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Table 1 Excerpts from Official Health Communications concerning PFAS

From: Official health communications are failing PFAS-contaminated communities

Agency/ Organization Short Excerpt
US Federal Agencies
 Agency for Toxic Substances and Disease Registry A large number of studies have examined possible relationships between levels of per- and polyfluoroalkyl substances (PFAS) in blood and harmful health effects in people. However, not all of these studies involved the same groups of people, the same type of exposure, or the same PFAS. These different studies therefore reported a variety of health outcomes. Research involving humans suggests that high levels of certain PFAS may lead to the following …
 ATSDR Clinician Guidance on PFAS It is possible that PFAS contributed to your health problems but there is no way to know if PFAS exposure has caused your illness or made it worse … Based on what we know at this time, there is no reason to think your health problem is associated with exposure to PFAS.
 ATSDR Talking to Your Doctor about Exposure to PFAS … some studies in people have shown that certain PFAS may affect growth, learning, and behavior of infants and older children, lower a woman’s chance of getting pregnant, interfere with the body’s natural hormones, increase cholesterol levels, affect the immune system, increase the risk of cancer. If you have any of these conditions and have been exposed to PFAS, you can tell your doctor.
 Department of Defense Scientists are still studying the health effects of exposure to PFAS. Although more research is needed, some studies in people have shown that certain PFAS may affect health.
 Environmental Protection Agency Because certain PFAS are known to cause risks to human health, the most important steps you and your family can take to protect your health is to understand how to limit your exposure to PFAS.
 Food and Drug Administration Exposure to some types PFAS have been linked to serious health effects.
 National Institute of Environmental Health Sciences The research conducted to date reveals possible links between human exposures to PFAS and adverse health outcomes.
 National Toxicology Program NTP is studying the potential health effects of PFAS through a large research effort with multiple facets including experimental rodent and cell-based test systems, literature review, and computer modeling, among others. Taken together, these studies give insights into the potential adverse health outcomes of PFAS in the human body.
Foreign Agencies
 Australian Government Department of Health PFAS has not been proven to cause any specific illnesses in humans …There is no current evidence that supports a substantial impact on an individual’s health from PFAS exposure.
 Australian Government National Health and Medical Research Council (Recreational Water) PFAS has not been shown to cause disease in humans.
 European Chemicals Agency Certain PFASs are known to accumulate in living things and cause toxic effects.
 European Environmental Agency See Fig. 1 for portrayal of health effects with denotation of high and low uncertainty
 Government of Canada Adverse environmental and health effects have been observed for well-studied PFAS (PFOS, PFOA, and LC-PFCAs and their salts and precursors) and they have been shown to pose a risk to the Canadian environment … PFAS used to replace regulated PFOS, PFOA, and LC-PFCAs may also be associated with environmental and/or human health effects.
NGOs / Professional Organizations
 American Academy of Pediatrics We currently do not have a clear answer on how PFAS can impact health but there are scientific studies going on right now to help us answer this question. Some of these studies show a possible connection between PFAS exposure and higher cholesterol levels, as well as effects on the hormone system, immune system, liver, and kidneys.
 American Association for the Advancement of Science - Risk Communications for Local and State Leaders A class of thousands of synthetic organic chemicals, not enough is known about the health impacts of most PFAS, but even small doses of several of the most-researched compounds can lead to health issues. These guides can help people engage their community members, drinking water providers, local and state regulatory agencies, and federal agencies to address PFAS in drinking water.
 American Water Works Association The EPA and the Agency for Toxic Substances and Disease Registry (ASTDR) both report that the most consistent health effect from PFAS exposure is increased cholesterol levels. There are more limited findings related to [list of health effects].
 Association of State and Territorial Health Officials - Clinicians FAQ There is evidence linking certain PFAS to adverse health effects in humans, with more evidence for some effects than for others.
 Association of State and Territorial Health Officials - General FAQ Studies show that different PFAS can cause different types of toxicity; EPA classifies them as having “suggestive” evidence of human carcinogenicity.
 Association of State and Territorial Health Officials - Public FAQ It is difficult to link current health issues with PFAS exposure.
 Environmental Council of the States - Health Communications Case Studies See health risk communications case studies
 Green Science Policy Institute The best-studied PFAS, PFOA and PFOS, are linked to liver damage, high cholesterol, obesity, diabetes, cancer, thyroid disease, asthma, immune system dysfunction, reduced fertility, low birth weight, and effects on children’s cognitive and neurobehavioral development. Ongoing research is finding similar health harm in other PFAS as they are studied.
 Health and Environment Alliance Scientific evidence suggests that exposure to PFAS can cause serious health impacts, among which kidney and liver damage, cancer, impaired fertility and immunity, and adverse pregnancy outcomes.
 Interstate Technology Regulatory Council Some PFAS have been linked to multiple health endpoints in studies of the general population and communities with contaminated drinking water. Laboratory animal toxicology studies and human epidemiological studies suggest health effects that may occur as a result of long-term exposure to PFOA and PFOS at environmentally relevant concentrations.
