Cross-cutting story 3: PFAS

Per- and polyfluoroalkyl substances (PFAS) are a group of over 4,700 widely used synthetic chemicals that persist in the environment. Because of their widespread use and persistent properties, they can be found in the environment, humans, animals, food and feed.

The majority of monitoring data are available for two substances in this group: perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS). Monitoring activities have detected PFAS across the world — even in snow on Mount Everest (Miner et al., 2021). PFAS have been identified in surface water in a number of European countries, such as Austria, France, Germany, the Netherlands and Sweden (Munoz et al., 2015; Pramanik, 2015; Sahlin, 2017; WHO Europe, 2017; Brandsma et al., 2019); and in other media such as rainwater (Cousins et al., 2022); groundwater (Bunting et al., 2021); soils and wild bird eggs (Groffen et al., 2017); predatory birds and mammals (Androulakakis et al., 2022); and fish (Surma et al., 2021). The levels of PFOS in rainwater in Europe have been found to exceed the EU’s environmental quality standard for surface waters (Cousins et al., 2022). In addition, the production and use of PFAS has contaminated drinking water supplies in several European countries (EEA, 2019). PFAS have also been detected in human blood (Göckener et al., 2020; HBM4EU, 2022) and breast milk (Serrano et al., 2021).

Of the relatively few well-studied PFAS, most are considered moderately to highly toxic. The adverse health impacts of PFAS include endocrine, immune, reproductive and developmental effects (EEA, 2019) (see Figure 1). It is not just individual PFAS that are harmful: combined exposure to mixtures of PFAS — also known as the ‘cocktail effect’ — adds to the health pressures as explained in the zero pollution ‘Signal’ on chemical mixtures. Human exposure to PFAS has been estimated to cost €52-84 billion in annual health costs in Europe (Goldenman et al., 2019).

Figure 1. Health impacts linked to PFAS exposure

Source: EEA (2019).

Animals may also be affected by PFAS, but fewer studies have documented these impacts. Once in the environment, PFAS pollution is very difficult and costly to remove; often, the clean-up bill and the health costs fall on society.

Emissions of PFAS to the environment

PFAS are widely used in building and consumer products, medicines and pesticides, and vehicles and energy production because of their appealing technical properties, whereby they resist heat, oil, grease and water. This results in emissions throughout the life cycles of these products, including from production, manufacturing, product use and waste management (Figure 2).

Figure 2. Life cycle of PFAS emissions

Source: ETC/WMGE (2021).

Large-scale environmental pollution has been found in Europe around PFAS production and manufacturing plants, such as in Antwerp, Belgium (Vito, 2022), and Dordrecht, the Netherlands (Gebbink and van Leeuwen, 2020). At the Antwerp site, the PFAS pollution is mainly from PFOS, a so-called ‘long-chain’ PFAS that accumulates in people and other organisms. PFOS is now largely banned but remains in the environment because it is so persistent. Long-chain PFAS have been substituted by so-called ‘short-chain’ PFAS that are less bioaccumulative in people. The pollution around the Dordrecht facility in the Netherlands stems from GenX, which is an example of a short-chain PFAS. It is highly water soluble and persistent, meaning that it bioaccumulates in aquatic environments. GenX provides an example of regrettable substitution as detailed in the zero pollution ‘Signal’ on regrettable substitution.

PFAS emissions from industrial installations to wastewater may be substantial. While larger industrial facilities have treatment plants, smaller factories may discharge wastewater to municipal treatment plants. In these cases, PFAS can end up in sewage sludge, which may subsequently be spread on agricultural land, potentially leading to the contamination of food. In Baden-Württemberg, Germany, mixtures of paper sludge and compost contaminated with PFAS from a paper factory were applied to farmed land over a period of several years leading to the contamination of agricultural land, groundwater, surface water and drinking water (BMUV, 2022).

Industrial waste sites are also a source of PFAS emissions. In addition, incinerating PFAS products can cause pollution if the treatment temperature is too low. Moreover, smouldering electronic and other waste can form toxic fumes that include PFAS (Lohmann et al., 2020). 

PFAS-based firefighting foams are also responsible for significant contamination in Europe. For example, in 2013 drinking water supplies to one third of the households in Ronneby, southern Sweden, were found to be highly contaminated by PFAS originating from firefighting foams used at a nearby military airport. Levels of perfluorohexanoic acid (PFHxA) and PFOS in the blood of members of the exposed community were found to be a hundredfold higher than general population (Xu et al., 2021). PFAS contamination was also identified as an environment and health risk at three firefighting training sites in Finland (Reinikainen et al., 2022) and at the locations of firefighting operations and training in Germany (BMUV, 2022).

