On April 10, the Environmental Protection Agency (EPA) implemented first-ever restrictions on the perfluoroalkyl and polyfluoroalkyl (PFAS) substances in drinking water, a pivotal move in shielding public well-being from waterborne hazards.

EPA’s cap target six PFAS compounds, including two of the oldest and most widespread PFAS—PFOA and PFOS—at 4 parts per trillion. The rule also sets limits of 10 ppt for PFHxS, PFNA, and HFPO-DA (also known as GenX), thereby establishing a benchmark for the most stringent health thresholds concerning these impurities in potable water.

Under the new rule, public water systems are required to monitor these PFAS compounds, with an initial monitoring period of three years, concluding by 2027, followed by ongoing compliance checks. Additionally, these systems must disclose information regarding the levels of these PFAS in drinking water, commencing in 2027. Further, public water systems are allotted five years—until 2029—to implement remedies aimed at decreasing PFAS levels if monitoring reveals that these levels exceed the designated maximum contaminant levels (MCLs).

Nicknamed “forever chemicals” because of their resistance to be degraded or destroyed, PFAS have been associated with several health issues, including high cholesterol, cancer, and thyroid disease. “There’s no doubt that these chemicals have been important for certain industries and consumer uses, but there’s also no doubt that many of these chemicals can be harmful to our health and our environment,” Michael Regan, EPA Administrator, said on a call to media this week.

Starting in 2029, public water systems found to have PFAS concentrations in drinking water surpassing the MCLs must take measures to reduce these levels and notify the public of the violation.

In an effort to help with enforcement, EPA announced it would make $1 billion in funding available through the Bipartisan Infrastructure Law to help states implement PFAS testing and treatment at public water systems and to help owners of private wells address PFAS contamination.

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This week, FDA issued an import alert for human food products with detectable levels of chemical contaminants that may present a safety concern to human health. The Import Alert 99-48, Detention without Physical Examination of Foods Due to Chemical Contamination, gives the agency the ability to help prevent entry of human food products into the U.S. if they are found to be contaminated with a broad range of human-made chemicals including benzene, dioxins and polychlorinated biphenyls (PCBs), and per- and polyfluoroalkyl substances (PFAS), among others.

PFAS are a diverse group of thousands of chemicals used in many different types of products. PFAS in the environment can enter the food supply through plants and animals grown, raised, or processed in contaminated areas. It is also possible for very small amounts of certain PFAS to enter foods through food packaging, processing, and cookware.

In 2022, FDA initiated a targeted survey for PFAS in 81 seafood samples collected at retail and determined that the estimated exposure to perfluorooctanoic acid (PFOA), a type of PFAS, from certain samples of canned clams from China is likely a health concern. The 81 samples in the survey consisted of clams, cod, crab, pollock, salmon, shrimp, tuna, and tilapia, most of which were imported to the U.S. The agency plans an additional targeted survey of molluscan shellfish this year, and this new import alert could be used to refuse entry of foods such as seafood contaminated with PFAS.

Specific firms and their food products found with levels of chemical contaminants that may pose a risk to human health may be subject to detention without physical examination under the new alert.

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In the U.S. and Europe, food manufacturers are preparing for a number of new regulations that target per- and polyfluoroalkyl substances (PFAS), a class of “forever chemicals” that persist in the environment and can harm human health.

Testing for PFAS and tracing them through supply chains and life cycles is a daunting task, but labs are rising to the challenge. New techniques make it possible to identify more PFAS than ever before, with increasing sensitivity and confidence.

Food suppliers should take advantage of new gains in PFAS testing and take the time to understand the substances’ occurrence in supply chains. These actions can help suppliers get ahead of regulations and respond proactively to increasing consumer concerns.

A Brief History of PFAS

The first PFAS were created in the 1930s. These chemicals repel both oil and water and are used in everything from food packaging to firefighting foam, fracking liquid, and consumer products such as lipstick and electronics. Some studies have found that the chemicals can cause cancer, kidney disease, and immune problems, among other ailments, and can persist indefinitely in the environment.

The first and most studied PFAS, perfluorooctyl sulfonate (PFOS) and perfluorooctanoic acid (PFOA), have been mostly phased out from use, but they remain in the environment and in our food systems. In the meantime, thousands of other PFAS compounds have proliferated. For most, there is little toxicity data available and the risks are unknown.

