“Forever chemicals” alarm bells! The hidden threats PFAS poses to health and the environment are fully exposed

PFAS are “permanent chemicals” that are difficult to decompose and are widely found in industrial and daily necessities. They are quietly contaminating water resources and accumulating in the human body, causing health risks such as cancer and immune abnormalities. Countries are launching dual responses with policies and science and technology.

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a large and diverse group of synthetic chemicals that have been widely used in industrial and consumer products since the mid-20th century due to their unique properties, including resistance to water, oil, and heat1. The main characteristic of PFAS is its strong carbon-fluorine bond, which is one of the strongest single bonds in all organic chemistry. This makes them extremely difficult to degrade in the environment and organisms, so they are called “forever chemicals.”2. This extraordinary stability is both an advantage of PFAS in industry and a major reason why they cause long-term contamination of the environment and pose potential risks to health.

PFAS are used in a wide range of applications, including in manufacturing as water-, oil- and fire-resistant coatings, emulsifiers and surfactants, and in consumer products such as non-stick cookware, food packaging and stain-resistant textiles1. However, there are growing global concerns about PFAS due to their persistence, bioaccumulation, and potential toxicity to ecosystems and human health2. This report aims to provide an in-depth analysis of PFAS’ environmental persistence, contamination pathways in water resources, purification challenges, links to chronic diseases, and the measures taken by the scientific community and policymakers to address these risks, in order to comprehensively assess the potential harm of PFAS to the environment and health.

PFAS are highly persistent primarily because of the perfluoroalkyl moiety in their chemical structure. The perfluoroalkyl moiety is extremely resistant to environmental and metabolic degradation due to the strength of the carbon-fluorine bond, the presence of multiple carbon-fluorine bonds on the same carbon atom, and the strong electron-withdrawing effect of fluorine4. This extreme stability means that the vast majority of PFAS either fail to degrade or are eventually converted into stable end products that are still PFAS. The continued release of these highly persistent chemicals will inevitably lead to widespread, long-term and increasing contamination2。

Bioaccumulation is the process by which PFAS accumulate in organisms over time because they are not easily metabolized or excreted from the body.5. Research shows that there are significant differences in the ability of different species to bioaccumulate PFAS. This difference is affected by a variety of ecological characteristics such as species, body size, habitat and feeding habits.9. For example, a study of the North Atlantic food web found that benthic omnivores and pelagic carnivores had the highest concentrations of PFAS9. There are also concerns about biomagnification, where PFAS concentrations increase as you move up trophic levels in the food chain, posing a potential risk to apex predators, including humans.2. Notably, while the production and use of some traditional long-chain PFAS has been phased out in many countries, the bioaccumulation potential and long-term effects of replacement short-chain PFAS, as well as other novel PFAS, remain largely unknown.8。

PFAS can contaminate water resources through various man-made ways5. Industrial emissions are one of the important sources of pollution, and factories that produce or use PFAS, such as electroplating, electronics, and textile manufacturing plants, may discharge these chemicals into surrounding waters.6. Another major source is aqueous film-forming foam (AFFF), which is widely used in airports, military bases and firefighting training sites to extinguish flammable liquid fires5. In addition, waste containing PFAS ends up in landfills, and leachate from rainwater seeping through the garbage layer may carry PFAS into groundwater and surface water.7. Even treated wastewater can be a pathway for PFAS to enter the environment because traditional wastewater treatment plants are often not equipped to remove PFAS.7. In agriculture, the use of PFAS-containing sewage sludge as fertilizer may also contaminate soil and subsequently groundwater and surface water.5. Atmospheric deposition, including long-distance transport of volatile PFAS, is also a pathway for PFAS contamination5. Finally, various types of consumer products containing PFAS may also release these chemicals into the environment during use or disposal.1。

