Lauren Zajac, MD, MPH, FAAP
Some drinking water systems in the United States are contaminated with perfluoroalkyl and polyfluoroalkyl substances, which are sometimes called the “forever chemicals." As a parent, you may wonder if these can affect your children's health, and how to limit exposure to these chemicals. This article gives an overview of perfluoroalkyl and polyfluoroalkyl substances (PFAS) and simple steps you can take to reduce exposure.
What are PFAS and why are they called “forever chemicals?"
PFAS stands for “perfluoroalkyl and polyfluoroalkyl substances," which are a group of human-made chemicals. PFAS have been used in many consumer and commercial products since the 1950s because they are durable and resistant to heat. They are known as the “forever chemicals" because they do not break down in the environment. As a result, they remain in soil and water for very long periods of time.
There are thousands of types of PFAS chemicals. Two common types are:
Where are PFAS found? How can my family be exposed?
The most common way PFAS can get into the body is when we eat or drink them. PFAS can be found in the following places:
PFAS may be in certain foods, like
fish and shellfish raised in waters contaminated with PFAS.
Food packaging like pizza boxes, popcorn bags, and fast food containers may be coated with PFAS to prevent sticking and leakage.
Water supplies (including public water systems and private water wells) can be contaminated with PFAS from local industries or the use of firefighting foam.
How long can PFAS stay in the body?
PFAS chemicals can remain in the body for many years.
How can PFAS affect health?
We currently do not have a clear answer on how PFAS can impact health but there are
scientific studies going on right now to help us answer this question. Some of these studies show a possible connection between PFAS exposure and higher
cholesterol levels, as well as effects on the hormone system, immune system, liver, and kidneys.
Can PFAS exposure be detected in a blood test?
Yes, but not for medical purposes. Blood testing for PFAS in children and adults has been done in several U.S. communities for public health research. While all people in the United States have a
detectable level of PFAS in their bodies because of their widespread use, these studies are looking at the levels of PFAS in the blood of people using a contaminated water supply. At this time, the results of the tests cannot be used to predict risk of health effects from PFAS exposure.
Should I ask my pediatrician to test my child's blood for PFAS?
No. Although some PFAS chemicals can be measured in blood, it involves specialized technology that is typically not available at commercial or clinical laboratories. Also, the results do not help doctors make medical decisions or predict future health effects. At most, the levels can be compared to the average levels in the blood of people in the United States.
Should I ask my pediatrician to test my child's blood for evidence of PFAS health effects?
No. It is not necessary to do blood work to look at cholesterol, liver, kidney, and hormones in children because of PFAS in the water supply. However, your pediatrician may order these tests for other reasons that are not related to PFAS. Remember,
routine check-ups, immunizations, screening for
cholesterol in children between age 9 to 11 years, and other standard preventive services and screening tests with your pediatrician is recommended.
Is there a treatment to remove PFAS from the body?
No. The best treatment is to prevent future exposures as much as possible. There is no known medication that can speed up the body's removal of PFAS.
Can I breastfeed my baby if I live in a community with PFAS water contamination?
Yes. There is no medical reason to stop breastfeeding due to PFAS concerns. The advantages of
breastfeeding for mom and baby outweigh potential risks of exposure to PFAS through breastmilk. Breastfeeding moms can reduce further exposure to PFAS chemicals by drinking bottled water until their water system improves.
Can PFAS be removed from the drinking water supply?
Yes. There are
ways to reduce PFAS levels in water systems with elevated levels of these chemicals. Some water systems have installed state-of-the-art filters that remove PFAS and other chemicals. Others have found new sources of water that do not have elevated levels of PFAS.
What is being done to reduce PFAS in water supplies across the country?
The Environmental Protection Agency (EPA) set a federal “health advisory" level of 70 parts per trillion for PFOS and PFOA in public water systems; however, this is not a required or enforceable standard. Several states have set their own enforceable limits for PFAS in public water systems that are stricter than the EPA health advisory level.
Consumer Confidence Reports are available so you can learn more about your local water system, and review the most recent water testing results. If you have a private water well,
Learn more about what tests are recommended to ensure your well water is safe to drink. You can also find out if the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) are working on
PFAS studies in your area.
Talk with your pediatrician
If you have questions about PFAS exposure, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU
) have staff who can also talk with parents about concerns over environmental toxins.
About Dr. Zajac
Lauren Zajac, MD, MPH, FAAP, an executive committee member of the American Academy of Pediatrics Council on Environmental Health, is an Assistant Professor in the Department of Environmental Medicine and Public Health and the Department of Pediatrics at the Icahn School of Medicine at Mount Sinai. Dr. Zajac serves as a pediatrician at the Region 2 Pediatric Environmental Health Specialty Unit, serving New Jersey, New York, Puerto Rico and the U.S. Virgin Islands. (serving NJ, NY, PR and USVI).