Testing for and analyzing PFAS requires liquid chromatography-mass spectrometry (LC-MS) capabilities, which were not available in most labs until the early 2000s. A validated method for testing for PFAS in drinking water was first set by the U.S. Environmental Protection Agency (EPA) in 2009. Over the past few years, the EPA also began exploring methods for identifying dozens of PFAS in groundwater, biosolids, and the air.

In January 2023, the European Union proposed the most wide-reaching PFAS regulation yet; it would ban 10,000 PFAS chemicals from use in most products. Whatever shape the final EU regulation takes, this new ban and other similar ones have created a need for more extensive PFAS testing.

In March 2023, the EPA proposed nationwide, legally enforceable limits for six PFAS chemicals in drinking water, and it is currently exploring limits for 23 other PFAS that can be identified and monitored using existing tests. These new standards are much stricter than existing recommendations. Still, drinking water is just one piece of the problem. Food is also a major source of PFAS exposure.

How PFAS Can Enter the Food Supply

A March 2023 study published in the journal Environmental Research found PFAS in freshwater fish in rivers, lakes, and streams across the country (Environ Res. 2023;220:115165). The researchers concluded that catching and eating one fish could be as toxic as drinking contaminated water for a month. Other recent studies have flagged high levels of PFAS in imported clams, dairy milk, and a variety of seafood, with lower levels in just about everything else.

A 2017 study (Enviro Sci Technol Lett. 2017;4:105-111) concluded that food can become contaminated by the chemicals when it touches wrappers or “biodegradable” forks and bowls that are made with them; the study found that people who ate out more had higher levels of PFAS in their blood. As a result, 11 U.S. states have implemented bans on PFAS in food packaging, most of which will go into effect by 2025.

But packaging is only one pathway for food contamination; PFAS are also located in soil and groundwater as a result of industrial uses, in the landfills where consumer products wind up, and even in the air.

Even our best attempts at a sustainable, circular food system can increase PFAS exposure in food. Fertilizers made from biosolids reclaimed from sewage treatment plants were once lauded as a sustainable farming solution, but most of these biosolids were never tested for PFAS, and tainted sludge can contaminate fields for decades, harming both farmers and consumers.

Best Practices in Testing

These different sources of PFAS can create food safety risks. Because food can be contaminated directly through packaging or indirectly through environmental pathways, food suppliers will increasingly need to identify and address PFAS sources to update supply chains.

Most states with PFAS packaging bans have banned specific substances, which can be identified through targeted analysis. But some states, like California, have set limits for total organic fluorine as a proxy for thousands of other PFAS, including some that may not have been added on purpose. This requires a non-targeted approach and quick and robust testing, as PFAS detection begins to impact critical business decisions and more companies request tests. Mass spectrometers allow testing labs to detect very low levels of PFAS contamination. In addition, they are very selective, increasing confidence in the lab results and ensuring that they are not detecting a false positive.

To reduce the amount of PFAS entering supply chains indirectly, the Environmental Defense Fund recommends that companies test proactively. The organization suggests prioritizing testing first for food grown near known sites of high ­contamination, then testing meat and seafood and finally testing products containing fat and oil. Forensic testing techniques can help suppliers examine which types of PFAS may have originated in their supply chains, so they can implement new practices or change suppliers accordingly. This will be especially important for producers exporting to Europe if the proposed EU ban on PFAS goes into effect.

A Foundation for the Future

Finding a capable PFAS testing partner now will prepare you to weather the quickly shifting regulatory winds. Having a strong testing partnership in place can also help you respond quickly to other emerging risks. After all, PFAS are not the only environmental contaminant of concern. The chemicals that we already know to test for are just the tip of the iceberg: If the story of PFAS teaches us anything, it should be to expect the unexpected.

The EPA estimates that there are 12,000 forever chemicals on the market today. Many are affecting our food supply and environment in ways that are not yet known. More regulation is needed, but for chemicals already in the supply chain, improvements in testing provide a starting point for defining the problem.

Dr. Butt is the manager of applied markets, global strategic technical marketing, for SCIEX.

