Per- and polyfluoroalkyl substances (PFAS) have earned the nickname "forever chemicals" for a reason. They often persist for years in the environment and in the human body. Research indicates that PFAS causes a whole range of serious health issues. So, why is it still so common in our water supplies?

Why are PFAS compounds so widespread

PFAS have been widely used for their ability to resist heat, oil, and water. They also act as powerful surfactants (compounds that alter the surface tension of water). These properties have made PFAS one of the most widely used groups of compounds in manufacturing. 

PFAS makes cookware nonstick, fast food containers greaseproof, fabrics stain resistant, and clothing waterproof. But they are also widely used in industrial settings including as lubricants, in fire fighting foams, and in the manufacture of semiconductors.

Many PFAS compounds are readily soluble in water and they are incredibly resistant to breaking down. This, combined with their widespread use, has resulted in their presence in every environment on the planet. This includes almost all our water sources, as well as the land used to grow our food. That is worrying enough. But research is continually uncovering new and disturbing health risks associated with PFAS exposure. And most of us are still being exposed to these chemicals daily. 

The growing understanding of PFAS health risks

Since the 1970s, concerns have been growing about the potential health effects of PFAS. However, research into these compounds is slow and complex. But the body of scientific evidence linking PFAS exposure to adverse health effects has grown significantly in recent years. As a result, we are starting to better understand the potential threat they cause.

Immunosuppression 

Several studies have linked PFAS with suppressed immune system and reduced vaccination response. As a result, many scientists classify PFAS as immunosuppressants. This is particularly concerning for parents since young children have less developed immune systems, and are constantly exposed to PFAS in their environment.

Metabolic diseases

Another set of studies links PFAS with a range of metabolic diseases. For instance, there is a proven link between increased PFAS exposure and dyslipidemia (high cholesterol). In turn, PFAS is associated with obesity, Metabolic Syndrome, and cardiovascular disease. Some studies even suggest a link with type 2 diabetes.

The exact mechanisms are unclear, but many PFAS compounds have structures that are similar to hormones in the body. This means that PFAS serve to disrupt the endocrine system. This also leads to a clear link between PFAS exposure and thyroid disease. It may also explain why PFAS causes low birth weight and premature birth.

Cancer

One of the most worrying aspects of PFAS is the link with cancer. In particular, they are linked with testicular, pancreatic, and kidney cancer. The International Agency for Research on Cancer (IARC) has already classified some PFAS as human carcinogens. Research is ongoing, made harder by the fact that almost all humans have some level of PFAS in their body. But we are seeing increasing numbers of reports that indicate at least a correlation between PFAS and many types of cancer. So, it seems like the entire class of PFAS chemicals is becoming a critical public health issue.

Why drinking water is your biggest PFAS risk

As mentioned above, many PFAS compounds are readily soluble in water. But they are incredibly hard to remove. Even more worrying, they seem to have become embedded in the water cycle. This has resulted in measurable levels of PFAS being detected in rain and snowfall wherever scientists have conducted experiments. 

The upshot is that around 100M US residents are exposed to high levels of PFAS in their municipal water. It is likely that a significant proportion of people drinking well water are also being exposed. This makes drinking water the single most important source of PFAS exposure for most people.

EPA Guidelines on Water PFAS Pollution

Over recent years, the Environmental Protection Agency (EPA) has actively addressed this issue, introducing statutory enforceable limits for certain types of PFAS in drinking water. The proposed rule sets maximum contaminant levels (MCLs) of 4 parts per trillion for two of the most-studied chemicals: PFOA and PFOS. 

The EPA is also proposing a hazard index approach to regulate four other PFAS: PFNA, PFHxS, PFBS, and GenX chemicals. This approach accounts for the cumulative risk posed by mixtures of these chemicals, recognizing that people are rarely exposed to just one compound in isolation. The hazard index would ensure that water systems monitor for these chemicals and take action if the combined level of these four PFAS poses a health risk.

Originally, this rule change was slated to come into effect by now but ongoing public consultations and political wrangling has caused some delay. Meanwhile, a growing number of states have started to impose their own controls.

Reducing your risk

You may be worried about how you and your family are affected by PFAS. Fortunately, there are a few things you can do to reduce your risk.

Reduce your exposure

This involves either avoiding or reducing the amount of PFAS in your food and drink. 

Filter Your Water: Not all water filters are created equal when it comes to PFAS. Look for filtration systems certified by independent third parties like NSF International. The most effective technologies for PFAS removal are:

• Granular Activated Carbon (GAC): Effective, especially in pitcher or faucet-mount filters, but requires regular replacement to maintain efficacy.
• Reverse Osmosis (RO): Considered the gold standard for removing a wide range of contaminants, including PFAS. RO systems are typically installed under the sink and treat water for drinking and cooking.

Avoid Exposure from Consumer Products: Many household and consumer products incorporate PFAS. This can get into your food, or even be absorbed through the skin. 

• Cookware: Switch to stainless steel, cast iron, or ceramic cookware instead of traditional nonstick pans.
• Food Packaging: Limit consumption of fast food or greasy takeout, as the wrappers, bags, and boxes are often treated with grease-resistant PFAS.
• Clothing/Furniture: Choose items that are not marketed as "stain-repellent" or "waterproof," as these coatings typically contain PFAS.

Take nutraceuticals and other supplements

There is increasing evidence that supplements may help protect against PFAS exposure. Cambiotics made headlines earlier this year for their microbiotic treatment that has been proven to reduce PFAS levels. Meanwhile, there are several other startups seeking to develop nutritional supplements that reduce PFAS. One such product is from NeutraOat. Their modified oat fiber is shown to absorb and reduce PFAS in the gut, thus reducing overall PFAS exposure. Other research has indicated that treatments for high cholesterol may also help to reduce PFAS. 

Monitor PFAS levels at home

If you are really concerned about PFAS, you can get at-home test kits to monitor the levels in both your blood and water supply. For instance, our PFAS Core Panel allows you to easily test your blood using a special microsampler device. You simply stick your finger with a lancet (like for a blood sugar test), collect a few drops of blood on the device, and mail it to our CLIA-certified lab. You then get your report back within a couple of weeks. If your levels are too high, you can take steps to identify and reduce the major sources of exposure. 

By understanding the risks and taking decisive action, you can significantly reduce your exposure to the persistent threat of PFAS pollution. Protecting public health starts with informed decisions in our own homes.

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