Who is most exposed to PFAS (forever chemicals)?

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Certain jobs and communities face higher exposure to PFAS (a type of forever chemical) and a higher risk of health impacts. Three jobs with higher exposure to PFAS are: firefighters, ski wax technicians, and chemical manufacturing workers. Communities near facilities that make or use PFAS may also have increased exposure. Those Nerdy Girls recommends caution, education, and advocacy – but not panic.

PFAS have been in the news due to industry cover-ups of potential health risks and new EPA limits on PFAS in drinking water. In this post, we’ll share which jobs and communities face the greatest exposure, how these people can protect themselves, and how we can all support vulnerable communities.

What are PFAS (forever chemicals) and why should I care about them?

PFAS (per- and polyfluoroalkyl substances) are a group of chemicals that are used to make a wide range of products that resist heat, water, and grease. These “forever chemicals” persist in the environment for years and enter our bodies through contaminated air, water, soil, food, or skin contact. In the United States and other developing countries, PFAS are detectable in virtually all blood samples (see US CDC data).

As discussed in a recent Nerdy Girls post, high levels of PFAS exposure has been linked with an increased risk of various health issues. The effects of lower doses of exposure are less clear. This post is focused on people with the greatest exposure to PFAS.

Who faces the greatest PFAS exposure?

  • Jobs with higher PFAS exposure. Firefighters, ski wax technicians, and people who work in chemical manufacturing (with fluorochemicals) have higher PFAS exposure and higher blood levels of these chemicals because they are exposed through air and/or direct contact. Other jobs that may involve higher PFAS exposure include electroplating, floor waxing, painting, carpet installation and treatment, and jobs that require frequent handling of PFAS-containing food packaging.
  • Communities with higher PFAS exposure. People who live near facilities that manufacture, use, or handle PFAS may also face higher PFAS exposure than average. These PFAS “hot spots” include some factories, military bases, airports (especially military airports and firefighting training areas – due to use of AFFF (aqueous film-forming foam)), wastewater treatment plants, and farms where sewage sludge is used for fertilizer, landfills, or incinerators. These communities are exposed to PFAS through contaminated water, air, soil, and food. Blood levels of PFAS in these communities vary greatly, but are often elevated and overlap with levels seen in higher PFAS occupations.

Health effects of higher levels of PFAS exposure

Will higher PFAS exposure impact my health? This is a tough question to answer because scientists don’t fully understand the links between PFAS exposure and health. It’s definitely not as simple as “PFAS exposure = health problems”. Your personal risk depends on the types and levels of PFAS you are exposed to, your life stage, your health status – and other factors that have not yet been identified. Research on this topic is ongoing, and we will continue to learn and share in the years ahead.

Conversations about the health risks associated with PFAS, and other risk factors, can be frustratingly vague. We often hear about “increased risk” but without hard numbers. Are we talking about a small risk increase or a 10-fold risk increase? If the risk is double, are we doubling a 1% risk or doubling a 10% risk? To bring things into sharper focus, we’ve drilled into the numbers for kidney cancer – one of the most serious health outcomes linked to PFAS exposure. To be clear, these estimates are rough, and this is not the only potential health impact of PFAS.

Studies of people with higher exposure to PFAS have consistently found more kidney cancer cases and deaths than expected, usually in the range of 10-50% more, depending on the study population. If the average person’s lifetime risk of kidney cancer is 2%, and we estimate a 25% increase in risk, high PFAS exposure would increase the lifetime risk from roughly 2% to 2.5%. This risk increase won’t affect most people, but it takes a huge toll on the small fraction of people who are affected and on a healthcare system serving millions of people.

By comparison, smoking cigarettes is a poster child for what a heavy-hitting risk factor looks like. A 2020 study in Japan found that men who smoke cigarettes have a roughly 15% (1 in 7) lifetime risk of dying from lung cancer, compared to a 3% (1 in 33) lifetime risk for men who don’t smoke.

Nerd Note: PFAS exposure impacts kidney cancer risk to a similar degree as other factors like obesity and alcohol consumption, and is less impactful than high blood pressure.

How can people with high exposure to PFAS protect themselves?

  • People in jobs with higher PFAS exposure. Follow work safety protocols and use PFAS-free alternatives where possible (e.g., alternative formulations for ski waxes and firefighting foams). Talk to your employer or occupational safety officer about PFAS to ensure that all possible protective measures are being taken.
  • People in communities that may be contaminated with PFAS. Learn about PFAS levels in your drinking water, install a water filter (if levels are high or unregulated), and avoid eating potentially contaminated foods (e.g., bivalve mollusks from contaminated waters).

How can everyone help?

We all have a role to play in reducing PFAS exposure in affected jobs and communities, which often include lower income or underserved racial groups. We need industries to find safer alternatives and governments to ramp up testing, cleanup, and regulations. To pitch in, reduce use of PFAS-containing products (to decrease demand), join an advocacy group or support politicians who endorse regulations like the Toxic Substances Control Act and the Superfund.

Closing thoughts

PFAS exposure is an important public health issue, yet it’s just one part of the health landscape. Our advice for people with higher exposure is to educate yourself, take precautions where possible, and invest in a healthy lifestyle (e.g., vaccines, regular exercise, a healthy diet, no smoking, limited alcohol, adequate sleep and manageable stress).

We hope that this series on PFAS helps you feel informed but not panicked. We don’t want to minimize the toll of these chemicals, but we also don’t want to create extra stress. To learn more, check out our curated resources below and stay tuned for future posts on PFAS exposure, water filters, testing, and more.

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