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A new report released by the Center for Biological Diversity and Public Employees for Environmental Responsibility revealed that some of the most widely used food pesticides in California contain “potentially dangerous” levels of per- and polyfluoroalkyl substances (PFAS) These substances are a class of nearly 15,000 chemicals that are often used to make thousands of consumer products across dozens of industries. They get their nickname of “forever chemicals” because they do not naturally degrade.

The testing for the study was conducted by an independent, certified laboratory, and the results found PFAS in three out of seven agricultural pesticides tested. No PFAS were detected in concentrations above the detection limit in the two residential pesticide products that were tested. These results suggest that at least some of the identified PFAS contamination of agricultural products is coming from other unknown sources.

The study authors submitted the results to the Environmental Protection Agency (EPA) and the California Department of Pesticide Regulation and were accompanied by a letter requesting that these products be removed from use until the contamination can be addressed. The letter goes on to state that one result was “100,000 times higher than the allowed limits for drinking water.” Statements such as this are often misleading; drinking water limits are set very low because they are based on daily consumption levels. Given how much water a human consumes, the daily limits set would be far lower than limits allowed in pesticides.

The toxicity of PFAS is not a new revelation. As far back as 1966, FDA rejected a petition from DuPont to use PFAS as a food additive, primarily due to animal studies indicating liver damage. However, the environmental and human health impacts of these chemicals have not been well researched. FDA began monitoring PFAS in food in 2019 and has detected them in some fruits and vegetables, but has not set any limits based on the low amount of data available.

A spokesperson for the International Fresh Produce Association noted that the science on PFAS is still developing, not just how it impacts produce, but also how it impacts items including cosmetics and non-stick cookware. Without more research on the topic, including studies on uptake levels for different commodities, any conclusions or regulatory responses right now are pure speculation.

To date, only a handful of European countries, including The Netherlands, Germany, Denmark, Sweden, and Norway, have taken steps to ban PFAS.

While most people are likely to have either consumed foods containing PFAS or used products made with the substances in the past, there is a need for a much better understanding of the causes of exposure  within the food and agriculture industry.

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This spring, two separate lawsuits were filed against McDonald’s and one was filed against Burger King alleging similar causes of action and seeking similar remedies, part of a growing trend of consumer product cases involving polyfluoroalkyl substances (PFAS).

PFAS, often known as “forever chemicals,” are commonly used in food packaging in an effort to prevent packaging leakage. On October 18, 2021, EPA Administrator Michael S. Regan announced a strategic roadmap aimed at significantly reducing the use of the chemicals, including a comprehensive strategy to address the problem.

“While the three cases were filed separately, they all rely in part on third-party testing reports, such as a Consumer Report that supposedly found elevated levels of total organic fluorine in food packaging, which some contend is a measure of PFAS,” says Matt Walker, an associate at Lathrop GPM Law Firm in Chicago.

The federal government’s actions toward PFAS in food packaging has largely relied on voluntary phase outs of certain compounds, but several states have moved to ban the sale of PFAS in food packaging.

The details of the cases are as follows. In April, plaintiff Azman Hussein sued Burger King in the U.S. District Court for the Northern District of California. The class action lawsuit alleges that ,while Burger King markets its food as using “real ingredients” with “no secrets,” and sustainable packaging, the company was allegedly exposing consumers to harm by using PFAS-coated food packaging.

“The complaint details several examples of Burger King’s statements about the safety of its food,” Walker says. “The proposed class includes any person in the United States, or the California subclass, who purchased Burger King products. Hussein seeks medical monitoring for the proposed class, in addition to monetary damages and injunctive relief.”

In a lawsuit filed March 28 in the U.S. District Court for the Southern District of Illinois, plaintiff Larry Clark alleged that McDonald’s Corporation also was using PFAS product packaging, contrary to its food-safety pledge, resulting in what the lawsuit says is fraud and deceptive business practices. “The plaintiff alleges he purchased products from various McDonald’s restaurants in several central Illinois counties, but does not identify any specific franchisees,” Walker says.

On March 31, plaintiff Ken McDowell brought a class action against McDonald’s Corporation in the U.S. District Court for the Northern District of Illinois, making similar allegations that the products were fraudulently and misleadingly marketed as safe for consumers and environmentally friendly, in violation of federal and state consumer protection laws. “Among monetary damages and injunctive relief, McDowell seeks medical monitoring on behalf of a national class and California subclass,” Walker adds.

