PFAS regulations
Per- and polyfluoroalkyl substances (PFAS) are a group of human-made chemicals used around the world in almost all industries and in many common consumer products. PFAS are known to be harmful to humans and other living organisms1, 2. While not all PFAS have been studied, the harmful effects of some PFAS have been known for a long time, such as perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS)3. PFAS are released into water, air, and soil during the production, use, and disposal of waste or products containing them4. Humans and other living organisms are exposed by drinking water, eating food, breathing air, and through direct skin contact with products containing the chemicals5. PFAS are useful because of their stable chemical properties (specifically their carbon-fluorine chemical bond), but this also means that PFAS build up over time, or bioaccumulate, in the environment and organisms6, 7. As PFAS are highly persistent, meaning they resist breaking down, PFAS are often called ‘forever chemicals’6. They have been widely used since the 1940s and are present in humans and ecosystems at increasing levels6 and cycle continually through the environment4.
Local, national, and global regulations aim to stop the production and release of non-essential PFAS into the environment and slow further contamination4. Regulations can include enforceable drinking water standards for PFAS, approved methods for disposing of or storing PFAS waste to limit environmental contamination, requirements for updating lists and monitoring of PFAS as hazardous chemicals, requirements for measuring and reporting PFAS in the environment, comprehensive reporting of PFAS production and use, and requirements for risk assessment prior to using new or old PFAS8. Regulations can also mandate cleanup of contaminated sites9. Industrial chemical use and pollution is a critical health and environmental concern worldwide10. No approved treatments are available to remove PFAS from the human body11.
PFAS are everywhere. Almost all industry sectors use PFAS, including biotechnology, building and construction, chemical and electronics industries, the energy sector, metal products manufacturing, and mining12. PFAS are in public and private sources of drinking water and in many foods, such as fish caught in water contaminated by PFAS or dairy products from livestock exposed to PFAS. Agricultural fertilizers are often made from biosolids from wastewater treatment plants, meaning they commonly contain PFAS and can impact ground water, surface water, and grazing animals13. The chemicals are used in food packaging, such as grease-resistant paper, fast food containers or wrappers, microwave popcorn bags, pizza boxes, and candy wrappers14, as well as in substances or additives in processed foods3. Personal care products (such as cosmetics, shampoo, and dental floss), household products, and household dust can contain PFAS. The chemicals are often used to make upholstery and clothing stain- or water-repellent. Non-stick cookware and many cleaning products, paints, sealants, and varnishes contain PFAS. PFAS are in fire extinguishing foam, specifically aqueous film-forming foam (AFFFs) used in emergencies and training14. PFAS are also used in construction materials and medical devices3. Soil and water near landfills, disposal sites, and hazardous waste sites are frequently contaminated with PFAS14.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Reduced PFAS exposure
Improved health outcomes
Improved water quality
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced health care costs
Improved air quality
What does the research say about effectiveness?
Per- and polyfluoroalkyl substances (PFAS) regulations are a suggested strategy to reduce or eliminate the introduction of more and new PFAS into the environment, to reduce humans’ and other living organisms’ exposure to PFAS, and to avoid increasing PFAS disposal and contamination challenges4, 6, 15, 16. PFAS as a group include thousands of chemicals with varying effects and toxicity, and many PFAS have not yet been studied14. Additional evidence is needed to confirm the long-term effects of regulations, since PFAS are forever chemicals that continue to cycle in the environment and remediation may not be possible or may be extremely costly.
Recommendations. Experts recommend rapidly restricting non-essential use of PFAS4, 6, 15, 16 and using fluorine-free alternatives whenever possible17. Definitions for essential uses of PFAS are not yet determined; however, a multi-country survey finds some agreement that chemical uses are more essential than recreation, household, and personal care uses18. Existing U.S. bans on persistent pollutants such as the pesticide DDT and PCB chemicals could inform PFAS regulations19, 20. Preventing PFAS contamination in water sources is recommended, rather than relying on drinking water treatments or filters at the point of use21. Proactively limiting PFAS discharges into air, water, and soil could help countries address growing problems with disposal and contamination4 and help protect wildlife from increased chemical pollution, advancing global conservation efforts22. Rain and soil everywhere in the world contain PFAS – often at levels exceeding safe guidelines set by the U.S. Environmental Protection Agency (EPA), the European Union, and other countries. Water cycles continuously through the environment and so PFAS’ presence is extremely difficult to reverse15. For this reason, some experts assert that PFAS in the environment have exceeded a planetary boundary for chemical pollution on Earth15, meaning the limits which keep Earth as a stable and resilient system to support human life23.
As PFAS affect the entire planet, experts recommend that governing bodies choose a shared operating definition for PFAS accepted by the scientific community5 and that research and regulation involve international cooperation24. Countries and governments can adopt a precautionary chemicals management strategy, since scientists cannot analyze the many chemicals being produced and released fast enough to identify all that are potentially harmful15. PFAS travel globally from sources via water and air, so local regulations may not be adequate25. Foods shipped worldwide also contain PFAS, such as fish from contaminated waterbodies, and foods grown in fertilizer from biosolids and any stored in lined containers14, 26, 27, 28, 29. Some experts advise regulating PFAS as one chemical class, on the basis that PFAS are highly persistent6, have the potential to accumulate, and are known to be or are potentially hazardous16. Regulations could require producers to release information on chemical structures and analysis being used in new PFAS30. Such regulation could help hold industries responsible for use of all PFAS, not only a few16 and encourage identification of PFAS that might be the safest for use13.
