How PFAS Are Impacting Human Health

By Dr. Chinta SidharthanReviewed by Lily Ramsey, LLM

What are PFAS, and why are they a problem?
Human exposure pathways and health risks
Global regulations and industrial backlash
Innovations in PFAS removal and detection
Future perspectives and public health strategy

In many regions of the world, including developed nations, drinking water is contaminated with invisible chemicals linked to cancer, immune disorders, and developmental delays.

Across the globe, per- and poly-fluoroalkyl substances (PFAS) — often called ‘forever chemicals’ due to their persistence in the environment — have seeped into drinking water, soil, and even the human bloodstream.

PFAS are synthetic chemicals that have been widely used since the mid-20th century. These chemicals were valued for their resistance to heat, water, and oil.

However, their persistence in the environment and bioaccumulation in living organisms have raised serious health concerns, with a growing body of research linking PFAS exposure to serious health concerns, including thyroid dysfunction, developmental issues, immunotoxicity, and cancer.^1–4

This article explores pathways of human exposure to PFAS, current epidemiological findings, regulatory developments in the European Union (EU) and the United States (US), industrial accountability, ongoing lawsuits, remediation technologies, and emerging PFAS detection tools.

Image Credit: Dabuch/Shutterstock.com

What are PFAS, and why are they a problem?

PFAS are a diverse group of synthetic compounds used in industrial applications and consumer products, such as firefighting foams, non-stick cookware, water-resistant textiles, and food packaging.

Their strong carbon-fluorine bonds make them highly resistant to environmental degradation, leading to widespread contamination of water supplies and ecosystems.^1–3

The persistence of PFAS in terrestrial and aquatic environments has resulted in bioaccumulation in plants, animals, and humans, raising concerns about long-term exposure. Furthermore, PFAS come in thousands of distinct types, further complicating regulatory efforts and scientific research.^1,2

Due to their stability and mobility, PFAS have been detected in some of the most remote regions, from Arctic ice to deep-sea environments, illustrating their global impact.

The challenge of addressing PFAS pollution is exacerbated by the fact that many industries continue to manufacture and use these substances despite growing evidence of their harm.³

Human exposure pathways and health risks

Humans are exposed to PFAS through contaminated drinking water, diet, household pollutants, consumer products, and occupational settings. Drinking water contamination is a significant concern, particularly in communities near industrial sites, military bases, and areas where PFAS-containing firefighting foams have been used.¹

Studies have shown that even low-level PFAS exposure through drinking water can lead to significant health effects over time. Additionally, PFAS have been found in food packaging, where they can leach into food and increase dietary exposure.^1,3

Substantial research has also linked exposure to PFAS to numerous diseases in humans. Epidemiological studies have found that PFAS exposure can increase the risk of kidney and testicular cancer.

The exact mechanisms are still being studied, but oxidative stress, immune suppression, and endocrine disruption are suspected contributors. Researchers have also found associations between PFAS exposure and pancreatic, breast, and liver cancers, indicating the need for further investigation.^1,2,4

Additionally, PFAS exposure has also been associated with interference with thyroid hormone regulation, potentially leading to hypothyroidism and other endocrine disorders.

Disruption of thyroid function also affects metabolism, growth, and development. Some studies suggest that even low levels of PFAS can alter thyroid hormone levels, increasing the risk of metabolic disorders.^1,2

Prenatal and early-life exposure to PFAS is also associated with low birth weight, developmental delays, immune dysfunction, and behavioral issues. Studies have shown that PFAS can cross the placenta and get transferred through breast milk, resulting in early-life exposure.

Research has also linked PFAS to decreased fertility, with evidence suggesting that they may disrupt hormone regulation critical for reproductive health.^1–3

Moreover, PFAS exposure has been shown to weaken immune responses, reducing vaccine efficacy and increasing susceptibility to infections. Research indicates that PFAS may impair immune cell function and disrupt immune signaling pathways. A growing body of evidence suggests that children exposed to PFAS may have a reduced immune response to routine vaccinations.^1,2,5

Among PFAS, long-chain PFAS, such as perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are more bioaccumulative and toxic due to their longer half-lives in the human body.

However, short-chain PFAS still pose environmental and health concerns, as they may have similar toxic effects. Some regulatory bodies are now calling for a ban on both long-chain and short-chain PFAS due to their persistent nature and potential for harm.^1–3

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Global regulations and industrial backlash

Recognizing the dangers of PFAS, governments worldwide have begun implementing numerous regulatory measures for the production and use of PFAS. The EU has restricted the use of PFOS since 2006 and continues to push for broader bans on PFAS substances.

A proposed PFAS restriction under the EU’s Registration, Evaluation, Authorization, and Restriction of Chemicals or REACH regulation is aimed at achieving one of the most comprehensive PFAS bans globally.¹

The US Environmental Protection Agency (EPA) has also issued health advisories and is moving toward enforceable limits for PFAS in drinking water. Some states have enacted stricter regulations than federal guidelines.

