PFAS is proven to cause cancer, high cholesterol, immunosuppression, and is linked to many other serious diseases. But ongoing biomonitoring by the CDC proves that almost everyone has some level of PFAS in their blood. So, clearly there must be some level of PFAS that is “safe”. Here, we address the important question: should you get tested, or not?
Why are PFAS so prevalent?
Since their invention some 80 years ago, PFAS have become a mainstay of the chemical industry. That’s because they have such unique properties that make them invaluable. PFAS makes your pans nonstick, your clothes waterproof, your fast food wrappers greaseproof, and your furniture stain-proof. But they are also used in medical device manufacturing automobiles (PFAS are great for reducing friction), and in countless other industries.
What are the health effects of PFAS?
For decades, scientists have been worried about the health effects of PFAS. But recently these health concerns have been growing rapidly. The WHO classified PFOA as carcinogenic in 2023. Numerous studies have linked PFAS with a range of cancers. PFAS is proven to cause dyslipidemia (high cholesterol), and is linked with cardiovascular disease. It is thought to be a major factor contributing to inflammation of the bowel, especially ulcerative colitis. PFAS can pass from a mother to her unborn baby, leading to lower immune response, reduced birth weight, and a higher risk of premature or pre-term births.
All in all, PFAS compounds are not great news for your body! Yet we know that almost every human being has some level of PFAS exposure. That must mean that there is some “safe” level of exposure.
How toxins affect the body
Toxins like PFAS have highly complex interactions with the body that lead to their toxicity. Toxicologists like to define different stages for how toxins impact your body.
- External exposure. This happens when you are exposed to the toxin in the environment around you.
- Internal exposure. Now the toxin has entered your body through ingestion, inhalation, or absorption.
- Biological dose. The level of toxin in your body has built up high enough to cause some harm.
- Biological effects. This happens once the cumulative harm from the biological dose starts to impact how cells function or reproduce.
- Disease. The cumulative biological effects have now triggered some form of disease such as cancer.
For many toxins, you need quite a high exposure over a short period of time to risk disease. That’s because the kidneys and liver are extremely efficient at eliminating a lot of toxins. But PFAS is known to accumulate in the body, meaning that your risk can build over time.
What is a safe level of PFAS?
In 2022, the National Academies of Science, Engineering, and Medicine (NASEM) released a 300 page report into PFAS. The report included a review of all the available evidence for PFAS health risks and resulted in new guidance for physicians.
Defining the NASEM level
Rather than focus on any specific PFAS, the NASEM report looks at the core set of PFAS that is tested by the CDC in their NHANES biomonitoring program. This involves a simple additive sum of levels of all the detected PFAS. The resulting number can be thought of as the NASEM level for PFAS.
- NASEM level under 2 ng/mL. This is viewed as a safe level of PFAS. In effect, this level is not sufficient to count as a biological dose.
- NASEM level between 2 and 20 ng/mL. This level is of some concern and the advice is to get tested for certain health conditions, especially if you are in a high risk group.
- A NASEM level above 20 ng/mL is viewed as placing you at high risk. People with this level are advised to get additional medical checkups and to take steps to eliminate sources of PFAS exposure.
Who should get a PFAS test?
Some of the health effects from PFAS exposure can affect anyone (for instance, increased risk of kidney cancer). However, certain groups are known to be at increased risk. As more research is done, this list is slowly growing.
Pregnant women
There is a proven link between PFAS exposure and preeclampsia, or dangerous high blood pressure during pregnancy. PFAS is also known to cross the placental boundary between mother and child. It causes reduced rate of fetal development and can trigger premature birth.
Postmenopausal women
Studies suggest PFAS can significantly increase the risk of cardiovascular disease in postmenopausal women. The exact mechanism is unclear, but there is evidence PFAS is associated with proteins that trigger inflammation and can lead to cardiovascular problems. There’s also strong evidence for a link between PFAS and high cholesterol, a known risk factor for coronary artery disease.
People with chronic bowel disease
Several studies have shown a link between PFAS and ulcerative colitis. The exact mechanism is unclear, but it could be related to the known inflammatory effects of PFAS. There is also evidence that PFAS affects bowel function for many people.
Men looking to have children
Many PFAS compounds are defined as endocrine disrupting chemicals. This means they impact the way the body reacts to certain hormones and can disrupt the production of these hormones. Studies have shown that this can lead to reduced fertility for men. It may also be why there is a link between PFAS and testicular cancer.
Conclusions
PFAS are so universal that pretty much everyone is exposed to them at some level. This means that probably not everyone should get tested for PFAS. However, if you are at increased risk, or if you live in an area with known PFAS pollution you should definitely consider buying a home PFAS test.
