204f3a42347ca84e5018 | url-status = live }}</ref><ref name="Lu 9800–9809">{{cite journal | vauthors = Lu Y, Gao K, Li X, Tang Z, Xiang L, Zhao H, Fu J, Wang L, Zhu N, Cai Z, Liang Y, Wang Y, Jiang G | display-authors = 6 | title = Mass Spectrometry-Based Metabolomics Reveals Occupational Exposure to Per- and Polyfluoroalkyl Substances Relates to Oxidative Stress, Fatty Acid β-Oxidation Disorder, and Kidney Injury in a Manufactory in China | journal = Environmental Science & Technology | volume = 53 | issue = 16 | pages = 9800–9809 | date = August 2019 | pmid = 31246438 | doi = 10.1021/acs.est.9b01608 | bibcode = 2019EnST...53.9800L | s2cid = 195762433 }}</ref><ref>{{cite journal | vauthors = Wang Y, Fu J, Wang T, Liang Y, Pan Y, Cai Y, Jiang G | title = Distribution of perfluorooctane sulfonate and other perfluorochemicals in the ambient environment around a manufacturing facility in China | journal = Environmental Science & Technology | volume = 44 | issue = 21 | pages = 8062–7 | date = November 2010 | pmid = 20879709 | doi = 10.1021/es101810h | bibcode = 2010EnST...44.8062W | url = http://ir.rcees.ac.cn/handle/311016/21070 | access-date = January 21, 2021 | archive-date = June 25, 2021 | archive-url = https://web.archive.org/web/20210625163522/http://ir.rcees.ac.cn/handle/311016/21070 | url-status = live }}</ref>
Five military installations in Washington State have been identified by the ] as having PFAS contamination.<ref>{{Cite web | url=https://www.epw.senate.gov/public/index.cfm/superfund-sites-identified-by-epa-to-have-pfas-contamination | title=SUPERFUND SITES IDENTIFIED BY EPA TO HAVE PFAS CONTAMINATION}}</ref> Toward environmental and consumer protections, the ] published a in November 2021, and in June 2022 the governor tasked the Washington State Department of Ecology with . Initial steps taken by the ] to protect the public from exposure through drinking water have included setting for five PFASs (PFOA, PFOS, PFNA, PFHxS, and PFBS), which were implemented in November 2021.<ref>{{cite journal | vauthors=Joyce Dinglasan-Panlilio M, Prakash SS, Baker JE |date=January 2014 | title=Perfluorinated compounds in the surface waters of Puget Sound, Washington and Clayoquot and Barkley Sounds, British Columbia | journal=Marine Pollution Bulletin |volume=78 |issue=1–2 | pages=173–180 | bibcode=2014MarPB..78..173J | doi=10.1016/j.marpolbul.2013.10.046 |pmid=24262211}}</ref><ref>{{cite journal |vauthors=Meador JP, Yeh A, Gallagher EP | date=November 2017 |title=Determining potential adverse effects in marine fish exposed to pharmaceuticals and personal care products with the fish plasma model and whole-body tissue concentrations | journal=Environmental Pollution |volume=230 | pages=1018–1029 | doi=10.1016/j.envpol.2017.07.047 | pmc=5595653 | pmid=28764109 |bibcode=2017EPoll.230.1018M}}</ref><ref>{{cite journal | vauthors=Strivens JE, Kuo LJ, Liu Y, Noor KL |date=June 2021 |title=Spatial and temporal baseline of perfluorooctanesulfonic acid retained in sediment core samples from Puget Sound, Washington, USA |journal=Marine Pollution Bulletin |volume=167 |pages=112381 | bibcode=2021MarPB.16712381S |doi=10.1016/j.marpolbul.2021.112381 |pmid=33962256 |s2cid=233999063 |doi-access=free}}</ref>


=== Firefighters === ===United Nations===
In 2009, PFOS, its salts, and ], as well as PFOA and PFHxS, were listed as ]s under the ] due to their ubiquitous, ] nature.<ref>{{cite journal | vauthors=Blum A, Balan SA, Scheringer M, Trier X, Goldenman G, Cousins IT, Diamond M, Fletcher T, Higgins C, Lindeman AE, Peaslee G, de Voogt P, Wang Z, Weber R | display-authors=6 | title=The Madrid Statement on Poly- and Perfluoroalkyl Substances (PFASs) | journal=Environmental Health Perspectives | volume=123 | issue=5 | pages=A107-111 | date=May 2015 | pmid=25932614 | pmc=4421777 | doi=10.1289/ehp.1509934}}</ref><ref>{{cite web |url=https://www.oecd.org/chemicalsafety/portal-perfluorinated-chemicals/webinars/Presentation%203_Melisa.pdf | title=Phasing out PFOS under the Stockholm Convention | first=Melisa | last=Lin | work=] | date=May 2014}}</ref> The convention has been ratified by 186 jurisdictions, but has most notably not been ratified by the United States, Israel, and Malaysia.<ref>{{Cite web |url=https://www.pops.int/TheConvention/ThePOPs/AllPOPs/tabid/2509/ | title=All POPs listed in the Stockholm Convention | website=pops.int}}</ref> The long-chain (C<sub>9</sub>–C<sub>21</sub>) PFCAs are currently under review for listing.<ref>{{Cite web |url=https://www.pops.int/TheConvention/ThePOPs/ChemicalsProposedforListing/tabid/2510/
]
|title=Chemicals proposed for listing under the Convention |website=pops.int}}</ref>
PFASs are commonly used in Class B ]s due to their hydrophobic and lipophobic properties, as well as the chemicals' when exposed to high heat.<ref name=":10">{{cite journal | vauthors = Laitinen JA, Koponen J, Koikkalainen J, Kiviranta H | title = Firefighters' exposure to perfluoroalkyl acids and 2-butoxyethanol present in firefighting foams | journal = Toxicology Letters | volume = 231 | issue = 2 | pages = 227–32 | date = December 2014 | pmid = 25447453 | doi = 10.1016/j.toxlet.2014.09.007 }}</ref>


==Occupational exposure==
Research into occupational exposure for firefighters is emergent, though frequently limited by underpowered study designs. A 2011 cross-sectional analysis of the C8 Health Studies found higher levels of PFHxS in firefighters compared to the sample group of the region, with other PFASs at elevated levels, without reaching statistical significance.<ref>{{cite journal | vauthors = Jin C, Sun Y, Islam A, Qian Y, Ducatman A | title = Perfluoroalkyl acids including perfluorooctane sulfonate and perfluorohexane sulfonate in firefighters | journal = Journal of Occupational and Environmental Medicine | volume = 53 | issue = 3 | pages = 324–8 | date = March 2011 | pmid = 21346631 | doi = 10.1097/jom.0b013e31820d1314 | s2cid = 41993931 }}</ref> A 2014 study in Finland studying eight firefighters over three training sessions observed select PFASs (PFHxS and PFNA) increase in blood samples following each training event.<ref name=":10" /> Due to this small sample size, a ] was not conducted. A 2015 cross-sectional study conducted in Australia found&nbsp; that PFOS and PFHxS accumulation was positively associated with years of occupational AFFF exposure through firefighting.<ref name=":9" />
Occupational exposure to PFASs occurs in numerous industries due to the widespread use of the chemicals in products and as an element of industrial process streams.<ref name=profile>{{cite journal | url=https://wwwn.cdc.gov/TSP/ToxProfiles/ToxProfiles.aspx?id=1117&tid=237 | title=Toxicological profile for Perfluoroalkyls | archive-url=https://web.archive.org/web/20210512154522/https://wwwn.cdc.gov/TSP/ToxProfiles/ToxProfiles.aspx?id=1117&tid=237 | archive-date=May 12, 2021 | journal=]| date=2018 | doi=10.15620/cdc:59198 | doi-access=free }}</ref> PFASs are used in more than 200 different ways in industries as diverse as electronics and equipment manufacturing, plastic and rubber production, food and textile production, and building and construction.<ref>{{cite journal | vauthors=Glüge J, Scheringer M, Cousins IT, DeWitt JC, Goldenman G, Herzke D, Lohmann R, Ng CA, Trier X, Wang Z | display-authors=6 | title=An overview of the uses of per- and polyfluoroalkyl substances (PFAS) | journal=Environmental Science: Processes & Impacts | date=October 2020 | volume=22 | issue=12 | pages=2345–2373 | pmid=33125022 | doi=10.1039/D0EM00291G | pmc=7784712}}</ref> Occupational exposure to PFASs can occur at fluorochemical facilities that produce them and other manufacturing facilities that use them for industrial processing like the chrome plating industry.<ref name=profile/> Workers who handle PFAS-containing products can also be exposed during their work, such as people who install PFAS-containing carpets and leather furniture with PFAS coatings, professional ski-waxers using PFAS-based waxes, and fire-fighters using PFAS-containing foam and wearing flame-resistant protective gear made with PFASs.<ref name=profile/><ref>{{cite journal | vauthors=Nilsson H, Kärrman A, Westberg H, Rotander A, van Bavel B, Lindström G | title=A time trend study of significantly elevated perfluorocarboxylate levels in humans after using fluorinated ski wax | journal=Environmental Science & Technology | volume=44 | issue=6 | pages=2150–2155 | date=March 2010 | pmid=20158198 | doi=10.1021/es9034733 | bibcode=2010EnST...44.2150N}}</ref><ref>{{cite journal | vauthors=Trowbridge J, Gerona RR, Lin T, Rudel RA, Bessonneau V, Buren H, Morello-Frosch R | title=Exposure to Perfluoroalkyl Substances in a Cohort of Women Firefighters and Office Workers in San Francisco | journal=Environmental Science & Technology | volume=54 | issue=6 | pages=3363–3374 | date=March 2020 | pmid=32100527 | pmc=7244264 | doi=10.1021/acs.est.9b05490 | bibcode=2020EnST...54.3363T | url=}}</ref>


===Exposure pathways===
Due to their use in training and testing, recent studies indicate occupational risk for military members and firefighters, as higher levels of PFASs in exposure were indicated in military members and firefighters when compared to the general population.<ref>{{cite journal | vauthors = Barton KE, Starling AP, Higgins CP, McDonough CA, Calafat AM, Adgate JL | title = Sociodemographic and behavioral determinants of serum concentrations of per- and polyfluoroalkyl substances in a community highly exposed to aqueous film-forming foam contaminants in drinking water | journal = International Journal of Hygiene and Environmental Health | volume = 223 | issue = 1 | pages = 256–266 | date = January 2020 | pmid = 31444118 | pmc = 6878185 | doi = 10.1016/j.ijheh.2019.07.012 }}</ref> PFAS exposure is prevalent among firefighters not only due to its use in emergencies, but also because it is used in personal protective equipment. In support of these findings, states like Washington and Colorado have moved to restrict and penalize the use of Class B firefighting foam for firefighter training and testing.<ref>{{cite report |date=1993-11-12|title=Colorado economic impact study on the Uranium Mill Tailings Remedial Action Project in Colorado: Colorado state fiscal year 1993|doi=10.2172/10112187 |url=https://digital.library.unt.edu/ark:/67531/metadc1279934/ |access-date=December 2, 2019 |archive-date=June 25, 2021|archive-url=https://web.archive.org/web/20210625165124/https://digital.library.unt.edu/ark:/67531/metadc1279934/|url-status=live}}</ref><ref>{{Cite web|title=Toxics in firefighting|url=https://ecology.wa.gov/Waste-Toxics/Reducing-toxic-chemicals/Addressing-priority-toxic-chemicals/PFAS/Toxics-in-firefighting|url-status=live|access-date=2022-01-14|website=ecology.wa.gov}}</ref>
People who are exposed to PFASs through their jobs typically have higher levels of PFASs in their blood than the general population.<ref name=profile/><ref name=exposed>{{cite journal |vauthors=Rotander A, Toms LM, Aylward L, Kay M, Mueller JF |date=September 2015 | title=Elevated levels of PFOS and PFHxS in firefighters exposed to aqueous film forming foam (AFFF) | journal=Environment International | volume=82 | pages=28–34 | doi=10.1016/j.envint.2015.05.005 | pmid=26001497|bibcode=2015EnInt..82...28R}}</ref><ref>{{cite journal | vauthors=Fromme H, Tittlemier SA, Völkel W, Wilhelm M, Twardella D | title=Perfluorinated compounds—exposure assessment for the general population in Western countries | journal=International Journal of Hygiene and Environmental Health | volume=212 | issue=3 | pages=239–270 | date=May 2009 | pmid=18565792 | doi=10.1016/j.ijheh.2008.04.007| bibcode=2009IJHEH.212..239F}}</ref> While the general population is exposed to PFASs through ingested food and water, occupational exposure includes accidental ingestion, inhalation exposure, and skin contact in settings where PFAS become volatile.<ref>{{cite journal | vauthors=Kärrman A, Harada KH, Inoue K, Takasuga T, Ohi E, Koizumi A | title=Relationship between dietary exposure and serum perfluorochemical (PFC) levels—a case study | journal=Environment International | volume=35 | issue=4 | pages=712–717 | date=May 2009 | pmid=19250678 | doi=10.1016/j.envint.2009.01.010| bibcode=2009EnInt..35..712K}}</ref><ref name=Buck2011/>


