What are risks of PFAS?

*Note, the following text is derived from our NC State Extension Publication on PFAS: Grieger and May. 2024. Guide to Understanding and Addressing PFAS in our Communities. NC State Extension Publication (AG-955). https://content.ces.ncsu.edu/Guide-to-Understanding-and-Addressing-PFAS-in-our-communities

Introduction

Exposure to per- and polyfluoroalkyl substances (PFAS) is an emerging issue of concern for North Carolina and its residents. The occurrence of PFAS may have significant effects on our health and the environment. Our Extension publication (here) is a guide to understanding and addressing PFAS in our households and communities. Information in this publication may be helpful for Extension agents, community members, and others who are interested in learning more about PFAS and their potential impact on our lives.

The following sections provides a brief overview of key information shared in our Extension publication on PFAS, Guide to Understanding and Addressing PFAS in our Communities,.

What are per- and polyfluoroalkyl substances (PFAS)? 

PFAS are a large group of chemicals that have been manufactured since the 1940s and continue to be widely used in household products today such as cosmetics, non-stick cookware, waterproof clothing, food packaging, and firefighting foams. Many PFAS have interesting, useful properties that include heat, water, or oil-resistance. These same properties make PFAS easy to transport in the environment and also difficult to degrade. In fact, PFAS have been called forever chemicals because they can build up and remain in the environment and our bodies for years.

Today, there are more than 14,000 different PFAS in use, many of which behave uniquely in the environment and our bodies. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate acid (PFOS) are two of the most widely used and investigated types of PFAS. These PFAS are called legacy PFAS because they are among some of the first PFAS in use. The legacy PFAS are also called long chain PFAS because of their molecular structure. PFOA and PFOS have been phased out of production, and have been replaced gradually by thousands of other PFAS. Many replacement PFAS (such as GenX) are known as short chain PFAS because their molecular structure is different from PFOA and PFOS.

How could I be exposed to PFAS?

PFAS are so widely used that they are found in the environment around the world. Most individuals in the United States have been exposed to PFAS during their lifetimes, and the chemicals are detectable in the blood of most Americans. Most individuals are exposed to PFAS through drinking water. Surface water and/or groundwater become contaminated with PFAS, and then enter the public water systems and private wells that residents rely on for drinking water. Residents who live near industries or sites contaminated with PFAS have a greater chance of having contaminated drinking water. According to the Environmental Protection Agency (EPA), most standard water treatment processes do not have the ability to remove PFAS.

Although water is the predominant path through which most individuals are exposed to PFAS, there are other exposure routes, such as eating foods grown in contaminated soil or fish from contaminated water and by breathing or swallowing PFAS-contaminated soil or dust. In addition, individuals can be exposed by using consumer products with PFAS. Those who work in industries that produce or use PFAS, such as manufacturing facilities or the fire service, may be exposed at greater rates than others.

What are the health effects from exposure?

Although research is still in its early stages, there are health effects that have been linked to PFAS exposure. These include:

  • Increased cancer risk: Several studies have reported an association between PFAS exposure and increased risk of some cancers, such as kidney and testicular cancer.
  • Effects on reproduction: PFAS exposure has associated effects on reproduction, including increased rates of infertility.
  • Effects on liver and thyroid glands: Studies have also reported an association between PFAS exposure and liver damage, changes in liver function, and changes in the levels of thyroid hormone.
  • Effects on childhood development and behavior: Exposure to PFAS has been linked to developmental issues in children that include reduced birth weight, delayed cognitive development, and changes in hormone levels.
  • Weakened immune function: Some studies have suggested that exposure to PFAS may weaken the immune system and increase individual susceptibility to infections.
  • Increased risk of obesity: Exposure to PFAS has been associated with increased body weight and body mass index in both adults and children.

The effects of PFAS exposure may depend on how often, how long, and how high the levels are, in addition to personal factors as age, sex, and overall health. Children may be more vulnerable than adults, given their higher rates of consumption of food and water relative to their body weight. To fully understand the extent of health effects from exposure to the thousands of PFAS currently in use, much more research is needed.

Can I have my drinking water tested for PFAS?

Drinking water is one of the primary ways in which humans and animals are exposed to PFAS. If you wish to have your drinking water tested for PFAS, the steps to take depend on the source of your water and your location. For more details on drinking water testing options, see our Extension publication here.

Agricultural producers can also request PFAS testing in water through a federal program associated with the US Department of Agriculture (USDA). The Conservation Evaluation and Monitoring Activity (CEMA) 209 offers testing to detect and measure PFAS in water and soil. This provides producers with a prescreening level of PFAS at their agricultural operation.

What are regulatory agencies doing to address PFAS?

After extensive research on PFAS, U.S. government agencies have begun to act. In 2023, the Environmental Protection Agency (EPA) proposed new regulations for six PFAS in public water systems , under the National Primary Drinking Water Regulation (NPDWR). The EPA proposed a maximum contaminant level (MCL) for PFOA and PFOS of four parts per trillion (ppt). The MCLs are the highest concentration of a contaminant that is allowed in drinking water at the water treatment plant. EPA’s NPDWR will also regulate four other PFAS chemicals, including GenX, PFNA, PFHxS, and PFBS. For these PFAS, a hazard index calculation is used to estimate if the combined concentrations pose a risk to human health. After being finalized, the proposed rule will go into effect in three years. In addition to regulation of these six PFAS in drinking water, the EPA also issued lifetime drinking water health advisory levels for GenX and PFBS at 10 ppt and 2,000 ppt, respectively. Health advisory levels are unenforceable guidelines that represent the concentration of a contaminant in drinking water from which no adverse health effects are expected to occur.

In North Carolina, the Department of Environmental Quality (NCDEQ) released an action strategy for PFAS in 2022 that included three key areas: 1) protecting communities from exposures to PFAS, 2) protecting drinking water sources through regulatory standards and pollution prevention, and 3) cleaning up contaminated sites that may affect human health and drinking water sources. Also in 2022 and over a three-month period, the NC DEQ tested 50 different municipal and county water systems that were associated with higher rates of PFOA and PFOS contamination over a three-month period. For details, see the DEQ Sampling of Public Water Systems. In addition, the NC DEQ is collecting discharge information to better understand exposures through emissions (such as air and water emissions from industrial sites) and health effects from PFAS exposures. The NC DEQ is developing emission permit conditions across the state and has begun requiring the disclosure of emission and discharge data. The NC DEQ has also proposed PFAS regulatory standards for ground and surface waters as well as drinking water standards (such as MCLs). These standards are expected to be a combination of enforceable regulations and voluntary actions. Finally, the NC DHHS recently introduced recommended limits on the consumption of certain freshwater fish found in the middle and lower Cape Fear River after detecting elevated levels of multiple PFAS, including PFOS, in fish collected from these areas. Similar to North Carolina, other states have begun setting regulatory limits for PFAS due to potential health and environmental concerns.

How can I learn more? 

If you are interested in learning more about PFAS and how to protect yourself or your community from potential exposures, the following resources may be helpful.