Studies generally agree that drinking contaminated water is the main way humans are exposed to PFAS6. Of concern, people living in communities with higher proportions of Black and Hispanic/Latinx residents are more likely to have harmful levels of PFAS in their water systems, which is related to the fact that sources of PFAS contamination (such as major manufacturers, airports, military bases, wastewater treatment plants, and landfills) are disproportionately located near the watersheds that serve these communities.59. Groundwater and subsurface soil layers may also be hotspots for PFAS accumulation and may further contaminate drinking water sources6。

Due to the unique chemical properties of PFAS, traditional water treatment methods are often ineffective at removing these substances.6. For example, processes such as coagulation, flocculation, filtration, chlorination and ozonation commonly used in full-scale drinking water treatment plants often have limited effectiveness in removing PFAS. This is because PFAS are highly chemically stable and water-soluble, allowing them to easily pass through these traditional treatment systems.

Currently, there are three main technologies considered effective in removing PFAS from drinking water42：

• Granular activated carbon (GAC) adsorption: GAC is a porous material that can remove PFAS from water through adsorption. GAC is generally more effective against longer chain PFAS, but may be less efficient at removing shorter chain PFAS. In addition, the presence of other organic matter in the water may also reduce the adsorption efficiency of GAC67。
• Ion exchange resin (IX): IX resin has a charge that attracts and removes oppositely charged PFAS ions. Compared with GAC, IX resin may have better removal effect on short-chain PFAS and have higher adsorption capacity. However, IX resin needs to be treated after use or regenerated to remove adsorbed PFAS, but the regeneration process will produce high-concentration PFAS wastewater67。
• Reverse Osmosis (RO): RO is a technology that uses high pressure to pass water through a semi-permeable membrane, which can effectively remove a variety of contaminants including short-chain and long-chain PFAS. RO has a high removal rate, but it also consumes a lot of energy and produces a concentrated wastewater stream that requires further treatment.67。

In addition to these mature technologies, there are also some emerging technologies under development, such as electrochemical oxidation, plasma technology, photocatalysis, sonochemical degradation, supercritical water oxidation, electron beam technology and foam separation, etc.5. These technologies hold the promise of providing more sustainable and thorough methods of removing or destroying PFAS, but many are still in the laboratory or experimental stage and face challenges in scaling up, cost-effectiveness, and by-product formation. It is important to note that regardless of the removal technology used, dealing with the resulting PFAS-rich wastes (such as spent activated carbon, ion exchange resins or reverse osmosis concentrates) is a significant challenge and requires safe and effective disposal or destruction methods.6。

A growing number of epidemiological studies demonstrate links between PFAS exposure and various adverse health outcomes in humans2. These associations include an increased risk of certain cancers, such as kidney, testicular, prostate, and possibly ovarian and thyroid cancers2. Regarding prostate cancer, a meta-analysis finds a positive association between PFOS exposure and risk96. For ovarian cancer, mixed PFAS exposure linked to increased risk96. However, existing epidemiological evidence on the association between PFAS exposure and breast cancer risk is insufficient, and study results are heterogeneous.97. Regarding the association between PFAS exposure and thyroid cancer, the results of the meta-analysis were also not significant, indicating that more longitudinal studies are needed to elucidate its role.99。

PFAS exposure has also been linked to impaired immune system function in children, including reduced antibody responses to some vaccines and an increased risk of infection7. Additionally, research suggests that exposure to PFAS during pregnancy may have adverse effects on children’s neurodevelopment, such as possible effects on IQ and executive function7. Other potential health effects include interfering with the body’s natural hormones, increasing cholesterol levels, altering liver enzymes, and being associated with gestational hypertension and preeclampsia7. However, determining the precise relationship between specific PFAS and specific health effects remains challenging due to the wide variety of PFAS, varying exposure pathways and levels, and varying research priorities.7。

Governments and international organizations are taking increasing measures to address PFAS contamination.6. The U.S. Environmental Protection Agency (EPA) issued the first legally binding national drinking water standards in April 2024, limiting levels of six PFAS30. These standards include a Maximum Contaminant Level (MCL) of 4.0 ppt (parts per trillion) for PFOA and PFOS, and an MCL of 10 ppt for PFHxS, PFNA and HFPO-DA (commonly known as GenX chemicals). In addition, the EPA has set a hazard index MCL of 1 for mixtures containing at least two PFAS (PFHxS, PFNA, HFPO-DA and PFBS).