Regulations should consider waste streams (e.g., plastic, metals, textile and leather, paper and cardboards), as some products contain and will release more PFAS than others; textile waste often exceeds limits5. Collecting food waste separately from other municipal solid waste prevents further contamination from materials containing PFAS and can reduce PFAS cycling via food waste compost31. Regulations can also mandate industries’ use of ‘green chemistry’ principles such as making chemical products that break down without harm and do not persist in the environment – this is also called ‘design for degradation’6.
PFAS and health: Overall effects. There is strong evidence that PFAS negatively affect human health outcomes. PFAS exposure can lead to negative reproductive health effects, including decreased fertility, and increased high blood pressure in pregnant individuals14. PFAS exposure can increase risk of cancer, such as prostate, kidney, and testicular cancer; reduce ability of the immune system to fight infection and to respond helpfully to vaccines32; interfere with natural hormones in the body; and increase cholesterol and obesity risk14, 33. PFAS accumulate in body tissues and are detected in the blood of most individuals in developed countries7, 34. PFAS appear to alter humans’ immune function, reducing resistance to infectious disease and increasing incidence of autoimmune disease32. PFAS appear to disrupt the body’s endocrine system and damage the liver7, 34 and reduce fetal growth35.
PFAS and health: Effects among children. In children, PFAS exposure can lead to low birth weight, developmental effects and delays, accelerated puberty, and behavioral changes14, 33. PFAS are associated with further negative health effects in children that include metabolic disorders, immune response that includes suppressed antibody response (the response which makes vaccines effective), asthma, altered kidney function, and delayed onset of puberty, according to studies from a range of countries including the U.S.33. Delayed onset puberty can suggest endocrine disruption and may affect children’s risk of disease in adulthood33. More research is needed to understand the health effects of exposure to low levels of PFAS over longer periods of time, particularly for children, as well as varying exposure by occupation14 and varying response to exposure among different sexes, species, and at different life stages34. More research is also needed into the health effects of PFAS as mixtures of many chemical compounds, reflecting how humans and organisms are usually exposed, rather than research focusing on individual compounds33.
General population exposure. Most U.S. residents have been exposed to PFAS. Known exposure is often low but being exposed to one source over a longer time can increase people’s PFAS levels. PFAS build up in humans and other organisms over time14. There is no known medication or treatment to reduce PFAS after exposure11. Health care providers may be able to do a blood test for PFAS levels, but current blood testing alone does not inform treatment or predict health effects. Providers can discuss an individual’s unique health factors, disease risk, and exposure history, including the duration, magnitude, and routes of potential exposure (such as a water supply, food, or occupational exposure), and whether reducing future exposure is possible11.
Groups with increased exposure and risk. Some people have higher occupational exposures, such as those working in firefighting, manufacturing or processing chemicals and products containing PFAS14, and ski wax technicians3. Pregnant and lactating women may have higher exposure through increased water intake. Children have increased exposure because they drink more water, eat more food, and breathe more air, per pound of body weight, compared to adults; young children who crawl or put things in their mouths may have increased exposure to PFAS in household items and dust; and infants are exposed to PFAS in formula and breast milk14, 36. In utero exposure appears possible, through placental exposure, though more research is needed on the effects7, 14. As of 2024, according to the U.S. EPA, the benefits of breastfeeding appear to outweigh the risks14.
PFAS and non-human organisms. Many studies indicate that PFAS negatively affect humans as well as other living organisms, often in similar ways22. The negative effects humans experience from PFAS may signal serious risks for wildlife – especially endangered and threatened species who face multiple human-caused threats22. PFAS can be harmful to aquatic fauna, amphibians, and insects, even in small amounts17. PFAS also build up, or bioaccumulate, in organisms’ tissues17, including in plants37. Fish can have especially high contamination from bioaccumulation in their tissues and organs17. Those at the tops of food webs, including humans, contain the most PFAS and other persistent chemicals because they consume other species – this is known as biomagnification17. Some persistent chemicals have been banned for decades but are still contributing to population declines; for example, killer whale populations could decrease by 50% in the next 100 years due to human-made persistent chemicals PCBs (polychlorinated biphenyls) and their effects on the animals’ reproductive and immune systems38. PFAS travel around the world on air particles25 and are present throughout the oceans, including in deep water, and are transported in a feedback loop via ocean currents. PFAS phased out of production are still being released from the Arctic back into the North Atlantic39.
Challenges. Experts caution that removing PFAS from contaminated land and drinking water is technically challenging, energy-intensive, and costly6, 40, 41 and in some cases impossible16. Countries including the U.S. face challenges determining appropriate regulatory authorities and in providing adequate funding for monitoring and remediation37. The U.S. EPA identifies three large-scale technologies for destruction and disposal of PFAS and PFAS-containing material: thermal destruction, landfills, and underground injection – but effectiveness is uncertain for all three types42. Processes to break down products containing PFAS, such as incineration, do not totally remove it17. Most water treatments do not remove PFAS from drinking water43. Those that appear most effective44 can be expensive and some create residual waste that must also be disposed40. Disposal of waste containing PFAS creates a contamination cycle: Landfills with products containing PFAS leach PFAS into the surrounding soil, ground, and surface water; wastewater treatment can transform PFAS and increase its concentration; and incineration can release toxic air pollution and greenhouse gases4. Although some PFAS are no longer in large-scale production, even these will take many more decades to reduce below safe thresholds in the environment – and companies still manufacture thousands of other PFAS15.