Moreover, litigation against PFAS manufacturers has resulted in multi-million-dollar settlements, with companies such as Dupont/Chemours and 3M being held accountable for environmental contamination.^1,4,6

However, despite regulatory progress, enforcement remains challenging due to industry resistance, economic considerations, and scientific uncertainties. Internal documents from chemical manufacturers reveal that companies were aware of PFAS toxicity decades ago but withheld this information from the public, delaying regulatory action.⁴

Moreover, industrial stakeholders continue to challenge regulations, arguing that alternative materials may be costly and lack the same functional properties as PFAS.^1,7

Innovations in PFAS removal and detection

The widespread contamination of the environment by PFAS and the growing evidence of its impact on human health has highlighted the necessity for effective remediation and detection technologies.

Remediation technologies for the removal of PFAS from contaminated water have evolved significantly in recent times. Traditional methods such as activated carbon filtration and ion exchange resins, which function on the principles of membrane filtration and adsorption, have been commonly used but have limitations in capturing smaller PFAS molecules.²

Researchers are now exploring metal-organic frameworks (MOFs), which are porous crystalline solids that have an ordered structure with extremely large internal surface areas, for selectively adsorbing PFAS from contaminated water.²

Emerging techniques in electrochemical and plasma-based degradation are also focusing on breaking down PFAS at the molecular level, offering potential solutions for the destruction of these compounds. These methods are promising but require further optimization for large-scale applications.²

However, new analytical advancements are also improving PFAS monitoring and risk assessment. Total fluorine measurements provide a more comprehensive picture of PFAS exposure by assessing overall fluorine content rather than focusing on individual compounds.³

Meanwhile, high-resolution mass spectrometry allows for suspect screening of PFAS precursors and previously unidentified organofluorine compounds, aiding regulatory efforts.

Additionally, portable testing kits are being developed to facilitate on-site PFAS detection, enabling communities to assess water quality in real-time.¹

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Future perspectives and public health strategy

Addressing PFAS contamination requires a comprehensive, multi-faceted approach that incorporates scientific research, policy changes, and public engagement. Expanding research efforts is essential to fully understand PFAS toxicity, including cumulative exposure risks and interactions between different PFAS compounds.

Additionally, enhancing detection methods through globally standardized and accessible testing techniques will improve monitoring and regulatory enforcement.²

Stronger regulations are also needed to establish enforceable limits on PFAS in water, soil, and air while promoting safer industrial alternatives. At the same time, investment in advanced remediation technologies is crucial to mitigate contamination and prevent further environmental damage.¹

Public awareness and advocacy play a key role in driving policy changes and ensuring industries remain accountable for their role in PFAS pollution. Since PFAS contamination is a global issue, international cooperation is necessary to standardize regulations, share scientific advancements, and develop sustainable solutions.

The urgency and seriousness of PFAS-related health risks underscores the need for coordinated efforts to limit exposure, enhance scientific understanding, and establish effective mitigation strategies.

Increased public pressure, legal actions, and regulatory momentum may pave the way for a future where PFAS pollution is effectively managed, safeguarding the health of both humans and ecosystems.

References

1. Brennan, N. M., Evans, A. T., Fritz, M. K., Peak, S. A., & von Holst, H. E. (2021). Trends in the Regulation of Per- and Polyfluoroalkyl Substances (PFAS): A Scoping Review. International journal of environmental research and public health, 18(20), 10900. https://doi.org/10.3390/ijerph182010900
2. FitzGerald, L. I., Olorunyomi, J. F., Singh, R., & Doherty, C. M. (2022). Towards solving the PFAS problem: The potential role of metal-organic frameworks. ChemSusChem, 15, 19. https://doi.org/10.1002/cssc.202201136
3. De Silva, A. O., Armitage, J. M., Bruton, T. A., Dassuncao, C., Heiger-Bernays, W., Hu, X. C., Kärrman, A., Kelly, B., Ng, C., Robuck, A., Sun, M., Webster, T. F., & Sunderland, E. M. (2021). PFAS Exposure Pathways for Humans and Wildlife: A Synthesis of Current Knowledge and Key Gaps in Understanding. Environmental toxicology and chemistry, 40(3), 631–657. https://doi.org/10.1002/etc.4935
4. Gaber, N., Bero, L., & Woodruff, T. J. (2023). The Devil they Knew: Chemical Documents Analysis of Industry Influence on PFAS Science. Annals of global health, 89(1), 37. https://doi.org/10.5334/aogh.4013
5. Dong, X., & Yang, J. Z. (2024). Conflicted and Relevant: Systematic Processing of Information on PFAS Contamination. Health communication, 39(13), 3493–3501. https://doi.org/10.1080/10410236.2024.2328456
6. Ng, C., Cousins, I. T., DeWitt, J. C., Glüge, J., Goldenman, G., Herzke, D., Lohmann, R., Miller, M., Patton, S., Scheringer, M., Trier, X., & Wang, Z. (2021). Addressing Urgent Questions for PFAS in the 21st Century. Environmental science & technology, 55(19), 12755–12765. https://doi.org/10.1021/acs.est.1c03386
7. Wickham, G. M., & Shriver, T. E. (2021). Emerging contaminants, coerced ignorance and environmental health concerns: The case of per- and polyfluoroalkyl substances (PFAS). Sociology of health & illness, 43(3), 764–778. https://doi.org/10.1111/1467-9566.13253