PFAS: Cancer & Other Health Effects
PFAS, known as "forever chemicals," have infiltrated our lives, raising cancer and other health risks. PFAS permeate our environment, but there are practical steps you can take to reduce exposure and take action to protect yourself and your family.
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What Are PFAS?
PFAS, or per- and polyfluoroalkyl substances, are artificial chemicals that make consumer goods water-, stain- and grease-resistant. They are toxic at extremely low levels and are nearly indestructible, earning them the nickname “forever chemicals.”
Research has shown a link between PFAs and several types of cancers and other health problems.
PFAS are almost impossible to avoid. They are in homes, offices, supermarkets, schools, consumer products and the food and water we consume. According to U.S. and international health and environmental agencies, their widespread presence highlights the need for proactive steps to minimize exposure.
Which Cancers Do PFAS Cause?
Many PFAS exist, but perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) are the most studied. In April 2024, the US Environmental Protection Agency designated PFOA and PFOS as hazardous substances under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), also known as the Superfund law. They have been phased out of production in the United States, but other countries may still manufacture them. New PFAS are being developed continually.
Studies on lab animals have shown that exposure to PFOA increases the risk of tumors in the liver, testicles, mammary glands and pancreas. These animal studies often help predict cancer risks in humans.
Human studies have shown possible links between PFOA exposure and testicular, kidney and thyroid cancer.
- Breast Cancer
- A 2023 study of postmenopausal women published in the International Journal of Cancer found a link between high PFOS levels and hormone receptor-positive breast cancer. There might be a link between PFOS and PFOA and different breast cancer subtypes.
- Kidney Cancer
- A 2021 study of 324 cases published in the Journal of the National Cancer Institute (NCI) found a link between high levels of PFOA in the blood and an increased kidney cancer risk. A 2023 study in the Journal of Environment International found higher risks of kidney cancer among African Americans, Native Hawaiians and Caucasians. The authors suggested this could be due to associations with another PFAS called perfluorononanoic acid (PFNA).
- Non-Hodgkin Lymphoma and Thyroid Cancer
- An ongoing study from the NCI is assessing if elevated levels of PFAS in serum increase the risk of non-Hodgkin lymphoma and thyroid cancer in a large cohort of 845 and 188 cases, respectively.
- Ovarian and Endometrial Cancer
- An NCI study using serum samples from postmenopausal women investigated associations between PFAS levels and risks of ovarian and endometrial cancers, evaluating 318 ovarian and 430 endometrial cancer cases, along with a control group of 589 cancer-free women
- Prostate Cancer
- A large prospective study published in the Journal of Environmental Research in 2023 found no significant link between serum PFAS levels and aggressive prostate cancer risk. However, the results did not rule out high exposure associations or non-aggressive cancer risks.
- Testicular Cancer
- Air Force servicemen exposed to high PFOS levels, especially firefighters, showed increased testicular cancer risk according to a 2023 study published in the Journal of Environmental Health Perspectives that used Department of Defense serum samples.
- Thyroid Cancer and Childhood Leukemia
- Research in the Finnish Maternity Cohort, published in the International Journal of Cancer in 2023, found no clear link between PFAS exposure during pregnancy and thyroid cancer in mothers.
The International Agency for Research on Cancer (IARC) classifies PFOA as “carcinogenic to humans” based on evidence from animal and human studies. The U.S. Environmental Protection Agency (EPA) also suggests evidence of PFOA’s carcinogenicity. However, more research is needed for definitive conclusions.
Other Health Problems Linked to PFAS
PFAS exposure may cause several health problems beyond cancer, as indicated by various research studies and health agencies, including the National Institutes of Health (NIH) and the EPA.
- Cholesterol and Obesity
- Research suggests that PFAS exposure can lead to higher cholesterol levels and an increased risk of obesity.
- Developmental Problems
- Studies have shown that PFAS can cause low birth weight, delayed growth, early puberty and behavioral changes in children.
- Hormonal Interference
- PFAS can disrupt the body's natural hormone functions, affecting thyroid and reproductive hormones.
- Immune System Effects
- According to the National Toxicology Program (NTP) and other studies, PFAS exposure has been associated with a reduced ability to fight infections and lower vaccine response.
- Liver Damage
- Studies have indicated that PFAS can alter liver function, leading to eventual liver damage.
- Pregnancy Complications
- Research has linked PFAS exposure to an increased risk of hypertension and preeclampsia during pregnancy.
- Reproductive Issues
- Research has linked PFAS exposure to decreased fertility and increased high blood pressure during pregnancy.
