Perfluorooactanoic Acid (PFOA) & Other PFAS Chemicals

At a Glance

Perfluorooactanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) are used extensively in commercial applications for their properties of being highly stable and having low surface tension. PFOA and PFOS are found in items ranging from cookware to carpeting and provide resistance to soil or stains. PFOA is a suspected endocrine disruptor and possible carcinogen, and PFOS has been linked to fertility challenges.

What are PFOA and PFOS?

PFOA is a highly fluorinated compound with low surface tension, making it a perfect chemical to help make products non-stick, water resistant and stain resistant. PFOA is very stable and bioaccumulates in the blood and in tissues such as liver and kidney in people and animals.[1],[2] It is believed to be an endocrine disruptor and may cause increased risk of breast cancer and disrupt development.[3],[4],[5],[6],[7],[8]

PFOS is closely related to PFOA, and is also ubiquitous in the environment. PFOS has been decreasing over the past decade as the chemical has been phased out of use in the United States.[9]

PFOA and PFOS are part of the perfluoroalkyl family (PFAS), which are chemicals that do not occur naturally in the environment. PFOA and PFOS are the most common of the PFAS family, although both are being phased out due to their adverse health and environmental effects.[10] They are being replaced with other PFAS compounds that share their potential to repel oil, grease and water.

Where are PFAS chemicals found?

PFAS chemicals can be found in non-stick cookware, stain-resistant carpeting and furniture, rainwear, and food packaging and contact paper (e.g., fast food wrappers, microwave popcorn bags). Although it is currently being phased out of production,[11] PFOS is generally used to provide resistance to soil or stains, especially in textiles, and it is the main ingredient in Scotchguard®. PFOA, specifically, has been used to make polytetrafluoroethylene (PTFE), and can be found at contaminant levels in products containing PTFE, such as Gore-Tex®, Teflon® and anti-aging cosmetics. Because PFOA is persistent in the environment, it is a common contaminant in drinking water.[12] PFOA is also found in indoor dust, especially in newly renovated buildings or homes with new furniture or carpeting.[13],[14],[15]

What evidence links PFAS chemicals to breast cancer?

Both the International Agency for Research on Cancer (IARC) and the U.S. Environmental Protection Agency (EPA) have designated PFOA as a potential human carcinogen.[16] In addition, there have been several findings that exposure to PFOA could be associated with endocrine disruption and an increased risk of developing breast cancer.

  • Studies in rodents have shown that exposure to PFOA can delay development of mammary glands, reduce birthweight and cause neonatal death.[17],[18],[19]
  • Exposure to PFOA can disrupt lactation in mothers and alter development of mammary glands in female mouse pups.[20]
  • Higher levels of PFOA and PFOS are associated with difficulty conceiving, longer delays in becoming pregnant[21] and early onset of menopause in women.[22],[23]
  • PFOS has been detected in amniotic fluid[24] and umbilical cord blood,[25] and is associated with lower weights at birth but higher weights at 20 months of age.[26]
  • Finally, a study of Inuit women in Greenland showed that women with higher blood serum levels of PFOS and PFOS and other PFAS chemicals have an increased risk of breast cancer.[27]

Short-chain PFAS Chemicals

Due to these and other health concerns, PFOA and PFOS have been voluntarily phased out of use. Because of their persistence, they are still found in wildlife across the planet.[28],[29] This has led manufacturers to begin replacing the longer-chain PFAS chemicals such as PFOA and PFOS with shorter-chain acids.[30] These newer chemicals may be less toxic and bioaccumulative, although emerging data indicate that many shorter-chain PFAS chemicals may have negative health effects.[31]

Perfluorohexanoic acid (PFHxA) and Perfluoroheptanoic acid (PFHpA) are both part of the perfluoroalkyl family (PFASs). PFHxA has been detected in drinking water in higher detection limits at a single site.[32] Some researchers believe that the increasing content of short chain PFASs in water reflects increased use of the PFASs as replacements for PFOS and PFOA-related substances.[33] Early research suggests PFHxA and PFHpA may be developmental toxicants. PFHpA demonstrated more severe effects on liver and heart development than PFHxA.[34]

