PFAS – Not just Forever, but Everywhere and Harmful – What to Know and Do

My last blogpost introduced the group of chemicals, polyfluoroalkyl substances or PFAS, also known as “forever” chemicals, and their risks to the environmental and public health. For this post, I want to stress the extent of our exposure to these chemicals and their impact to our health.

The fact that there are more than 4,500 PFAS compounds produced ought to tell us that they are found in a huge number of products. Also, the question of why do we need so many non-stick like chemicals  comes to mind. Most of us may only be familiar with only a few of products that contain PFAS — non-stick cookware, and stain resistant fabrics for clothing, carpet, and furniture. In reality the number of common everyday products containing PFAS number in the hundreds, and many of these will surprise you. For example, PFAS can be found in some: candy wrappers, cleaning products, cosmetics, dental floss, electronics and circuit boards, fire-fighting foams, food packaging, hydraulic fluid, inks, metal plating paints, pesticides, photographic processing paper, polishes, shampoo, surfactants, and other related products. With PFAS in so many products we use or are in contact with daily, it is no wonder that 98% of us have PFAS in our blood, and the extent that they are found in our water and the environment. So, including the descriptor “everywhere” in addition to “forever” is reasonable.

Being forever and everywhere alone is reason for alarm, but combining the growing understanding of the impacts to human health, greatly escalates the danger of this group of compounds. Research studies on PFAS and human health are relatively recent, but the variety of adverse health risks known to date are highly significant and should prompt immediate response. Studies have shown the health effects include increased risk of: asthma, diabetes, decreased birth weight, cancer (kidney, testicular), increased cholesterol, kidney and liver disease, decreased immune response, decreased fertility, obesity, thyroid disease, and reduced vaccine response. These health impacts are what we know now from studies that have only looked into a small portion of the PFAS compounds.

All this information on the persistent, ubiquitous, and harmful characteristics of PFAS compounds should be a wake up call for all of us — consumers, manufacturers, regulators, and policy makers. Fortunately, the level of concern and action is slowly increasing in society. EPA is investing many resources in new regulations and research, and some states are moving rapidly to set higher drinking water standards and bans of PFAS in some or all products. A few recent examples include:

  • California banned PFAS in paper products and requires cookware to disclose the presence of PFAS, and further they will ban PFAS in children’s clothing
  • Colorado banned use of fire-fighting foams with PFAS
  • New York state ban of PFAS in detergents and paper products in 2022 
  • Maine banned the intentional addition of PFAS in food packaging in 2019  and has banned added PFAs in all products, and will be phased in
  • Pennsylvania has limited two common PFAS compounds, PFOA and PFOS in drinking water to 14 and 18 parts per trillion.
  • Vermont will ban PFAS in food packaging, carpets, rugs and ski wax
  • Washington state prohibited PFAS in food packaging in 2022
To date 2,850 locations in all 50 states are known to have PFAS contamination (Check out Environmental Working Groups’ interactive map: https://www.ewg.org/interactive-maps/pfas_contamination/map/).

Unfortunately, there is still much to learn, and we can expect new research to expand our understanding of the risks and seriousness of this issue. What can we as consumers do now?

A couple of suggestions are:

Check out these other tips from Clean Water Fund.

PFAS – Prevalent and Persistent Pollution 

Per- and poly-flouroalkyl substances (PFAS) are a family of over 4,500 manufactured fluorine chain chemicals that are used in a wide variety of non-stick, heat, stain and oil resistant products. Common applications and products containing PFAS include non-stick cookware, food packaging, stain resistant fabrics, cleaning products, shampoo, cosmetics, toothpaste and floss, paint, pesticides, and firefighting foams. 

Due to the extensive use, PFAS compounds have been observed in groundwater and drinking water supplies, invertebrates, fish, amphibians, reptiles, birds, mammals, and humans throughout the United States and world. Due to the many carbon to fluorine bonds, one of the strongest bonds in nature, these compounds are very resistant to breakdown and therefore persist in the environment, giving rise to the term “forever” chemicals. 

Furthermore, studies have shown that over 95% of people in the US have measurable amounts of PFAS in their bodies, with certain PFAS compounds remaining in the body for 4-8 years. Compounding this prevalence and persistence is the fact that the amounts are increasing in the environment, some food products and animals, a process known as bioaccumulation, and as the use of PFAS containing products increase, the amount in surface and groundwater accumulate. 

The source of PFAS in humans is from food, dust and drinking water, with recent studies showing that the contribution from drinking water is as high as 90%. The effect on human health has been researched only on a dozen or less PFAS compounds including PFOA and PFOS, the most widely used PFAS compounds. 