In response to regulations for PFAS known to be hazardous, manufacturers often substitute other PFAS with unknown toxicity16, 17. Analytical methods currently cover only around 50 PFAS, but as the effects of more PFAS are understood, many countries continue to lower the thresholds for safe exposure24. Studying PFAS is technically challenging because the laboratory tools used for sampling contain PFAS, and consumer products brought to testing sites can contaminate the samples37. Long-chain PFAS have been used longer and are more studied and regulated (e.g., PFOA and PFOS); newer short-chain PFAS are often produced in response to regulation41, 43 and appear to be less bioaccumulative, but move more easily through aquatic systems and soil45 and are still very persistent40. New technology to test for and analyze PFAS in air, water, and in living and non-living parts of ecosystems is leading to the identification of new PFAS46. There is currently no official list of all PFAS compounds in use37. In the U.S., chemical and product manufacturers are not required to disclose when they sell, make, or use PFAS because the formulations may be proprietary and covered by trade secrecy laws13.
Costs. The profits companies make from producing PFAS are billions of dollars less than the estimated costs for remediation and health care related to PFAS exposure47. The Minnesota Pollution Control Agency estimates that while PFAS can be purchased for $50-$1,000 per pound, it costs between $2.7 million and $18 million USD per pound to remove and destroy PFAS from municipal wastewater – an unaffordable cost for the facilities. The cost to remove and destroy PFAS in some wastewater streams in Minnesota alone could cost between $14 and $28 billion USD over 20 years48. A report by the Nordic Council of Ministers estimates the direct health care costs in Europe to be €52-85 billion per year49. The cost to remove and destroy the total PFAS released annually into the environment is estimated to exceed the global GDP of $106 trillion USD50.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: suggested by expert opinion.
Per- and polyfluoroalkyl substances (PFAS) regulations are a suggested strategy to reduce disparities in negative health outcomes and in environmental contamination experienced by communities with less wealth and racially and ethnically minoritized communities10. Humans are widely exposed to chemical pollution but such communities experience disproportionately high exposure10. Indigenous peoples may also have higher exposure via multiple factors63, 64. Multiple authorities, including the U.S. National Academies of Sciences, Engineering, and Medicine (NASEM) and the World Health Organization (WHO), have called for better hazard and risk assessment related to population-level chemical exposure10.
Disposal of waste containing PFAS can create environmental contamination, such as near landfills and incinerators. In the U.S., hazardous waste treatment, storage, and disposal facilities are more often located in communities with more racially and ethnically minoritized individuals and higher poverty rates4. A study of drinking water quality in multiple U.S. states suggests that watersheds with community water systems serving a higher proportion of Latina/o and Black residents are more likely to contain PFAS sources, such as an industrial facility, military fire training area, or civilian airport65. Such watersheds have even greater likelihood of containing a waste sector PFAS source, such as wastewater treatment plant effluent discharge or a landfill65. A pilot study of PFAS in soil near a hazardous waste incinerator suggests that individuals with lower incomes and those with less education are at higher risk of exposure66.
A California-based study of pesticide application suggests pesticides containing PFAS were more likely to be applied near community water supplies serving communities with lower incomes and racially and ethnically minoritized communities67. More and complete data on sources of PFAS contamination and exposure in rural areas is also needed, as rural agricultural communities rely on groundwater and practices like pesticide application pose a range of risks67. This poses an increased risk for rural residents who rely on private wells for drinking water, which are often shallow; unlike municipal water supplies, private wells serving fewer than 25 people are not regulated under the U.S. EPA’s Safe Drinking Water Act that ensures drinking water meets health-based standards68.
Indigenous peoples appear to have higher exposure to PFAS compared to non-Indigenous populations, via multiple pathways. In North America, Native and First Nations and tribally affiliated people experience land dispossession, resettlement, and landscape fragmentation, as well as disproportionately high exposure to environmental hazards, and inadequate mitigation63, 64. These Nations and Indigenous peoples also maintain livelihood or subsistence practices that include hunting, fishing, and foraging, as well as other spiritual and cultural practices, which may increase their exposure to environmental contaminants63, 64. Indigenous peoples in the Arctic (including Alaska, Canada, and Greenland) may be highly exposed to persistent organic pollutants (POPs) including PFAS, mainly through traditional diets. Arctic plant and animal species are highly exposed because the regions are hemispheric sinks, meaning persistent pollutants are carried there on ocean and wind currents69. Biomagnification also means that POPs are highly concentrated at the top of Arctic food webs, especially in marine mammals69. Inuit in East Greenland who consume traditional marine diets have the highest PFAS blood serum concentrations in the Arctic and in any non-occupationally exposed population worldwide70. More research is needed to understand exposure to POPs and to interpret PFAS blood serum levels and potential health risks69.
Recommendations. Precautionary management strategies for chemicals emphasize the importance of acting quickly on scientific findings, noting that slow regulation when risks were known, contributed to serious health consequences from lead, asbestos, and radiation10. Failing to include individuals from affected communities in discussion and decision-making can exacerbate and prolong negative outcomes71. Organizers from communities impacted by chemical pollution exposure do collaborate with public health researchers and environmental health scientists to bring attention to exposures and influence policy change10. Indigenous peoples are also involved in environmental monitoring, policy advocacy, and resistance, though greater and intentional engagement in decision-making is needed72. Communities often marginalized should have input into essential use decisions for PFAS71. Regulations, such as on fish consumption, must consider the availability, affordability, quality, and cultural relevance of additional or alternative food sources59, 73, 74. Experts recommend that those organizing research and regulation meetings increase representation from lower- and middle-income countries and that more research be funded and conducted on PFAS’ presence in these countries24.