===Professional ski wax technicians===
=== Exposure after World Trade Center terrorist attacks ===
Compared to the general public exposed to contaminated drinking water, professional ski wax technicians are more strongly exposed to PFASs (PFOA, PFNA, PFDA, PFHpA, PFDoDA) from the ] used to coat the bottom of skis to reduce the friction between the skis and snow.<ref name=review>{{cite journal | vauthors=Lucas K, Gaines LG, Paris-Davila T, Nylander-French LA | title=Occupational exposure and serum levels of per- and polyfluoroalkyl substances (PFAS): A review | journal=American Journal of Industrial Medicine | volume=66 | issue=5 | pages=379–392 | date=May 2023 | pmid=36573587 | doi=10.1002/ajim.23454 | s2cid=255211077 | doi-access=free}}</ref> During the coating process, the wax is heated, which releases fumes and airborne particles.<ref name=review/> Compared to all other reported occupational and residential exposures, ski waxing had the highest total PFAS air concentrations.<ref>{{cite journal | vauthors=Paris-Davila T, Gaines LG, Lucas K, Nylander-French LA | title=Occupational exposures to airborne per- and polyfluoroalkyl substances (PFAS)-A review | journal=American Journal of Industrial Medicine | volume=66 | issue=5 | pages=393–410 | date=May 2023 | pmid=36719301 | doi=10.1002/ajim.23461 | s2cid=256481718}}</ref>
The 11 September 2001 collapse of the World Trade Center buildings in New York City resulted in the release of chemicals from the destruction of construction and electrical material and long-term chemical fires. This collapse caused the release of several toxic chemicals, including fluorinated surfactants used as soil- and stain-resistant coatings on various materials.<ref name=":11">{{cite journal | vauthors = Tao L, Kannan K, Aldous KM, Mauer MP, Eadon GA | title = Biomonitoring of perfluorochemicals in plasma of New York State personnel responding to the World Trade Center disaster | journal = Environmental Science & Technology | volume = 42 | issue = 9 | pages = 3472–8 | date = May 2008 | pmid = 18522136 | doi = 10.1021/es8000079 | url = https://figshare.com/articles/journal_contribution/2941570 | bibcode = 2008EnST...42.3472T | access-date = December 2, 2019 }}</ref> First responders to this incident were exposed to PFOA, PFNA, and PFHxS through inhalation of dust and smoke released during and after the collapse of the World Trade Center.<ref name=":11" />


===Manufacturing workers===
Fire responders who were working at or near ground zero were assessed for respiratory and other health effects from exposure to emissions at the World Trade Center. Early clinical testing showed a high prevalence of respiratory health effects. Early symptoms of exposure often presented with persistent coughing and wheezing. PFOA and PFHxS levels were present in both smoke and dust exposure, but first responders exposed to smoke had higher concentrations of PFOA and PFHxS than those exposed to dust.<ref name=":11" />
People who work at fluorochemical production plants and in manufacturing industries that use PFASs in the industrial process can be exposed to PFASs in the workplace. Much of what we know about PFAS exposure and health effects began with medical surveillance studies of workers exposed to PFASs at fluorochemical production facilities. These studies began in the 1940s and were conducted primarily at U.S. and European manufacturing sites. Between the 1940s and 2000s, thousands of workers exposed to PFASs participated in research studies that advanced scientific understanding of exposure pathways, ] properties, and adverse health effects associated with exposure.<ref name=status/><ref name=Thirty>{{cite journal | vauthors=Costa G, Sartori S, Consonni D | title=Thirty years of medical surveillance in perfluooctanoic acid production workers | journal=Journal of Occupational and Environmental Medicine | volume=51 | issue=3 | pages=364–372 | date=March 2009 | pmid=19225424 | doi=10.1097/JOM.0b013e3181965d80 | s2cid=34813716}}</ref><ref>{{cite journal | vauthors=Olsen GW, Burris JM, Burlew MM, Mandel JH | title=Plasma cholecystokinin and hepatic enzymes, cholesterol and lipoproteins in ammonium perfluorooctanoate production workers | journal=Drug and Chemical Toxicology | volume=23 | issue=4 | pages=603–20 | date=November 2000 | pmid=11071397 | doi=10.1081/DCT-100101973 | s2cid=30289350}}</ref>


The first research study to report elevated organic fluorine levels in the blood of fluorochemical workers was published in 1980.<ref name=status/> It established inhalation as a potential route of occupational PFAS exposure by reporting measurable levels of organic fluorine in air samples at the facility.<ref name=status/> Workers at fluorochemical production facilities have higher levels of PFOA and PFOS in their blood than the general population. Serum PFOA levels in fluorochemical workers are generally below 20,000&nbsp;ng/mL but have been reported as high as 100,000&nbsp;ng/mL, whereas the mean PFOA concentration among non-occupationally exposed cohorts in the same time frame was 4.9&nbsp;ng/mL.<ref name=Cross>{{cite journal | vauthors=Sakr CJ, Kreckmann KH, Green JW, Gillies PJ, Reynolds JL, Leonard RC |date=October 2007 |title=Cross-sectional study of lipids and liver enzymes related to a serum biomarker of exposure (ammonium perfluorooctanoate or APFO) as part of a general health survey in a cohort of occupationally exposed workers |journal=Journal of Occupational and Environmental Medicine | volume=49 |issue=10 | pages=1086–1096 | doi=10.1097/JOM.0b013e318156eca3 | pmid=18000414 |s2cid=20124680}}</ref><ref name=assessment/> Among fluorochemical workers, those with direct contact with PFASs have higher PFAS concentrations in their blood than those with intermittent contact or no direct PFAS contact.<ref name=Thirty/><ref name=Cross/> Blood PFAS levels have been shown to decline when direct contact ceases.<ref name=Cross/><ref>{{cite journal |vauthors=Olsen GW, Chang SC, Noker PE, Gorman GS, Ehresman DJ, Lieder PH, Butenhoff JL | date=February 2009 | title=A comparison of the pharmacokinetics of perfluorobutanesulfonate (PFBS) in rats, monkeys, and humans | journal=Toxicology |volume=256 | issue=1–2 |pages=65–74 |doi=10.1016/j.tox.2008.11.008 |pmid=19059455|bibcode=2009Toxgy.256...65O}}</ref> PFOA and PFOS levels have declined in U.S. and European fluorochemical workers due to improved facilities, increased usage of ], and the discontinuation of these chemicals from production.<ref name=Thirty/><ref>{{cite journal | vauthors=Steenland K, Zhao L, Winquist A |date=May 2015 |title=A cohort incidence study of workers exposed to perfluorooctanoic acid (PFOA) |journal=Occupational and Environmental Medicine |volume=72 |issue=5 |pages=373–380 |doi=10.1136/oemed-2014-102364 | pmid=25601914 |s2cid=28440634}}</ref> Occupational exposure to PFASs in manufacturing continues to be an active area of study in China with numerous investigations linking worker exposure to various PFASs.<ref>{{cite journal | vauthors=Fu J, Gao Y, Wang T, Liang Y, Zhang A, Wang Y, Jiang G | title=Elevated levels of perfluoroalkyl acids in family members of occupationally exposed workers: the importance of dust transfer | journal=Scientific Reports | volume=5 | issue=1 | pages=9313 | date=March 2015 | pmid=25791573 | pmc=5380130 | doi=10.1038/srep09313 | bibcode=2015NatSR...5.9313F}}</ref><ref>{{cite journal | vauthors=Gao Y, Fu J, Cao H, Wang Y, Zhang A, Liang Y, Wang T, Zhao C, Jiang G | display-authors=6 | title=Differential accumulation and elimination behavior of perfluoroalkyl Acid isomers in occupational workers in a manufactory in China | journal=Environmental Science & Technology | volume=49 | issue=11 | pages=6953–6962 | date=June 2015 | pmid=25927957 | doi=10.1021/acs.est.5b00778 | bibcode=2015EnST...49.6953G | s2cid=23947500}}</ref><ref>{{cite journal | vauthors=Lu Y, Gao K, Li X, Tang Z, Xiang L, Zhao H, Fu J, Wang L, Zhu N, Cai Z, Liang Y, Wang Y, Jiang G | display-authors=6 | title=Mass Spectrometry-Based Metabolomics Reveals Occupational Exposure to Per- and Polyfluoroalkyl Substances Relates to Oxidative Stress, Fatty Acid β-Oxidation Disorder, and Kidney Injury in a Manufactory in China | journal=Environmental Science & Technology | volume=53 | issue=16 | pages=9800–9809 | date=August 2019 | pmid=31246438 | doi=10.1021/acs.est.9b01608 | bibcode=2019EnST...53.9800L | s2cid=195762433}}</ref>
=== Mitigation measures ===
Several strategies have been proposed as a way to protect those who are at greatest risk of occupational exposure to PFAS, including exposure monitoring, regular blood testing, and the use of PFAS-free alternatives. For example, fluorine-free firefighting foam and plant-based ski wax contain no PFAS and greatly reduce the occupational hazards associated with certain professions.<ref>{{Cite journal |last1=Horst |first1=John |last2=Quinnan |first2=Joseph |last3=McDonough |first3=Jeffrey |last4=Lang |first4=Johnsie |last5=Storch |first5=Peter |last6=Burdick |first6=Jeffrey |last7=Theriault |first7=Corey |date=April 2021 |title=Transitioning Per‐ and Polyfluoroalkyl Substance Containing Fire Fighting Foams to New Alternatives: Evolving Methods and Best Practices to Protect the Environment |url=https://onlinelibrary.wiley.com/doi/10.1111/gwmr.12444 |journal=Groundwater Monitoring & Remediation |language=en |volume=41 |issue=2 |pages=19–26 |doi=10.1111/gwmr.12444 |s2cid=235578939 |issn=1069-3629}}</ref>


===Firefighters===
== Remediation solutions ==
]
=== Water treatment ===
PFASs are commonly used in Class B ]s due to their hydrophobic and lipophobic properties, as well as the stability of the chemicals when exposed to high heat.<ref name=foams>{{cite journal | vauthors=Laitinen JA, Koponen J, Koikkalainen J, Kiviranta H | title=Firefighters' exposure to perfluoroalkyl acids and 2-butoxyethanol present in firefighting foams | journal=Toxicology Letters | volume=231 | issue=2 | pages=227–232 | date=December 2014 | pmid=25447453 | doi=10.1016/j.toxlet.2014.09.007}}</ref>

Research into occupational exposure for firefighters is emergent, though frequently limited by underpowered study designs. A 2011 cross-sectional analysis of the C8 Health Studies found higher levels of PFHxS in firefighters compared to the sample group of the region, with other PFASs at elevated levels, without reaching statistical significance.<ref>{{cite journal | vauthors=Jin C, Sun Y, Islam A, Qian Y, Ducatman A | title=Perfluoroalkyl acids including perfluorooctane sulfonate and perfluorohexane sulfonate in firefighters | journal=] | volume=53 | issue=3 | pages=324–328 | date=March 2011 | pmid=21346631 | doi=10.1097/jom.0b013e31820d1314 | s2cid=41993931}}</ref> A 2014 study in Finland studying eight firefighters over three training sessions observed select PFASs (PFHxS and PFNA) increase in blood samples following each training event.<ref name=foams/> Due to this small sample size, a ] was not conducted. A 2015 cross-sectional study conducted in Australia found that PFOS and PFHxS accumulation was positively associated with years of occupational AFFF exposure through firefighting.<ref name=exposed/>

Due to their use in training and testing, studies indicate occupational risk for military members and firefighters, as higher levels of PFASs exposure were indicated in military members and firefighters when compared to the general population.<ref>{{cite journal | vauthors=Barton KE, Starling AP, Higgins CP, McDonough CA, Calafat AM, Adgate JL | title=Sociodemographic and behavioral determinants of serum concentrations of per- and polyfluoroalkyl substances in a community highly exposed to aqueous film-forming foam contaminants in drinking water | journal=International Journal of Hygiene and Environmental Health | volume=223 | issue=1 | pages=256–266 | date=January 2020 | pmid=31444118 | pmc=6878185 | doi=10.1016/j.ijheh.2019.07.012 | bibcode=2020IJHEH.223..256B}}</ref> PFAS exposure is prevalent among firefighters not only due to its use in emergencies but also because it is used in ]. In support of these findings, states like Washington and Colorado have moved to restrict and penalize the use of Class B firefighting foam for firefighter training and testing.<ref>{{cite report | url=https://digital.library.unt.edu/ark:/67531/metadc1279934/ |title=Colorado economic impact study on the Uranium Mill Tailings Remedial Action Project in Colorado: Colorado state fiscal year 1993 | doi=10.2172/10112187 | date=November 12, 1993 | archive-date=June 25, 2021|archive-url=https://web.archive.org/web/20210625165124/https://digital.library.unt.edu/ark:/67531/metadc1279934/ | url-status=live | doi-access=free}}</ref><ref>{{Cite web |url=https://ecology.wa.gov/waste-toxics/reducing-toxic-chemicals/washingtons-toxics-in-products-laws/toxics-in-firefighting |title=Toxics in firefighting | work=]}}</ref>