 National Groundwater Association - PFAS Risk Communication for Contractors There is evidence some PFAS can be harmful to human health.
 National Resource Defense Council Linked to a variety of health problems, among them cancer and developmental issues, PFAS can be harmful at extremely low doses.
 Pediatric Environmental Health Specialty Units While current evidence is compelling, causality has not been definitively established for a wide range of health effects. Many uncertainties and data gaps remain and will require further research. The most consistent findings from epidemiology studies are elevated blood serum total cholesterol levels among exposed populations, with strong evidence for a causal relationship between PFOA exposure and elevations in serum lipids.
Sierra Club They are linked to a variety of health problems including kidney and testicular cancer, immune system damage, high cholesterol and digestive system problems, and significant changes to liver, thyroid, and pancreatic function.
 Silent Spring Institute Silent Spring Institute is studying this class of chemicals because some types of PFAS have been linked to cancers, including breast cancer, immunotoxicity in children, thyroid disease, reproductive problems, and other health effects.
 Silent Spring Institute - PFAS REACH Information for Clinicians See guidance for clinicians for performing laboratory tests, examinations, or counseling for adults and children
 Silent Spring Institute - PFAS REACH Information for Patients Several national and international health agencies have reviewed the results of peer-reviewed epidemiological (human populations) and toxicological (laboratory animals) research and written scientific assessments based on these studies, including [list of studies] … At least one of these assessments concluded that PFAS exposure is associated with [list of health effects].
US States
 Alabama Department of Environmental Management Studies have shown possible adverse human health effects from exposure to PFAS.
 Alaska Department of Spill Prevention and Response Although these two compounds are the most studied, a growing body of research indicates additional PFAS compounds may have similar health or environmental effects and may be co-contaminants.
 Arizona Department of Environmental Quality PFAS exposure is linked to potential adverse human health outcomes …
 Arkansas Department of Health Some health studies indicate that exposure to PFOA and PFOS over certain levels may result in adverse health effects, including developmental effects to fetuses during pregnancy or to breastfed infants, cancer, liver effects, immune effects, thyroid effects, and other health effects.
 California Environmental Protection Agency Exposure to unsafe levels of PFOA/PFOS may result in adverse health effects including developmental effects to fetuses during pregnancy, cancer, liver effects, immune effects, thyroid effects, and other effects (such as cholesterol changes).
 Colorado Department of Health and Environment Whether PFAS chemicals harm health depends on many factors. These factors include amount of exposure, age, genetics, and health history. Research involving humans strongly suggests exposure to certain PFAS chemicals, including PFOA and PFOS may [list of health effects] … Though additional research is needed, it is likely other PFAS may have health impacts like PFOA and PFOS.
 Connecticut Department of Energy and Environmental Protection Certain PFAS have been linked to health risks including developmental effects in fetuses and infants, various forms of cancer, and decreased liver, thyroid, and immune system function.
 Connecticut Department of Public Health Therefore even low levels in drinking water may increase your risk of developing a variety of health risks if exposure is long term (months to years). Exposure to PFAS above the CT Action Level does not necessarily mean that health effects will happen.
 Delaware Natural Resources and Environmental Control & Delaware Department of Health and Social Services Some toxicological studies have found that exposure to these substances can cause serious health effects.
 Florida Department of Environmental Protection When released into the environment, PFAS can cause contamination to soil, groundwater and surface water, and these impacts may pose a risk to public health and the environment.
 Georgia Environmental Protection Division Peer-reviewed studies of laboratory animals and epidemiological studies of human populations indicate that exposure to PFOA and PFOS over certain levels may result in adverse health effects.
 Hawaii Department of Health While there are thousands of PFASs, only a relatively small number are considered to pose a significant risk to human health and the environment ... Some of the newer replacement compounds, such as HFPO-DA (GenX) and ADONA, are being evaluated for potential risks.
 Illinois Environmental Protection Agency While research on the effects of PFAS exposure on human health is ongoing, current scientific studies have identified possible adverse health effects such as increased cholesterol levels, increased risk for thyroid disease, low infant birth weights, reduced response to vaccines, liver and kidney toxicity, and pregnancy-induced hypertension.
 Indiana Department of Environmental Management Both PFOA and PFOS are commonly found in the environment. Studies indicate that exposure to PFOA and PFOS above certain levels may result in adverse health effects.
 Iowa Department of Natural Resources The existing body of scientific literature suggests that exposure to these compounds may result in health effects such as developmental defects in fetuses and infants as well as certain types of cancer.
 Kentucky Energy and Environment Cabinet There is evidence that exposure to PFAS may impact reproductive and developmental health, increase the risk for cancer, disrupt thyroid hormones, and affect the immune system.
 Maine Department of Environmental Protection Health agencies are working to understand more about the health effects of low level, long-term exposure.
 Maryland Department of the Environment According to the Agency for Toxic and Disease Registry (ATSDR) some, but not all, studies in humans with PFAS exposure have shown that certain PFAS may [list of health effects].