Disproportionate Costs. A lack of PFAS regulation and resulting contamination can have disproportionate negative social and economic effects on communities, particularly communities with fewer resources, including some rural communities and geographically remote Arctic communities. Some communities suffer disproportionately from reduced availability of housing with safe water sources, from economic damages to agricultural industries (e.g., when PFAS are detected in water consumed by farm animals, it can reduce milk sales), and from high levels of occupational PFAS exposure while being economically reliant on the companies responsible for PFAS contamination13. Economic and cultural costs may differ among populations; for example, tribal lands may be close to industrial sources of PFAS, in regions dependent on limited water sources like the Southwestern U.S., and tribes may have smaller environmental offices and budgets than can reasonably assess PFAS13.
What is the relevant historical background?
Chemical pollution threatens the Earth’s ecosystems, food security, and human health and reproduction. Chemicals of concern, including PFAS, are associated in humans with serious disease and disorders which continue to increase in prevalence10. Some persistent pollutants have been banned in the U.S. due to their negative effects, such as the pesticide DDT in 197219 and PCB chemicals in 197920. However, companies still produce millions of pounds of industrial chemicals for widespread use each year, including in the U.S., and use is increasing annually around the world10. Environmental hazards are more likely to be sited near communities which are marginalized, who may have less political power, less access to information and resources, and who may not be engaged in siting decisions65. Redlining and historic segregation practices in the U.S. also determined where racially and ethnically minoritized communities, and sources of industrial pollution, are located65.
PFAS as a group contains over 9,000 synthetic chemicals used worldwide in industry and consumer products3, beginning in the 1940s75. Methods to test for PFAS were not widely available until the early 2000s, when PFAS began to be widely documented in environmental samples; since then, more sensitive analytical methods have shown PFAS are present around the world75. Some industrial self-regulation followed: companies 3M and DuPont voluntarily ended production of PFOS and PFOA in the early 2000s37. The U.S. EPA finalized a rule designating PFOA and PFOS as hazardous substances in April 20248. However, both companies knew about the health effects in the 1960s and in the following decades strategically suppressed research and worked to distort public discourse. The Toxic Substances Control Act (TSCA) became law in 1976, but under the Nixon administration was shaped by the chemical industry to restrict chemical testing and data collection and ensure the burden-of-proof is regulators’ responsibility76, 77. Governmental decision-makers were aware of risks as early as 200678 with the health effects publicly established in 201176. Companies like 3M, Dupont, and Chemours are facing thousands of lawsuits76. Some tribes, such as the Fond du Lac Band of Lake Superior Chippewa, have filed lawsuits against 3M and other companies, for PFAS contamination present in its water and fish79. Some experts assert that government knowledge combined with the failure to regulate harmful activities, or to create a legal environment that allows for harm to occur or continue, constitute state-facilitated corporate crime, i.e. shared responsibility between companies and governments80.
Regulation approaches. The U.S. requires chemical-specific data for national regulation – but political will has historically been weak as PFAS’ utility and benefit are well-recognized, and the potential harms of the thousands of compounds on the global market is not feasible to demonstrate37. The U.S. has been slower than some other countries to regulate PFAS at the federal level, so some states and local governments have regulated PFAS and other chemicals or chemical classes locally10, 37. Some states have pre-emptions in place that prohibit setting more restrictive regulations than those at the federal level37. Environmental chemicals in the U.S. are governed by multiple laws, and overseen by multiple agencies, further contributing to patchwork regulation10. Most U.S. laws require the federal government to identify and request data from the industry and to evaluate potential chemical toxicity10.
In contrast, the European Union requires chemical manufacturers and importers to demonstrate to the European Chemicals Agency (ECHA) that chemical substances can be safely used81. Since 2007, companies have been required to generate data on potential chemical exposure and toxicity, to use this data to develop and apply appropriate risk management measures, to communicate these measures to users, and to submit this information to the ECHA for decision-making. This regulation is called REACH (Registration, Evaluation, Authorization and Restriction of Chemicals) (Woodruff 2023, ECHA-REACH). Compared with the U.S., the EU and Canada have stronger regulations to reduce and control PFAS production and use37.
The Stockholm Convention is a global treaty adopted in 2001 to protect human health and the environment from persistent organic pollutants (POPs), which include PFAS2, 82. The treaty requires parties to adopt control measures, eliminate release of POPs where feasible, and in some cases, prohibit or restrict production and use, and aims to ensure waste and stockpiles containing POPs are well-managed82. The U.S. signed the treaty in 2001 but has not ratified it83.
Some nations and groups have begun passing laws and signing treaties giving legal personhood to bodies of water and species such as whales, to protect them because of their environmental and cultural importance84, 85.
Equity Considerations
- Who in your region, state, or community experiences disproportionate exposure to potentially hazardous chemicals, including PFAS? Where are companies who produce (or historically produced) PFAS or PFAS-containing products located? Where are sites located with current or historic heavy use of PFAS-containing products, such as airports, paper mills, firefighting or military fire training sites, etc.?
- What local watersheds contain PFAS sources, such as wastewater treatment plants, landfills, or other industrial sites where PFAS are used? Who relies on these watersheds for drinking water and other ecosystem services? How many rural residents rely on private wells for drinking water and live near agricultural fields, contamination sites or waterways in your watershed area, putting them at increased risk of exposure?
- How is your community testing and monitoring water, soil, air quality, and measuring ecosystem health? How are findings communicated when potentially harmful PFAS levels are identified?
- How do your state or local regulations compare with federal regulations or recommended safe standards?