===Exposure after September 11 attacks===
The ] and resulting fires caused the release of toxic chemicals used in materials such as stain-resistant coatings.<ref name=plasma>{{cite journal | url=https://figshare.com/articles/journal_contribution/2941570 | vauthors=Tao L, Kannan K, Aldous KM, Mauer MP, Eadon GA | title=Biomonitoring of perfluorochemicals in plasma of New York State personnel responding to the World Trade Center disaster | journal=Environmental Science & Technology | volume=42 | issue=9 | pages=3472–3478 | pmid=18522136 | doi=10.1021/es8000079 | bibcode=2008EnST...42.3472T | date=May 2008}}</ref> First responders to this incident were exposed to PFOA, PFNA, and PFHxS through inhalation of dust and smoke released during and after the collapse of the World Trade Center.<ref name=plasma/>

Fire responders who were working at or near ground zero were assessed for respiratory and other health effects from exposure to emissions at the World Trade Center. Early clinical testing showed a high prevalence of respiratory health effects. Early symptoms of exposure often presented with persistent coughing and wheezing. PFOA and PFHxS levels were present in both smoke and dust exposure, but first responders exposed to smoke had higher concentrations of PFOA and PFHxS than those exposed to dust.<ref name=plasma/>

===Mitigation measures===
Several strategies have been proposed as a way to protect those who are at greatest risk of occupational exposure to PFAS, including exposure monitoring, regular blood testing, and the use of PFAS-free alternatives such as fluorine-free firefighting foam and plant-based ski wax.<ref>{{Cite journal | vauthors=Horst J, Quinnan J, McDonough J, Lang J, Storch P, Burdick J, Theriault C | date=April 2021 |title=Transitioning Per- and Polyfluoroalkyl Substance Containing Fire Fighting Foams to New Alternatives: Evolving Methods and Best Practices to Protect the Environment |journal=Groundwater Monitoring & Remediation |volume=41 |issue=2 |pages=19–26 |doi=10.1111/gwmr.12444 |bibcode=2021GMRed..41b..19H |s2cid=235578939 |issn=1069-3629|doi-access=free}}</ref>

=== Food and consumer goods ===
PFASs were found in many plant-based straws, such as paper straws.<ref>{{cite journal | last1=Timshina | first1=Alina | last2=Aristizabal-Henao | first2=Juan J. | last3=Da Silva | first3=Bianca F. | last4=Bowden | first4=John A. | title=The last straw: Characterization of per- and polyfluoroalkyl substances in commercially-available plant-based drinking straws | journal=Chemosphere | publisher=Elsevier BV | volume=277 | year=2021 | issn=0045-6535 | doi=10.1016/j.chemosphere.2021.130238 | page=130238| pmid=33770693 }}</ref><ref>{{cite journal | last1=Boisacq | first1=Pauline | last2=De Keuster | first2=Maarten | last3=Prinsen | first3=Els | last4=Jeong | first4=Yunsun | last5=Bervoets | first5=Lieven | last6=Eens | first6=Marcel | last7=Covaci | first7=Adrian | last8=Willems | first8=Tim | last9=Groffen | first9=Thimo | title=Assessment of poly- and perfluoroalkyl substances (PFAS) in commercially available drinking straws using targeted and suspect screening approaches | journal=Food Additives & Contaminants: Part A | publisher=Informa UK Limited | volume=40 | issue=9 | date=24 August 2023 | issn=1944-0049 | doi=10.1080/19440049.2023.2240908 | pages=1230–1241| pmid=37619405 }}</ref>

==Remediation==
{{main|Remediation of per- and polyfluoroalkyl substances}}

===Water treatment===
Several technologies are currently available for remediating PFASs in liquids. These technologies can be applied to drinking water supplies, groundwater, industrial wastewater, surface water, and other applications such as landfill ]. Influent concentrations of PFASs can vary by orders of magnitude for specific media or applications. These influent values, along with other general ] (for example, pH) can influence the performance and operating costs of the treatment technologies. The technologies are: Several technologies are currently available for remediating PFASs in liquids. These technologies can be applied to drinking water supplies, groundwater, industrial wastewater, surface water, and other applications such as landfill ]. Influent concentrations of PFASs can vary by orders of magnitude for specific media or applications. These influent values, along with other general ] (for example, pH) can influence the performance and operating costs of the treatment technologies. The technologies are:
* Photodegradation<ref>{{Cite journal | url=https://onlinelibrary.wiley.com/doi/10.1002/solr.202400116 |last1=Bertucci |first1=Simone |last2=Lova |first2=Paola |date=May 2024 |title=Exploring Solar Energy Solutions for Per- and Polyfluoroalkyl Substances Degradation: Advancements and Future Directions in Photocatalytic Processes |journal=Solar RRL |volume=8 |issue=9 | doi=10.1002/solr.202400116 | issn=2367-198X|doi-access=free }}</ref>
* Foam fractionation<ref>{{Cite journal |last1=Burns |first1=David J. |last2=Hinrichsen |first2=Helena M. |last3=Stevenson | first3=Paul | last4=Murphy | first4=Peter J. C. |date=June 1, 2022 |title=Commercial-scale remediation of per- and polyfluoroalkyl substances from a landfill leachate catchment using Surface-Active Foam Fractionation (SAFF®) |journal=Remediation Journal |volume=32 | issue=3 |pages=139–150 | doi=10.1002/rem.21720 | issn=1051-5658 |doi-access=free |bibcode=2022RemJ...32..139B}}</ref>
* ] * ]
* ] * ]
Line 246: Line 272:
* ] * ]
* ] * ]
* ]<ref name=12treatment/>
* ]<ref name = "pfas">{{cite web |title=Treatment Technologies |url=https://pfas-1.itrcweb.org/12-treatment-technologies/ |website=PFAS — Per- and Polyfluoroalkyl Substances |publisher=Interstate Technology & Regulatory Council (ITRC) |location=Washington, DC |date=September 2020 |access-date=March 27, 2021 |archive-date=March 27, 2021 |archive-url=https://web.archive.org/web/20210327121341/https://pfas-1.itrcweb.org/12-treatment-technologies/ |url-status=live }}</ref>
* ]<ref name=Fischer>{{cite news|url=https://www.scientificamerican.com/article/how-to-destroy-forever-chemicals/| vauthors = Fischer L |date=January 31, 2022|title=How to Destroy 'Forever Chemicals'|work=Scientific American}}</ref> * ]<ref name=Destroy>{{cite news | url=https://www.scientificamerican.com/article/how-to-destroy-forever-chemicals/ | title=How to Destroy 'Forever Chemicals' | first=LARS | last=FISCHER | work=] |date=January 31, 2022}}</ref>
* Low Energy Electrochemical Oxidation (EOx)


Private and public sector applications of one or more of these methodologies above are being applied to remediation sites throughout the United States and other international locations.<ref>{{cite web |url=https://www.battelle.org/government-offerings/energy-environment/environmental-services/contaminated-sites/pfas-assessment-mitigation?gclid=CjwKCAiA0uLgBRABEiwAecFnkxYeWkGcQGadQ7jSjyDARNQW8ComIJhBePweSebN8Fu3n5SXfwe_mhoCL30QAvD_BwE |title=PFAS Assessment & Mitigation |publisher=Battelle Memorial Institute |location=Columbus, OH |access-date=2018-12-18 |archive-date=December 18, 2018 |archive-url=https://web.archive.org/web/20181218193428/https://www.battelle.org/government-offerings/energy-environment/environmental-services/contaminated-sites/pfas-assessment-mitigation?gclid=CjwKCAiA0uLgBRABEiwAecFnkxYeWkGcQGadQ7jSjyDARNQW8ComIJhBePweSebN8Fu3n5SXfwe_mhoCL30QAvD_BwE |url-status=live }}</ref> Most solutions involve on-site treatment systems, while others are leveraging off-site infrastructure and facilities, such as a ] facility, to treat and dispose of the PFAS pool of compounds. Private and public sector applications of one or more of these methodologies above are being applied to remediation sites throughout the United States and other international locations.<ref>{{cite news | url=https://www.epa.gov/sciencematters/reducing-pfas-drinking-water-treatment-technologies | title=Reducing PFAS in Drinking Water with Treatment Technologies | work=] | date=August 23, 2018}}</ref> Most solutions involve on-site treatment systems, while others are leveraging off-site infrastructure and facilities, such as a ] facility, to treat and dispose of the PFAS pool of compounds.


The US-based Interstate Technology and Regulatory Council (ITRC) has undertaken an extensive evaluation of ex-situ and in-situ treatment technologies for PFAS-impacted liquid matrices. These technologies are divided into field-implemented technologies, limited application technologies, and developing technologies and typically fit into one of three technology types:<ref name=12treatment>{{Cite web | url=https://pfas-1.itrcweb.org/12-treatment-technologies/ | title=12 Treatment Technologies | work=Interstate Technology and Regulatory Council}}</ref>
Most recently, a 2022 study published in the '']'' found that a heat-and pressure-based technique known as ''supercritical water oxidation'' destroyed 99% of the PFASs present in a water sample. During this process, oxidizing substances are added to PFAS-contaminated water and then the liquid is heated above its critical temperature of 374 degrees Celsius at a pressure of more than 220 ]. The water becomes ], and, in this state, water-repellent substances such as PFASs dissolve much more readily.<ref name=Fischer />
* Separation
* Concentration
* Destruction


The type of PFAS remediation technology selected is often a reflection of the PFAS contamination levels and the PFAS signature (i.e. the combination of short- and long-chain PFAS substances present) in conjunction with the site-specific water chemistry and cross contaminants present in the liquid stream. More complex waters such as landfill leachates and WWTP waters require more robust treatment solutions which are less vulnerable to blockage.
==== Theoretical and early-stage solutions ====
{{Close paraphrasing|section|source=https://msutoday.msu.edu/news/2018/diamond-technology-cleans-up-pfas-contaminated-wastewater|date=May 2023}}
The ]-] team has a viable solution to treat PFAS-contaminated wastewater that, in 2018, was reported to be ready for a pilot-scale investigation. The electrochemical oxidation system used boron-doped diamond electrodes in a process breaking down the contaminants' formidable molecular bonds and cleaning the water while systematically destroying the hazardous compounds.<ref name="msutoday">{{cite web | vauthors = Cameron L | date = 9 October 2018 | work = MSU Today | publisher = Michigan State University |url=http://msutoday.msu.edu/news/2018/diamond-technology-cleans-up-pfas-contaminated-wastewater/ |title=Diamond technology cleans up PFAS-contaminated wastewater |access-date=2018-12-18 |archive-date= 19 December 2018 |archive-url= https://web.archive.org/web/20181219182632/https://msutoday.msu.edu/news/2018/diamond-technology-cleans-up-pfas-contaminated-wastewater/ |url-status=live }}</ref>


====Stripping and enrichment====
<blockquote>"EO, or electrochemical oxidation, is a simple, clean, and effective method for destruction of PFASs and other co-contaminants as a complementary procedure to other wastewater treatment processes," said Cory Rusinek, an electrochemist at MSU-Fraunhofer. "If we can remove it from wastewater, we can reduce its occurrence in surface waters."<ref name = "msutoday" /></blockquote>
Foam Fractionation utilizes the air/water interface of a rising air bubble to collect and harvest PFAS molecules. The hydrophobic tail of many long-chain criteria PFAS compounds adhere to this interface and rise to the water surface with the air bubble where they present as a foam for harvesting and further concentration. The foam fractionation technique is a derivation of traditional absorptive bubble separation techniques used by industries for decades to extract amphiphilic contaminants. The absence of a solid absorptive surface reduces consumables and waste byproducts and produces a liquid hyper-concentrate which can be fed into one of the various PFAS destruction technologies. Across various full-scale trials and field applications, this technique provides a simplistic and low operational cost alternative for complex PFAS-impacted waters.<ref>{{Cite journal | last1=We | first1=Angel Chyi En | last2=Zamyadi | first2=Arash | last3=Stickland | first3=Anthony D. | last4=Clarke | first4=Bradley O. | last5=Freguia | first5=Stefano | date=March 5, 2024 | title=A review of foam fractionation for the removal of per- and polyfluoroalkyl substances (PFAS) from aqueous matrices | journal=] | volume=465 | pages=133182 | doi=10.1016/j.jhazmat.2023.133182 | issn=0304-3894 | doi-access=free | pmid=38071776 |bibcode=2024JHzM..46533182W}}</ref>


