This story was originally produced by WBUR. It's being shared with partners through the New England News Collaborative.
It’s impossible to completely avoid PFAS, a class of human-made chemicals that has been linked to a growing list of serious medical concerns. There are thousands of types of PFAS, and many are not well studied. Yet they’re in everything from stain-resistant rugs to dental floss, outdoor gear, food packaging and soil.
“These chemicals are in all of us — everyone — and they're everywhere,” said Linda Birnbaum, the former director of the federal government’s National Institute of Environmental Health Sciences and the National Toxicology Program.
Birnbaum and others have advocated for better regulation and more limited use of PFAS, short for per- and polyfluoroalkyl substances.
“We really have to turn off the tap for this stuff,” Birnbaum said.
While scientists work to better understand these chemicals and their risks, there are some strategies you can use to reduce your exposure.
WBUR spoke to more than a half-dozen PFAS experts to learn what changes they’ve made in their own lives and what they recommend to avoid PFAS.
Tips to mitigate your PFAS risk
1. Check your drinking water for PFAS
“Based on what we currently know, contamination in drinking water tends to be the most critical route of exposure for the majority of the general population,” said Megan Romano, an epidemiologist at Dartmouth’s Geisel School of Medicine.
So, what can be done?
First, a key question is whether your tap water comes from a municipal system or a private well.
Municipal water
For those on municipal water, the good news is that Massachusetts has some of the strictest drinking water standards for PFAS in the country. That means there’s testing for and good data about what’s in municipal water — and a requirement to fix it, if levels are too high.
You can search for data on your community by going to this state website and typing in "PFAS6" under "chemical name."
Private wells
For those who get water from a private well, you’ll likely have to pay for your own test.
The state provides data from well water samples taken in municipalities where more than 60% of residents rely on private wells. It’s worth noting that PFAS levels can vary within a small area. So even if your neighbors have test results, experts say it’s still worth getting your own well tested.
Certified labs can do PFAS water testing. However, there are not many labs in Massachusetts that do this testing, and it can cost close to $500. The state maintains a database of certified labs as well as an FAQ for private well owners.
Water filters and bottled water
If you have PFAS in your well water or municipal water, filters can help, although their effectiveness varies.
Two types of filters are known to reduce PFAS: reverse osmosis and granular activated carbon filters. The key is to keep up with regular maintenance and replace the filters as instructed. Duke University provides a tip sheet on the different types of filters.
Don’t forget: Bottled water isn’t always better since it often isn’t tested for PFAS. Massachusetts created water quality standards for bottlers that include PFAS testing and provides a list of those licensed to distribute in the state.
2. Avoid PFAS in food and kitchen supplies
Scientists have found PFAS in food, food packaging and various kitchen items.
In food wrappers and containers, PFAS are often added to help make them resistant to oil, water and grease.
Elsie Sunderland, an environmental chemist at Harvard, tested some compostable containers from a university dining hall. Her team found PFAS leached out of the containers at levels higher than have been measured at a superfund site on Cape Cod.
“So there's a lot of PFAS in the coatings of certain compostables,” said Sunderland. “That's the bad news. The good news is, in just a few years, a lot of people heard about this. And now you have PFAS-free compostables.” An environmental advocacy group, compiled a list of products whose makers have pledged not to use PFAS.
Avoid grease-resistant food containers
Experts recommend reducing the length of time food is in containers or food wrappers that might have PFAS. For example, if you are refrigerating food for later, put it into a different container. And when heating up food, it’s best to use a container that’s unlikely to have PFAS, such as a glass or ceramic container.
How much PFAS transfers from wrappers and containers into food? This can vary, according to Dartmouth’s Romano. Some factors include what type of PFAS is in the product, and “the temperature, the acidity of the food, how you're handling the package,” Romano said.
Romano urged people to avoid microwave popcorn that comes in a bag. It is, unfortunately, “the perfect delivery system,” she said, “because you have the heat and the oil that's going from the packaging into the popcorn.”
Avoid nonstick pans
Many nonstick pots and pans contain PFAS. When cooking, the chemicals can get into the air and may also migrate into food. Environmental contamination from manufacturing sites and landfills is also a concern. So, some experts say it’s best to avoid these products.
“I would try to pick a pan that doesn't list itself as nonstick,” said Sunderland.
Instead, experts recommend using cookware made of cast iron, stainless steel, glass or enamel. There is also a growing market for “PFAS-free” kitchen items (but be sure to read the tip below about how to decode a PFAS label).
Which foods have PFAS?
PFAS in the soil or groundwater can be absorbed by crops and plants, or consumed by fish swimming in nearby rivers and streams.
PFAS also tend to concentrate in wastewater. One byproduct from wastewater treatment, known as biosolids, is used as fertilizer. In some states, these fertilizers have been spread on fields, contaminating crops and animal feed, even showing up in cows’ milk and meat.
Although scientists have found PFAS in some produce, meat and dairy products, there isn’t yet enough information to make concrete dietary recommendations.