While the complaints make various allegations of potential human health effects and refer to various state and federal regulatory actions to address PFAS, these lawsuits do not bring traditional tort claims for personal injury says Walker. Instead, they bring claims arising from the misrepresentation of their products as safe based on violations of consumer protection and false advertising laws. “Certainly, a judgment in favor of plaintiffs would be detrimental for the industry, but even in the absence of a verdict, the combination of media attention, increasing regulatory pressure, and consumer activism means that the food industry will likely be the target of continuing litigation,” Walker adds.

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Per- and polyfluoroalkyl substances (PFAS) refer to an expansive array of chemicals that have been used in industrial applications since the 1940s. There are thousands of different types of PFAS, estimated to include as many as 10,000 chemical compounds, which are utilized for countless applications. PFAS are oil, water, and friction resistant and can withstand significant variations in temperature. PFAS are used in textiles, paper, cookware, fire suppression foams, and packaging. They are used widely in industries such as aerospace, microchip manufacturing, automotive, construction, aviation, and food packaging, among many others.

Given their uniquely valuable properties and range of uses, PFAS were initially hailed as wonder compounds. In 1967, FDA approved the first PFAS for use in food packaging. In the decades that followed, PFAS were used in the packaging of countless thousands of products. Currently, FDA’s Inventory of Food Contact Substances Listed in 21 CFR includes more than 30 PFAS. Such a listing means the agency has deemed the PFAS safe for their intended use and allows them to be legally marketed as food contact substances.

The Problems with PFAS

Once heralded, PFAS have turned out to be decidedly more problematic than previously imagined. They are long-lasting, environmentally destructive, and potentially toxic. PFAS take an extraordinarily long time to break down. Decades of widespread use have led to dangerous environmental accumulation. These “forever chemicals” can now be reliably detected in the oceans, drinking water, soil, plants, other animals, food, and even our own blood. Numerous studies indicate a causal link between human and animal health problems and environmental exposure to PFAS.

PFAS are subject to significant backlash, and food companies may soon face a litany of risks by continuing to use PFAS in their packaging.

In recent years, there has been a significant push by consumers, scientists, environmental advocacy groups, and many companies seeking to end the use of PFAS, especially in food packaging. Numerous food companies—including household names like Chipotle, McDonald’s, Panera, Taco Bell, Whole Foods, and Wendy’s—have pledged to stop using food packaging manufactured with PFAS. Additionally, Connecticut, Maine, Minnesota, New York, Vermont, and Washington have enacted laws banning the use of PFAS in food packaging.

The federal government has also been getting in on the act. In 2016, FDA banned manufacturers from using long-chain PFAS in food packaging. These are even longer lasting than the comparable “short-chain” PFAS. However, after the discovery that at least one short-chain PFAS continued to linger in the body after consumption of a food contaminated with the compound, FDA and manufacturers partnered in announcing that they would phase out use of the compound as a food container coating.

On October 18, 2021, EPA Administrator Michael S. Regan announced a strategic roadmap aimed at significantly reducing the use of the chemicals, including a comprehensive strategy to address the problem.

According to EPA, exposure to high levels of certain PFAS has been shown to lead to adverse health outcomes; however, research is ongoing to determine how different levels of exposure to various PFAS can lead to a variety of health effects. Research is also underway to better understand the health effects associated with low levels of exposure to PFAS over long periods of time, especially in children. These are difficult questions to answer for many reasons. The sheer ubiquity of these chemicals and our continuous exposure to them makes it difficult to identify correlations. Additionally, it is exceedingly difficult to identify which problems are attributable to which of the thousands of PFAS in widespread use. Consequently, it will take time to get clear answers.

What is clear is that PFAS are subject to significant backlash, and food companies may soon face a litany of risks by continuing to use PFAS in their packaging. Among these risks are geographical sales constraints, regulatory violations, lawsuits, and product boycotts.

Sales constraints simply refer to the inability to ship products into jurisdictions that ban the use of these chemicals in packaging. These bans subject companies to potential regulatory enforcement actions, including fines and other penalties. Moreover, we predict a significant uptick in class action claims brought against companies using PFAS packaging. Already, we are seeing an increase in product boycotts against such companies. The fact that so many large companies have already disavowed the use of these products will likely serve to strengthen the argument that companies are on notice that these products pose a potential danger to consumers. Thus, we strongly recommend that companies still utilizing PFAS packaging materials consider switching to non-PFAS products.