====Destruction====
In September 2019, it was reported '']'' sp. strain A6 could be a potential remediator of PFAS, including saturated ones such as PFOS.<ref>{{cite web |url=https://earther.gizmodo.com/a-new-jersey-soil-bacteria-is-first-to-break-down-toxic-1838215840 |title=A New Jersey Soil Bacteria Is First to Break Down Toxic 'Forever Chemical' | vauthors = Mandelbaum RF |date=2019-09-18 |website=Gizmodo |access-date=2019-09-19 |archive-date=September 20, 2019 |archive-url=https://web.archive.org/web/20190920132218/https://earther.gizmodo.com/a-new-jersey-soil-bacteria-is-first-to-break-down-toxic-1838215840 |url-status=live }}</ref> PFAS with ]s are easier to break down: the commercial dechlorination culture KB1 (contains '']'') is capable of breaking down such substances, but not saturated PFAS. When alternative, easier-to-digest substrates are present, microbes may prefer them over PFAS.<ref>{{cite web | vauthors = Lim XZ |title=Can microbes save us from PFAS? |url=https://cen.acs.org/environment/persistent-pollutants/microbes-save-us-PFAS/99/i10 |website=cen.acs.org}}</ref>
In 2007, it was found that high-temperature incineration of sewage sludge reduced the levels of perfluorinated compounds significantly.<ref>{{cite journal | pmid=17632203 | last1=Loganathan | first1=Bommanna G. | last2=Sajwan | first2=Kenneth S. | last3=Sinclair | first3=Ewan | last4=Kurunthachalam Senthil | first4=Kumar | last5=Kannan | first5=Kurunthachalam | title=Perfluoroalkyl sulfonates and perfluorocarboxylates in two wastewater treatment plant facilities in Kentucky and Georgia | journal=] | date=December 2007 | volume=41 | issue=20 | pages=4611–4620| doi=10.1016/j.watres.2007.06.045 }}</ref>

A 2022 study published in the '']'' found that a heat- and pressure-based technique known as ''supercritical water oxidation'' destroyed 99% of the PFAS present in a water sample. During this process, oxidizing substances are added to PFAS-contaminated water and then the liquid is heated above its critical temperature of 374 degrees Celsius at a pressure of more than 220 ]. The water becomes ], and, in this state, water-repellent substances such as PFASs dissolve much more readily.<ref name=Destroy/>

====Theoretical and early-stage solutions====
A possible solution for PFAS-contaminated wastewater treatment has been developed by the ]-] team. Boron-doped diamond electrodes are used for the electrochemical oxidation system where it is capable of breaking PFAS molecular bonds which essentially eliminates the contaminates, leaving fresh water.<ref name=Diamond>{{cite news |title=Diamond technology cleans up PFAS-contaminated wastewater | url=https://msutoday.msu.edu/news/2018/diamond-technology-cleans-up-pfas-contaminated-wastewater | first=Layne | last=Cameron | work=] | date=October 9, 2018 | archive-url=https://web.archive.org/web/20181219182632/https://msutoday.msu.edu/news/2018/diamond-technology-cleans-up-pfas-contaminated-wastewater/ | archive-date=19 December 2018 | url-status=live}}</ref>

'']'' sp. strain A6 has been shown to be a PFAS and PFOS remediator.<ref>{{cite web | url=https://gizmodo.com/a-new-jersey-soil-bacteria-is-first-to-break-down-toxic-1838215840 | title=A New Jersey Soil Bacteria Is First to Break Down Toxic 'Forever Chemical' | first=Ryan F. | last=Mandelbaum | work=] | date=September 18, 2019 | archive-date=September 20, 2019 | archive-url=https://web.archive.org/web/20190920132218/https://earther.gizmodo.com/a-new-jersey-soil-bacteria-is-first-to-break-down-toxic-1838215840 | url-status=live}}</ref> PFAS with ]s are easier to break down: the commercial dechlorination culture KB1 (contains '']'') is capable of breaking down such substances, but not saturated PFAS. When alternative, easier-to-digest substrates are present, microbes may prefer them over PFAS.<ref>{{cite web | last=Lim | first=XiaoZhi | title=Can microbes save us from PFAS? | url=https://cen.acs.org/environment/persistent-pollutants/microbes-save-us-PFAS/99/i10 | work=] | url-access=subscription}}</ref>


===Chemical treatment=== ===Chemical treatment===
A study published in '']'' in August 2022 indicated that perfluoroalkyl carboxylic acids (PFCAs) can be ] via heating in a ] such as ]. It reported that heating PFCAs in an 8 to 1 mixture of ] and water at {{cvt|80-120|C|F|0|abbr=on}} in the presence of ] caused the removal of the ] group at the end of the carbon chain, creating a perfluoroanion that mineralizes into ] and other salts such as sodium ], ], ], ], and ]. The process does not work on ] such as PFOS.<ref>{{cite journal | vauthors = Trang B, Li Y, Xue XS, Ateia M, Houk KN, Dichtel WR | title = Low-temperature mineralization of perfluorocarboxylic acids | journal = Science | volume = 377 | issue = 6608 | pages = 839–845 | date = August 2022 | pmid = 35981038 | doi = 10.1126/science.abm8868 | bibcode = 2022Sci...377..839T | doi-access = free }}</ref> A more recent study published in '']'' shows breakdown of C-F bonds and their mineralization as YF<sub>3</sub> or YF<sub>6</sub> clusters.<ref>{{cite journal | vauthors = Abbas M, Maceda AM, Firouzi HR, Xiao Z, Arman HD, Shi Y, Zhou HC, Balkus KJ | display-authors = 6 | title = Fluorine extraction from organofluorine molecules to make fluorinated clusters in yttrium MOFs | journal = Chemical Science | volume = 13 | issue = 48 | pages = 14285–14291 | date = December 2022 | pmid = 36545134 | pmc = 9749115 | doi = 10.1039/D2SC05143E }}</ref> Another study in the Journal of the American Chemical Society described the PFAs breakdown using metal-organic frameworks (MOFs).<ref>{{cite journal | vauthors = Wen Y, Rentería-Gómez Á, Day GS, Smith MF, Yan TH, Ozdemir RO, Gutierrez O, Sharma VK, Ma X, Zhou HC | display-authors = 6 | title = Integrated Photocatalytic Reduction and Oxidation of Perfluorooctanoic Acid by Metal-Organic Frameworks: Key Insights into the Degradation Mechanisms | journal = Journal of the American Chemical Society | volume = 144 | issue = 26 | pages = 11840–11850 | date = July 2022 | pmid = 35732040 | doi = 10.1021/jacs.2c04341 | s2cid = 249956841 }}</ref> A study published in '']'' in August 2022 indicated that perfluoroalkyl carboxylic acids (PFCAs) can be ] via heating in a ] such as ]. Heating PFCAs in an 8 to 1 mixture of ] and water at {{cvt|80-120|C|F|0|abbr=on}} in the presence of ] caused the removal of the ] group at the end of the carbon chain, creating a perfluoroanion that mineralizes into ] and other salts such as sodium ], ], ], ], and ]. The process does not work on ] such as PFOS.<ref>{{cite journal | vauthors=Trang B, Li Y, Xue XS, Ateia M, Houk KN, Dichtel WR | title=Low-temperature mineralization of perfluorocarboxylic acids | journal=Science | volume=377 | issue=6608 | pages=839–845 | date=August 2022 | pmid=35981038 | doi=10.1126/science.abm8868 | bibcode=2022Sci...377..839T | doi-access=free}}</ref> A 2022 study published in '']'' shows breakdown of C-F bonds and their mineralization as YF<sub>3</sub> or YF<sub>6</sub> clusters.<ref>{{cite journal | vauthors=Abbas M, Maceda AM, Firouzi HR, Xiao Z, Arman HD, Shi Y, Zhou HC, Balkus KJ | display-authors=6 | title=Fluorine extraction from organofluorine molecules to make fluorinated clusters in yttrium MOFs | journal=Chemical Science | volume=13 | issue=48 | pages=14285–14291 | date=December 2022 | pmid=36545134 | pmc=9749115 | doi=10.1039/D2SC05143E}}</ref> Another study in the ] described the PFASs breakdown using ] (MOFs).<ref>{{cite journal | vauthors=Wen Y, Rentería-Gómez Á, Day GS, Smith MF, Yan TH, Ozdemir RO, Gutierrez O, Sharma VK, Ma X, Zhou HC | display-authors=6 | title=Integrated Photocatalytic Reduction and Oxidation of Perfluorooctanoic Acid by Metal-Organic Frameworks: Key Insights into the Degradation Mechanisms | journal=Journal of the American Chemical Society | volume=144 | issue=26 | pages=11840–11850 | date=July 2022 | pmid=35732040 | doi=10.1021/jacs.2c04341 | s2cid=249956841}}</ref>

==Analytical methods==
Analytical methods for PFAS analysis fall into one of two general categories; targeted analysis or non-targeted analysis. Targeted analyses use reference standards to determine concentrations of specific PFAS, but this requires a high-purity standard for each compound of interest. Due to the large number of possible targets, unusual PFAS may go unreported by these methods. Non-targeted analyses measure other factors, such as total organic fluorine, which can be used to estimate the total concentration of PFAS in a sample, but cannot provide concentrations of individual compounds. The two types of analyses are often combined; by subtracting the mass of target analytes from the non-targeted analysis results, one can get an estimate for what fraction of PFAS has been "missed" by the targeted analysis.

Targeted analysis generally use ] (LC-MS) instruments. Currently, EPA Method 537.1 is approved for use in drinking water and includes 18 PFAS.<ref>{{Cite web |last=Development |first=Office of Research & |title=Method 537.1 Determination of Selected Per- and Polyflourinated Alkyl Substances in Drinking Water by Solid Phase Extraction and Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS) |url=https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=348508&Lab=CESER&simpleSearch=0&showCriteria=2&searchAll=537.1&TIMSType=&dateBeginPublishedPresented=03/24/2018 |access-date=2024-09-22 |website=cfpub.epa.gov |language=en}}</ref> EPA Method 1633 is undergoing review for use in wastewater, surface water, groundwater, soil, biosolids, sediment, landfill leachate, and fish tissue for 40 PFAS, but is currently being used by many laboratories in the United States.<ref>{{Cite web |last=US EPA |first=OW |date=2020-11-29 |title=CWA Analytical Methods for Per- and Polyfluorinated Alkyl Substances (PFAS) |url=https://www.epa.gov/cwa-methods/cwa-analytical-methods-and-polyfluorinated-alkyl-substances-pfas#method-1633 |access-date=2024-09-22 |website=www.epa.gov |language=en}}</ref> Regulatory limits for PFOA and PFOS set by the US EPA (4 parts-per-trillion) are limited by the capability of methods to detect low level concentrations.<ref>{{Cite web |last=US EPA |first=OA |date=2023-03-14 |title=Biden-Harris Administration Proposes First-Ever National Standard to Protect Communities from PFAS in Drinking Water |url=https://www.epa.gov/newsreleases/biden-harris-administration-proposes-first-ever-national-standard-protect-communities |access-date=2024-09-22 |website=www.epa.gov |language=en}}</ref>

Non-targeted analyses include total organic fluorine (TOF, including variations, e.g., adsorbable organic fluorine, AOF; extractable organic fluorine, EOF), ], and other methods in development.<ref>{{Cite journal | last1=Ateia |first1=Mohamed |last2=Chiang |first2=Dora |last3=Cashman | first3=Michaela | last4=Acheson |first4=Carolyn |date=April 11, 2023 |title=Total Oxidizable Precursor (TOP) Assay─Best Practices, Capabilities and Limitations for PFAS Site Investigation and Remediation | journal=Environmental Science & Technology Letters |volume=10 |issue=4 | pages=292–301 | doi=10.1021/acs.estlett.3c00061 |issn=2328-8930 |pmc=10259459 | pmid=37313434|bibcode=2023EnSTL..10..292A}}</ref><ref>{{Cite journal | last1=Wang |first1=Qi | last2=Ruan |first2=Yuefei |last3=Yuen |first3=Calista N.T. |last4=Lin |first4=Huiju |last5=Yeung | first5=Leo W.Y. | last6=Leung |first6=Kenneth M.Y. |last7=Lam |first7=Paul K.S. |date=December 2023 | title=Tracing per- and polyfluoroalkyl substances (PFASs) in the aquatic environment: Target analysis and beyond |journal=TrAC Trends in Analytical Chemistry |volume=169 |pages=117351 | doi=10.1016/j.trac.2023.117351 |doi-access=free}}</ref>