Implementation Examples
As of April 2024, the U.S. House of Representatives introduced bill HR 8074, the Forever Chemical Regulation and Accountability Act, which would phase out production of non-essential PFAS over ten years and prohibit release of PFAS. Essential use would need to be proven and accepted by the U.S. Environmental Protection Agency (EPA). Companies which use or manufacture PFAS would also be required to report their use of PFAS designated ‘essential’51. Non-profits such as ChemSec track which global companies produce PFAS, help companies review their supply chains, and connect companies who want to use safer chemical alternatives with suppliers47. The EPA has developed a PFAS Strategic Roadmap, which recommends preventing PFAS from entering the environment, to reduce exposure and risks of future contamination and ensuring that disadvantaged communities have equitable access to solutions52.
Addressing PFAS exposure and contamination in the U.S. involves work and coordination by many federal agencies. This work includes measuring and monitoring PFAS exposure in humans and in other living organisms, such as marine species; measuring PFAS in farm animals and some food products; site investigations, cleanup procedures, and local restrictions on PFAS-containing products, such as firefighting foams containing PFAS; and provision of fluorine-free alternatives. The EPA details the many industries and product manufacturing processes where PFAS are used, and the emission types produced, in its interim guidance on destruction and disposal42. As PFOA and PFOS are designated hazardous substances under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA, also known as Superfund), they are subject to tracking and release reporting under the Community Right-to-Know Act (RCRA) and Toxic Release Inventory (TRI). Compliance with CERCLA includes mandatory reporting to the National Response Center after spills or unplanned releases, and failure to report can result in large fines9.
President Biden’s Bipartisan Infrastructure Law allocates more than $10 billion USD to be distributed via the EPA, the Department of Defense (DoD), and Centers for Disease Control Agency for Toxic Substances and Disease Registry (CDC ATSDR) to address emerging contaminants and to study exposures and health risks from PFAS in drinking water in communities near former and current military bases53. The EPA also set a National Primary Drinking Water Regulation for six PFAS in drinking water – these levels are legally enforceable under the Safe Drinking Water Act54, 55. Multiple agencies are also studying PFAS exposure and impacts, detection and remediation technology; developing occupational health training; and providing communication and guidance53. PFAS blood testing programs can be useful to monitor exposed populations over time and to compare with those with less exposure, but there is currently no correlation between a specific level and any health outcome13.
Some U.S. states are enacting or considering laws restricting PFAS in firefighting foam; regulating PFAS amounts in drinking water, food packaging and consumer products; and allocating funds for cleanup and remediation56. As of 2024, Maine and Minnesota have enacted the most comprehensive laws56. Community-based organizations are also engaged in scientific, educational, and advocacy efforts around chemical pollution, such as Alaska Community Action on Toxics (ACAT)57. Anishinnaabe community members and Midwestern partners developed the Gigiigoo’inaan App58, to support safe fish consumption and preserve culturally significant traditions58, 59. As of 2020, a Tribal PFAS Working Group including representatives from Tribal councils on water, science, toxics, waste response, and pesticide programs supports PFAS remediation60. The Arctic Monitoring and Assessment Programme (AMAP) is a working group of the Artic Council, the intergovernmental forum promoting cooperation in the Arctic. AMAP monitors and assesses the impacts of pollutants on the environment and health and informs implementation of the Stockholm Convention on Persistent Organic Chemicals (POPs)61. Its work suggests that declining air concentrations of certain POPs may be increasing again as climate change melts ice caps62.
Implementation Resources
‡ Resources with a focus on equity.
US EPA-PFAS - U.S. Environmental Protection Agency (U.S. EPA). Per- and polyfluoroalkyl substances (PFAS).
US DHHS ATSDR-PFAS - U.S. Department of Health and Human Services (U.S. DHHS), Agency for Toxic Substances and Disease Registry (ATSDR). Per- and polyfluoroalkyl substances (PFAS) and your health.
ITRC-PFAS - Interstate Technology Regulatory Council (ITRC). PFAS Home.
Safer States-PFAS - Safer States. National alliance of environmental health organizations and coalitions. Our Priorities: PFAS “Forever Chemicals”.
Safer States-PFAS Policy Toolkit 2024 - Safer States. National alliance of environmental health organizations and coalitions. PFAS Policy Toolkit. 2024.
USGS-PFAS Tapwater Dashboard - United States Geological Survey (USGS). PFAS in U.S. Tapwater Interactive Dashboard.
OECD-Chemistry - Organisation for Economic Co-operation and Development (OECD). Risk management, risk reduction and sustainable chemistry.
LeMonde-PFAS Europe Map - Dagorn G, Aubert R, Horel S, et al. ‘Forever pollution’: Explore the map of Europe’s PFAS contamination. LeMonde. 2023.
ECHA-PFAS - European Chemicals Agency (ECHA). Per- and polyfluoroalkyl substances (PFAS).
Footnotes
* Journal subscription may be required for access.
1 US EPA-PFAS Roadmap 2023 - U.S. Environmental Protection Agency (U.S. EPA). EPA’s PFAS strategic roadmap: Second annual progress report. December 2023.
2 UNEP-Stockholm PFAS - United Nations Environment Programme (UNEP). Stockholm Convention: PFASs listed under the Stockholm Convention.
3 CDC NIOSH-PFAS - The National Institute for Occupational Safety and Health (NIOSH). Per- and polyfluoroalkyl substances (PFAS). Centers for Disease Control and Prevention (CDC).
4 Stoiber 2020 - Stoiber T, Evans S, Naidenko O. Disposal of products and materials containing per- and polyfluoroalkyl substances (PFAS): A cyclical problem. Chemosphere. 2020;260:127659.