Perfluorobutane sulfonic acid (PFBS) is also part of the perfluoroalkyl family. PFBS was developed in 2003 as a PFOS replacement. PFBS has been found in drinking water and samples of whole fish including striped mullet, anchovies, young hake and swordfish fillets. Since 2003, it has also been marketed as a stain resistant for carpets.[35] One Study found PFBS in household cleaning products between 2007 and 2011.[36] It has been suggested that PFBS could affect neuronal development[37] and potentially alter the hormonal system by allowing imbalances between androgens and estrogens.[38],[39]

Perfluorononanoic acid (PFNA) and Perfluorododecanoic acid (PFDoA) are synthetic perfluorinated chemicals that have been found in humans and wildlife worldwide. PFNA may lead to reproductive toxicity to males.[40] Several epidemiological studies have found a link between PFOS, PFOA and PFNA and reduced semen quality.[41],[42],[43] PFDoA has been found to affect the reproductive function of male rats.[44]

Perfluorooctane sulfonamide (PFOSA) is also part of the perfluoroalkyl family. It has been found to damage the health of cells and their ability to process fats in salmon liver cells.[45] A study on pregnant Danish women and serum levels of PFAS found a significant positive association with PFOSA and breast cancer.[46]

Perfluorobutyric acid (PFBA) is part of the perfluoroalkyl family and low levels have been detected in drinking water.[47] A 2014 study found high accumulation levels on lettuce and strawberries irrigated with reclaimed water.[48] PFBA has also been found in donor blood serum samples[49] and in samples from ski wax technicians who were exposed to high levels of PFASs.[50]

Perfluorohexane sulfonic acid (PFHxS) is ubiquitous in the environment. One study detected PFHxS in nearly all people tested for PFASs.[51] An analysis of water and fish contaminated by an accidental release of firefighting foam in Canada found a small amount of PFHxS present.[52] In addition a Swedish study detected high levels of several PFASs including PFHxS in firefighters compared to a control group.[53] PFHxS has also been found to alter motor activity in mouse and rat pups, but thus far studies have not examined effects in humans.[54] PFHxS along with other PFASs have been detected in breast milk, and it was concluded that lactation is a considerable source of exposure to perfluorinated chemicals for infants.[55]

Who is most likely to be exposed to PFOA & PFOS?

PFOA and PFOS are ubiquitous,[56] meaning that almost everyone will be exposed to at least small amounts.[57] People living near PFOA manufacturing sites and regions with PFOA-impacted drinking water may be at risk for exposure to higher levels of PFOA.[58]

Who is most vulnerable to the health effects of PFAS?

Women, particularly pregnant women, and children are most vulnerable to the potential health effects of PFAS chemical exposure.

What are the top tips to avoid exposure to PFOA & PFOS?

  • Do not using non-stick cookware made from perfluorinated compounds. Instead, use ceramic coated non-stick or well-seasoned cast iron cookware.
  • Avoid food contact paper treated with grease-resistant coatings, like paper wrapping and coated cardboard boxes used at fast food restaurants.
  • Avoid “anti-aging” cosmetics containing PTFE.
  • People living in areas with PFOA impacted drinking water should consider drinking bottled water.

[1] U.S. EPA. Perfluorooctanoic Acid (PFOA) and Fluorinated Telomers. Available online: http://epa.gov/opptintr/pfoa/. Accessed July 27, 2015.

[2] European Chemicals Agency (ECHA). Member State Committee Support Document for Identification of Pentadecafluorooctanoic Acid (PFOA), as a substance of very high concern because of its CMR and PBT properties. June 14, 2013. http://echa.europa.eu/documents/10162/8059e342-1092-410f-bd85-80118a5526f5

[3] EPA. Draft Risk Assessment of the Potential Human Health Effects Associated with Exposure to Perfluorooctanoic Acid and its Salts. Available online: http://www.epa.gov/oppt/pfoa/pubs/pfoarisk.pdf. Accessed July 27, 2015.

[4] Knox, S.S., Jackson, T., Javins, B., Frisbee, S.J., Shankar, A., & Ducatman, A.M. “Implications of early menopause in women exposed to perfluorocarbons.” J Clin Endocrinol Metab. 2011 Jun;96(6):1747-53.

[5] Fei C, Mclaughlin JK, Tarone Re, & Olsen J. “Fetal growth indicators and perfluorinated chemicals: a study in the Danish National Birth Cohort.” Am J Epidemiol. 2008 Jul 1;168(1):66-72.