The EPA Roadmap

The EPA’s PFAS Roadmap is a lengthy document that details the agency’s thinking, explains the need for change, and sets timelines by which EPA intends to take specific actions. In short, EPA commits to a series of new policies aimed at safeguarding public health, protecting the environment, and holding polluters accountable for violations arising from the use of PFAS.

EPA proposes a comprehensive, multi-tiered approach, shaped by the unique challenges of addressing PFAS contamination. That is, because PFAS pollution is not a legacy issue, meaning the chemicals continue to be used in U.S. commerce, EPA must focus on both cleaning up downstream PFAS pollution and preventing future PFAS pollution. In turn, the EPA approach will focus on three central directives: research, restrict, and remediate.

Research. The research directive refers to EPA making significant investments in research, development, and innovation to increase understanding of PFAS exposures and toxicities, human health and ecological effects, and effective interventions that incorporate the best available science. That is, because we are still understanding the severity and significance of the risks posed by PFAS, the agency intends to pursue a science-based approach to better understand the risks and solutions involving PFAS.

Restrict. The restrict directive refers to taking actions intended to restrict future use and pollution. Here, the agency plans to pursue a comprehensive approach to proactively prevent PFAS from entering air, land, and water at levels capable of causing an adverse impact on human health and the environment.

Remediate. The remediate directive predictably refers to the agency’s goal of cleaning up PFAS pollution. To accomplish this, the agency intends to broaden and accelerate the cleanup of PFAS contamination to protect human health and ecological systems.

EPA’s goals and timelines address a broad area of regulatory decision making, reporting requirements, and environmental thresholds that will span a period of years, with most planned actions being implemented by the end of 2024. For example, EPA is looking at PFAS chemicals that it has previously reviewed through the Toxic Substances Control Act (TSCA) New Chemicals Program, including those that it reviewed prior to the 2016 TSCA amendments. This could lead to currently approved PFAS being disapproved. EPA also recently launched a stewardship program to encourage companies to voluntarily withdraw previously granted PFAS low volume exemptions (LVEs), and is currently revisiting past PFAS regulatory decisions and addressing those that are insufficiently protective.

Given this plan, it is unlikely that a formal federal ban will be implemented in the near term. However, a formal withdrawal of an LVE or other similar action could have substantially the same effect. Thus, and for all the reasons described above, now is the best time for companies to begin planning and taking action to address PFAS packaging.

Alternative Options

The good news is that emerging technologies are allowing for a mostly seamless transition between PFAS packaging and safer, more environmentally friendly packaging with the same qualities that PFAS packaging is known for. Already, numerous companies are offering sustainable, PFAS-free packaging to accommodate the expected boom.  

Two of the most common types of paper that provide barrier protections (i.e., grease and water resistance) are natural greaseproof paper (NGP), which is made through the refinement of wood pulp, and vegetable parchment. These two materials both have a dense cellulose structure that confers grease resistance. Additionally, novel applications using common plant-based fibers have shown great promise.

The creation of new types of sustainable, PFAS-free packaging is creating significant market opportunities for forward-looking companies. Given the regulatory outlook, that will only increase, as companies expand further into this area and deploy more resources to development and innovation. Consequently, we should expect to see the continuing proliferation of novel packaging products that will serve the same purpose as PFAS, but without the concomitant health and legal risks. Thus, we again advise companies to take steps now to prepare for the changes ahead.

Chappelle is a food industry lawyer and a consultant at Food Industry Counsel, LLC. Reach him at chappelle@foodindustrycounsel.com. Stevens, also a food industry attorney, is a founding member of Food Industry Counsel, LLC, and a member of the Food Quality & Safety Editorial Advisory Panel. Reach him at stevens@foodindustrycounsel.com.

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The Biden Administration announced on October 18, 2021, that Environmental Protection Agency (EPA) regulators will set enforceable limits on per- and polyfluoroalkyl substances (PFAS). The chemicals have been manufactured since the 1950s and are now widely detected in nearly every human. However, there are still a lot of unknowns regarding how they get into the body and what harm they cause.