5 Pivato 2024 - Pivato A, Beggio G, Maggi S, et al. The presence of PFAS in wastes and related implications on the current and proposed European regulatory framework: A systematic critical review. Detritus Journal. 2024;26:89-105.
6 Cousins 2020 - Cousins IT, DeWitt JC, Glüge J, et al. The high persistence of PFAS is sufficient for their management as a chemical class. Environmental Science Processes and Impacts. 2020;22:2307-2312.
7 Costello 2022 - Costello E, Rock S, Stratakis N, et al. Exposure to per- and polyfluoroalkyl substances and markers of liver injury: A systematic review and meta-analysis. Environmental Health Perspectives. 2022;130(4).
8 US EPA-Actions to address PFAS - U.S. Environmental Protection Agency (U.S. EPA). Key EPA actions to address PFAS.
9 US EPA-PFAS CERCLA 2024 - U.S. Environmental Protection Agency (U.S. EPA). Memorandum: PFAS Enforcement discretion and settlement policy under CERCLA. April 19, 2024.
10 Woodruff 2023 - Woodruff TJ, Rayasam SDG, Axelrad DA, et al. A science-based agenda for health- and protective chemical assessments and decisions: Overview and consensus statement. Environmental Health. 2023;21(132).
11 US DHHS ATSDR-PFAS Clinicians 2024 - Agency for Toxic Substances and Disease Registry (ATSDR). Per- and polyfluoroalkyl substances (PFAS) and your health: PFAS information for clinicians – 2024. U.S. Department of Health and Human Services (U.S. DHHS).
12 Gluge 2020 - Glüge J, Scheringer M, Cousins IT, et al. An overview of the uses of per- and polyfluoroalkyl substances (PFAS). Environmental Science: Process and Impacts. 2020;22:2345-2373.
13 ITRC-PFAS Guidance 2023 - Interstate Technology Regulatory Council (ITRC). Technical and Regulatory Guidance: Per-and polyfluoroalkyl substances (PFAS). September 2023.
14 US EPA-PFAS Explained - U.S. Environmental Protection Agency (U.S. EPA). PFOA, PFOS and Other PFAS: Our current understanding of the human health risks and environmental risks of PFAS.
15 Cousins 2022 - Cousins IT, Johansson JH, Salter ME, et al. Outside the safe operating space of a new planetary boundary for per- and polyfluoroalkyl substances (PFAS). Environmental Science and Technology. 2022;56(16):11172-11179.
16 Kwiatkowski 2020 - Kwiatkowski CF, Andrews DQ, Birnbaum LS, et al. Scientific basis for managing PFAS as a chemical class. Environmental Science and Technology Letters. 2020;7(8):532-543.
17 Brunn 2023 - Brunn H, Arnold G, Körner W, et al. PFAS: Forever chemicals—persistent, bioaccumulative and mobile. Reviewing the status and the need for their phase out and remediation of contaminated sites. Environmental Sciences Europe. 2023;35(20).
18 Karinen 2024 - Karinen AK, Tobi H, Devilee J, et al. Citizens’ opinions on (non-)essential uses of persistent chemicals: A survey in seven European countries. Environmental Science and Policy. 2024;153:103666.
19 US EPA-DDT - U.S. Environmental Protection Agency (U.S. EPA). Ingredients used in pesticide products. DDT – A brief history and status.
20 NOAA-PCBs - National Oceanic and Atmospheric Administration (NOAA). National Ocean Service. What are PCBs?
21 Herkert 2020 - Herkert NJ, Merrill J, Peters C, et al. Assessing the effectiveness of point-of-use residential drinking water filters for perfluoroalkyl substances (PFASs). Environmental Science & Technology Letters. 2020;7(3):178-184.
22 Andrews 2023 - Andrews DQ, Stoiber T, Temkin AM, Naidenko OV. Discussion. Has the human population become a sentinel for the adverse effects of PFAS contamination on wildlife health and endangered species? Science of the Total Environment. 2023;901:165939.
23 Richardson 2023 - Richardson K, Steffen W, Lucht W, et al. Earth beyond six of nine planetary boundaries. Science Advances. 2023;9(37).
24 DeWitt 2024 - DeWitt J, Glüge J, Cousins IT, et al. Zürich II statement on per- and polyfluoroalkyl substances (PFASs): Scientific and regulatory needs. Environmental Science and Technology. 2024.
25 Faust 2023 - Faust J. PFAS on atmospheric aerosol particles: A review. Environmental Science: Process and Impacts. 2023;25:133-150.
26 Pozzebon 2023 - Pozzebon, EA, Seifert, L. Emerging environmental health risks associated with the land application of biosolids: A scoping review. Environmental Health. 2023;22(57).
27 Johnson 2022b - Johnson GR. PFAS in soil and groundwater following historical land application of biosolids. Water Research. 2022;211(August 2021):118035.
28 Venkatesan 2013 - Venkatesan AK, Halden RU. National inventory of perfluoroalkyl substances in archived U.S. biosolids from the 2001 EPA National Sewage Sludge Survey. Journal of Hazardous Materials. 2013;252-253:413-418.
29 Hoang 2022 - Hoang SA, Bolan N, Madhubashani AMP, et al. Treatment processes to eliminate potential environmental hazards and restore agronomic value of sewage sludge: A review. Environmental Pollution. 2022;293(August 2021):118564.
30 De Silva 2021 - De Silva AO, Armitage JM, Bruton TA, et al. PFAS exposure pathways for humans and wildlife: A synthesis of current knowledge and key gaps in understanding. Environmental Toxicology and Chemistry. 2021;40(3):631-657.