Human exposure to PFAS in Europe

People may be exposed to PFAS from multiple sources — such as using products containing PFAS or via food and water, contamination in the environment, industrial production processes or food packaging. Indoors, PFAS are emitted into the air from products, textiles, cleaning agents, sprays, cosmetics and personal care products, the heating of certain products (such as popcorn bags), and building materials.

The people likely to be most at risk are workers who are in repeated contact with PFAS — either directly or via air, aerosols, dust or ingesting food during the workday. This includes workers in PFAS-producing plants, those using specific products for manufacturing (such as hard-chrome plating) and those applying the product professionally (e.g. in firefighting equipment and ski wax) EEA (2019).

The HBM4EU project recently investigated levels of PFAS in the blood of teenagers from across Europe and detected PFAS in the blood of all individuals sampled – with the contamination mainly caused by substances that have already been banned, but that are extremely persistent (Weise et al., 2022). Figure 3 presents the share of teenagers with combined blood levels of four PFAS (PFOA, perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS) and PFOS) above 6.9 µg/L. When an individual exhibits blood levels above this threshold, it implies that they have exceeded EFSA’s guideline value for the tolerable weekly intake of the four PFAS - the maximum intake in food that can be consumed weekly over a lifetime without risking adverse health effects (Schrenk et al., 2020). In all nine countries a share of teenagers had blood levels of PFAS above the health-based guidance value, ranging from 1% in Spain to 24% in France (Lobo Vicente et al., forthcoming). Average blood levels were significantly higher in northern and western Europe than in southern and eastern Europe. Boys had higher PFAS blood levels than girls, and higher levels were found in teenagers from households with a higher education level. In addition, higher PFAS blood levels were linked to the consumption of fish, seafood, eggs, offal and locally produced food (Richterová et al., 2023). On average, 14% of the teenagers showed blood levels of PFASs above the guidance value (HBM4EU, 2022).

Figure 3. Share of European teenagers in nine European countries with combined blood levels of PFAS above the health-based guidance value (2014 - 2021)

Source: Lobo Vicente et al., forthcoming.

Impact of risk management measures on human exposure to PFAS

Once the persistence and toxicity of PFOS and PFOA became known, industrial initiatives to substitute these substances and regulatory restrictions on production and use led to changes in human exposure. In 2006, the marketing and use of PFOS was restricted in the EU under the Dangerous Substances Directive, with this restriction now transferred to the Regulation concerning the registration, evaluation, authorisation and restriction of chemicals (REACH). Later in 2009, PFOS was added to the list of persistent organic pollutants (POPs) targeted for elimination under the Stockholm Convention, with PFOA added in 2019. Both PFOS and PFOA are also restricted under the POPs Regulation.  

Evidence from the German Environmental Survey shows how changing use patterns reduced citizens’ exposure to PFOS and PFOA in Germany over the period 1982 to 2019 (Figure 4). Levels of PFOS and PFOA in young adults have declined by as much as 90% and 70%, respectively, compared with the highest levels in 1986 (Göckener et al., 2020, Schröter-Kermani et al., 2013). Nevertheless, PFOA and PFOS were consistently detected in every single sample and sometimes exceeded health-based guidance values, demonstrating how persistent chemicals remain problematic long after they are banned.

Figure 4. Blood levels of PFOS and PFOA in young adults in Germany from 1982 to 2019

Note: This presents the geometric mean value, normalised to the value measured in 1986. Hence the value for 1986 = 100%.

Sources: Göckener et al. (2020); Schröter-Kermani et al. (2013).

Click here to view the figure enlarged

Managing the risks of PFAS as a group

As mentioned above, PFAS are regulated at global level under the Stockholm Convention, with a broader range of restrictions in place at EU level under the POPs Regulation and REACH (ECHA, 2022a).

The EU’s chemicals strategy for sustainability recommends avoiding all non-essential uses of PFAS across the EU; this is in line with the zero pollution hierarchy, which prioritises ‘prevention’. The strategy also calls for the restriction of PFAS as a ‘group’ of chemicals. In tandem, the European Chemicals Agency (ECHA) recently prepared a proposal to ban all PFAS from firefighting foams (ECHA, 2022b). Five Member States are also working on a proposal that would ban PFAS in many other use cases across the EU under REACH (RIVM, 2022).

In parallel, the EU has set limits for groups of PFAS under the 2020 Drinking Water Directive. Most recently, the Commission proposed to include PFAS in the lists of water pollutants to be controlled in surface waters and groundwater under the Water Framework Directive, the Groundwater Directive and the Environmental Quality Standards Directive (EC, 2022).

Cover image source: © Matjaz Krivic, Well with Nature /EEA