- Thyroid Disease
- There is a connection between PFAS exposure and an increased risk of thyroid problems, as shown in various epidemiological studies.
According to health organizations and agencies, including the EPA, NIH and the Agency for Toxic Substances and Disease Registry, these findings underscore an urgent need for further research into the health risks of PFAS at multiple exposure levels.
Who Is Most at Risk of PFAS Exposure?
Studies have indicated that high exposure to PFAS over a long time period — six months or more — can increase the risk of different cancers, according to the American Cancer Society.
Among the people most likely to face this type of exposure include civilian and military firefighters, first responders and those who live near PFAS-contaminated water.
Firefighters & First Responders
Firefighters and first responders have an increased risk of developing cancer due to exposure to PFAS present in aqueous film-forming foam (AFFF) and protective gear. In 2022, the International Association of Fire Fighters (IAFF) linked 75% of the names on the IAFF Fallen Fire Fighter Memorial Wall to occupational cancer.
A 2023 study published in the Journal of Environmental Research reviewed previous research into the risk forever chemicals pose to firefighters. Researchers found that firefighters have higher levels of PFAS in their blood compared to the general population, leading to increased risks of certain cancers.
The authors wrote that factors such as job duties and duration of employment significantly influence PFAS exposure levels among firefighters.
People Living Near PFAS-Contaminated Water
PFAS are concerning due to their persistence in the environment and the human body. Studies have found a widespread presence of PFAS in people’s blood, with higher levels in communities with contaminated water supplies. However, occupational exposure can result in even higher levels.
How To Avoid PFAS Exposure
While PFAS are all around us, you can take action to avoid them.
- Public Water Supply
- If you use a public water system, contact your local utility to see if they have tested for PFAS. If not, ask them to test it. You can also test it yourself using a state-certified lab.
- Private Wells
- Regularly test your well water for PFAS. Use a state-certified lab and compare results with state or EPA guidelines. If PFAS levels are high, consider using alternative water sources for drinking and cooking or install a certified home water treatment system.
- Food
- Avoid PFAS in your food by choosing products with minimal packaging. Avoid nonstick cookware and be cautious of produce and fish from contaminated areas.
- Consumer Products
- Avoid using products containing PFAS, such as certain non-stick cookware, stain-resistant fabrics and some cleaning products. Although most companies nowadays manufacture non-stick cookware without PFAS, Consumer Reports detected the presence of PFAS as a byproduct in certain non-stick cookware products as recently as 2022. Don’t use steel wool or other scraping cleaners on non-stick items, be wary of microwave popcorn (including organic brands) and even keep a lookout when purchasing dental floss; all of which can increase your exposure to PFAS.
- Contaminated Fish
- Avoid eating fish from waters contaminated with PFAS. Follow local fish consumption advisories.
- Breastfeeding
- PFAS can transfer into breast milk. Despite this, breastfeeding benefits often outweigh the risks. Consult your doctor for personalized advice.
If PFAS levels in nearby water sources or your workplace are high, consult your state environmental agency or health department for advice. Consider installing a water filter that is certified to reduce PFAS levels. For more information, contact local health agencies or visit the EPA website to stay updated on PFAS regulations and health guidelines.
PFAS Exposure Lawsuits
Forever chemical lawsuits primarily involve people who developed certain cancers after working in first responder positions, such as firefighters or cancer patients who lived near PFAS-contaminated water.
- Water Contamination
- People who file PFAS-contaminated water lawsuits were exposed to PFAS water contamination and lived near known contamination sites. Depending on the state, people may have limitations when filing lawsuits. They typically had to have received a diagnosis in the year 2000 or later. They'll also have to have drank from contaminated water supply from 1990 or later for at least six consecutive months and have a diagnosis of kidney cancer, pancreatic cancer, prostate cancer, testicular cancer or ulcerative colitis.
- Firefighter Turnout Gear
- People who file firefighter turnout gear lawsuits have worked as firefighters, paramedics or first responders and, since then, received a diagnosis of kidney (renal) or testicular cancer, chronic kidney disease (CKD), thyroid disease or ulcerative colitis.
- Aqueous Film-Forming Foam (AFFF)
- People filing aqueous film-forming foam lawsuits include firefighters, paramedics and first responders who worked with aqueous film-forming foam during their careers and have received a cancer diagnosis. If you fit any of these descriptions and have been diagnosed with the conditions for one of these litigations, consider speaking with an attorney who specializes in PFAS lawsuits.
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