Communities across the U.S. are discovering drinking water contaminated by perfluoroalkyl and polyfluoroalkyl substances (PFAS) and determining appropriate actions. There are currently no federal PFAS drinking water standards despite widespread drinking water contamination, ubiquitous population-level exposure, and toxicological and epidemiological evidence of adverse health effects. Absent federal PFAS standards, multiple U.S. states have developed their own health-based water guideline levels to guide decisions about contaminated site cleanup and drinking water surveillance and treatment. We examined perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) water guideline levels developed by the U.S. Environmental Protection Agency (EPA) and state agencies to protect people drinking the water, and summarized how and why these levels differ. We referenced documents and tables released in June 2018 by the Interstate Technology and Regulatory Council (ITRC) to identify states that have drinking water and groundwater guideline levels for PFOA and/or PFOS that differ from EPA’s health advisories (HAs). We also gathered assessment documents from state websites and contacted state environmental and health agencies to identify and confirm current guidelines. Seven states have developed their own water guideline levels for PFOA and/or PFOS ranging from 13 to 1000 ng/L, compared to EPA’s HA of 70 ng/L for both compounds individually or combined. We find that the development of PFAS guideline levels via exposure and hazard assessment decisions is influenced by multiple scientific, technical, and social factors, including managing scientific uncertainty, technical decisions and capacity, and social, political, and economic influences from involved stakeholders. Assessments by multiple states and academic scientists suggest that EPA’s HA is not sufficiently protective. The ability of states to develop their own guideline levels and standards provides diverse risk assessment approaches as models for other state and federal regulators, while a sufficiently protective, scientifically sound, and enforceable federal standard would provide more consistent protection.
Sociodemographic Factors Are Associated with the Abundance of PFAS Sources and Detection in U.S. Community Water Systems
Abstract. Drinking water contaminated by per- and polyfluoroalkyl substances (PFAS) is a widespread public health concern, and exposure–response relationsh
Tap Water Contributions to Plasma Concentrations of Poly- and Perfluoroalkyl Substances (PFAS) in a Nationwide Prospective Cohort of U.S. Women
Abstract Background: Between 2013 and 2015, concentrations of poly- and perfluoroalkyl substances (PFAS) in public drinking water supplies serving at least six million individuals exceeded the level set forth in the health advisory established by the U.S. Environmental Protection Agency. Other than data reported for contaminated sites, no systematic or prospective data exist on the relative source contribution (RSC) of drinking water to human PFAS exposures. Objectives: This study estimates the RSC of tap water to overall PFAS exposure among members of the general U.S. population. Methods: We measured concentrations of 15 PFAS in home tap water samples collected in 1989–1990 from 225 participants in a nationwide prospective cohort of U.S. women: the Nurses’ Health Study (NHS). We used a one-compartment toxicokinetic model to estimate plasma concentrations corresponding to tap water intake of PFAS. We compared modeled results with measured plasma PFAS concentrations among a subset of 110 NHS participants. Results: Tap water perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) were statistically significant predictors of plasma concentrations among individuals who consumed ≥8 cups of tap water per day. Modeled median contributions of tap water to measured plasma concentrations were: PFOA 12% (95% probability interval 11%–14%), PFNA 13% (8.7%–21%), linear perfluorooctanesulfonic acid (nPFOS) 2.2% (2.0%–2.5%), branched perfluorooctanesulfonic acid (brPFOS) 3.0% (2.5%–3.2%), and perfluorohexanesulfonic acid (PFHxS) 34% (29%–39%). In five locations, comparisons of PFASs in community tap water collected in the period 2013–2016 with samples from 1989–1990 indicated increases in quantifiable PFAS and extractable organic fluorine (a proxy for unquantified PFAS). Conclusions: Our results for 1989–1990 compare well with the default RSC of 20% used in risk assessments for legacy PFAS by many agencies. Future evaluation of drinking water exposures should incorporate emerging PFAS. https://doi.org/10.1289/EHP4093
A Statistical Approach for Identifying Private Wells Susceptible to Perfluoroalkyl Substances (PFAS) Contamination
Abstract. Drinking water concentrations of per- and polyfluoroalkyl substances (PFAS) exceed provisional guidelines for millions of Americans. Data on priv
High organofluorine concentrations in municipal wastewater affect downstream drinking water supplies for millions of Americans
