Per- and poly-fluoroalkyl substances (PFAS)
PFAS is an abbreviation for per-and polyfluoroalkyl substances. These are manufactured chemicals that have been used for more than 50 years. PFAS like compounds are applied to surfaces to make products non-stick, water repellent and fire, weather and stain resistant. PFAS and PFAS like compounds are also used in a range of consumer products, such as carpets, stain repellents, clothes and paper and have also been used in firefighting foams and pesticides.
PFAS are not broken down by physical, chemical or biological factors. This creates a problem: PFAS last for a long time in soil, water and the products we own and for this reason we call them persistent organic pollutants or POPS.
There are many types of PFAS. The most common types especially found in firefighting-foams, that affect the general population in Australia, are:
- perfluorooctane sulfonate (PFOS)
- perfluorooctanoic acid (PFOA).
Both PFOS and PFOA are highly soluble in water which means they can easily move (or leach) from soil into groundwater (bore water), where they can move long distances. They can also flow into creeks, rivers and lakes. There it can become part of the food chain, being transferred from animals to other animals or to humans.
The human body can only get rid of PFOS and PFOA slowly and this can result in a build-up of PFAS in the body.
PFAS and your health
The Expert Health Panel for PFAS found that although the scientific evidence about humans being exposed to PFAS is minimal, there are reviews and scientific research that have provided consistent reports that several health effects are linked to PFAS. These include:
- increased levels of cholesterol in the blood;
- increased levels of uric acid in the blood;
- reduced kidney function;
- alterations in some indicators of immune function;
- altered levels of thyroid hormones and sex hormones;
- later age for starting menstruation (periods) in girls, and earlier menopause; and
- lower birth weight in babies.
The term ‘association’ means the data indicates that there is a relationship between PFAS exposure and the above health effects; however, this does not necessarily mean that the PFAS exposure causes the health effect. The associations found between PFAS and health effects are generally small and within normal ranges for the whole population. There is very limited evidence of human disease or other harm resulting from PFAS at the time of exposure.
Early indications suggest that PFAS exposure has a minimal impact on your health, however, because of the weaknesses in the scientific evidence, other important health effects cannot be completely ruled out.
What about exposure in pregnant women and children?
Unborn babies (foetus) can be exposed to PFAS if their mother’s blood contains PFAS because PFAS crosses the placenta during pregnancy. However, scientific research does not indicate that PFAS exposure during pregnancy has a major impact on poor health in pregnant women or their babies.
It is safe for (and recommended) mothers living in or around sites contaminated with PFAS to continue to breast feed. This is because there are significant health benefits of breast feeding which are well established and far outweigh any potential health risks to an infant from any PFAS possibly transferred through breast milk.
Do PFAS cause cancer?
There is no current evidence that suggests an increase in overall cancer risk.
There has been one study that observed an increased risk of testicular and kidney cancer in one group of people exposed to PFAS. However, this may have been caused by other factors and the evidence has not been confirmed by other studies. Although the evidence for causing cancer is very weak and inconsistent, it is still important to not completely rule out PFAS as a cause. For further information on PFAS and human health, read the PFAS Expert Health Panel – Report to the Minister, March 2018.
How you are exposed to PFAS?
If you have not worked with PFAS or visited a contaminated site, you can be exposed to PFOS and PFOA through the air, indoor dust, food, water and various products. For most people, food is expected to be the primary source of exposure to these chemicals.
PFAS has been found in groundwater used for drinking interstate. However, shallow groundwater where contamination can occur is usually not used for drinking in South Australia because of its high salinity levels. Groundwater is not considered a source of exposure to PFAS in South Australia.
Mains water (tap water) is safe in South Australia even if sourced from groundwater because in locations were bores are used there is no PFAS contamination.
Getting tested for your exposure to PFAS
Because of the widespread use and persistence of PFAS in the environment, a blood test will show that all people in Australia will have some PFAS (most commonly PFOS) in their body.
PFAS blood tests provide a measure of a persons’ exposure and they can be compared to levels seen in the general community. However, these results do not provide information to make clinical, diagnostic or therapeutic decisions.
In general, blood testing for PFAS is not recommended as the information will not help your medical practitioner to make clinical decisions about your health care.
For highly exposed groups (such as those that have worked with PFAS), biochemical or disease screening or health interventions are not supported by evidence, however, tests are can be taken that may help with ensuring control of exposure.
There is currently no accepted clinical treatment to reduce levels of PFAS in the human body.
Community exposure to PFAS and testing
In Australia and internationally where PFOS and PFOA have become restricted, as a general trend, blood levels for PFOS and PFOA have been lowering. It is expected this decline in blood levels will continue, but it will take many decades for humans not to be exposed to these substances due to their persistent nature.
Future controls on PFAS in the community
Specific PFAS chemicals will continue to be regulated because of how long the chemicals stay in the environmental and build up over time. This regulation does not need to be justified by strong evidence of health effects to continue.
PFAS in South Australia
South Australia was the first state to ban fluorinated firefighting foams on 30 January 2018. The ban came into effect following the amendment of the Environment Protection (Water Quality) Policy 2015 under the Environment Protection Act 1993.
This ban stops further environmental and human health risks associated with PFAS use, and provides the community and industry with certainty around the use of these products.
Due to their wide use and persistence in the environment, PFAS can be found in soils, surface water and groundwater in low concentrations in many areas in South Australia.
Because PFAS can persist in the environment for a long time, if large quantities of PFAS were used, an accumulation of PFAS can be found. This means higher concentrations of the chemicals will be measured at places such as fire station sites and airports.
PFAS in Australia
In Australia, PFAS have been used for a long time in both consumer products and industrial applications. There are now PFAS contaminated sites resulting from these various uses, including from the use of firefighting foams that contained PFAS. Over time, the chemicals have worked their way through the soil to contaminate surface and groundwater and have moved into adjoining land areas. PFAS are also present in our landfills and wastewater treatment facilities and more broadly in the environment.
PFAS are not manufactured in Australia, but they can be imported into Australia. Since 2002, the national Industrial Chemicals Notification and Assessment Scheme (NICNAS) restricted the importation and use of PFAS to only essential uses for which no appropriate alternatives are available.
International Regulation of PFAS
The Stockholm Convention on Persistent Organic Pollutants outlined the globally accepted standard for the use and management of persistent organic pollutants, also called POPs. PFOS, its salts and other PFOS-related chemicals were listed on Annex B (restrictions) of the Stockholm Convention in 2009, with continued use permitted in some instances. PFOA, its salts and other PFOA-related chemicals were nominated in 2015 for listing on the Stockholm Convention - the earliest date for the Convention’s decision-making body to decide on the listing of PFOA is 2019. The Australian Commonwealth Government is yet to confirm the listing of PFOS but has a process for doing so.
For further information on PFASs, contact SA Health’s Scientific Services on (08) 8226 7100, or visit the Commonwealth Department of Health’s web page