October 31st, 2022

Per- and polyfluoroalkyl substances (PFAS) or forever chemicals are being found all throughout the world as their use has risen over the past 6 plus decades. PFAS are a family of chemicals known as POPS or persistent organic pollutants as they are reported to not break down easily. They have been found in products like Teflon based nonstick cookware, Scotch Guard and Gortex stain-resistant carpeting and clothing, dental floss, commercial firefighting foams and many types of food packaging. Unfortunately, these toxins have been detected in drinking water, house dust and foods/beverages of common consumption. See below for a more comprehensive list.

Biomonitoring analysis note that 98% of Americans have detectable amounts of PFAS in their blood and tissues. "The report concluded that an association is likely between chronic PFAS exposure in children and medical concerns such as elevated blood cholesterol levels, dyslipidemias, slightly lowered birth weight and reduced antibody response to certain vaccines/infections.

Children are more vulnerable to environmental pollutants like PFAS than adults because of breathing space closer to the floor, lower body weight, differences in water and food intake, developing organ systems and longer lifespans during which toxic effects might manifest. " Children consume more water and food per body weight increasing the concentration of PFAS that they are exposed to per day. Children are rapidly growing which allows the interface between PFAS chemicals and the dividing and growing cells to shorten increasing disease risk.

According to the EPA's website: Current peer-reviewed scientific studies have shown that exposure to certain levels of PFAS may lead to:
• Reproductive effects such as decreased fertility or increased high blood pressure in pregnant women.
• Developmental effects or delays in children, including low birth weight, accelerated puberty, bone variations, or behavioral changes.
• Increased risk of some cancers, including prostate, kidney, and testicular cancers.
• Reduced ability of the body’s immune system to fight infections, including reduced vaccine response.
• Interference with the body’s natural hormones.
• Increased cholesterol levels and/or risk of obesity.
Watch the documentary "The Devil We Know" for an intimate look at this issue.


AAP Recommendations: Key recommendations for pediatric health care providers
Assess patients for common sources of PFAS in the environment, including drinking water, fish/game caught in contaminated areas and occupations including firefighters and military, and provide families with strategies to reduce exposure such as:

• Filter contaminated drinking water with an NSF-certified filter.
• Follow local consumption advisories for fish and game.
• Use stainless steel or cast-iron cookware instead of Teflon nonstick.
• Avoid stain-resistant textiles, waterproofing sprays and products with PTFE or “fluoro” ingredients on the label.

Offer PFAS blood testing to patients with a likely history of elevated exposure (e.g., live in a community with contaminated drinking water). The ideal blood test should assess the concentration of seven common PFAS compounds. For those tested, use the sum of seven PFAS compounds to inform clinical care:
<2 nanograms per milliliter (ng/mL): PFAS-related adverse effects not expected; provide usual standard of care; 2-20 ng/mL: potential for PFAS-related adverse effects (especially in sensitive groups); encourage exposure reduction strategies, provide usual standard of care with prioritization of dyslipidemia screening per AAP recommendations; ≥20 ng/mL: increased risk of adverse effects; encourage exposure reduction strategies, provide usual standard of care with prioritization of dyslipidemia screening per AAP recommendations, conduct thyroid function testing (with TSH) at well visits for patients over 18 years and assess for signs and symptoms of testicular cancer and ulcerative colitis for those over 15 years.
(Woolf et. al. 2022)

If there are not enough reasons already, here is another consideration. If you have an allergic phenotype, a tendency toward allergic diseases like allergic rhinitis, asthma and eczema, then you really want to avoid endocrine disrupting chemicals, EDC's. The allergic phenotype immunologically is known as a TH2 or T helper cell type 2 polarized immune state. This means that at baseline your immune system releases chemicals that promote the release of cells like eosinophils and mast cells which in turn release chemicals like histamine that cause our nasty symptoms of sneezing, wheezing and itching.

It turns out that the EDC's promote the polarization of the immune system towards a TH 2 slant and away from the TH1 polarity. This shift leads to a movement away from effective pathogen killing in the body making you more susceptible to infections and inflammation. Covid19 comes into view here as TH2 dominance is not useful against SARS2.

EDC's are of no value to us as humans. We should avoid them at all costs. Visit the Environmental Working Group's site for more information. See the links below for a deeper dive.

Dr. M

Woolf AAP Article on PFAS
EDC Article #1
EDC Article #2
Kabir Environmental Article
Eva Cell Biology Article

Comprehensive EPA list: PFAS can be present in our water, soil, air, and food as well as in materials found in our homes or workplaces, including:
• Drinking water – in public drinking water systems and private drinking water wells.
• Soil and water at or near waste sites - at landfills, disposal sites, and hazardous waste sites such as those that fall under the federal Superfund and Resource Conservation and Recovery Act programs.
• Fire extinguishing foam - in aqueous film-forming foams (or AFFFs) used to extinguish flammable liquid-based fires. Such foams are used in training and emergency response events at airports, shipyards, military bases, firefighting training facilities, chemical plants, and refineries.
• Manufacturing or chemical production facilities that produce or use PFAS – for example at chrome plating, electronics, and certain textile and paper manufacturers.
• Food – for example in fish caught from water contaminated by PFAS and dairy products from livestock exposed to PFAS.
• Food packaging – for example in grease-resistant paper, fast food containers/wrappers, microwave popcorn bags, pizza boxes, and candy wrappers.
• Household products and dust – for example in stain and water-repellent used on carpets, upholstery, clothing, and other fabrics; cleaning products; non-stick cookware; paints, varnishes, and sealants.
• Personal care products – for example in certain shampoo, dental floss, and cosmetics.
• Biosolids – for example fertilizer from wastewater treatment plants that is used on agricultural lands can affect ground and surface water and animals that graze on the land.