Wastewater receives per- and polyfluoroalkyl substances (PFAS) from diverse consumer and industrial sources, and discharges are known to be a concern for drinking water quality. The PFAS family includes thousands of potential chemical structures containing organofluorine moieties. Exposures to a few well-studied PFAS, mainly perfluoroalkyl acids (PFAA), have been associated with increased risk of many adverse health outcomes, prompting federal drinking water regulations for six compounds in 2024. Here, we find that the six regulated PFAS (mean = 7 to 8%) and 18 measured PFAA (mean = 11 to 21%) make up only a small fraction of the extractable organofluorine (EOF) in influent and effluent from eight large municipal wastewater treatment facilities. Most of the EOF in influent (75%) and effluent (62%) consists of mono- and polyfluorinated pharmaceuticals. The treatment technology and sizes of the treatment facilities in this study are similar to those serving 70% of the US population. Despite advanced treatment technologies, the maximum EOF removal efficiency among facilities in this work was <25%. Extrapolating our measurements to other large facilities across the United States results in a nationwide EOF discharge estimate of 1.0 to 2.8 million moles F y −1 . Using a national model that simulates connections between wastewater discharges and downstream drinking water intakes, we estimate that the sources of drinking water for up to 23 million Americans could be contaminated above regulatory thresholds by wastewater-derived PFAS alone. These results emphasize the importance of further curbing ongoing PFAS sources and additional evaluations of the fate and toxicity of fluorinated pharmaceuticals.
County-level associations between drinking water PFAS contamination and COVID-19 mortality in the United States
Epidemiologic and animal studies both support relationships between exposures to per- and polyfluoroalkyl substances (PFAS) and harmful effects on the immune system. Accordingly, PFAS have been identified as potential environmental risk factors for adverse COVID-19 outcomes.
Delayed discovery, dissemination, and decisions on intervention in environmental health: a case study on immunotoxicity of perfluorinated alkylate substances
Identification and characterization of environmental hazards that impact human health must rely on the best possible science to inform and inspire appropriate public health intervention. The perfluorinated alkylate substances (PFASs) are persistent emerging pollutants that are now being recognized as important human health hazards. Although the PFASs have been produced for over 60 years, academic research on environmental health aspects has appeared only in the most recent 10 years or so. In the meantime, these persistent chemicals accumulated in the global environment. Some early studies e.g., on population exposures and toxicity, were not released to the public until after year 2000. Still, the first PFAS risk assessments ignored these reports and relied on scant journal publications. The first guidelines and legal limits for PFAS exposure, e.g., from drinking water, were proposed 10 years ago. They have decreased substantially since then, but remain higher than suggested by data on human adverse effects, especially on the immune system, that occur at background exposure levels. By now, the best-known PFASs are being phased out, and related PFASs are being introduced as substitutes. Given the substantial delays in discovery of PFAS toxicity, in dissemination of findings, and in regulatory decisions, PFAS substitutes and other persistent industrial chemicals should be subjected to prior scrutiny before widespread usage.
Characteristics of ‘early adopters’ of water treatment capacity needed to remove PFAS and other emerging contaminants in the United States
Larger CWS were 7–8 times more likely than smaller systems to adopt advanced treatment processes over 2004–2022. , Past work shows exposures to drinking water contaminants can differ among regions with varying sociodemographic composition, in part due to disparities in siting of pollution sources. Drinking water treatment by reverse osmosis, ion exchange, or activated carbon has been recommended by United States (US) regulatory agencies for community water systems (CWS) with elevated concentrations of emerging chemical toxicants such as per- and polyfluoroalkyl substances (PFAS). However, barriers faced by CWS in implementing such technologies are not well understood. Here we used a national scale ( n = 36 611 CWS) Kaplan–Meier “survival” analysis, as well as adjusted piecewise logistic regression models, to retrospectively examine characteristics of CWS that were “early adopters” of these treatment technologies between 2004–2022. Results showed the largest CWS serving >100 000 customers adopted the treatment technologies considered here 7–8 times faster than small and very small CWS serving <3300 customers from 2004–2022. Nationally and for a case study of CWS with elevated PFAS concentrations, the odds of CWS adopting the treatment technologies considered in this study between 2004–2022 were significantly lower (10–25%) for each 10% higher proportion of non-Hispanic Black residents. Results were generally consistent when focusing on CWS with prior MCL violations and in CWS across different US regions , system sizes, and source water types. The proportion of American Indian and Alaskan Native residents was also inversely associated with adoption of the treatment technologies for certain groups of CWS. These results suggest managerial and financial barriers to removal of high levels of emerging contaminants in drinking water may be most pronounced for some small CWS and those serving selected historically marginalized communities.