 Massachusetts Department of Environmental Protection Studies indicate that exposure to sufficiently elevated levels of certain PFAS may cause a variety of health effects including developmental effects in fetuses and infants, effects on the thyroid, liver, kidneys, certain hormones and the immune system. Some studies suggest a cancer risk may also exist in people exposed to higher levels of some PFAS.
 Michigan Department of Environment, Great Lakes, and Energy Health effects associated with PFAS include [list of health effects] … Studies in animals help us understand what could happen in people. Animals given very high amounts of PFOS and PFOA showed [list of health effects].
 Minnesota Department of Health Numerous studies have shown that higher levels of exposure to PFAS are associated with a wide range of human health effects … However, more work needs to be done to determine if PFAS, or other factors, caused the effects.
 Minnesota Department of Health - Fact Sheet for Health Professionals Drinking water at or above the guidelines does not pose an immediate health risk. We do not have evidence of human harm at current levels.
 Montana Department of Environmental Quality There is evidence that exposure to PFAS can lead to adverse human health effects.
 New Hampshire Department of Health and Human Services Available scientific research does not provide consistent information about whether PFAS cause health problems in humans … Because of inconsistent and contradictory findings of the effects of PFAS in people, more scientific studies are needed to be sure which health effects, if any, are caused by exposure to PFAS.
 New Jersey Department of Health Since human health effects are associated with even low-level exposures to PFOA and PFOS, it is important to minimize increases in exposure from drinking water.
 New Mexico Environment Department The health effects of these emerging contaminants are still being studied, but research indicates that some PFAS may affect reproductive health, increase the risk of some cancers, affect childhood development, increase cholesterol levels, affect the immune system, and interfere with the body’s hormones.
 Rick Langley Letter to North Carolina Clinicians It remains unclear if these tests [PFAS blood tests] would be clinically useful, and it is not possible to connect PFAS test results with clinical outcomes.
 North Carolina Department of Health and Human Services Whether or not you develop health problems after being exposed to PFAS depends on how much, how often, and for how long you are exposed, as well as which PFAS you are exposed to. Personal factors including age, lifestyle, and overall health can impact your body’s ability to respond to chemical exposures.
 North Dakota Department of Environmental Quality Some studies have shown a relationship between PFAS chemicals in the body and a higher chance of some diseases … Many but not all studies in humans show that certain PFAS chemicals may harm developing fetuses and cause problems during childhood development.
 Ohio Environmental Protection Agency Studies in humans and animals show that there may be negative health effects from exposure to certain PFAS. Completely stopping exposure to PFAS is not practical, because they are so common and present throughout the world.
 Oregon Health Authority The research suggests that exposure to high levels of PFAS may [list of health effects].
 Pennsylvania Department of Environmental Protection PFOA and PFOS are also very persistent in the human body, and exposures to these chemicals are known to have a number of adverse effects in laboratory animals and humans.
 Rhode Island Department of Health As a result, as people get exposed to PFAS from different sources over time, the level of PFAS in their bodies may lead to adverse health effects. The likelihood of adverse health effects depends on several factors such as the amount and concentration of PFAS ingested as well as the time span of exposure.
 Tennessee Department of Environment and Conservation There is evidence that exposure to PFAS can lead to adverse health outcomes in humans … However, a review of potential human health effects due to PFAS exposure by the Australian Government Department of Health’s Expert Health Panel concluded “there was insufficient evidence of causation between PFAS exposure and any adverse health outcomes.”
 Texas Department of State Health Services PFAS exposure may be associated with increased risk of some adverse effects on human health and may include [list of health effects] … However, these types of health problems can be caused by many different factors including lifestyle, environmental, social, and genetic, and it is difficult to know if PFAS exposure has caused health problems or made them worse.
 Utah Department of Environmental Quality Some, but not all, studies in humans with exposure to PFAS have shown that certain PFAS may [list of health effects].
 Vermont Department of Health Some scientific studies suggest that certain PFAS may affect different systems in the body. Although more research is needed, some studies in people have shown that certain PFAS may [list of health effects].
 Virginia Department of Health Studies in humans and animals show that there may be negative health effects from exposure to certain PFAS. Completely stopping exposure to PFAS is not practical, because they are so common and present throughout the world.
 Washington State Department of Health Current public health recommendations to limit PFAS exposure are typically based on health effects in laboratory animals and findings from observational studies in humans that have been exposed to PFAS. Such studies suggest that higher exposure to certain PFAS may lead to [list of health effects].
 Washington State Department of Health – Resources for Health Care Providers Laboratories capable of processing individual clinical serum samples collected by health care providers are listed below.
 Wisconsin Department of Health Services This research suggests that high levels of certain PFAS may [list of health effects].
Local Governments / Associations
 Mariana Islands Water Operator Association Studies indicate that exposure to PFOA and PFOS over certain levels may result in adverse health effects …
 Spokane Regional Health District Some studies on people exposed to PFOA and PFOS over a long period of time indicate that exposure may [list of health effects].
 Town of Natick, MA: Department of Public Works Water/Sewer Division Some people who drink water containing PFAS6 in excess of the MCL may experience certain adverse effects.
  1. All agency/organization website links and quotations were tested and cross checked on March 14, 2022