Table 1: EPA final national maximum contaminant levels for PFAS in drinking water

compound	Final MCLG (ppt)	Final MCL (ppt)
Perfluorooctanoic acid (PFOA)	zero	4.0
Perfluorooctane sulfonate (PFOS)	zero	4.0
Perfluorohexane sulfonate (PFHxS)	10	10
Perfluorononanoic acid (PFNA)	10	10
Hexafluoropropylene oxide dimer acid (HFPO-DA) (GenX Chemicals)	10	10
Mixture (PFHxS, PFNA, HFPO-DA, PFBS) (Hazard Index)	1	1

In the EU, regulation of PFAS is also being strengthened, including the revised Drinking Water Directive setting limits for the sum of 20 individual PFAS in drinking water, as well as limits for the total concentration of all PFAS30. Some EU countries, such as Denmark, Sweden and Germany, have adopted stricter measures than the EU30. In addition, many countries, including the United States and the European Union, participate in the Stockholm Convention on Persistent Organic Pollutants, which seeks to limit the production and use of hazardous chemicals, including certain PFAS.35. In the United States, some states are also actively developing their own drinking water standards and product bans32。

Scientific research plays a vital role in informing risk assessments, health advice and policy development. Government agencies (such as the U.S. Environmental Protection Agency, Centers for Disease Control and Prevention/Administration of Toxic Substances and Disease Registry, National Institute of Environmental Health Sciences) and academic institutions are actively conducting research on PFAS to better understand their sources, environmental fate, toxicity, and effective remediation technologies1. However, regulatory challenges remain due to the wide variety of PFAS, complex exposure pathways, and an evolving understanding of their long-term effects.

Based on the above research results, PFAS poses significant potential risks to the ecological environment and human health. Their environmental persistence results in widespread and ongoing contamination, while their bioaccumulation allows these chemicals to accumulate in the food chain, where they may ultimately cause harm to top consumers, including humans. PFAS contaminates water resources in various ways, from industrial emissions to the use of consumer products, putting drinking water in many areas at risk of contamination. While some purification technologies exist for removing PFAS from water, these have limitations in terms of effectiveness, cost and waste management. Epidemiological evidence shows that PFAS exposure is associated with an increased risk of a variety of chronic diseases, including certain cancers, immune system disorders, and developmental problems. Ecological risks are also significant. PFAS have been shown to be toxic to aquatic life and may have knock-on effects on the entire ecosystem through the food web.6. Due to the persistence of PFAS, existing contamination will persist for a long time even if its use is stopped, posing a long-term threat to the environment and human health.

Addressing the challenges posed by PFAS requires close collaboration between science and policy. Continued scientific research is critical to a deeper understanding of the sources, fate, and toxicity of PFAS and the development of effective detection, removal, and destruction technologies1. The findings of scientific research should inform the development of health-based guidelines and regulatory standards by government agencies and international organizations6. Policy plays a key role in limiting PFAS use and releases, setting water quality standards, and funding research and remediation efforts6. Given the wide variety of PFAS, a comprehensive strategy is needed that not only targets specific PFAS but considers entire classes of chemicals to prevent the creation of alternative but equally harmful substances. International cooperation is also critical to tackling this global problem.

This report summarizes the significant risks PFAS pose to the environment and human health. The persistence and widespread presence of these “forever chemicals” and the limitations of current technologies in remediation make combating PFAS contamination a long-term and complex challenge. Mitigating these risks requires a multifaceted and integrated approach, including continued and in-depth scientific research, effective policy development that is responsive to new knowledge, innovation in remediation technologies, and international collaboration. Only through these collaborative efforts can we better protect human health and the environment from the long-term threat of PFAS contamination.

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