A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects
Here, we review present understanding of sources and trends in human exposure to poly- and perfluoroalkyl substances (PFASs) and epidemiologic evidence for impacts on cancer, immune function, metabolic outcomes, and neurodevelopment. More than 4000 PFASs have been manufactured by humans and hundreds have been detected in environmental samples. Direct exposures due to use in products can be quickly phased out by shifts in chemical production but exposures driven by PFAS accumulation in the ocean and marine food chains and contamination of groundwater persist over long timescales. Serum concentrations of legacy PFASs in humans are declining globally but total exposures to newer PFASs and precursor compounds have not been well characterized. Human exposures to legacy PFASs from seafood and drinking water are stable or increasing in many regions, suggesting observed declines reflect phase-outs in legacy PFAS use in consumer products. Many regions globally are continuing to discover PFAS contaminated sites from aqueous film forming foam (AFFF) use, particularly next to airports and military bases. Exposures from food packaging and indoor environments are uncertain due to a rapidly changing chemical landscape where legacy PFASs have been replaced by diverse precursors and custom molecules that are difficult to detect. Multiple studies find significant associations between PFAS exposure and adverse immune outcomes in children. Dyslipidemia is the strongest metabolic outcome associated with PFAS exposure. Evidence for cancer is limited to manufacturing locations with extremely high exposures and insufficient data are available to characterize impacts of PFAS exposures on neurodevelopment. Preliminary evidence suggests significant health effects associated with exposures to emerging PFASs. Lessons learned from legacy PFASs indicate that limited data should not be used as a justification to delay risk mitigation actions for replacement PFASs.
Can profiles of poly- and Perfluoroalkyl substances (PFASs) in human serum provide information on major exposure sources?
Humans are exposed to poly- and perfluoroalkyl substances (PFASs) from diverse sources and this has been associated with negative health impacts. Advances in analytical methods have enabled routine detection of more than 15 PFASs in human sera, allowing better profiling of PFAS exposures. The composition of PFASs in human sera reflects the complexity of exposure sources but source identification can be confounded by differences in toxicokinetics affecting uptake, distribution, and elimination. Common PFASs, such as perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) and their precursors are ubiquitous in multiple exposure sources. However, their composition varies among sources, which may impact associated adverse health effects.
PFAS Statewide Sampling Dataset: PFAS drinking water sampling data from U.S. community water systems
This repository contains a sample of U.S. community water systems (CWS) included in the PFAS statewide sampling dataset. In the first versions of this dataset, 18 states were included as part of Liddie et al., 2023. The statewide sampling dataset now includes compiled data from 28 U.S. statewide sampling campaigns of CWS for per- and polyfluoroalkyl substances (PFAS) in drinking water. The full dataset of samples spans the 2016-2024 period. All data were either publicly available or provided by state agencies upon request. The full dataset contains approximately 98,000 samples from 11,138 CWS in Alabama, Arizona, California, Colorado, Georgia, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, and Wisconsin. Concentrations of 5-40 targeted PFAS were analyzed by multiple labs contracted by the states using comparable methods, including either US EPA Method 537, 537.1, or 533. We assigned a conservative, uniform detection limit at the 98th percentile of all reports detection limits (5 ng/L) for the 5 PFAS that were measured in all states consistently. This dataset also incorporates data from the US EPA’s Safe Drinking Water Information System, including the source water type, county served, zip code, system city, and total population served. The 8-digit hydrological unit code in which a CWS intake is estimated to reside is also provided using data from the United States Geological Survey. This was done by geocoding each CWS using geographical data provided by state agencies, reported zip codes (when available), or based on additional information provided by each system (e.g., system name, city, city served). At this time, the full datasets (either system-level or sample-level) are available by request (see contact information below). Note that additional fields, such continuous concentration data, reported detection limits, concentrations of other PFAS analytes, are also available. Proper citation of both this repository and the original associated paper (see recommended citations below) are required for use of these data. Due to the significant time investment required to curate these data, additional data requests beyond the scope of the details listed here are welcomed but should be agreed upon (e.g., in terms of co-authorship) with the primary point of contact. Please contact Jahred Liddie (jliddie@g.harvard.edu) for questions/suggestions, access to additional variables, or access to the full sampling datasets.