==Sample chemicals== ==Sample chemicals==
Some common per- and polyfluoroalkyl substances include:<ref>{{cite web |title=Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS): Frequently Asked Questions |url=https://www.atsdr.cdc.gov/pfas/docs/pfas_fact_sheet.pdf |publisher=Centers for Disease Control |access-date=13 August 2019 |date=August 22, 2017 |archive-date=October 18, 2020 |archive-url=https://web.archive.org/web/20201018004606/https://www.atsdr.cdc.gov/pfas/docs/pfas_fact_sheet.pdf |url-status=live }}</ref><ref>{{cite web |title=ORD subset of PFAS with ongoing work methods; CompTox Chemicals Dashboard |url=https://www.epa.gov/sites/production/files/2019-05/documents/pfas_research_list.pdf |publisher=EPA |date=2019-03-11 |access-date=August 13, 2019 |archive-date=July 15, 2019 |archive-url=https://web.archive.org/web/20190715212833/https://www.epa.gov/sites/production/files/2019-05/documents/pfas_research_list.pdf |url-status=live }}</ref> Some common per- and polyfluoroalkyl substances include:<ref>{{cite web |url=https://www.atsdr.cdc.gov/pfas/docs/pfas_fact_sheet.pdf |title=Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS): Frequently Asked Questions |publisher=] |date=August 22, 2017 |archive-date=October 18, 2020 |archive-url=https://web.archive.org/web/20201018004606/https://www.atsdr.cdc.gov/pfas/docs/pfas_fact_sheet.pdf |url-status=live}}</ref><ref>{{cite web |title=ORD subset of PFAS with ongoing work methods; CompTox Chemicals Dashboard |url=https://www.epa.gov/sites/production/files/2019-05/documents/pfas_research_list.pdf |publisher=] |date=March 11, 2019 |archive-date=July 15, 2019 |archive-url=https://web.archive.org/web/20190715212833/https://www.epa.gov/sites/production/files/2019-05/documents/pfas_research_list.pdf |url-status=live}}</ref>


* ] aka ] aka ] * ] (aka ] or ])
* ]s * ] (PFCAs)
* ] (PFSAs)
* ]
* ] (FTOHs)
* ]
{| class="wikitable sortable plainrowheaders" {| class="wikitable sortable plainrowheaders"
|- |-
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|} |}


== Films == ==In popular culture==

=== Films ===
* '']'' (2018) * '']'' (2018)
* '']'' (2019) * '']'' (2019)


== See also == ==See also==
* ] * ]
* ], formerly Fluoroware, of ], manufacturer of teflon components for health and semiconductor ] * ], formerly Fluoroware, of ], manufacturer of teflon components for health and semiconductor ]
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* ] (PTFE) * ] (PTFE)
* ], subclass of per- and polyfluoroalkyl substances * ], subclass of per- and polyfluoroalkyl substances
* ], as the general category for policy interventions aiming to mitigate associated effects on human populations


== References == ==References==
{{Reflist}} {{Reflist}}


== Further reading == ==Further reading==
{{refbegin}} {{refbegin}}
* ], "You Make Me Sick: How corporate scientists discovered – and then helped to conceal – the dangers of forever chemicals", '']'', 27 May 2024, pp.&nbsp;38–47.
* {{cite journal | vauthors = Lindstrom AB, Strynar MJ, Libelo EL | title = Polyfluorinated compounds: past, present, and future | journal = Environmental Science & Technology | volume = 45 | issue = 19 | pages = 7954–61 | date = October 2011 | pmid = 21866930 | doi = 10.1021/es2011622 | url = https://semanticscholar.org/paper/67e1420b4aa02ee006e48ef9d66dc9943d9aaf31 | bibcode = 2011EnST...45.7954L | s2cid = 206946893 | access-date = December 2, 2019 | archive-date = October 6, 2021 | archive-url = https://web.archive.org/web/20211006204821/https://www.semanticscholar.org/paper/Polyfluorinated-compounds%3A-past%2C-present%2C-and-Lindstrom-Strynar/67e1420b4aa02ee006e48ef9d66dc9943d9aaf31 | url-status = live }}
* {{cite journal | vauthors=Lindstrom AB, Strynar MJ, Libelo EL | title=Polyfluorinated compounds: past, present, and future | journal=Environmental Science & Technology | volume=45 | issue=19 | pages=7954–7961 | date=October 2011 | pmid=21866930 | doi=10.1021/es2011622 | bibcode=2011EnST...45.7954L | s2cid=206946893}}
* {{cite journal| vauthors = Ritter SK| year = 2015| title = The Shrinking Case For Fluorochemicals| journal = ]| volume = 93| issue = 28| pages = 27–29| doi = 10.1021/cen-09328-scitech1| url = http://cen.acs.org/articles/93/i28/Shrinking-Case-Fluorochemicals.html| access-date = August 3, 2016| archive-date = August 18, 2016| archive-url = https://web.archive.org/web/20160818040400/http://cen.acs.org/articles/93/i28/Shrinking-Case-Fluorochemicals.html| url-status = live}}
* {{cite journal| vauthors=Ritter SK | title=The Shrinking Case For Fluorochemicals| journal=]| volume=93| issue=28| pages=27–29| doi=10.1021/cen-09328-scitech1| url=https://cen.acs.org/articles/93/i28/Shrinking-Case-Fluorochemicals.html | date=July 13, 2015 | url-access=limited | archive-date=August 18, 2016| archive-url=https://web.archive.org/web/20160818040400/http://cen.acs.org/articles/93/i28/Shrinking-Case-Fluorochemicals.html| url-status=live}}
* {{cite journal | vauthors = Lehmler HJ | title = Synthesis of environmentally relevant fluorinated surfactants—a review | journal = Chemosphere | volume = 58 | issue = 11 | pages = 1471–96 | date = March 2005 | pmid = 15694468 | doi = 10.1016/j.chemosphere.2004.11.078 | bibcode = 2005Chmsp..58.1471L }}
* {{cite journal | vauthors=Lehmler HJ | title=Synthesis of environmentally relevant fluorinated surfactants—a review | journal=Chemosphere | volume=58 | issue=11 | pages=1471–1496 | date=March 2005 | pmid=15694468 | doi=10.1016/j.chemosphere.2004.11.078 | bibcode=2005Chmsp..58.1471L}}
{{refend}} {{refend}}


== External links == ==External links==
* at the ] * at the ]
* at the ] * at the ]
* at the ] * at the ]
* at the ] * at the ]
* </nowiki> in the U.S.]
* *
* , National Institute for Occupational Safety and Health * , National Institute for Occupational Safety and Health
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* , ] * , ]


{{Authority control}}

]
]
]
] ]
] ]
] ]
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]

Latest revision as of 06:42, 30 December 2024

Class of perfluorinated chemical compounds "PFAS" redirects here. For other uses, see PFAS (disambiguation).

Per- and polyfluoroalkyl substances (PFAS or PFASs) are a group of synthetic organofluorine chemical compounds that have multiple fluorine atoms attached to an alkyl chain; there are 7 million such chemicals according to PubChem. PFAS came into use after the invention of Teflon in 1938 to make fluoropolymer coatings and products that resist heat, oil, stains, grease, and water. They are now used in products including waterproof fabric such as Nylon, yoga pants, carpets, shampoo, feminine hygiene products, mobile phone screens, wall paint, furniture, adhesives, food packaging, heat-resistant non-stick cooking surfaces such as Teflon, firefighting foam, and the insulation of electrical wire. PFAS are also used by the cosmetic industry in most cosmetics and personal care products, including lipstick, eye liner, mascara, foundation, concealer, lip balm, blush, and nail polish.

Many PFAS such as PFOS and PFOA pose health and environmental concerns because they are persistent organic pollutants; they were branded as "forever chemicals" in an article in The Washington Post in 2018. Some have half-lives of over eight years due to a carbon-fluorine bond, one of the strongest in organic chemistry. They move through soils and bioaccumulate in fish and wildlife, which are then eaten by humans. Residues are now commonly found in rain, drinking water, and wastewater. Since PFAS compounds are highly mobile, they are readily absorbed through human skin and through tear ducts, and such products on lips are often unwittingly ingested. Due to the large number of PFAS, it is challenging to study and assess the potential human health and environmental risks; more research is necessary and is ongoing.

Exposure to PFAS, some of which have been classified as carcinogenic and/or as endocrine disruptors, has been linked to cancers such as kidney, prostate and testicular cancer, ulcerative colitis, thyroid disease, suboptimal antibody response / decreased immunity, decreased fertility, hypertensive disorders in pregnancy, reduced infant and fetal growth and developmental issues in children, obesity, dyslipidemia (abnormally high cholesterol), and higher rates of hormone interference.

The use of PFAS has been regulated internationally by the Stockholm Convention on Persistent Organic Pollutants since 2009, with some jurisdictions, such as China and the European Union, planning further reductions and phase-outs. However, major producers and users such as the United States, Israel, and Malaysia have not ratified the agreement and the chemical industry has lobbied governments to reduce regulations or has moved production to countries such as Thailand, where there is less regulation. In the United States, the Republican Party has filibustered bills regulating the chemicals. Cover-ups and the suppression of studies in 2018 by the Trump administration led to bipartisan outrage.

The market for PFAS was estimated to be $28 billion in 2023 and the majority are produced by 12 companies: 3M, AGC Inc., Archroma, Arkema, BASF, Bayer, Chemours, Daikin, Honeywell, Merck Group, Shandong Dongyue Chemical, and Solvay. Sales of PFAS, which cost approximately $20 per kilogram, generate a total industry profit of $4 billion per year on 16% profit margins. Due to health concerns, several companies have ended or plan to end the sale of PFAS or products that contain them; these include W. L. Gore & Associates (the maker of Gore-Tex), H&M, Patagonia, REI, and 3M. PFAS producers have paid billions of dollars to settle litigation claims, the largest being a $10.3 billion settlement paid by 3M for water contamination in 2023. Studies have shown that companies have known of the health dangers since the 1970s – DuPont and 3M were aware that PFAS was "highly toxic when inhaled and moderately toxic when ingested". External costs, including those associated with remediation of PFAS from soil and water contamination, treatment of related diseases, and monitoring of PFAS pollution, may be as high as US$17.5 trillion annually, according to ChemSec. The Nordic Council of Ministers estimated health costs to be at least €52–84 billion in the European Economic Area. In the United States, PFAS-attributable disease costs are estimated to be US$6–62 billion.

Definition

Skeletal structure of PFOS, an effective, persistent and bioaccumulative fluorosurfactant
A physical sample of PFOA, appearing as a white solid as seen here in a relatively pure form. It is commonly referred to as the main harmful PFAS chemical and PFOA is responsible for many of the negative health effects commonly associated with PFAS.

Per- and polyfluoroalkyl substances are a group of synthetic organofluorine chemical compounds that have multiple fluorine atoms attached to an alkyl chain. Different organizations use different definitions for PFAS, leading to estimates of between 8,000 and 7 million chemicals within the group. The EPA toxicity database, DSSTox, lists 14,735 unique PFAS chemical compounds.

An early definition required that they contain at least one perfluoroalkyl moiety, −CnF2n+1. Beginning in 2021, the OECD expanded its terminology, stating that "PFAS are defined as fluorinated substances that contain at least one fully fluorinated methyl or methylene carbon atom (without any H/Cl/Br/I atom attached to it), i.e., with a few noted exceptions, any chemical with at least a perfluorinated methyl group (−CF3) or a perfluorinated methylene group (−CF2−) is a PFAS." This definition notably includes Carbon tetrafluoride.

The United States Environmental Protection Agency defines PFAS in the Drinking Water Contaminant Candidate List 5 as substances that contain "at least one of the following three structures: R−CF2−CF(R')R", where both the −CF2− and −CF− moieties are saturated carbons, and none of the R groups can be hydrogen; R−CF2−O−CF2−(R'), where both the −CF2− moieties are saturated carbons, and none of the R groups can be hydrogen; or CF3−C−(CF3)RR', where all the carbons are saturated, and none of the R groups can be hydrogen.

A summary table of some PFAS definitions is provided in Hammel et al (2022).

Fluorosurfactants

A shiny spherical drop of water on blue cloth
Fluorine-containing durable water repellent makes a fabric water-resistant.

Fluorinated surfactants or fluorosurfactants are a subgroup of PFAS characterized by a hydrophobic fluorinated "tail" and a hydrophilic "head" that behave as surfactants. These are more effective at reducing the surface tension of water than comparable hydrocarbon surfactants. They include the perfluorosulfonic acids, such as perfluorooctanesulfonic acid (PFOS), and the perfluorocarboxylic acids like perfluorooctanoic acid (PFOA).

As with other surfactants, fluorosurfactants tend to concentrate at the phase interfaces. Fluorocarbons are both lipophobic and hydrophobic, repelling both oil and water. Their lipophobicity results from the relative lack of London dispersion forces compared to hydrocarbons, a consequence of fluorine's large electronegativity and small bond length, which reduce the polarizability of the surfactants' fluorinated molecular surface. Fluorosurfactants are more stable than hydrocarbon surfactants due to the stability of the carbon–fluorine bond. Perfluorinated surfactants persist in the environment for the same reason.