31 Timshina 2024 - Timshina A, Robey NM, Oldnettle A, et al. Investigating the sources and fate of per- and polyfluoroalkyl substances (PFAS) in food waste compost. Waste Management. 2024;180(15):125-134.
32 US DHHS NTP-Immunotoxicity 2016 - National Toxicology Program (NTP). NTP Monograph: Immunotoxicity associated with exposure to perfluorooctanoic acid or perfluorooctane sulfonate. U.S. Department of Health and Human Services (U.S. DHHS); 2016.
33 Rappazzo 2017 - Rappazzo KM, Coffman E, Hines EP. Exposure to perfluorinated alkyl substances and health outcomes in children: A systematic review of the epidemiologic literature. International Journal of Environmental Research and Public Health. 2017;14(7):691.
34 Fenton 2021 - Fenton SE, Ducatman A, Boobis A, et al. Per- and polyfluoroalkyl substance toxicity and human health review: Current state of knowledge and strategies for informing future research. Environmental Toxicology and Chemistry. 2021;40(3):606-630.
35 Bach 2015 - Bach CC, Bech BH, Brix N, et al. Perfluoroalkyl and polyfluoroalkyl substances and human fetal growth: A systematic review. Critical Reviews in Toxicology. 2015;45(1).
36 Hoadley 2023 - Hoadley L, Watters M, Rogers R, et al. Public health evaluation of PFAS exposures and breastfeeding: A systematic literature review. Toxicological Sciences. 2023;194(2):121-137.
37 Brennan 2021 - Brennan NM, Evans AT, Fritz MK, et al. Trends in the regulation of per- and polyfluoroalkyl substances (PFAS): A scoping review. International Journal of Environmental Research and Public Health. 2021;18(20):10900.
38 Desforges 2018 - Desforges J, Hall A, McConnell B, et al. Predicting global killer whale population collapse from PCB pollution. Science. 2018;361(6409):1373-1376.
39 Dunn 2024 - Dunn M, Vojta S, Soltwedel T, et al. Passive sampler derived profiles and mass flows of perfluorinated alkyl substances (PFASs) across the Fram Strait in the North Atlantic. Environmental Science & Technology Letters. 2024;11(2):166-171.
40 Li 2020 - Li Y, Zhang Q, Cai Y, Yang Q, Chang SX. Minimum tillage and residue retention increase soil microbial population size and diversity: Implications for conservation tillage. Science of the Total Environment. 2020;716:137164.
41 Ateia 2019 - Ateia M, Maroli A, Tharayil N, et al. The overlooked short- and ultrashort chain poly- and perfluorinated substances: A review. Chemosphere. 2019;220:866-882.
42 US EPA-PFAS Interim Guidance 2024 - U.S. Environmental Protection Agency (U.S. EPA). Interim guidance on the destruction and disposal of Perfluoroalkyl and polyfluoroalkyl substances and materials containing perfluoroalkyl and polyfluoroalkyl substances-Version 2(2024).
43 Rahman 2014 - Rahman MF, Peldszus S, Anderson WB. Behavior and fate of perfluoroalkyl and polyfluoroalkyl substances (PFAS) in drinking water treatment: A review. Water Research. 2014;50:318-340.
44 US EPA-TDB PFAS - U.S. Environmental Protection Agency (U.S. EPA). Drinking water treatability database (TDB): Per- and polyfluoroalkyl substances.
45 Brendel 2018 - Brendel S, Fetter E, Staude C, et al. Short-chain perfluoroalkyl acids: Environmental concerns and a regulatory strategy under REACH. Environmental Sciences Europe. 2018;30:9.
46 Nakayama 2019 - Nakayama SF, Yoshikane M, Onoda Y, et al. Worldwide trends in tracing poly- and perfluoroalkyl substances (PFAS) in the environment. TrAC Trends in Analytical Chemistry. 2019;121:115410.
47 ChemSec-PFAS - ChemSec. All you need to know about PFAS.
48 MPA-Municipal PFAS 2023 - Minnesota Pollution Control Agency. Evaluation of Current Alternatives and Estimated Cost Curves for PFAS Removal and Destruction from Municipal Wastewater, Biosolids, Landfill Leachate, and Compost Contact Water. Barr Engineering Co., Hazen and Sawyer. 2023.
49 NCM-Goldenman 2019 - Goldenman N, Fernandes M, Holland M, et al. The cost of inaction: A socioeconomic analysis of environmental and health impacts linked to exposure to PFAS. Nordic Council of Ministers. 2019.
50 Ling 2024 - Ling A. Estimated scaled of costs to remove PFAS from the environment at current emission rates. Science of The Total Environment. 2024;918.
51 HR 8074 - 118th Congress 2023-2024. House of Representatives (HR) 8074. Forever Chemical Regulation and Accountability Act of 2024.
52 US EPA-PFAS Roadmap 2021-2024 - U.S. Environmental Protection Agency (U.S. EPA). PFAS strategic roadmap: EPA’s commitment to action 2021-2024.
53 White House-PFAS Fact Sheet 2023 - The White House. Fact sheet: Biden-Harris Administration takes new action to protect communities from PFAS pollution. 2023.
54 US EPA-Drinking Water Regulation - U.S. Environmental Protection Agency (U.S. EPA). Ground water and drinking water: National primary drinking water regulations.
55 US EPA-PFAS - U.S. Environmental Protection Agency (U.S. EPA). Per- and polyfluoroalkyl substances (PFAS).
56 NCSL-PFAS 2023 - National Conference of State Legislatures (NCSL). Per- and polyfluoroalkyl substances (PFAS): State legislation and federal action.
