PFAS are a large class of chemicals used in water, oil, and heat-resistant coatings on products. Exposure to PFAS is associated with numerous health outcomes, with children being especially vulnerable. Learn about where PFAS are found and how to protect your family from exposure.
What are PFAS
Per- and polyfluoroalkyl substances (PFAS) is a very large class of chemicals used in water, oil, and heat-resistant coatings on products. PFAS are considered “forever chemicals,” meaning that they do not break down in the environment and accumulate in water sources, wildlife, and our bodies. There are thousands of PFAS that may be present in consumer products and in the environment, but very few have been comprehensively tested for toxicity.
PFAS exposure is widespread in the United States due to its extensive use and environmental contamination. Studies conducted by the CDC found that every American has PFAS in their blood.
PFAS sources of exposure
PFAS are found in many consumer products including:
- Fast food wrappers, microwave popcorn bags, pizza boxes, candy wrappers
- Nonstick cookware
- Stain-resistant coatings on carpets and upholstery
- Waterproof clothing and footwear
- Cleaning and personal care products
- Dental floss
- Paints and varnishes
- Artificial turf glass blades and backing
You can also be exposed to PFAS through:
- Drinking contaminated water
- Using nonstick pans that have PFAS to cook food
- Eating foods packaged in containers that use PFAS
- Breathing in contaminated dust
- Eating meat of animals exposed to PFAS
Health outcomes associated with PFAS exposure
Exposure to PFAS is associated with numerous health outcomes. A scientific panel of epidemiologists convened to study the health impacts of widespread PFAS water contamination in the Mid-Ohio Valley found links to high cholesterol, ulcerative colitis, thyroid disease, kidney cancer, testicular cancer, and pregnancy-induced hypertension. PFAS have also been shown to interfere with the immune system and to lower the efficacy of vaccines in children. There is also evidence that elevated blood levels of some PFAS may increase the risk of more severe COVID-19 outcomes.
PFAS exposure begins in utero, and is detectable in cord blood serum, indicating transfer from mother to fetus. In utero exposure to PFAS is linked to poor outcomes for pregnant people and their children, specifically hypertensive disorders of pregnancy (HDP), placental dysfunction, adverse health outcomes, preeclampsia, and low birth weight.
Children are especially vulnerable to PFAS exposures because they eat a less varied diet and consume more food and water than adults, and are closer to the ground where PFAS settle in dust and soil. They also have more future years of life over which PFAS can bioaccumulate in their bodies and chronic diseases may develop. Numerous adverse health impacts have been associated with PFAS exposure in children including cardiometabolic outcomes, obesity, allergy, asthma, reduced vaccine response, thyroid impairment, altered pubertal onset, and impaired neurodevelopment.
How to protect yourself and your family from PFAS
- Use a water filter that can remove PFAS
- Limit consumption of take out and fast foods
- Choose stainless or cast iron pans and avoid nonstick cookware
- Avoid stain-resistant and waterproofing sealants on fabrics
- Advocate for stronger regulations to limit the presence of PFAS in consumer products and drinking water
How we’re studying PFAS at Mount Sinai
Dania Valvi MD, PhD, MPH, studies the effects of PFAS exposure during pregnancy on multiple child health outcomes. Using a metabolomics approach to identify biomarkers in serum, Dr. Valvi and other researchers uncovered that pregnant people exposed to high levels of PFAS had children with higher levels of liver enzymes which predispose them to a higher risk of liver injury. This study was selected as paper of the year by the National Institute for Environmental Health Sciences (NIEHS).
Dr. Valvi was also involved in a study that found that prenatal exposure to PFAS is linked to negative birth outcomes including low birth weight and length and smaller head circumference. Pregnant people exposed to higher levels of PFAS also had higher serum-thyroid-stimulating hormone (TSH), demonstrating a link between PFAS and thyroid disruption.
Dr. Valvi’s work also demonstrates a role for PFAS in endocrine disruption and risk of type 2 diabetes. Using glucose tolerance tests, she found an association between higher serum levels of perfluorooctane sulfonate (PFOS) across the life course and decreased insulin sensitivity and increased activity of beta-cells, the insulin-producing cells in the pancreas.
Douglas Walker, PhD, and Dr. Valvi were involved in a 2019 study that examined the effects of PFAS on glucose metabolism in obese and overweight Hispanic children in the Los Angeles area. This study found that higher PFAS exposure was associated with dysregulation of multiple lipid and amino acid pathways, as well as alterations in glucose homeostasis. These results indicate that PFAS influences type 2 diabetes in children. Further studies are underway to investigate the mechanism of this association using high-resolution metabolomics. This work has the potential to identify new biomarkers to improve precision medicine approaches for the prevention of type 2 diabetes in diverse multiethnic populations.
Anna Robuck, PhD, a postdoctoral fellow in Dr. Walker’s laboratory, has extensive experience measuring PFAS in wildlife throughout the eastern United States. During her graduate work at the University of Rhode Island/Harvard STEEP (Sources, Transport, Exposure, & Effects of PFAS) Center, Dr. Robuck characterized the presence of both legacy and novel PFAS in the livers, brains, and other organs of seabirds living downstream of an industrial chemical site in Massachusetts. Additional work with the U.S. EPA characterized hundreds of emerging or entirely novel PFAS in surface water and fish in waters adjacent to the city of Philadelphia in the Delaware River. Some of these novel PFAS appear in fish at extremely high levels, and appear to be even more bioaccumulative than some legacy PFAS.
Under the mentorship of Dr. Walker, Dr. Robuck is extending this work to characterize novel and legacy PFAS in humans and in drinking water source waters through funding from the ATSDR Multi-Site PFAS Study housed at Rutgers University. This study will evaluate novel and legacy PFAS in residents and their drinking water from the same area in which she found PFAS in surface water and fish. In addition, this study will assess associations between novel PFAS exposure and biomarkers of disease and immune response. Dr. Robucks is uniquely positioned to do this work at the Institute, which houses one of only two laboratories in the world able to accurately screen for novel PFAS.
PFAS Outreach and Advocacy at the Institute
- Drs. Sarah Evans and Lauren Zajac published a commentary in Pediatric Research urging stronger federal regulations on PFAS in drinking water.
- Dr. Evans presented expert testimony to the State of Connecticut on behalf of the Institute in support of a ban on PFAS in consumer packaging, which later passed. The bill passed in 2021.
- Drs. Maida Galvez, Lauren Zajac, and Cappy Collins, pediatricians within the Pediatric Environmental Health Specialty Unit (PEHSU) at Mount Sinai, together with the Agency for Toxic Substances and Disease Registry (ATSDR) work extensively to counsel communities and clinicians in New York and New Jersey impacted by industrial PFAS contamination.