“We just don't have comprehensive data from diet items in the U.S.,” said Sunderland. “If you look at the parallel European data, diet is the predominant exposure pathway for most groups.”
Which food groups were the biggest contributors varied by age, gender, location and other factors, she said.
Several studies, including a recent U.S. study, suggest certain fish and shellfish have higher levels of PFAS, although it did not seem to be an issue for most commercially available fish.
3. Reduce PFAS around the house and in clothing
Limit PFAS in air and dust
PFAS are present in many household items, like stain-resistant carpets and upholstery, and from those surfaces, they can transfer into the air and dust.
“If you have a product that you sprayed in your home or that was treated with a stain-resistant coating, like carpeting, that is volatilizing — it's evaporating into the air in your home,” said Courtney Carignan, an exposure scientist and environmental epidemiologist at Michigan State University. “In your home, you're breathing it in. You're accidentally ingesting it.”
Experts recommend wiping surfaces with a damp cloth instead of dry dusting, using a HEPA air filter and using a vacuum with a HEPA filter.
Avoid stain-resistant or waterproof products
Stain-resistant and water-resistant products can contain PFAS, such as tablecloths, rugs, handbags and couches, as well as raincoats, camping tents and leggings.
“These surface coatings, they're very thin — and they are variable — but they're very, very concentrated in some of the products where they use them intentionally,” said Sunderland, of Harvard University. “That is why you can just have it kind of rub off everywhere and go everywhere.”
Experts recommend skipping stain-resistant coatings or sprays for furniture, shoes and clothing. And they suggest avoiding products labeled as stain-resistant or waterproof.
Some environmental advocacy groups create lists of companies that have pledged to avoid PFAS (such as this list). It’s also possible to ask a manufacturer or retailer whether their products are fluorine-free.
4. Avoid PFAS in cosmetics, lotions and dental floss
Scientists are discovering that lots of personal care products have PFAS in them.
However, there’s some debate over how much PFAS enter the body through the skin. Birnbaum, the former director of the National Toxicology Program, said the latest evidence suggests that PFAS can enter through the skin but is not as readily absorbed as when drinking or eating.
“You can show that it slowly penetrates the skin,” she said.
PFAS absorption also may vary depending on the type of PFAS, as well as the individual.
“So children, for example, have much more porous skin and so would be more susceptible to this kind of exposure than, say, an adult,” said Harvard’s Sunderland.
Be wary of waterproof products
Experts say personal care products labeled waterproof, water-resistant, long-wear or long-lasting are more likely to contain PFAS. They recommend checking ingredient lists (see the next tip) and reducing the number of products you use regularly.
“This is a risk-benefit equation. If something makes you really happy, use it,” said Sunderland, but she suggests using only the products you like the most. “In your 20 products, you could just pick one to three.”
And Sunderland recommends consulting a website that provides information to help consumers select products with fewer harmful chemicals.
Dental floss
After an analysis found that dental floss can be a source of PFAS, it drove some people to search for floss without PFAS. Experts WBUR consulted recommend using silk or nylon dental floss that is coated in wax. This website also lists which dental floss products avoid PFAS.
5. Read labels with PFAS in mind
“PFAS-free” labels
Read the letters carefully. It’s best to go with “PFAS-free” not “PFOA-free” or “PFOS-free.”
PFOA and PFOS are two types of PFAS. In the U.S., manufacturers stopped producing them after they were linked to health concerns. But there are thousands of other PFAS chemicals that may be in the product, and little is known about most of them. When testing nonstick pans, Consumer Reports found that even some pans labeled “PFOA-free” were full of PFAS.
Several experts pointed to this list of products made by companies that pledged they do not have PFAS.
It’s worth noting that Consumer Reports recommends looking for PTFE-free pans when it comes to cookware. And their experts question the “PFAS-free” label, since it may indicate the PFAS levels are below a certain threshold rather than not in the product at all.
Watch out for these ingredients
For products like moisturizers, sunscreen, eye drops or lipstick, check the ingredients for “PTFE” or anything that starts with “fluoro.” Experts say they’re likely to contain PFAS.
“The products where the concentrations were the highest, you could see some sort of fluorinated ingredient,” said Sunderland, a professor at Harvard.
Still, experts caution that ingredient lists can be deceiving. Some PFAS may bear different names or remain unlabeled.
“Even me, as a chemist, looking at an ingredient list, it's difficult to understand what the ingredients are and what's in them,” said Heidi Pickard, a doctoral student at Harvard University studying PFAS. She said she checks a few websites before purchasing a new product. You can find a list of common PFAS ingredients in cosmetics from the FDA.
6. Other resources and guidance
Academics, journalists and environmental advocacy groups have put together guidance on how to reduce exposure to PFAS.
Here is guidance on limiting PFAS exposure from the PFAS Exchange.
Here is guidance from Consumer Reports, which has done extensive PFAS testing.
Here is the Green Science Policy Institute’s list of brands and products that have made commitments not to use PFAS.
Here is Silent Spring’s smartphone app, which helps people reduce exposure to harmful chemicals.
Here is the Environmental Working Group’s effort to vet products for various harmful chemicals.