PFAS chemicals (a.k.a. “forever chemicals”) are linked with a wide range of serious health issues. Many of these have a disproportionate impact on first responders. At Relentless Health, our mission is to improve health and fitness outcomes for first responders. So, we have developed a convenient at-home finger stick blood test for PFAS. Here, we explore a bit more about PFAS testing and explain why we chose to focus on at-home testing.
What are PFAS and why are they used?
PFAS stands for per and poly-fluoroalkyl substances. They are a large family of man-made chemicals that first emerged in the late 1930s. Since then, PFAS have been widely used due to their desirable properties. This included being waterproof, stain resistant and grease repellent. Common applications include:
- Water-repellent coatings on raincoats and other outdoor clothing
- Greaseproof coatings on fast food cartons and wrappers
- Stain-resistant coatings on fabrics, carpets, furniture, and shoes
- Non-stick coatings on cookware and bakeware
Many types of PFAS have gained notoriety, such as PFOS, PFOA, and PTFE. But there are many more that are currently used or were used in the not-so-distant past. A key problem is that PFAS are extremely hard to break down in the body and the environment, earning them the nickname of “forever chemicals”.
Health concerns about PFAS
Over recent years more and more reports link PFAS to a range of health issues from developmental disorders to cancer. A quick search of PubMed shows a dramatic increase in the number of scientific research papers covering the topic of PFAS, with articles doubling every year over the past 5 years. So far, peer-reviewed research has shown that certain levels of PFAS exposure lead to:
- Higher risk of some forms of cancer, including kidney, prostate, and testicular cancer
- Reduced ability for the immune system to fight infections
- Changes to hormone function that may impact reproductive health and fertility
- Changes to metabolic health, including higher cholesterol and increased risk of obesity
- Physical and behavioral developmental challenges in children
Given the mounting evidence of the negative consequences of PFAS, several Federal agencies in the U.S. are actively working on regulatory, health, and policy measures to mitigate the impacts of PFAS, including the Environmental Protection Agency (EPA), National Institutes of Health (NIH), Food and Drug Administration (FDA), and Centers for Disease Control (CDC).
Who gets exposed to PFAS?
PFAS exposure can be classified as either occupational or environmental. Here we look at these in a bit more detail.
Occupational exposure to PFAS
Occupational exposure to PFAS occurs in many professions. In some cases, the exposure is obvious–if you are a worker in a chemical plant producing PFAS, you are likely exposed to it daily. Other occupational PFAS exposures are less obvious. For example, ski waxers, carpet fitters, and textile workers often handle compounds that contain high levels of PFAS. But some groups are exposed in ways that are much less obvious.
Firefighters rely on their protective gear to keep them alive and safe in fires. This gear uses a huge range of PFAS chemicals in order to deliver the necessary properties such as waterproofness, heat resistance, and moisture wicking. When you expose these fabrics to extreme conditions, inevitably some PFAS will leach out and affect the user. The extent of this problem is made clear in ongoing research into PFAS in firefighter gear conducted by NIST. Of course, many firefighters have also been directly exposed to PFAS due to its widespread use in aqueous film-forming foams (AFFF or fire fighting foam). As a result, they rank as one of the occupations with the highest levels of PFAS exposure.
Environmental exposure to PFAS
Environmental exposure largely occurs due to contaminated groundwater. Recently, the EPA imposed strict legal limits on the levels of certain PFAS compounds in drinking water. However, many people still live in locations where there is significant PFAS contamination. For instance, recent research found that the entire Great Lakes basin is so heavily polluted with PFAS that it is routinely found in precipitation as well as all groundwater sources. And of course the people suffering from occupational exposure are all too often also exposed through their environment.
The Relentless Health PFAST-24 test
Our close collaboration with first responders highlighted to us the need for better testing for PFAS exposure.
The standard approach to PFAS testing
The typical PFAS test involves providing a blood specimen that is first processed to separate out the serum (liquid part) from the proteins. The serum is taken to a specialist lab where it is analyzed for the presence of specific PFAS compounds. Such tests are accurate, but have their drawbacks. For a start, the blood must be collected by a healthcare professional. This collection is usually done at a doctor’s office or phlebotomy clinic. The sample must be processed rapidly to prevent degradation. And the whole process is typically pretty expensive.
Developing an at-home test
We wanted to develop a more convenient and affordable test that would still yield reliable results. Our starting point was a technique called dried blood spot testing. Here, you make a small prick in the end of your finger with a lancet. A few drops of blood are collected on a special card and allowed to dry. The sample is then stable enough to be sent to a lab by normal mail. At the lab, a precise amount of the dried sample is processed and analyzed to determine the presence of PFAS. This approach works, but it has some drawbacks. For instance, the user may not allow enough blood to collect on the card and the technician must stamp out a circle of the sample for analysis. If either of these isn’t done correctly, there is a risk the results will be inaccurate
Microsampling for easy at-home testing
At Relentless Health, our updated approach uses a special microsampling device instead of a sample collection card. This is carefully calibrated to collect precisely 30 microliters of blood on a stable medium at the tip of the device. Once the blood is collected, the device can be returned to the lab by mail. The sample is extremely stable, and there is a known volume, which makes it far easier to analyze accurately. Moreover, it is a much easier process for the user.
Using this approach, we have developed our PFAS at-home sample test that can detect up to 24 compounds. PFAST-24 will soon be available to buy from our website and our app. Meanwhile, you can sign up for the wait list on the form below. We will be donating a portion of every sale we make to organizations and causes that are important to our first responder community.