[6] White SS, Stanko JP, Kato K, Calafat AM, Hines EP, & Fenton SE. “Gestational and chronic low-dose PFOA exposures and mammary gland growth and differentiation in three generations of CD-1 mice.” Environ Health Perspect. 2011 Aug;119(8):1070-6.

[7] Lau C, Anitole K, Hodes C, Lai D, Pfahles-Hutchens A, & Seed J. “Perfluoroalkyl acids: a review of monitoring and toxicological findings.” Toxicol Sci. 2007 Oct;99(2):366-94.

[8] U.S. EPA. Draft Risk Assessment of the Potential Human Health Effects Associated with Exposure to Perfluorooctanoic Acid and its Salts. Available online: http://www.epa.gov/oppt/pfoa/pubs/pfoarisk.pdf Accessed July 27, 2015.

[9] Kato K, Wong L-Y, Jia LT, et al. Trends in exposure to polyfluoroalkyl chemicals in the U.S. population:1999-2008.Environ Sci Technol. 2001;

[10] ATSDR: Agency for toxic substances and disease registry. Toxic substances portal – perfluoroalkyls. Public health statement for perfluoroalkyls. 2015. Available online: https://www.atsdr.cdc.gov/phs/phs.asp?id=1115&tid=237 (Accessed October, 2016).

[11] USEPA. Perfluorooctanoic acid (PFOA), perfluorooctyl sulfonate (PFOS), and other long-chain perfluorinated chemicals (LCPFCs). Available online: https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/perfluorooctanoic-acid-pfoa-perfluorooctyl-sulfonate. Updated April 14, 2016. Accessed April 19, 2016.

[12] U.S EPA. Emerging Contaminants – Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Available online: https://www.epa.gov/sites/production/files/2014-04/documents/factsheet_contaminant_pfos_pfoa_march2014.pdf Accessed March 22, 2016.

[13] Fraser AJ et al. “Polyfluorinated compounds in serum linked to indoor air in office environments.” Environ Sci Technol. 2012. 46(2);1209-15.

[14] U.S EPA. Emerging Contaminants – Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Available online: https://www.epa.gov/sites/production/files/2014-04/documents/factsheet_contaminant_pfos_pfoa_march2014.pdf Accessed March 22, 2016.

[15] Zhang T, Sun HW, Wu Q, Zhang XZ, Yun SH, & Kannan K. “Perfluorochemicals in meat, eggs, and indoor dust in China: assessment of sources and pathways of human exposure to perfluorochemicals.” Environ Sci Technol. 2010 May 1;44(9):3572-9.

[16] EPA. Draft Risk Assessment of the Potential Human Health Effects Associated with Exposure to Perfluorooctanoic Acid and its Salts. Available online: http://www.epa.gov/oppt/pfoa/pubs/pfoarisk.pdf Accessed July 27, 2015.

[17] White SS, Stanko JP, Kato K, Calafat AM, Hines EP, & Fenton SE. “Gestational and chronic low-dose PFOA exposures and mammary gland growth and differentiation in three generations of CD-1 mice.” Environ Health Perspect. 2011 Aug;119(8):1070-6.

[18] Lau C, Anitole K, Hodes C, Lai D, Pfahles-Hutchens A, & Seed J. “Perfluoroalkyl acids: a review of monitoring and toxicological findings.” Toxicol Sci. 2007 Oct;99(2):366-94.

[19] U.S. EPA. Draft Risk Assessment of the Potential Human Health Effects Associated with Exposure to Perfluorooctanoic Acid and its Salts. Available online: http://www.epa.gov/oppt/pfoa/pubs/pfoarisk.pdf Accessed July 27, 2015.

[20] White SS et al. “Gestational PFOA exposure of mice is associated with altered mammary gland development in dams and female offspring.” Toxicol Sci. 2007 Mar;96(1):133-44.

[21] Fei C, McLaughlin JK, Lipworth L, Olsen J. Maternal levels of perfluorinated chemicals and subfecundity. Human Reproduction. 2009;24:1200-5.

[22] Knox SS, Jackson T, Javins B, Frisbee SJ, Shankar A, & Ducatman AM. “Implications of early menopause in women exposed to perfluorocarbons.” J Clin Endocrinol Metab. 2011 Jun;96(6):1747-53.

[23] Fei C, Mclaughlin JK, Tarone Re, & Olsen J. “Fetal growth indicators and perfluorinated chemicals: a study in the Danish National Birth Cohort.” Am J Epidemiol. 2008 Jul 1;168(1):66-72.

