Clinical Implications of New Drinking Water Regulation for "Forever Chemicals"
By Rachel Criswell, Abby F Fleisch, and Alan Ducatman
JAMA
August 14, 2024
DOI: 10.1001/jama.2024.12705
In April 2024, the US Environmental Protection Agency (EPA) announced its new maximum contaminant levels for some perfluoroalkyl and polyfluoroalkyl substances (PFASs), setting safe drinking water levels for these contaminants at near zero.1 PFASs encompass a class of thousands of synthetic chemical compounds composed of fluorinated carbon chains of varying lengths. PFASs make consumer and industrial products oil- and water-resistant, and many persist in the environment virtually indefinitely and in the human body with multiyear half-lives. The new EPA regulations for specific PFASs reflect what years of epidemiologic and basic science research have shown concerning cancer and other outcomes. This has prompted lay media attention to the dangers of the most commonly studied of these “forever chemicals” as endocrine disrupters and their link to a surprising range of long-term health effects that may share roots in immune, hepatic, cell membrane, and energy metabolism toxicity. The new EPA regulation, far below the previous drinking water health advisory of 70 parts per trillion, and recent media interest will lead many patients to question whether they have been exposed to unsafe PFAS levels. Patients will look to their clinicians for answers regarding their PFAS exposure and risk mitigation, creating a new focus on these chemicals in the clinical realm.
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