PFAS and Health

PFAS can be measured in the blood of most people around the world, including Minnesotans. For most people, consumer products that are grease, oil, stain and/or water resistant are a much greater source of PFAS exposure than drinking water. PFAS chemicals are commonly used in non-stick and stain-resistant consumer products, food packaging, fire-fighting foam, and industrial processes. 

People can be exposed to PFAS in many ways including drinking water where the source has been impacted by PFAS contamination. For most Minnesotans, the majority of PFOS exposure comes from non-drinking water sources. These can include:

• Using consumer products treated with PFAS such as stain resistant carpeting and water-repellent clothing.
• Eating food packaged in material that contains PFAS.
• Eating fish caught from water contaminated by PFOS.
• Eating food grown or raised near places with PFAS exposure.

More information can be found at PFAS chemical exposure | ATSDR (cdc.gov).

There are many different PFAS, and each may impact health differently. Most studies about their effects on human and animal health have been done on two PFAS chemicals, PFOA and PFOS.

The most consistently observed and strongest evidence for harmful impacts on human health is for immune suppression such as decreased vaccination response, changes in liver function such as higher cholesterol, elevated liver enzymes, and lower birth weight. In addition, lifetime exposure to PFOA has also been associated with kidney cancer. MDH develops guidance values to protect people who are most highly exposed and people who are most sensitive to the potentially harmful effects of a contaminant, including pregnant people, fetuses, infants, and children.

While we believe the immediate health risks for most people exposed to PFAS are low, the latest information indicates that fetuses and infants are more vulnerable and can be among the most highly exposed. Several PFAS are known to cross the placenta and concentrate within breastmilk. Long-term exposure to several PFAS, including PFOA, PFOS, and PFHxS, leads to a buildup of these chemicals in people of child-bearing age, which then increases exposure to fetuses and breastfed babies. Breastfeeding is a healthy activity for both baby and parent. If you have concerns about possible risks from PFOS during breastfeeding, consult with your physician. MDH recommends that women currently breastfeeding and pregnant women who plan to breastfeed continue to do so. MDH recommends that women who plan to become pregnant follow the recommendations in Reducing Exposures: Per- and Polyfluoroalkyl substances (PFAS) (PDF).

Consumption of infant formula mixed with water containing PFAS can result in higher exposure to PFAS because babies drink more water per body weight than adults. If you are concerned about exposure to PFAS by consumption of infant formula and would like to lower your baby’s exposure to PFAS, consider using water that has been filtered to remove PFAS, as your water source.

Because PFAS are so widely found in the environment, eliminating all exposure to PFAS is unlikely; however, you can take the following steps to reduce your exposure.

• Limit use of consumer products that contain PFAS. PFAS is used in many consumer products. Here is a selection of items that might contain PFAS:
  • Food packaging, including grease-resistant paper, fast food containers/wrappers, microwave popcorn bags, pizza boxes, and candy wrappers.
  • Nonstick cookware.
  • Stain-resistant coatings used on carpets, upholstery, and other fabrics.
  • Water-resistant clothing.
  • Some cleaning products.
  • Some personal care products (shampoo, dental floss) and cosmetics (nail polish, eye makeup).
  • Some paints, varnishes, and sealants.
• Follow the fish consumption guidance to choose fish low in PFAS to put on your plate —Some PFAS, predominantly PFOS, may be present in the fish people catch and eat. Fish Consumption Guidance is available on the MDH webpage: Fish Consumption Guidance.
• Remove household dust. Household dust can be a significant source of PFAS exposure, especially for infants and young children. Indoor sources (e.g., consumer products, floor waxes, stain-resistant treated upholstery and carpets) contribute most to PFAS in house dust. Keeping floors and other surfaces free of dust can limit this exposure.