57 ACAT - Alaska Community Action on Toxics (ACAT). Protecting health, ensuring justice.
58 ITCM-Our Fish App - Inter-Tribal Council of Michigan (ITCM). Gigiigoo'inann Study. Gigiigoo'inann App (Our Fish App).
59 Dellinger 2022 - Dellinger MJ, Pingatore N, Chelius T, et al. Environmental health literacy for Anishinaabe (Great Lakes Native American) fish consumers: A randomized control trial. Environmental Research. 2022;212(PB):113335.
60 NTWC-PFAS Group - National Tribal Water Council (NTWC). Tribal PFAS Working Group.
61 AMAP - Arctic Monitoring & Assessment Programme (AMAP). Working Group of the Arctic Council.
62 AMAP-POPs Iceland - AMAP. Maps & Graphics: PCB-52 and PCB-1010 in the air at Stórhöfði, Iceland.
63 Hoover 2012 - Hoover E, Cook K, Plain R, et al. Indigenous peoples of North America: Environmental exposures and reproductive justice. Environmental Health perspectives. 2012;120(12):1645-1649.
64 Ford 2020 - Ford JD, King N, Galappaththi EK, et al. The resilience of Indigenous peoples to environmental change. One Earth. 2020;2(6):532-543.
65 Liddie 2023 - Liddie JM, Schaider LA, Sunderland EM. Sociodemographic factors are associated with the abundance of PFAS sources and detection in U.S. community water systems. Environmental Science & Technology. 2023;57(21):7092-7912.
66 Martin 2023 - Martin KV, Hilbert TJ, Reilly M, et al. PFAS soil concentrations surrounding a hazardous waste incinerator in East Liverpool, Ohio, an environmental justice community. Environmental Science and Pollution Research. 2023;30:80643-80654.
67 Libenson 2024 - Libenson A, Karasaki S, Cushing LJ, et al. PFAS-contaminated pesticides applied near public supply wells disproportionately impact communities of color in California. ACS EST Water. 2024;4(6):2495-2503.
68 S 433 - 93rd Congress, 2nd Session, 1974. Senate (S) 433: Safe Drinking Water Act.
69 Byrne 2022 - Byrne S, Seguinot-Medina S, Waghiyi V, et al. PFAS and PBDEs in traditional subsistence foods from Sivuqaq, Alaska. Environmental Science and Pollution Research. 2022;29:77145-77156.
70 Sonne 2023 - Sonne C, Desforges J, Gustavson K, et al. Assessment of exposure to perfluorinated industrial substances and risk of immune suppression in Greenland and its global context: a mixed-methods study. Lancet Planetary Health. 2023;7(7):E570-E579.
71 Suffill 2024 - Suffill E, White MP, Hale S, et al. Regulating ‘forever chemicals’: Social data are necessary for the successful implementation of the essential use concept. Environmental Sciences Europe. 2024;36:111.
72 Fernandez-Llamazares 2020 - Fernández-Llamazares A, Garteizgogeascoa M, Basu N, et al. A state-of-the-art review of Indigenous peoples and environmental pollution. Integrated Environmental Assessment and Management. 2020;16(3):324-341.
73 Dellinger 2023 - Dellinger MJ, Daskalska L, Ripley M. A thirty-year contaminant trend analysis in Great Lakes Native American fish harvests 1991–2021. Environmental Pollution. 2023;333(June):122075.
74 PBS-WW Fish advisories - Public Broadcasting Service (PBS) Wisconsin. News: Why fish consumption advisories in Great Lakes states carry their own risks. Wisconsin Watch. April 19, 2023.
75 ITRC-PFAS History 2020 - Interstate Technology Regulatory Council (ITRC). Fact sheet: History and use of per- and polyfluoroalkyl substances (PFAS) found in the environment. August 2020.
76 Richter 2021 - Richter L, Cordner A, Brown P. Producing ignorance through regulatory structure: The case of per- and polyfluoroalkyl substances (PFAS). Sociological Perspectives. 2021;64(4):631-656.
77 Gaber 2023 - Gaber N, Bero L, Woodruff T. The devil they knew: Chemical documents analysis of industry influence on PFAS science. Annals of Global Health. 2023;89(1):37.
78 US EPA-PFOA Facts 2015 - U.S. Environmental Protection Agency (U.S. EPA). Assessing and managing chemicals under TSCA. Fact Sheet: 2010/2015 PFOA Stewardship Program.
79 MPR-Kraker 2023 - Kraker D. Fond du Lac Band sues 3M and other companies over PFAS pollution. Minnesota Public Radio (MPR) News. July 27, 2023.
80 LeMonde-Horel 2023 - Horel S. Revealed: The massive contamination of Europe by PFAS ‘forever chemicals’. Le Monde. February 23, 2023.
81 ECHA-REACH - European Chemicals Agency (ECHA). Legislation: Understanding REACH.
82 UNEP-Stockholm Overview - United Nations Environment Programme (UNEP). Stockholm Convention: Overview.
83 US DS-Stockholm - U.S. Department of State (U.S. DS). Office of Environmental Quality. Stockholm Convention on persistent organic pollutants.
84 Magallanes 2018 - Magallanes CI. From rights to responsibilities using legal personhood and guardianship for rivers. In: ResponsAbility: Law and governance for living well with the Earth. London: Routledge; 2018.
85 ABC-Smith 2024 - Smith M, Boucher DL. Whales have been given legal ‘personhood’ by Māori and Pacific leaders. So what’s next? ABC News: Pacific Beat. April 9, 2024.
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