Exposure to these two chemicals have been attributed to significant health risks including increased risk of cancer, increased cholesterol, hormonal changes and decreased fertility, thyroid disruption and low birth weight. PFOA and PFOS were phased out by the mid 2000’s, and concentrations in humans have decreased slightly since then. However, many more PFAS are being used and produced and there remains a significant gap of knowledge on the environmental and human health effects of other PFAS compounds.

PFAS concentrations in drinking water tend to be greater near manufacturing plants, military bases and airports were firefighting foam is used. The EPA has issued a health advisory (not a regulation) of 70 parts per trillion (ppt) for drinking water, whereas Europe and several US states have imposed more stringent limits of PFAS in drinking water. 

Even though our knowledge of the extent of risks of all PFAS compounds is very limited, the good news is that several filtration systems have been shown to be effective in removing many PFAS contaminants. These include activated carbon (10-97% removal), ion exchange (90-99% removal) and reverse osmosis (93-99% removal). These filters can be installed in homes to treat either the entire home (point of entry, POE), or point of use (POU) typically installed under the sink for drinking and cooking use. 

In addition to treating our drinking water, we can all be better stewards by the choices we make. Proper recycling and disposal of unwanted household goods and products may help contain some PFAS. Investing in learning what products contain PFAS could help in making better product choices, but unfortunately, only broad product categories, as described earlier, are published. Whether a specific product contains PFAS is not readily available since no labeling requirement exists currently. More info on PFAS can be found at: CDC: https://www.cdc.gov/biomonitoring/PFAS_FactSheet.html; EPA: https://www.epa.gov/pfas; and MDE: https://mde.maryland.gov/programs/Water/water_supply/Pages/PFAS_Home.aspx   


  • PFAS compounds are very resistant to breakdown and therefore persist in the environment, giving rise to the term “forever” chemicals.
  • Studies have shown that over 95% of people in the US have measurable amounts of PFAS in their bodies, with certain PFAS compounds remaining in the body for 4-8 years.
  • Health risks include increased risk of cancer, increased cholesterol, hormonal changes and decreased fertility, thyroid disruption and low birth weight.

Just Keep Swimming (Safely)

In the heat of summer, there is nothing more refreshing than heading to a pool, beach, or some other cool place for a swim. As a kid, I loved going to my grandmother’s house to play in the pool with my cousins. We would hold diving contests, play games of “Sharks and Minnows,” and enjoy the occasional popsicle as well. My husband and I recently moved into our new house, which has a pool, and it has brought back many of these fun memories. But, it also got me thinking about making sure that people enjoy my pool safely. So, today I thought I would offer some tips around making sure we can all be safe and have fun at the pool!

Having fun in the sun means being prepared for everything the sun brings with it! The warmth from the sun can turn dangerous without the right protection. There are a variety of options you can consider, although the most popular and common one is probably sunscreen. The most important thing when using sunscreen is to make sure you are following instructions for the sunscreen you are using. It will tell you how to apply it and how often you’ll need to reapply to make sure it is protecting you and your family.

But you should also consider sun protection options like protective clothing, umbrellas, or going inside. If you have children who make the putting on sunscreen a difficult process, protective clothing might be a great option. My husband recently bought two shirts that protect against the sun and he found it much easier than trying to remember to reapply after swimming. Although it isn’t always an option, if you are able, going inside during the hottest part of the day can also be very helpful. Anything to avoid a sunburn, right?

Children sitting by the pool. Images by rawpixel.com.

Another important aspect of staying safe at the pool is following any posted rules or clearly explaining your family’s own pool rules. For example, many pools have a no running rule, which can be difficult for kids to understand. Talking about this rule ahead of time might help. You could even do a science experiment to show kids different surfaces and how they change when they are wet. Having kids participate and understand what it means for something to be slippery and dangerous might help them understand why that rule applies at the pool. Discussing rules like this ahead of time can be a good way to make sure everyone is on the same page. For example, you might have a rule that your kids can only be in certain parts of the pool. You can talk to young kids ahead of time and explain how the depth can change in some pools and that it isn’t safe for them to be in deeper areas. Explaining why the rule exists might make the kids more likely to follow it.

As a parent, there are many other things you can do to ensure pool safety. The US Consumer Product Safety Commission has a website dedicated to sharing this information. You can go to https://www.poolsafely.gov/parents/ to check it out. It shares information about making sure kids have appropriate supervision, teaching kids to swim, and installing protective barriers and other equipment. Be sure to check out the information and resources on the website to see if there is anything that will be helpful for you and your family.

Enjoy some safe and fun pool time this summer!