People can also be exposed to PFAS from consuming water with levels of PFAS above health-based guidance. Water with PFAS levels above health-based guidance is safe for bathing, showering, swimming, washing clothes, and cleaning, but should not be used for drinking or cooking. Consider the following to understand PFAS levels in water:

• Review PFAS Findings in Public Water Systems by visiting MDH’s Dashboard for PFAS Testing in Drinking Water and the Minnesota Control Agency’s (MPCA) Minnesota Groundwater Contamination Atlas.
• Test private well water to determine PFAS and other chemical contaminants. Information about private drinking water well sampling is available on the MDH PFAS and Private Wells and the MPCA Well Sampling in the East Metro Area website.
• Consider home water treatment if you live near a source of drinking water that is contaminated with PFAS, know there is PFAS in your drinking water, or are concerned about PFAS. Reverse osmosis and activated carbon treatment systems can reduce the levels of PFAS in drinking water. MDH provides information about inexpensive and easy-to-use systems that people can install in their home to reduce exposure to PFAS through drinking water on the following webpages:
  • Water Treatment Using Carbon Filters: GAC Filter Information
  • PFAS and Home Treatment of Water
  • Evaluation of Perfluorochemical Removal by a Small, Point-of-Use Filter (PDF)
• Prepare infant formula with filtered water or bottled water if your water source has high levels of PFAS. People who are pregnant, fetuses, and children are sensitive to accumulating PFAS in their bodies and should reduce their exposure to PFAS. If your drinking water comes from a public water system which is treating drinking water to at or below MDH health-based guidance, tap water can be used to prepare infant formula.
• Avoid contact with foam on water surfaces. Several things, including PFAS, can cause foam to form on the surface of water bodies. PFAS-containing foam on water surfaces does not pose a risk to human health if skin contact with foam is minor and infrequent. Wash skin that has come into contact with foam with soap and water.

PFAS may be present in lakes and rivers at very low levels. MDH has determined that exposure to PFAS through swimming is not a health concern. PFAS are poorly absorbed through skin and swallowing small amounts of water while swimming will not result in significant exposure. Also, because there is little evaporation of PFAS from water into the air, exposure from breathing while swimming or bathing is not a health concern.

If you have been exposed to perfluoroalkyl and polyfluoroalkyl substances (PFAS) and are concerned about your health, you can talk to your Health Care Provider.

• We don’t know if exposure to PFAS may cause health problems in the future. You can talk to your health care provider and ask if you need to be monitored for symptoms or conditions that may be caused by PFAS exposure in the future.
• Testing Your Blood for PFAS (PDF) - It is possible to get your blood tested for PFAS, but the results have some important limitations. This information sheet will help you understand what blood testing can tell you and whether blood testing is a good choice for you.

MDH develops guidance values to protect people who are most highly exposed and people who are most sensitive to the potentially harmful effects of a contaminant, including pregnant people, fetuses, infants, and children. A person drinking water at or below the guidance value would be at little or no risk for harmful health effects. A full list of guidance values can be found online at the Human Health-Based Water Guidance Table.

Table of Health-based Values for PFAS

How changing knowledge has impacted drinking water guidance over time

MDH has reviewed and updated guidance for PFAS in drinking water since 2002. Below is a description of how drinking water guidance has changed over time.

MDH Guidance Values (ppb) – 2002 to 2023

How health risk is assessed when more than one chemical is present in drinking water

In some cases, water may contain multiple contaminants. Exposure to multiple contaminants may cause health effects that would not be predicted based on separate exposures to the individual concentrations of each contaminant present.  When more than one PFAS is present in drinking water, MDH evaluates the “additive” risk that is created by the presence of multiple contaminants.

For more information, visit the MDH webpage: Evaluating Concurrent Exposures to Multiple Chemicals.

MDH develops health-based air guidance values to evaluate potential human health risks from exposures to chemicals in ambient air. An air guidance value is a concentration of a chemical that is likely to pose little or no risk to human health. Air guidance values are developed using public health protective practices that protect susceptible portions of the population (including but not limited to children, pregnant women and their fetuses, individuals compromised by pre-existing diseases, and elderly persons). Air guidance values apply to short time periods as well as a lifetime of exposure.

MDH has not previously derived air guidance values for PFAS. Currently, there is insufficient inhalation data available for PFAS to derive air guidance directly; however, PFAS information via the oral exposure route is more robust. Route-to-route extrapolation was implemented using MDH’s health-based guidance values information for PFAS in drinking water to derive air values.

More information can be found on the MDH Air Guidance Values webpage.

The table below shows the air guidance values (in micrograms per cubic meter, µg/m3) for five PFAS. MDH intends to derive air guidance values for additional PFAS as information becomes available.

Table of Current Air Guidance Values for PFAS

For questions about health-based guidance and risk:

Contact the MDH Health Risk Assessment Unit at health.risk@state.mn.us or call 651-201-4899.

For questions about health and contaminated sites:

Contact MDH Site Assessment and Consultation Unit at health.hazard@state.mn.us or call 651-201-4897.