How to Reduce Your Risk from PFAS

By Adrienne S. Allen, MD

PFAS (perfluoroalkyl substances) seem to be all around us. In August, the city of Cambridge switched its water supply, which flows from the Stony Brook Watershed into a reservoir at Fresh Pond, to the Massachusetts Water Resources Authority (MWRA) due to high levels of PFAS in the water. This switch is costing the city $2 million per month. 

In July, local news reported on PFAS contamination near the Wachusett Reservoir, likely from compost made from sewage sludge. Firefighting foam used on military bases on Cape Cod has exposed residents to PFAS toxicity. Boston Mayor Michelle Wu recently ordered no new artificial turf be installed in the city due to PFAS found on those fields.

In early September, the US Environmental Protection Agency (EPA) issued an advisory that PFAS from plastic pesticide containers leach into the pesticide causing land contamination when sprayed. This was just after a June EPA update that redefined safe water levels for these chemicals. The science around PFAS is rapidly evolving as we learn more about the health risks. 

What are PFAS? 

PFAS are manufactured chemicals that have been used in industry and consumer products worldwide since the 1940s. They are known as the “forever chemicals” because they do not break down in the environment and remain in soil and water for very long periods.

Where are PFAS found?​

PFAS are found in many things that repel water, grease, and stains.

• Fast food wrappers, microwave popcorn packaging, pizza boxes 
• Nonstick cookware like Teflon 
• Personal care products (shampoo, dental floss)
• Water-resistance gear: jackets, winter gear, camping equipment 
• Furniture and carpets treated for stain resistance
• Firefighting foam 
• Pesticides 
• Artificial turf 

How do PFAS cause contamination? 

PFAS can migrate into soil, water, and air during production, use, and improper storage. 

What are the effects on humans and animals? 

PFAS are found in the blood of people and animals all over the world and are present at low levels in a variety of food products, for example, in fish and shellfish. PFAS enter the body through ingestion or inhalation, and some PFAS can build up in people and animals with repeated exposure over time.  

The Agency for Toxic Substances and Disease Registry and the EPA have linked PFAS exposure to multiple cancers (especially kidney cancer), thyroid dysfunction, and high cholesterol. In addition, PFAS may impact the immune system and reduce the antibody response to vaccines. Some human studies suggest that exposure to high levels of certain PFAS may lead to an increased risk of high blood pressure or preeclampsia in pregnant women and decreases in infant birth weight. In a study of United States women that measured serum concentrations of PFAS, the highest quartile started menopause about two years earlier than women in the lowest exposure group. 

In 2022, the National Academies of Medicine issued guidelines to help monitor patients who have had high exposures to PFAS and help communities reduce the risk of exposure. In addition, last September, the Massachusetts Medical Society passed a resolution to help educate physicians about PFAS and resolved to lobby the legislature to pass PFAS- reducing regulations. 

How to reduce exposure: 

• Eat at home more often, avoid non-stick pans, and choose steel or cast iron pans for cooking. Ask restaurants if their packaging is PFAS free. 
• Skip the stain treatment and flame retardants on furniture—natural fabrics like wool have natural stain and flame resistance.
• Play sports on grass. If playing on a turf field, wash hands before eating and shower after play. 
• Keep your soil safe. Decrease pesticide use, and check your compost. Black Earth compost picks up much of Belmont’s compost and regularly tests and reports out PFAS levels in its products. 
• Choose companies that have reduced or eliminated PFAS use.
• Monitor your water. Fortunately, Belmont water comes from the MWRA, which has filtered out most PFAS of concern and regularly tests and reports on levels. If you have a well, consider testing. 
• Dust and vacuum regularly to limit exposure from products in the home. 

What else can you do? 

Lobby legislators to phase out PFAS where possible. Eleven states, including California, Colorado, Connecticut, Hawaii, Maine, Maryland, Minnesota, New York, Rhode Island, Vermont, and Washington, have enacted phase-outs of PFAS in food packaging. Further, a few bills have been introduced in Massachusetts to help curb PFAS use in the state.  

Finally, manufacturers are developing new kinds of PFAS. Some of these chemicals may have properties similar to the existing PFAS, and some may be less persistent in the environment. Unfortunately, there are very few scientific studies on new PFAS, so more research is necessary to discover whether they may be a health concern.

Adrienne S. Allen, MD, is senior medical director of quality, safety, and sustainability at the Mass General Brigham Salem/North Shore Physicians Group. She also serves as vice chair of the Belmont Board of Health.