[24] Stein CR, Wolff MS, Calafat AM, Kato K, Engel SM. Comparison of polyfluoroalkyl compound concentrations in maternal serum and amniotic fluid: a pilot study. Reprod Toxicol. 2012;34:312-16.

[25] Apelberg BJ, Goldman LR, Calafat AM, et al. Determinants of fetal exposure to polyfluoroalkyl compounds in Baltimore, Maryland. Environ Sci Technol. 2007;41:3891-7.

[26] Maisonet M, Terrell ML, McGeehin MA, et al. Maternal concentrations of polyfluoroalkyl compounds during pregnancy and fetal and postnatal growth in British girls. Environ Health Perspect. 2012;120:1432-7.

[27] Bonefeld-Jorgensen EC, Long M, Bossi R, et al. Perfluorinated compounds are related to breast cancer risk in Greenlandic Inuit: a case control study. Environ Health. 2011;10:88.

[28] Jensen AA, Leffers H. Emerging endocrine disrupters: perfluoroalkylated substances. Int J Androl. 2008;31:161-9.

[29] Kato K, Wong L-Y, Jia LT, et al. Trends in exposure to polyfluoroalkyl chemicals in the U.S. population:1999-2008.Environ Sci Technol. 2001;

[30] NICNAS: National Industrial Chemicals Notification and Assessment Scheme. Per- and poly-fluorinated alkyl substances. 2016.  Available online: https://www.nicnas.gov.au/communications/publications/information-sheets/existing-chemical-info-sheets/perfluorinated-chemicals-pfcs-factsheet (Accessed October, 2016).

[31] NICNAS: National Industrial Chemicals Notification and Assessment Scheme. Per- and poly-fluorinated alkyl substances. 2016.  Available online: https://www.nicnas.gov.au/communications/publications/information-sheets/existing-chemical-info-sheets/perfluorinated-chemicals-pfcs-factsheet (Accessed October, 2016).

[32] Potential Designated Chemicals: Perfluoroalkul and polyfluoroalkyl substances. Biomonitoring California. 2015. Available online: http://biomonitoring.ca.gov/sites/default/files/downloads/PotenDesigPFASs_031315.pdf

[33] Rahman M, Peldszus S, Anderson W (2014). Behavior and fate perfluoroalkyl and polyfluoroalkyl substances (PFASs) in drinking water treatment: A review. Water Res 50:318-340.

[34] Kim M, Park MS, Son J, Park I, Lee HK, Kim C, Min BH, Ryoo J, Choi KS, Lee DS, Lee HS. Perfluoroheptanoic acid affects amphibian embryogenesis by inducing the phosphorylation of ERK and JNK. International journal of molecular medicine. 2015 Dec 1;36(6):1693-700.

[35] Potential Designated Chemicals: Perfluoroalkul and polyfluoroalkyl substances. Biomonitoring California. 2015. Pg. 2. Available online: http://biomonitoring.ca.gov/sites/default/files/downloads/PotenDesigPFASs_031315.pdf

[36] Liu X, Guo Z, Krebs KA, Pope RH, Roache NF (2014a). Concentrations and trends of perfluorinated chemicals in potential indoor sources from 2007 through 2011 in the US. Chemosphere 98:51-57.

[37] Slotkin T, MacKillop E, Melnick R, Thayer K, Seidler F (2008). Developmental neurotoxicity of perfluorinated chmicals modeled in vitro. Environ Health Perspect 116:716-722.

[38] Gorrochategui E, Perez-Albaladejo E, Casas J, Lacorte S, Porte C (2014). Perfluorinated chemicals: Differential toxicity, inhibition of aromatase activity and alteration of cellular lipids in human placental cells. Toxicol Appl Pharmacol 277:124- 130.

[39] Potential Designated Chemicals: Perfluoroalkul and polyfluoroalkyl substances. Biomonitoring California. 2015. Pg. 2. Available online: http://biomonitoring.ca.gov/sites/default/files/downloads/PotenDesigPFASs_031315.pdf

[40] Feng Y, Fang X, Shi Z, Xu M, Dai J. Effects of PFNA exposure on expression of junction-associated molecules and secretory function in rat Sertoli cells. Reproductive toxicology. 2010 Nov 30;30(3):429-37.