Fluorosurfactants such as PFOS, PFOA, and perfluorononanoic acid (PFNA) have caught the attention of regulatory agencies because of their persistence, toxicity, and widespread occurrence in the blood of general populations.

PFASs are used in emulsion polymerization to produce fluoropolymers, used in stain repellents, polishes, paints, and coatings.

Health and environmental effects

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PFASs were originally considered to be chemically inert. Early occupational studies revealed elevated levels of fluorochemicals, including perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA, C8), in the blood of exposed industrial workers, but cited no ill health effects. These results were consistent with the measured serum concentrations of PFOS and PFOA in 3M plant workers ranging from 0.04 to 10.06 ppm and 0.01 to 12.70 ppm, respectively, well below toxic and carcinogenic levels cited in animal studies. Given, however, the serum elimination half-life of four to five years and widespread environmental contamination, molecules have been shown to accumulate in humans sufficiently to cause adverse health outcomes.

Effects of exposure to PFASs on human health

Prevalence in rain, soil, water bodies, and air

In 2022, levels of at least four perfluoroalkyl acids (PFAAs) in rain water worldwide greatly exceeded the EPA's lifetime drinking water health advisories as well as comparable Danish, Dutch, and European Union safety standards, leading to the conclusion that "the global spread of these four PFAAs in the atmosphere has led to the planetary boundary for chemical pollution being exceeded".

It had been thought that PFAAs would eventually end up in the oceans, where they would be diluted over decades, but a field study published in 2021 by researchers at Stockholm University found that they are often transferred from water to air when waves reach land, are a significant source of air pollution, and eventually get into rain. The researchers concluded that pollution may impact large areas.

In 2024, a worldwide study of 45,000 groundwater samples found that 31% of samples contained levels of PFAS that were harmful to human health; these samples were taken from areas not near any obvious source of contamination.

Soil is also contaminated and the chemicals have been found in remote areas such as Antarctica. Soil contamination can result in higher levels of PFAs found in foods such as white rice, coffee, and animals reared on contaminated ground.

Adverse health outcomes

From 2005 to 2013, three epidemiologists known as the C8 Science Panel conducted health studies in the Mid-Ohio Valley as part of a contingency to a class action lawsuit brought by communities in the Ohio River Valley against DuPont in response to landfill and wastewater dumping of PFAS-laden material from DuPont's West Virginia Washington Works plant. The panel measured PFOA (also known as C8) serum concentrations in 69,000 individuals from around DuPont's Washington Works Plant and found a mean concentration of 83 ng/mL, compared to 4 ng/mL in a standard population of Americans. This panel reported probable links between elevated PFOA blood concentration and hypercholesterolemia, ulcerative colitis, thyroid disease, testicular cancer, kidney cancer as well as pregnancy-induced hypertension and preeclampsia.

The severity of PFAS-associated health effects can vary based on the length of exposure, level of exposure, and health status.

Pregnancy and lactation issues

Exposure to PFAS is a risk factor for various hypertensive disorders in pregnancy, including preeclampsia and high blood pressure. It is not clear whether PFAS exposure is associated with wider cardiovascular disorders during pregnancy. Human breast milk can harbor PFASs, which can be transferred from mother to infant via breastfeeding.

Use of various personal care products, such as nail care products, fragrances, makeup, hair dyes and hair sprays, by pregnant women and lactating mothers has been shown to be associated with significantly higher levels of PFAS in the blood and breastmilk of the mothers. For example, PFOS levels of women who dyed their hair at least twice during pregnancy were more than a third higher than those who did not. PFOS is one of the most common and most dangerous of the PFAS compounds.

Fertility issues

Endocrine disruptors, including PFASs, are linked with the male infertility crisis.

A report in 2023 by the Icahn School of Medicine at Mount Sinai linked high exposure to PFAS with a 40% decrease in the ability for a woman to have a successful pregnancy as well as hormone disruption and delayed puberty onset.

Human developmental issues

Fetuses and children are especially vulnerable to the harms of PFAS chemicals because they have been shown to be linked to major adverse health conditions, including abnormally small birth weight syndrome in newborns, preterm birth, shorter lactation periods, breastmilk of diminished nutritional content, one or more neurodevelopmental disorders, and decreased response to childhood vaccines.

Liver issues

A meta-analysis for associations between PFASs and human clinical biomarkers for liver injury, analyzing PFAS effects on liver biomarkers and histological data from rodent experimental studies, concluded that evidence exists that PFOA, perfluorohexanesulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) caused hepatotoxicity in humans.

Cancer

PFOA is classified as carcinogenic to humans (Group 1) by the International Agency for Research on Cancer (IARC) based on "sufficient" evidence for cancer in animals and "strong" mechanistic evidence in exposed humans. IARC also classified PFOS as possibly carcinogenic to humans (Group 2b) based on "strong" mechanistic evidence. There is a lack of high-quality epidemiological data on the associations between many specific PFAS chemicals and specific cancer types, and research is ongoing.

Hypercholesterolemia

A response is observed in humans where elevated PFOS levels were significantly associated with elevated total cholesterol and LDL cholesterol, highlighting significantly reduced PPAR expression and alluding to PPAR independent pathways predominating over lipid metabolism in humans compared to rodents.

Ulcerative colitis

PFOA and PFOS have been shown to significantly alter immune and inflammatory responses in human and animal species. In particular, IgA, IgE (in females only) and C-reactive protein have been shown to decrease whereas antinuclear antibodies increase as PFOA serum concentrations increase. These cytokine variations allude to immune response aberrations resulting in autoimmunity. One proposed mechanism is a shift towards anti-inflammatory M2 macrophages and/or T-helper (TH2) response in intestinal epithelial tissue which allows sulfate-reducing bacteria to flourish. Elevated levels of hydrogen sulfide result, which reduce beta-oxidation and nutrient production, leading to a breakdown of the colonic epithelial barrier.

Thyroid disease

Hypothyroidism is the most common thyroid abnormality associated with PFAS exposure. PFASs have been shown to decrease thyroid peroxidase, resulting in decreased production and activation of thyroid hormones in vivo. Other proposed mechanisms include alterations in thyroid hormone signaling, metabolism and excretion as well as function of nuclear hormone receptor.

Bioaccumulation and biomagnification

Bioaccumulation of PFAS: PFASs from sediments and water can accumulate in marine organisms. Animals higher up the food chain accumulate more PFAS because they absorb PFAS in the prey they consume.
In marine species of the food web

Bioaccumulation controls internal concentrations of pollutants, including PFAS, in individual organisms. When bioaccumulation is looked at in the perspective of the entire food web, it is called biomagnification, which is important to track because lower concentrations of pollutants in environmental matrices such as seawater or sediments, can very quickly grow to harmful concentrations in organisms at higher trophic levels, including humans. Notably, concentrations in biota can even be greater than 5000 times those present in water for PFOS and C10–C14 PFCAs. PFAS can enter an organism by ingestion of sediment, through the water, or directly via their diet. It accumulates namely in areas with high protein content, in the blood and liver, but it is also found to a lesser extent in tissues.

Biomagnification can be described using the estimation of the trophic magnification factor (TMF), which describes the relationship between the contamination levels in a species and their trophic level in the food web. TMFs are determined by graphing the log-transformed concentrations of PFAS against the assigned trophic level and taking the antilog of the regression slope (10).

In a study done on a macrotidal estuary in Gironde, SW France, TMFs exceeded one for nearly all 19 PFAS compounds considered in the study and were particularly high for PFOA and PFNA (6.0 and 3.1 respectively). A TMF greater than one signifies that accumulation in the organism is greater than that of the medium, with the medium being seawater in this case.

PFOS, a long-chain sulfonic acid, was found at the highest concentrations relative to other PFASs measured in fish and birds in northern seas such as the Barents Sea and the Canadian Arctic.

A study published in 2023 analyzing 500 composite samples of fish fillets collected across the United States from 2013 to 2015 under the EPA's monitoring programs showed freshwater fish ubiquitously contain high levels of harmful PFAS, with a single serving typically significantly increasing the blood PFOS level.

Bioaccumulation and biomagnification of PFASs in marine species throughout the food web, particularly frequently consumed fish and shellfish, can have important impacts on human populations. PFASs have been frequently documented in both fish and shellfish that are commonly consumed by human populations, which poses health risks to humans and studies on the bioaccumulation in certain species are important to determine daily tolerable limits for human consumption, and where those limits may be exceeded causing potential health risks. This has particular implications for populations that consume larger numbers of wild fish and shellfish species. PFAS contamination has also resulted in disruptions to the food supply, such as closures and limits on fishing.

Fluorosurfactants with shorter carbon chains may be less prone to accumulating in mammals; there is still some concern that they may be harmful to both humans and the environment.

Suppression of information on health effects

Since the 1970s, DuPont and 3M were aware that PFAS was "highly toxic when inhaled and moderately toxic when ingested". Producers used several strategies to influence science and regulation – most notably, suppressing unfavorable research and distorting public discourse.

In 2018, under the Presidency of Donald Trump, White House staff and the United States Environmental Protection Agency pressured the U.S. Agency for Toxic Substances and Disease Registry to suppress a study that showed PFASs to be even more dangerous than previously thought.

Concerns, litigation, and regulations in specific countries and regions

Arctic

In 2024, research at McGill University in Quebec, indicated that PFASs were being brought to the Arctic from polluted southern waters by migrating birds. Although it is much less than compared to the introduction by wind and the oceans, the birds become vectors, transmitting the toxic chemicals. Rainer Lohmann, an oceanographer at the University of Rhode Island, noted that this has a significant localized affect that is devastating for Arctic predators who accumulate toxins in their bodies because the contaminants from the birds often enter the food chain directly since the birds are the prey of many species.

Australia

In 2017, the ABC's current affairs program Four Corners reported that the storage and use of firefighting foams containing perfluorinated surfactants at Australian Defence Force facilities around Australia had contaminated nearby water resources. In 2019, remediation efforts at RAAF Base Tindal and the adjacent town of Katherine were ongoing. In the 2022 Australian federal budget $428 million was allocated for works at HMAS Albatross, RAAF Base Amberley, RAAF Base Pearce and RAAF Base Richmond including funding to remediate PFAS contamination.

Canada

Although PFASs are not manufactured in Canada, they may be present in imported goods and products. In 2008, products containing PFOS as well as PFOA were banned in Canada, with exceptions for products used in firefighting, the military, and some forms of ink and photo media.

Health Canada has published drinking water guidelines for maximum concentrations of PFOS and PFOA to protect the health of Canadians, including children, over a lifetime's exposure to these substances. The maximum allowable concentration for PFOS under the guidelines is 0.0002 milligrams per liter. The maximum allowable concentration for PFOA is 0.0006 milligrams per liter. In August 2024, Health Canada established an objective of 30 ng/L for the sum of the concentration of 25 PFASs detected in drinking water.

New Zealand

The New Zealand Environmental Protection Agency (EPA) has banned the use of per- and polyfluoroalkyl substances (PFAS) in cosmetic products starting from 31 December 2026. This will make the country one of the first in the world to take this step on PFAS to protect people and the environment.

United Kingdom

The environmental consequences of PFAS, especially from firefighting activities, have been recognized since the mid-1990s and came to prominence after the Buncefield explosion on 11 December 2005. The Environment Agency has undertaken a series of projects to understand the scale and nature of PFAS in the environment. The Drinking Water Inspectorate requires water companies to report concentrations of 47 PFAS.

European Union

Many PFASs are either not covered by European legislation or are excluded from registration obligations under the EU Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) chemical regulation. Several PFASs have been detected in drinking water, municipal wastewater, and landfill leachates worldwide.

In 2019, the European Council requested the European Commission to develop an action plan to eliminate all non-essential uses of PFAS due to the growing evidence of adverse effects caused by exposure to these substances; the evidence for the widespread occurrence of PFAS in water, soil, articles, and waste; and the threat it can pose to drinking water. Germany, the Netherlands, Denmark, Norway, and Sweden submitted a so-called restriction proposal based on the REACH regulation to achieve a European ban on the production, use, sale and import of PFAS. The proposal states that a ban is necessary for all use of PFAS, with different periods for different applications when the ban takes effect (immediately after the restriction comes into force, five years afterward, or 12 years afterward), depending on the function and the availability of alternatives. The proposal has not assessed the use of PFAS in medicines, plant protection products, and biocides because specific regulations apply to those substances (Biocidal Products Regulation, Plant Protection Products Regulation, Medicinal Products Regulation) that have an explicit authorization procedure that focuses on risk for health and the environment.

The proposal was submitted on 13 January 2023 and published by the European Chemicals Agency (ECHA) on 7 February. From 22 March to 21 September, citizens, companies, and other organizations commented on the proposal during a public consultation. Based on the information in the restriction proposal and the consultation, two committees from ECHA formulate an opinion on the risk and socio-economic aspects of the proposed restriction. Within a year of publication, the opinions are sent to the European Commission, which makes a final proposal that is submitted to the EU Member States for discussion and decision. Eighteen months after the publication of the restriction decision (which may differ from the original proposal), it will enter into force.

