PFAS were originally considered to be
chemically inert. Early occupational studies revealed elevated levels of fluorochemicals, including
perfluorooctanesulfonic acid (PFOS) and
perfluorooctanoic acid (PFOA), in the blood of exposed industrial workers, but cited no ill health effects. These results were consistent with the measured serum concentrations of PFOS and PFOA in
3M plant workers ranging from 0.04 to 10.06 ppm and 0.01 to 12.70 ppm, respectively, well below toxic and
carcinogenic levels cited in animal studies. This lengthy residence time and widespread environmental contamination lead to accumulation of PFAS in humans sufficient to cause adverse health outcomes.|left From 2005 to 2013, three
epidemiologists known as the C8 Science Panel conducted health studies in the Mid-Ohio Valley as part of a contingency to a class action lawsuit brought by communities in the
Ohio River Valley against DuPont. The panel measured
PFOA serum concentrations in 69,000 individuals from around DuPont's
Washington Works Plant and found a mean concentration of 83 ng/mL, compared to 4 ng/mL in a standard population of Americans. This panel reported probable links between elevated PFOA blood concentration and
high cholesterol,
ulcerative colitis,
thyroid disease,
testicular cancer,
kidney cancer, pregnancy-induced
hypertension and
preeclampsia. The severity of PFAS-associated health effects can vary based on the length of exposure, level of exposure, and health status. Human breast milk can harbor PFAS, which can be transferred from mother to infant via breastfeeding. Use of personal care products, such as nail care products, fragrances, makeup, hair dyes and hair sprays, by pregnant women and
lactating mothers is associated with raised levels of PFAS in blood and breastmilk. For example, PFOS levels of women who
dyed their hair at least twice during pregnancy were more than a third higher than those who did not. PFOS is one of the most common and most dangerous of the PFAS compounds.
Fertility issues Endocrine disruptors, including PFAS, are linked with the
male infertility crisis. A report in 2023 by the
Icahn School of Medicine at Mount Sinai linked high exposure to PFAS with a 40% decrease in the ability for a woman to have a successful pregnancy as well as hormone disruption and delayed
puberty onset.
Human developmental issues Fetuses and children are especially vulnerable to the harms of PFAS chemicals because they have been shown to be linked to major adverse health conditions, including
abnormally small birth weight syndrome in newborns,
preterm birth, shorter
lactation periods, breastmilk of diminished nutritional content, one or more
neurodevelopmental disorders, and decreased response to childhood
vaccines.
Cancers PFOA is classified as
carcinogenic to humans (Group 1) by the
International Agency for Research on Cancer (IARC) based on "sufficient" evidence for cancer in animals and "strong" mechanistic evidence in exposed humans. IARC also classified PFOS as possibly carcinogenic to humans (Group 2b) based on "strong" mechanistic evidence. There is a lack of high-quality epidemiological data on the associations between many specific PFAS chemicals and specific cancer types, and research is ongoing.
High cholesterol A response is observed in humans where elevated PFOS levels were significantly associated with elevated total
cholesterol and
LDL cholesterol, highlighting significantly reduced
PPAR expression and alluding to PPAR independent pathways predominating over
lipid metabolism in humans compared to rodents.
Ulcerative colitis PFOA and PFOS have been shown to significantly alter immune and inflammatory responses in human and animal species. In particular,
IgA,
IgE (in females only) and
C-reactive protein have been shown to decrease whereas
antinuclear antibodies increase as PFOA serum concentrations increase. These
cytokine variations allude to immune response aberrations resulting in
autoimmunity. One proposed mechanism is a shift towards anti-inflammatory M2
macrophages and/or (TH2) response in intestinal
epithelial tissue which allows
sulfate-reducing bacteria to flourish. Elevated levels of
hydrogen sulfide result, which reduce
beta-oxidation and nutrient production, leading to a breakdown of the colonic epithelial barrier.
Thyroid disease Hypothyroidism is the most common thyroid abnormality associated with PFAS exposure. PFAS have been shown to decrease
thyroid peroxidase, resulting in decreased production and activation of
thyroid hormones in vivo. Other proposed mechanisms include alterations in thyroid hormone signaling, metabolism and excretion as well as function of
nuclear hormone receptor, has been described. This suggests a strong influence on peripheral rather than central thyroid hormone sensitivity. == Responses to knowledge of harmful effects ==