[41] Joensen U, Bossi R, Leffers H, Jensen A et al. (2009). Do perfluoroalkyl compounds impair human semen quality? Environ Health Perspect 117:923-927.

[42] Toft G, Jonsson B, Lindh C, Giwercman A et al. (2012). Exposure to perfluorinated compounds and human semen quality in Arctic and European populations. Hum Reprod 27:2532-2540.

[43] Louis G, Chen Z, Schisterman E, Sweeney K et al. (2015). Perfluorochemicals and human semen quality: The LIFE Study. Environ Health Perspect 123:57-63.

[44] Shi Z, Zhang H, Liu Y, Xu M, Dai J. Alterations in gene expression and testosterone synthesis in the testes of male rats exposed to perfluorododecanoic acid. Toxicological sciences. 2007 Jul 1;98(1):206-15.

[45] Wågbø AM, Cangialosi MV, Cicero N, Letcher RJ, Arukwe A. Perfluorooctane sulfonamide-mediated modulation of hepatocellular lipid homeostasis and oxidative stress responses in Atlantic salmon hepatocytes. Chemical research in toxicology. 2012 May 31;25(6):1253-64.

[46] Bonefeld-Jørgensen EC, Long M, Fredslund SO, Bossi R, Olsen J. Breast cancer risk after exposure to perfluorinated compounds in Danish women: a case–control study nested in the Danish National Birth Cohort. Cancer Causes & Control. 2014 Nov 1;25(11):1439-48.

[47]Rahman M, Peldszus S, Anderson W (2014). Behavior and fate perfluoroalkyl and polyfluoroalkyl substances (PFASs) in drinking water treatment: A review. Water Res 50:318-340.

[48] Blaine A, Rich C, Sedlacko E, Hyland K et al. (2014). Perfluoroalkyl acid uptake in lettuce (Lactuca sativa) and strawberries (Fragaria ananassa) irrigated with reclaimed water. Environ Sci Technol 48:14361-14368.

[49] Lee H, Mabury S (2011). A pilot survey of legacy and current commercial fluorinated chemicals in human sera from United States donors in 2009. Environ Sci Technol 45: 8067−8074.

[50] Nilsson H, Kärrman A, Rotander A, van Bavel B et al. (2013). Biotransformation of fluorotelomer compound to perfluorocarboxylates in humans. Environ Int 51:8-12.

[51] Calafat A, Wong L, Kuklenyik Z, Reidy J, Needham L (2007). Polyfluoroalkyl chemicals in the U.S. population: Data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and comparisons with NHANES 1999-2000. Environ Health Perspect 115:1596-1602.

[52] Moody C, Martin J, Kwan W, Muir D, Mabury S (2002). Monitoring perfluorinated surfactants in biota and surface water samples following an accidental release of firefighting foam into Etobicoke Creek. Environ Sci Technol 36:545-551.

[53] Rotander A, Kärrman A, Toms L, Kay M et al. (2015). Novel fluorinated surfactants tentatively identified in firefighters using liquid chromatography quadrupole time-of-flight tandem mass spectrometry and a case-control approach. Environ Sci Technol 49:2434- 2442.

[54] ATSDR: Agency for toxic substances and disease registry. Toxic substances portal – perfluoroalkyls. Public health statement for perfluoroalkyls. 2015. Available online: https://www.atsdr.cdc.gov/phs/phs.asp?id=1115&tid=237 (Accessed October, 2016).

[55] Kärrman A, Ericson I, van Bavel B, Darnerud PO, Aune M, Glynn A, Lignell S, Lindström G. Exposure of perfluorinated chemicals through lactation: levels of matched human milk and serum and a temporal trend, 1996-2004, in Sweden. Environmental Health Perspectives. 2007 Feb 1:226-30.

[56] Jensen, A. A., & Leffers, H. (2008). Emerging endocrine disrupters: perfluoroalkylated substances. International Journal of Andrology31(2), 161–169. doi:10.1111/j.1365-2605.2008.00870.x.

[57] Calafat, A., Ye, X., Wong, L.-Y., JA, R., & LL, N. (2008). Exposure of the U.S. population to bisphenol A and 4-tertiary-octylphenol. Environ Health Persp, 116, 2003–2004.

[58] U.S EPA. Emerging Contaminants – Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Available online: https://www.epa.gov/sites/production/files/2014-

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