Isolating the AFFF Signature in Coastal Watersheds Using Oxidizable PFAS Precursors and Unexplained Organofluorine
Abstract. Water supplies for millions of U.S. individuals exceed maximum contaminant levels for per- and polyfluoroalkyl substances (PFAS). Contemporary an
Socioeconomic Disparities in Exposures to PFAS and Other Unregulated Industrial Drinking Water Contaminants in US Public Water Systems
Addressing Urgent Questions for PFAS in the 21st Century
Abstract. Despite decades of research on per- and polyfluoroalkyl substances (PFAS), fundamental obstacles remain to addressing worldwide contamination by
US drinking water quality: exposure risk profiles for seven legacy and emerging contaminants
Advances in drinking water infrastructure and treatment throughout the 20th and early 21st century dramatically improved water reliability and quality in the United States (US) and other parts of the world. However, numerous chemical contaminants from a range of anthropogenic and natural sources continue to pose chronic health concerns, even in countries with established drinking water regulations, such as the US.
TrifluoroaceticAcid (TFA) Exceeds All Other ExtractableOrganofluorine in Drinking Water from Eastern Massachusetts, UnitedStates
Abstract Per- and polyfluoroalkyl substances (PFAS) are present in drinking water consumed by ∼200 million United States (US) residents, but many are not detected by routine monitoring methods. Here, we aimed to better characterize the organofluorine mass budget in US drinking water samples from 19 sites in eastern Massachusetts. Extractable organofluorine (EOF) was detected at 16/17 sites served by community water systems (CWS) using conventional treatment techniques (coagulation, flocculation, clarification, and filtration). At these sites, a suite of 37 targeted PFAS accounted for 6–68% of the EOF and suspect screening identified fluorinated agrochemicals in almost all samples. High EOF concentrations in untreated source waters for two CWS that used granular activated carbon (GAC) and ion-exchange (IX) treatment, were reduced below detection in finished drinking water samples. Our EOF measurements were not selective for trifluoroacetic acid (TFA), so we measured concentrations in triplicate samples at one conventional treatment site and from the IX and GAC sites. At these sites, TFA concentrations were higher than those of EOF and were unaffected by the treatment type. Results of this pilot study show GAC and IX treatment removed virtually all organofluorine in drinking water other than TFA.
Scientific Basis for Managing PFAS as a Chemical Class
Abstract This commentary presents a scientific basis for managing as one chemical class the thousands of chemicals known as PFAS (per- and polyfluoroalkyl substances). The class includes perfluoroalkyl acids, perfluoroalkylether acids, and their precursors; fluoropolymers and perfluoropolyethers; and other PFAS. The basis for the class approach is presented in relation to their physicochemical, environmental, and toxicological properties. Specifically, the high persistence, accumulation potential, and/or hazards (known and potential) of PFAS studied to date warrant treating all PFAS as a single class. Examples are provided of how some PFAS are being regulated and how some businesses are avoiding all PFAS in their products and purchasing decisions. We conclude with options for how governments and industry can apply the class-based approach, emphasizing the importance of eliminating non-essential uses of PFAS, and further developing safer alternatives and methods to remove existing PFAS from the environment.