The EPA’s PFAS Strategic Roadmap is a three-year plan detailing actions to help prevent PFAS from being released into the air and food supply and to expand cleanup efforts. The agency wants to implement the roadmap prior to the 2024 Presidential election.

Craig Butt, PhD, staff application scientist in the Americas for SCIEX, believes the new roadmap is a broad and ambitious plan to tackle PFAS contamination thanks to three main objectives—research, restrict, and remediate. “The approach considers the entire lifecycle assessment of PFAS from manufacture to use in commercial and industrial products to final disposal, which helps to ensure a more comprehensive and protective strategy,” he tells Food Quality & Safety. “The roadmap also emphasizes a strong investment in scientific, evidence-based decision-making through supporting research to fill key knowledge gaps, such as exposure pathways, toxicity assessment, and remediation.”

Specific plans include testing drinking water nationwide, implementing drinking water regulations and health advisories, assessing exposure and toxicity, developing new analytical testing methods, and monitoring PFAS in fish tissues and air emissions.

“The roadmap commits to monitoring PFAS levels in fish, an important food source for many people,” Butt says. “But, more holistically, the strategy will evaluate the importance of food ingestion as a source of PFAS exposure to humans. Presumably, this will answer questions such as, is food ingestion a significant source of PFAS exposure and which foods contribute the most to our exposure? Further, monitoring PFAS in biosolids and air will help ensure that farms and the entire food system is better protected from PFAS contamination.”

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Fast food isn’t exactly known for its health benefits, but a new U.S. study suggests even the packaging may be harmful.

The study found one-third of fast food packaging contain per- and polyfluoroalkyl substances (PFASs) that give it stain-resistant, water-repellant, and nonstick properties. But these fluorinated chemicals have also been linked to an increased risk of certain cancers, hormone problems, high cholesterol, obesity, and immune suppression in human and animal studies.

“Our study is the most comprehensive assessment of how common fluorinated chemicals are in fast food wrappers in the U.S., and which types of wrappers are most likely to contain them,” said lead study author Laurel Schaider of the Silent Spring Institute, Newton, Mass.

“We found that nearly half of paper wrappers, for instance wrappers for sandwiches and burgers and flat bags for cookies and pastries, contained fluorinated chemicals, and that around 20 percent of paperboard packaging, for instance boxes for French fries and fried foods, contained fluorinated chemicals,” Schaider added by email.

PFASs aren’t found naturally in the environment. These man-made chemicals have been used for decades in products ranging from food wrappers to clothing, nonstick cookware, and fire-fighting foams. People may be exposed to PFASs from direct contact with these products, through the air they breathe, the food they eat, and the water they drink.

For the study, Schaider and colleagues tested for PFASs in more than 400 samples of paper wrappers, paperboard, and drink containers from 27 fast food chains across the U.S.

More than half of the tests were done on food contact paper, including 138 wrappers for sandwiches or burgers, 68 wrappers for dessert or bread, and 42 wrappers for Tex-Mex foods.

Overall, 46 percent of paper wrappers tested positive for PFASs. This included 38 percent of sandwich and burger wrappers, 56 percent of bread or dessert wrappers and 57 percent of wrappers for Tex-Mex food, researchers report online February 1 in Environmental Science and Technology Letters.

Tests of 30 samples from paper cups didn’t turn up any of these chemicals. But in tests of 25 other beverage containers, 16 percent did have PFASs.

Researchers also did more extensive testing on a subset of 20 samples to see what types of PFASs were in the food packaging. Six of these samples contained a type of PFASs called PFOA (perfluorooctanoic acid, or C8) that many U.S. manufacturers voluntarily stopped using in 2011 due to concerns about the potential health risks.

One limitation of the study is that researchers were unable to assess how often people came into contact with these chemicals in food packaging, the authors note.

Still, the results show that even chemicals being phased out due to health concerns are still widely used, said Dr. Leonardo Trasande, an environmental medicine researcher at New York University School of Medicine who wasn’t involved in the study.

“This study reinforces the reality that these chemicals are highly persistent in the environment, and may find their ways into people’s bodies for years after they are no longer intentionally added,” Trasande said by email.

“This study adds to concerns about chemicals that contaminate highly processed or packaged foods, potentially magnifying health effects above and beyond the effects that may result from their high-fat or high-sugar content,” Trasande added.