Spring Drinking Water Tune-Up

Home appliances require periodic maintenance to ensure they last and operate effectively. This is especially true if they have filters such as a vacuum or heating/air conditioner. Your water supply and filtration system also needs regular attention. Water quality is very important to your health, so understanding your water supply, its quality, and treatment is essential.

Depending on your supply (public or private well), tune up procedures will vary. For public water supplies, which go through extensive testing and treatment, there may be little to do unless you have older plumbing pipe and fixtures. In this case, testing for lead and copper is recommended. 

If you are on a drinking water well, have your water tested annually for coliform bacteria, E.coli and nitrate (animal waste and sewage contaminants), and every three years test for chloride, copper, lead, iron, pH, manganese, sulfates, and total dissolved solids. In some areas, there may be other contaminants such as arsenic or radium (local health departments can provide information), which you can test for. Be sure to use a certified lab – your local county health department should have a list. If your water results indicate treatment is needed, go to this resource to find out more about filters: http://dwit.psiee.psu.edu/dwit.asp.

Whatever type of water filter you use — faucet, pitcher, refrigerator or under the sink filter – they all require maintenance. Simply be sure to change the filters as recommended by the manufacturer. Not changing them can lead to reduction in water flow and filtration performance, and can also result in contaminants no longer being trapped, which can then be released into the water. Water filters can also build up bacteria if not changed as recommended. If you have a whole house or faucet filtration system, be sure to follow the manufacturers’ recommended maintenance schedule. 

Investing a little time to check on your water and filtration system can help ensure safe drinking water for you and your family.

What Are the Pros and Cons of Fluoride in Drinking Water? 

Fluoride was originally added to public drinking water in the 1950s as a way to reduce dental cavities or tooth decay. There are some natural water supplies that contain fluoride, and public utilities will test to determine if removal or addition is warranted. 

The American Dental Association, Centers for Disease Control and others supported this effort then and still do today. The Environmental Protection Agency established a maximum contaminant level (MCL) of 4 mg/l or ppm and most utilities will add fluoride at 0.5 – 1.5 mg/l. 

In the years since initiation of fluoridation, there have been numerous studies which have investigated the potential health impacts associated with fluoride. Several studies have shown a link of ingested fluoride with an increase of dental and skeletal fluorosis (staining or pitting of teeth in children, or bone weakness), cognitive impairment, hypothyroidism, enzyme and electrolyte derangement, and uterine cancer. However, the American Cancer Society recently has stated that research has not shown a link of fluoride and cancer. 

Concentrations of fluoride in these studies varied, but some show a link to health effects at levels of 1-2 mg/l, well below the EPA MCL. The Department of Health and Human Service has recommended an optimal level of 0.7 milligrams per liter is set to promote public health benefits of fluoride for preventing tooth decay while minimizing the chance for dental fluorosis and other health issues. 

Currently the EPA is reviewing the new risk assessment of fluoride to determine whether to revise the drinking water standard. 

Given the increasing concern over potential health impacts with fluoridated water, there are efforts by various groups to lobby for utilities to stop adding fluoride to drinking water. One argument used is that since the use of fluoridated toothpaste and other topical products, which have been shown to be more effective than a water source, fluoridation is no longer warranted, especially given the potential harm to certain individuals or populations. In recent years, over 75 cities have stopped adding fluoride to their drinking water supply. Further the U.S. Public Health Service has lowered its recommended level of fluoride in drinking water. 

If you are concerned about fluoride in your drinking water, check with your public water utility. An annual Consumer Confidence Report is available and will inform you of the amount of fluoride in the water supply. If you are using a private well, you can have your water tested. There are several filters that will remove fluoride including anion exchange, activated alumina, and the most common is reverse osmosis which can be installed under the sink to treat your drinking water. 

For more information on water quality and testing, check out our website.

Health Benefits of Gardening

Often for this blog, I get to write posts about physical activity (the benefits, how to get started, or fun ways to be active). It’s definitely no secret that I am a lover of physical activity and I occasionally try to convince my coworkers to participate in physical activity challenges offered by our human resources office. Recently, I was talking with a coworker about one of these challenges and she let me know that she didn’t think she would be much help to the team. Knowing she is an avid gardener, I reminded her that time spent in the garden would be considered physical activity and she was surprised. Which got me thinking, do many people not think of gardening as being physically active? 

Photo by Rachel Claire on Pexels.com

So, for today, I thought we could talk a bit about gardening and all the wonderful benefits it can bring to your life! To start, gardening typically involves movement and is great for the body. Being in the garden might include bending, stretching, walking, lifting, and a variety of other movements that are beneficial for your body and your health. Also, gardening is often done outside, so it gives us the opportunity to soak up some sunlight and increase our Vitamin D levels. Finally, for many people, gardening is much more enjoyable than going to the gym. And since it is fun, people are more likely to do it. So, gardening can be an easy and fun way to increase the amount of time you spend being physically active. 