Italy

127,000 residents in the Veneto region are estimated to have been exposed to contamination through tap water, and it is thought to be Europe's biggest PFAS-related environmental disaster. While Italy's National Health Institute (ISS, Istituto Superiore di Sanità) set the threshold limit of PFOA in the bloodstream at 8 nanograms per milliliter (ng/mL), some residents had reached 262 and some industrial employees reach 91,900 ng/mL. In 2021 some data was disclosed by Greenpeace and local citizens after a long legal battle against the Veneto Region and ISS, which for years has denied access to data, despite values known since or even before 2017. The Veneto region has not carried out further monitoring or taken resolutive actions to eliminate pollution and reduce, at least gradually, the contamination of non-potable water. Although in 2020 the European Food Safety Agency (EFSA) has reduced by more than four times the maximum tolerable limit of PFAS that can be taken through the diet, the region has not carried out new assessments or implemented concrete actions to protect the population and the agri-food and livestock sectors. Some limits were added to monitoring the geographical area, which does not include the orange zone and other areas affected by contamination, as well as the insufficiency of analysis on important productions widespread in the areas concerned: eggs (up to 37,100 ng/kg), fish (18,600 ng/kg) spinach and radicchio (only one sampling carried out), kiwis, melons, watermelons, cereals (only one sample was analyzed), soy, wines and apples.

Japan

A study of public water bodies ending in March 2022 showed that the sum of PFOS and PFOA concentrations exceeded 50 ng/L in 81 out of 1,133 test sites and in some cases are present at elevated levels in blood. This has led to pressure to increase regulations.

Sweden

Highly contaminated drinking water has been detected at several locations in Sweden. Such locations include Arvidsjaur, Lulnäset, Uppsala and Visby. In 2013, PFAS were detected at high concentrations in one of the two municipality drinking water treatment plants in the town of Ronneby, in southern Sweden. Concentrations of PFHxS and PFOS were found at 1700 ng/L and 8000 ng/L, respectively. The source of contamination was later found to be a military fire-fighting exercise site in which PFAS containing fire-fighting foam had been used since the mid-1980s.

Additionally, low-level contaminated drinking water has also been shown to be a significant exposure source of PFOA, PFNA, PFHxS and PFOS for Swedish adolescents (ages 10–21). Even though the median concentrations in the municipality drinking water were below one ng/L for each individual PFAS, positive associations were found between adolescent serum PFAS concentrations and PFAS concentrations in drinking water.

United States

An estimated 26,000 U.S. sites are contaminated with PFASs. More than 200 million Americans are estimated to live in places where the PFAS level in tap water, including PFOA and PFOS levels, exceeds the 1 ppt (part per trillion) limit set in 2022 by the EPA.

Based on tap water studies from 716 locations from 2016 and 2021, the U.S. Geological Survey (USGS) found that the PFAS levels exceeded the EPA advisories in approximately 75% of the samples from urban areas and in approximately 25% of the rural area samples.

Certain PFASs are no longer manufactured in the United States as a result of phase-outs including the PFOA Stewardship Program (2010–2015), in which eight major chemical manufacturers agreed to eliminate the use of PFOA and PFOA-related chemicals in their products and emissions from their facilities. However, they are still produced internationally and are imported into the U.S. in consumer goods. Some types of PFAS are voluntarily not included in food packaging.

In 2021, Senators Susan Collins of Maine and Richard Blumenthal of Connecticut proposed the No PFAS in Cosmetics Act in the United States Senate. It was also introduced in the United States House of Representatives by Michigan Representative Debbie Dingell, but the Republican Party, supported by the U.S. chemical industry filibustered the bill.

Military bases

The water in and around at least 126 U.S. military bases has been contaminated by high levels of PFASs because of their use of firefighting foams since the 1970s, according to a study by the U.S. Department of Defense. Of these, 90 bases reported PFAS contamination that had spread to drinking water or groundwater off the base.

In 2022, a report by the Pentagon acknowledged that approximately 175,000 U.S. military personnel at two dozen American military facilities drank water contaminated by PFAS that exceeded the U.S. EPA limit. However, according to the Environmental Working Group, the Pentagon report downplayed the number of people exposed to PFAS, which was probably over 640,000 at 116 military facilities. The EWG found that the Pentagon also omitted from its report some types of diseases that are likely to be caused by PFAS exposure, such as testicular cancer, kidney disease, and fetal abnormalities.

Environmental Protection Agency actions

The United States Environmental Protection Agency has published non-enforceable drinking water health advisories for PFOA and PFOS. In March 2021 EPA announced that it would develop national drinking water standards for PFOA and PFOS. Drinking water utilities are required to monitor PFAS levels and may receive subsidies to do so. There are also regulations regarding wastewater (effluent guidelines) for industries that use PFASs in the manufacturing process as well as biosolids (processed wastewater sludge used as fertilizer).

The EPA issued health advisories for four specific PFASs in June 2022, significantly lowering their safe threshold levels for drinking water. PFOA was reduced from 70 ppt to 0.004 ppt, while PFOS was reduced from 70 ppt to 0.02 ppt. A safe level for the compound GenX was set at 10 ppt, while that for PFBS was set at 2000 ppt. While not enforceable, these health advisories are intended to be acted on by states in setting their own drinking water standards.

In August 2022, the EPA proposed to add PFOA and PFOS to its list of hazardous substances under the Superfund law. EPA issued a final rule in April 2024, which requires that polluters pay for investigations and cleanup of these substances.

USGS map showing the number of PFAS detections in tap water samples from select sites across the US.

In April 2024, the EPA issued a final drinking water rule for PFOA, PFOS, GenX, PFBS, PFNA, and PFHxS. Within three years, public water systems must remove these six PFAS to near-zero levels. States may be awarded grants up to $1 billion in aid to help with the initial testing and treatment of water for this purpose.

Legal actions

In February 2017, DuPont and Chemours (a DuPont spin-off) agreed to pay $671 million to settle lawsuits arising from 3,550 personal injury claims related to the releasing of PFASs from their Parkersburg, West Virginia, plant into the drinking water of several thousand residents. This was after a court-created independent scientific panel—the C8 Science Panel—found a "probable link" between C8 exposure and six illnesses: kidney and testicular cancer, ulcerative colitis, thyroid disease, pregnancy-induced hypertension and high cholesterol.

In October 2018, a class action suit was filed by an Ohio firefighter against several producers of fluorosurfactants, including 3M and DuPont, on behalf of all U.S. residents who may have adverse health effects from exposure to PFASs. The story is told in the film Dark Waters.

In June 2023, 3M reached a US$10.3 billion settlement with several US public water providers to resolve water pollution claims tied to PFAS, while Chemours, DuPont and Corteva settled similar claims for $1.19 billion.

In December 2023, as part of a four-year legal battle, the EPA banned Inhance, a Houston, Texas-based manufacturer that produces an estimated 200 million containers annually with a process that creates PFOA, from using the manufacturing process. In March 2024, the United States Court of Appeals for the Fifth Circuit overturned the ban. While the court did not deny the containers’ health risks, it said that the EPA could not regulate the manufactured containers under Toxic Substances Control Act of 1976, which only addresses "new" chemicals.

State actions

In 2021, Maine became the first U.S. state to ban these compounds in all products by 2030, except for instances deemed "currently unavoidable".

As of October 2020, the states of California, Connecticut, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Vermont, and Wisconsin had enforceable drinking water standards for between two and six types of PFAS. The six chemicals (termed by the Massachusetts Department of Environmental Protection as PFAS6) are measured either individually or summed as a group depending on the standard; they are:

California

In 2021 California banned PFASs for use in food packaging and from infant and children's products and also required PFAS cookware in the state to carry a warning label.

Maine

A program licensed and promoted by the Maine Department of Environmental Protection that provided free municipal wastewater sludge (biosolids) to farmers as fertilizer has resulted in PFAS contamination of local drinking water and farm-grown produce.

Michigan

The Michigan PFAS Action Response Team (MPART) was launched in 2017 and is the first multi-agency action team of its kind in the nation. Agencies representing health, environment, and other branches of state government have joined together to investigate sources and locations of PFAS contamination in the state, take action to protect people's drinking water, and keep the public informed. Groundwater is tested at locations throughout the state by various parties to ensure safety, compliance with regulations, and proactively detect and remedy potential problems. In 2010, the Michigan Department of Environmental Quality (MDEQ) discovered levels of PFASs in groundwater monitoring wells at the former Wurtsmith Air Force Base. In 2024, citizen-led testing near the base in Oscoda discovered high levels of PFAS in foam along the shore of Lake Huron. As additional information became available from other national testing, Michigan expanded its investigations into other locations where PFAS compounds were potentially used. In 2018, the MDEQ's Remediation and Redevelopment Division (RRD) established cleanup criteria for groundwater used as drinking water of 70 ppt of PFOA and PFOS, individually or combined. The RRD staff are responsible for implementing these criteria as part of their ongoing efforts to clean up sites of environmental contamination. The RRD staff are the lead investigators at most of the PFAS sites on the MPART website and also conduct interim response activities, such as coordinating bottled water or filter installations with local health departments at sites under investigation or with known PFAS concerns. Most of the groundwater sampling at PFAS sites under RRD's lead is conducted by contractors familiar with PFAS sampling techniques. The RRD also has a Geologic Services Unit, with staff who install monitoring wells and are also well versed with PFAS sampling techniques. The MDEQ has been conducting environmental clean-up of regulated contaminants for decades. Due to the evolving nature of PFAS regulations as new science becomes available, the RRD is evaluating the need for regular PFAS sampling at Superfund sites and is including an evaluation of PFAS sampling needs as part of a Baseline Environmental Assessment review. Earlier in 2018, the RRD purchased lab equipment that will allow the MDEQ Environmental Lab to conduct analyses of certain PFAS samples. (Currently, most samples are shipped to one of the few labs in the country that conduct PFAS analysis, in California, although private labs in other parts of the country, including Michigan, are starting to offer these services.) As of August 2018, RRD has hired additional staff to work on developing the methodology and conducting PFAS analyses.

In 2020 Michigan Attorney General Dana Nessel filed a lawsuit against 17 companies, including 3M, Chemours, and DuPont, for hiding known health and environmental risks from the state and its residents. Nessel's complaint identifies 37 sites with known contamination. The Michigan Department of Environment, Great Lakes, and Energy introduced some of the strictest drinking water standards in the country for PFAS, setting maximum contaminant levels (MCLs) for PFOA and PFOS to 8 and 16 ppt respectively (down from previous existing groundwater cleanup standards of 70 ppt for both), and introducing MCLs for five other previously unregulated PFAS compounds, limiting PFNA to six ppt, PFHxA to 400,000 ppt, PFHxS to 51 ppt, PFBS to 420 ppt and HFPO-DA to 370 ppt. The change adds 38 additional sites to the state's list of known PFAS contaminated areas, bringing the total number of known sites to 137. About half of these sites are landfills and 13 are former plating facilities.

In 2022 PFOS was found in beef produced at a Michigan farm: the cattle had been fed crops fertilized with contaminated biosolids. State agencies issued a consumption advisory, but did not order a recall, because there currently is no PFOS contamination in beef government standards.

A 2024 study found that "atmospheric deposition could be a significant environmental pathway, particularly for the Great Lakes."

Minnesota

In February 2018, 3M settled a lawsuit for $850 million related to contaminated drinking water in Minnesota.

New Jersey

In 2018 the New Jersey Department of Environmental Protection (NJDEP) published a drinking water standard for PFNA. Public water systems in New Jersey are required to meet an MCL standard of 13 ppt. In 2020 the state set a PFOA standard at 14 ppt and a PFOS standard at 13 ppt.

In 2019 NJDEP filed lawsuits against the owners of two plants that had manufactured PFASs, and two plants that were cited for water pollution from other chemicals. The companies cited are DuPont, Chemours, and 3M. NJDEP also declared five companies to be financially responsible for statewide remediation of the chemicals. Among the companies accused were Arkema and Solvay regarding a West Deptford Facility in Gloucester County, where Arkema manufactured PFASs, but Solvay claims to have never manufactured but only handled PFASs. The companies denied liability and contested the directive. In June 2020, the EPA and New Jersey Department of Environmental Protection published a paper reporting that a unique family of PFAS used by Solvay, chloroperfluoropolyether carboxylates (ClPFPECAs), were contaminating the soils of New Jersey as far from the Solvay facility as 150 km. and the ClPFPECAs were found in water as well.

Later in 2020, the New Jersey state attorney general filed suit in the New Jersey Superior Court against Solvay regarding PFAS contamination of the state's environment. In May 2021, Solvay issued a press release that the company is "discontinuing the use of fluorosurfactants in the U.S.".

New York

In 2016, New York, along with Vermont and New Hampshire, acknowledged PFOA contamination by requesting the EPA to release water quality guidance measures. Contamination has been observed by the New York State Department of Environmental Conservation in Hoosick Falls, Newburgh, Petersburgh, Poestenkill, Mahopac, and Armonk.