Avoiding fast food is one way to limit exposure.

Serving food in wax paper instead of grease-resistant wrappers typically used in food packaging might also reduce contact with the chemicals, Trasande said.

Diners can also limit exposure by avoiding oily food, high-temperature food, and taking food out of wrappers right away so it has less contact time with any chemicals, said Xindi Hu, an environmental health researcher at Harvard T.H. Chan School of Public Health in Boston who wasn’t involved in the study.

Whenever possible, customers should avoid disposable packaging, Hu added by email.

“If they are dining in, then it is not necessary to use paper plates,” Hu said. “Some restaurants do not provide regular dishes for logistical reasons, but from the perspective of reducing exposure to chemicals in food packaging, it is actually encouraged that restaurants use more regular dishes.”

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Drinking water supplies for more than six million Americans contain unsafe levels of industrial chemicals that have been linked to cancer and other serious health problems, a U.S. study suggests.

The chemicals—known as PFASs (for polyfluoroalkyl and perfluoroalkyl substances)—are used in products ranging from food wrappers to clothing to nonstick cookware to fire-fighting foams. They have been linked with an increased risk of kidney and testicular cancers, hormone disruption, high cholesterol, and obesity.

“PFASs are a group of persistent manmade chemicals that have been in use since 60 years ago,” said lead study author Xindi Hu, a public health and engineering researcher at Harvard T.H. Chan School of Public Health in Boston and Harvard University in Cambridge, Massachusetts.

Once these chemicals get into the water, they’re hard to get out, Hu added by email.

“Most current wastewater treatment processes do not effectively remove PFASs,” Hu said.

The problem may be much more widespread than the current study findings suggest because researchers lacked data on drinking water from smaller public water systems and private wells that serve about one-third of the U.S. population—about 100 million people, Hu noted.

To assess how many people may be exposed to PFASs in drinking water supplies, researchers looked at concentrations of six types of these chemicals in more than 36,000 water samples collected nationwide by EPA from 2013-2015.

They also looked at industrial sites that manufacture or use PFASs, military training sites and civilian airports where fire-fighting foam containing PFASs is used; and at wastewater treatment plants.

Discharges from these plants, which are unable to remove PFASs from wastewater by standard treatment methods, could contaminate groundwater, researchers note in the journal Environmental Science and Technology Letters, online August 9. So could the sludge that the plants generate and which is frequently used as fertilizer.

The study found that PFASs were detectable at the minimum reporting levels required by the EPA in 194 out of 4,864 water supplies in 33 states across the U.S.

Drinking water from 13 states accounted for 75 percent of the unsafe supply, led by California, New Jersey, North Carolina, Alabama, Florida, Pennsylvania, Ohio, New York, Georgia, Minnesota, Arizona, Massachusetts, and Illinois.

Sixty-six of the public water supplies examined, serving six million people, had at least one water sample that measured at or above what the EPA considers safe for human consumption.

The highest levels of PFASs were detected near industrial sites, military bases, and wastewater treatment plants—all places where these chemicals may be used or found.

One limitation of the study is that researchers lacked data on how long people lived in areas supplied by contaminated water or how much of this water people actually drank, the authors note. The risk of many health problems linked to the chemicals is associated with long-term exposure.

A second Harvard study from one of the co-authors on the paper, Philippe Grandjean, focused on a new potential health problem tied to PFASs.

Grandjean and colleagues studied nearly 600 adolescents from the Faroe Islands, an island country off the coast of Denmark, who received vaccines to protect against diphtheria and tetanus.

The subset of these teens exposed to PFASs at a young age had lower-than-expected levels of antibodies against diphtheria and tetanus despite receiving vaccinations, according to the study online August 9 in the journal Environmental Health Perspectives.

This suggests that PFASs, which are known to interfere with immune function, may be involved in reducing the effectiveness of vaccines in children, the authors conclude.

Previous research has found lower responses to vaccinations at ages 5 and 7 with exposure to the chemicals, Grandjean said by email. The current study in teens suggests that the problem persists as children get older.

“So the negative effects on immune functions appear to be lasting,” Grandjean said. “Sadly, there is very little that an exposed resident can do, once the exposure has led to an increased amount of PFASs in the body.”

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