The benefits of gardening don’t stop with your body, they extend to your mind as well! Studies have shown that people who see and spend time around plants and gardens (often called green space) experience less anxiety, depression, and stress. In fact, one study found that daily gardening lowered dementia risk by 36%. Finally, AARP mentions that gardening can be a great way to reduce loneliness. Participating in community gardens or other group gardening programs can help people feel connected to others. This can be a great way to help your community and get to know others. 

Photo by Uriel Mont on Pexels.com

So, what can you do with this information? Well, if you think you might like gardening, try it out in small ways. Get a houseplant, start an indoor herb garden, and see if you enjoy tending those things. If you have a little bit more space, you could consider moving on to a window box, hanging basket, or small container garden (there are lots of tutorials online for this sort of thing). It may not be an option for everyone, but you could even plant a large outdoor garden with whatever vegetables you and your family enjoy, if you have the time and space. You may or may not be aware, but you can even get involved with your local extension office! Extension offices across the country operate Master Gardener programs. You could go to one of the classes they offer and learn more about gardening. Or, you could complete the training to become a Master Gardener yourself, and join a community of folks who love to garden and teach others about gardening!

The level to which you participate in gardening is totally up to you, but if gardening is something you like or think you might like, find ways to incorporate it into your life. It could have a host of benefits beyond the beautiful flowers or tasty things you grow. 

We’ve Missed You!

While Breathing Room has been on something of a short hiatus for the past few weeks, we were diligently working behind the scenes developing a brand new University of Maryland Extension website, complete with an improved user navigation and more ways to help Marylanders find the answers they need.

The UME Family and Consumer Sciences team offers numerous programs and educational opportunities, even above and beyond the scope of this blog. Our experts specialize in health, financial wellness, food safety, health insurance literacy, nutrition, mental wellness, and community outreach.

Visit the new Extension website to learn about them and the wide variety of educational opportunities the Family and Consumer Sciences program offers!

Ideas for Cooking as a Family

Thinking about kids in the kitchen might bring to mind images of piles of dirty dishes, flour strewn across counters, and a general mess. But kids are capable of doing more in the kitchen than just making a mess! Getting kids involved in cooking family meals can be an important way to build healthy habits. Involving kids in cooking at home may help motivate them to try new foods. Additionally, research shows that cooking meals at home and eating them as a family might be a positive impact on children’s diets*. So, if we know cooking at home with our kids can be so beneficial, how do we make it happen? 

Photo by August de Richelieu on Pexels.com
  • Start when kids are young and start with small tasks. 
    • A preschooler might be able to hang out in the kitchen while dinner is being prepared, rather than playing in another area. And, they could help with simple tasks like putting toppings on a pizza, stirring things, or turn pages in a recipe book. 
    • They could also help count things being used in recipes, like eggs as they are being cracked. 
    • If kids get used to the idea of being around and helping prepare meals, it may be easier to keep them involved as they get older. 

Even if kids are older and have not been in the kitchen much, there are still ways to get them involved! 

Photo by Pixabay on Pexels.com
  • Rely on things your kids already find interesting. 
    • For example, if kids enjoy reading you could try making food mentioned in their book. There are even books like How to Feed Your Parents and Rainbow Stew that include recipes for the meals mentioned in the books. 
    • Or maybe your kids are interested in television shows like Master Chef Junior, Chopped, or the Great British Baking Show. If so, they might be interested in attempting recipes from the show or trying to develop their own creative recipes. 
    • You might have to do a bit of research to see if there are any fun recipes in the shows, books, or other media your kids enjoy, but connecting cooking to something they already love can help get them interested! 
  • Include them when planning meals for the week. This might not work for younger kids without some restrictions (unless you want ice cream for every meal). But, especially for older kids, giving them some say in what goes on the menu might help them feel more excited about getting dinner on the table. 
    • For even older kids, you might be able to make cooking dinner a chore you assign (if that is something your family does). At first, they may need parental assistance, but as they build their cooking skills they could get to the point where they can cook a meal for the entire family on their own!

Hopefully, these helpful tips and strategies give you some ideas about how to include your family in cooking meals. Just remember that kids should only be asked to do things appropriate for their age and that most kids (especially younger kids) will need parental supervision to ensure there are no accidents! 

Happy cooking!

* Rockett HR. Family dinner: more than just a meal. J Am Diet Assoc. 2007;107: 1498-1501.