After a class action lawsuit, in 2021, the village of Hoosick Falls received a $65.25 million settlement from Saint-Gobain Performance Plastics, Honeywell, 3M, and DuPont due to the disposal of PFAS chemicals into the groundwater of the local water treatment plant.

Washington

Five military installations in Washington State have been identified by the United States Senate Committee on Environment and Public Works as having PFAS contamination. Toward environmental and consumer protections, the Washington State Department of Ecology published a Chemical Action Plan in November 2021, and in June 2022 the governor tasked the Washington State Department of Ecology with phasing out manufacture and import of products containing PFASs. Initial steps taken by the Washington State Department of Health to protect the public from exposure through drinking water have included setting State Action Levels for five PFASs (PFOA, PFOS, PFNA, PFHxS, and PFBS), which were implemented in November 2021.

United Nations

In 2009, PFOS, its salts, and perfluorooctanesulfonyl fluoride, as well as PFOA and PFHxS, were listed as persistent organic pollutants under the Stockholm Convention on Persistent Organic Pollutants due to their ubiquitous, persistent, bioaccumulative, and toxic nature. The convention has been ratified by 186 jurisdictions, but has most notably not been ratified by the United States, Israel, and Malaysia. The long-chain (C9–C21) PFCAs are currently under review for listing.

Occupational exposure

Occupational exposure to PFASs occurs in numerous industries due to the widespread use of the chemicals in products and as an element of industrial process streams. PFASs are used in more than 200 different ways in industries as diverse as electronics and equipment manufacturing, plastic and rubber production, food and textile production, and building and construction. Occupational exposure to PFASs can occur at fluorochemical facilities that produce them and other manufacturing facilities that use them for industrial processing like the chrome plating industry. Workers who handle PFAS-containing products can also be exposed during their work, such as people who install PFAS-containing carpets and leather furniture with PFAS coatings, professional ski-waxers using PFAS-based waxes, and fire-fighters using PFAS-containing foam and wearing flame-resistant protective gear made with PFASs.

Exposure pathways

People who are exposed to PFASs through their jobs typically have higher levels of PFASs in their blood than the general population. While the general population is exposed to PFASs through ingested food and water, occupational exposure includes accidental ingestion, inhalation exposure, and skin contact in settings where PFAS become volatile.

Professional ski wax technicians

Compared to the general public exposed to contaminated drinking water, professional ski wax technicians are more strongly exposed to PFASs (PFOA, PFNA, PFDA, PFHpA, PFDoDA) from the glide wax used to coat the bottom of skis to reduce the friction between the skis and snow. During the coating process, the wax is heated, which releases fumes and airborne particles. Compared to all other reported occupational and residential exposures, ski waxing had the highest total PFAS air concentrations.

Manufacturing workers

People who work at fluorochemical production plants and in manufacturing industries that use PFASs in the industrial process can be exposed to PFASs in the workplace. Much of what we know about PFAS exposure and health effects began with medical surveillance studies of workers exposed to PFASs at fluorochemical production facilities. These studies began in the 1940s and were conducted primarily at U.S. and European manufacturing sites. Between the 1940s and 2000s, thousands of workers exposed to PFASs participated in research studies that advanced scientific understanding of exposure pathways, toxicokinetic properties, and adverse health effects associated with exposure.

The first research study to report elevated organic fluorine levels in the blood of fluorochemical workers was published in 1980. It established inhalation as a potential route of occupational PFAS exposure by reporting measurable levels of organic fluorine in air samples at the facility. Workers at fluorochemical production facilities have higher levels of PFOA and PFOS in their blood than the general population. Serum PFOA levels in fluorochemical workers are generally below 20,000 ng/mL but have been reported as high as 100,000 ng/mL, whereas the mean PFOA concentration among non-occupationally exposed cohorts in the same time frame was 4.9 ng/mL. Among fluorochemical workers, those with direct contact with PFASs have higher PFAS concentrations in their blood than those with intermittent contact or no direct PFAS contact. Blood PFAS levels have been shown to decline when direct contact ceases. PFOA and PFOS levels have declined in U.S. and European fluorochemical workers due to improved facilities, increased usage of personal protective equipment, and the discontinuation of these chemicals from production. Occupational exposure to PFASs in manufacturing continues to be an active area of study in China with numerous investigations linking worker exposure to various PFASs.

Firefighters

Firefighters using aqueous film forming foam (AFFF)

PFASs are commonly used in Class B firefighting foams due to their hydrophobic and lipophobic properties, as well as the stability of the chemicals when exposed to high heat.

Research into occupational exposure for firefighters is emergent, though frequently limited by underpowered study designs. A 2011 cross-sectional analysis of the C8 Health Studies found higher levels of PFHxS in firefighters compared to the sample group of the region, with other PFASs at elevated levels, without reaching statistical significance. A 2014 study in Finland studying eight firefighters over three training sessions observed select PFASs (PFHxS and PFNA) increase in blood samples following each training event. Due to this small sample size, a test of significance was not conducted. A 2015 cross-sectional study conducted in Australia found that PFOS and PFHxS accumulation was positively associated with years of occupational AFFF exposure through firefighting.

Due to their use in training and testing, studies indicate occupational risk for military members and firefighters, as higher levels of PFASs exposure were indicated in military members and firefighters when compared to the general population. PFAS exposure is prevalent among firefighters not only due to its use in emergencies but also because it is used in personal protective equipment. In support of these findings, states like Washington and Colorado have moved to restrict and penalize the use of Class B firefighting foam for firefighter training and testing.

Exposure after September 11 attacks

The September 11 attacks and resulting fires caused the release of toxic chemicals used in materials such as stain-resistant coatings. First responders to this incident were exposed to PFOA, PFNA, and PFHxS through inhalation of dust and smoke released during and after the collapse of the World Trade Center.

Fire responders who were working at or near ground zero were assessed for respiratory and other health effects from exposure to emissions at the World Trade Center. Early clinical testing showed a high prevalence of respiratory health effects. Early symptoms of exposure often presented with persistent coughing and wheezing. PFOA and PFHxS levels were present in both smoke and dust exposure, but first responders exposed to smoke had higher concentrations of PFOA and PFHxS than those exposed to dust.

Mitigation measures

Several strategies have been proposed as a way to protect those who are at greatest risk of occupational exposure to PFAS, including exposure monitoring, regular blood testing, and the use of PFAS-free alternatives such as fluorine-free firefighting foam and plant-based ski wax.

Food and consumer goods

PFASs were found in many plant-based straws, such as paper straws.

Remediation

Main article: Remediation of per- and polyfluoroalkyl substances

Water treatment

Several technologies are currently available for remediating PFASs in liquids. These technologies can be applied to drinking water supplies, groundwater, industrial wastewater, surface water, and other applications such as landfill leachate. Influent concentrations of PFASs can vary by orders of magnitude for specific media or applications. These influent values, along with other general water quality parameters (for example, pH) can influence the performance and operating costs of the treatment technologies. The technologies are:

Private and public sector applications of one or more of these methodologies above are being applied to remediation sites throughout the United States and other international locations. Most solutions involve on-site treatment systems, while others are leveraging off-site infrastructure and facilities, such as a centralized waste treatment facility, to treat and dispose of the PFAS pool of compounds.

The US-based Interstate Technology and Regulatory Council (ITRC) has undertaken an extensive evaluation of ex-situ and in-situ treatment technologies for PFAS-impacted liquid matrices. These technologies are divided into field-implemented technologies, limited application technologies, and developing technologies and typically fit into one of three technology types:

  • Separation
  • Concentration
  • Destruction

The type of PFAS remediation technology selected is often a reflection of the PFAS contamination levels and the PFAS signature (i.e. the combination of short- and long-chain PFAS substances present) in conjunction with the site-specific water chemistry and cross contaminants present in the liquid stream. More complex waters such as landfill leachates and WWTP waters require more robust treatment solutions which are less vulnerable to blockage.

Stripping and enrichment

Foam Fractionation utilizes the air/water interface of a rising air bubble to collect and harvest PFAS molecules. The hydrophobic tail of many long-chain criteria PFAS compounds adhere to this interface and rise to the water surface with the air bubble where they present as a foam for harvesting and further concentration. The foam fractionation technique is a derivation of traditional absorptive bubble separation techniques used by industries for decades to extract amphiphilic contaminants. The absence of a solid absorptive surface reduces consumables and waste byproducts and produces a liquid hyper-concentrate which can be fed into one of the various PFAS destruction technologies. Across various full-scale trials and field applications, this technique provides a simplistic and low operational cost alternative for complex PFAS-impacted waters.

Destruction

In 2007, it was found that high-temperature incineration of sewage sludge reduced the levels of perfluorinated compounds significantly.

A 2022 study published in the Journal of Environmental Engineering found that a heat- and pressure-based technique known as supercritical water oxidation destroyed 99% of the PFAS present in a water sample. During this process, oxidizing substances are added to PFAS-contaminated water and then the liquid is heated above its critical temperature of 374 degrees Celsius at a pressure of more than 220 bars. The water becomes supercritical, and, in this state, water-repellent substances such as PFASs dissolve much more readily.

Theoretical and early-stage solutions

A possible solution for PFAS-contaminated wastewater treatment has been developed by the Michigan State University-Fraunhofer team. Boron-doped diamond electrodes are used for the electrochemical oxidation system where it is capable of breaking PFAS molecular bonds which essentially eliminates the contaminates, leaving fresh water.

Acidimicrobium sp. strain A6 has been shown to be a PFAS and PFOS remediator. PFAS with unsaturated bonds are easier to break down: the commercial dechlorination culture KB1 (contains Dehalococcoides) is capable of breaking down such substances, but not saturated PFAS. When alternative, easier-to-digest substrates are present, microbes may prefer them over PFAS.

Chemical treatment

A study published in Science in August 2022 indicated that perfluoroalkyl carboxylic acids (PFCAs) can be mineralized via heating in a polar aprotic solvent such as dimethyl sulfoxide. Heating PFCAs in an 8 to 1 mixture of dimethyl sulfoxide and water at 80–120 °C (176–248 °F) in the presence of sodium hydroxide caused the removal of the carboxylic acid group at the end of the carbon chain, creating a perfluoroanion that mineralizes into sodium fluoride and other salts such as sodium trifluoroacetate, formate, carbonate, oxalate, and glycolate. The process does not work on perfluorosulfonic acids such as PFOS. A 2022 study published in Chemical Science shows breakdown of C-F bonds and their mineralization as YF3 or YF6 clusters. Another study in the Journal of the American Chemical Society described the PFASs breakdown using metal-organic frameworks (MOFs).

Analytical methods

Analytical methods for PFAS analysis fall into one of two general categories; targeted analysis or non-targeted analysis. Targeted analyses use reference standards to determine concentrations of specific PFAS, but this requires a high-purity standard for each compound of interest. Due to the large number of possible targets, unusual PFAS may go unreported by these methods. Non-targeted analyses measure other factors, such as total organic fluorine, which can be used to estimate the total concentration of PFAS in a sample, but cannot provide concentrations of individual compounds. The two types of analyses are often combined; by subtracting the mass of target analytes from the non-targeted analysis results, one can get an estimate for what fraction of PFAS has been "missed" by the targeted analysis.

Targeted analysis generally use liquid chromatography–mass spectrometry (LC-MS) instruments. Currently, EPA Method 537.1 is approved for use in drinking water and includes 18 PFAS. EPA Method 1633 is undergoing review for use in wastewater, surface water, groundwater, soil, biosolids, sediment, landfill leachate, and fish tissue for 40 PFAS, but is currently being used by many laboratories in the United States. Regulatory limits for PFOA and PFOS set by the US EPA (4 parts-per-trillion) are limited by the capability of methods to detect low level concentrations.

Non-targeted analyses include total organic fluorine (TOF, including variations, e.g., adsorbable organic fluorine, AOF; extractable organic fluorine, EOF), total oxidizable precursor assay, and other methods in development.

Sample chemicals

Some common per- and polyfluoroalkyl substances include:

Name Abbreviation Structural formula Molecular weight (g/mol) CAS No.
Perfluorobutane sulfonamide H-FBSA C4F9SO2NH2 299.12 30334-69-1
Perfluoropentanesulfonamide PFPSA C5F11SO2NH2 349.12 82765-76-2
Perfluorohexanesulfonamide PFHxSA C6F13SO2NH2 399.13 41997-13-1
Perfluoroheptanesulfonamide PFHpSA C7F15SO2NH2 449.14 82765-77-3
Perfluorooctanesulfonamide PFOSA C8F17SO2NH2 499.14 754-91-6
Perfluorobutanesulfonyl fluoride PFBSF C4F9SO2F 302.09 375-72-4
Perfluorooctanesulfonyl fluoride PFOSF C8F17SO2F 502.12 307-35-7

In popular culture

Films

See also

References

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