Agencies Encourage Clinicians to Consider Occupational Exposures to PFAS

A new document published by CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) discusses considerations for clinicians whose patients are concerned about exposure to per- and polyfluoroalkyl substances (PFAS). According to the agencies, increases in cholesterol levels, lower antibody response to vaccines, kidney and testicular cancer, and changes in liver enzymes are among the health effects potentially associated with exposure to PFAS. Other potential health effects include pregnancy-induced hypertension, preeclampsia, and decreases in birth weight. As community awareness around this group of synthetic chemicals increases, people are asking healthcare providers for counseling and support regarding exposure. The new document highlights ingestion of contaminated food and water as a main route of exposure to PFAS but notes that workplaces that manufacture, use, or handle PFAS present additional exposure sources.

One way that clinicians can determine the duration, magnitude, and routes of a patient’s PFAS exposures is by taking an exposure history. A PFAS exposure history asks about a patient’s occupational or recreational exposures to fluorochemical manufacturing processes, firefighting foams, ski wax, and other PFAS-containing materials, among other questions. In addition to identifying current and past PFAS exposures, an exposure history can help patients understand how they have been exposed to PFAS and whether current exposures can be reduced. CDC and ATSDR recommend that clinicians consult with an occupational and environmental medicine specialist regarding workplace exposure reduction strategies.

The document is available as a PDF from ATSDR’s website.

Related: An article published in the March 2022 issue of The Synergist focuses on the challenges in researching and managing exposure to PFAS. Another article published later that year explores how PFAS complicate product stewards' efforts to plan ahead.