Forever Ends Here: PFAS & Policy for Worker Health and Safety

Demystifying PFAS: Guidance on Exposure, Testing, and Clinical Follow-Up for Occupational Health with Laura Anderko, PhD, RN, Co-Author, Guidance on PFAS Exposure, Testing, and Clinical Follow-up (NASEM, 2022)

Recent reviews from the Agency for Toxic Substances and Disease Registry (ATSDR, 2024) and the National Academies of Sciences, Engineering and Medicine (NASEM, 2022) found sufficient evidence linking PFAS exposure to several health effects, including immune suppression, dyslipidemia, kidney cancer, and reduced fetal and infant growth. This presentation will summarize current guidance on exposure reduction, laboratory testing, and clinical management considerations. Workers in several industries face elevated PFAS risks. Dr. Anderko will discuss the role of occupational health personnel in offering guidance on blood testing and discussing with workers the potential risks and benefits of using blood testing results to guide clinical management. 

Hidden in Plain Sight: Mapping PFAS Exposure Pathways with Leena Nylander-French, PhD, CIH, Director, North Carolina Occupational Safety and Health Education and Research Center

PFAS exposure in worker populations has historically been limited and generally restricted to fluorochemical plant workers involved in PFAS production. However, research has shown that a variety of worker types, including professional ski waxers and firefighters, may be exposed to several different PFAS at levels often similar to or higher than levels among fluorochemical plant workers. Leena Nylander-French’s presentation will explore recent research into the diverse exposure pathways for PFAS and will highlight gaps to be further studied.

The Chemistry of Protection: Evaluation and Performance of PFAS and Non-PFAS Firefighter Turnout Gear with R. Bryan Ormond, PhD, Associate Professor, Wilson College of Textiles, North Carolina State University

The personal protective equipment that structural firefighters wear is designed to safeguard them from thermal, physical, and chemical hazards while maintaining thermo-physiological comfort. Historically, the outer layer of this structural turnout gear is finished with a durable water and oil repellent layer of per- and polyfluoroalkyl substances. Due to the health hazards of using PFAS, the U.S. Fire Service began using non-PFAS-based water repellants in turnout gear to limit exposure. In this presentation, Bryan Ormond will evaluate different types of turnout gear and the advantages and disadvantages of using certain chemicals to protect firefighters on the job. 

Expanding CHAMACOS into Forever Chemicals: A Pilot Study on Farmworkers' and Children's Health in the Salinas Valley with Ana Maria Mora, MD, PhD, Associate Researcher, Center for Environmental Research and Community Health (CERCH), UC Berkeley

Exposure to PFAS in drinking water is a serious concern due to the chemicals’ high aqueous solubility. A spatial analysis of 2013-2015 national drinking water PFAS concentrations from the U.S. EPA estimated six million U.S. residents, including those in California’s Monterey County, had access to drinking water supplies with PFAS concentrations exceeding the U.S. EPA’s lifetime health advisory. In this current pilot study, we aim to examine PFAS concentrations in drinking water samples from the Salinas Valley, California. We also aim to assess PFAS concentrations in blood samples from Salinas Valley residents. Located within Monterey County, the Salinas Valley is home to an old army airfield (now the Municipal Airport) and Fort Ord, two likely sources of PFAS exposure. The Valley is also the home to CHAMACOS, a longitudinal birth cohort of ~600 low-income, Mexican American mother-child dyads whose health has been tracked for over 20 years.

Testing and Responsible Reporting of PFAS in The California Firefighter Cancer Research Study with Shehnaz Hussain, PhD, ScM, Professor, Department of Public Health Sciences, UC Davis; and Derek Urwin, PhD, Assistant Adjunct Professor, UC Los Angeles; and Fire Captain, Los Angeles County Fire Department

Cancer is the leading cause of death among California firefighters. Unfortunately, the precise determinants as well as their mechanisms of action are poorly understood, and effective preventive interventions remain elusive. The International Agency for Research on Cancer has designated some PFAS as human carcinogens with the highest level of evidence. Firefighters have an additional burden of exposure through firefighting foams and nearly all structural firefighting turnout gear. The California Firefighter Cancer Research Study (CAFF-CRS) is a large, well-characterized, longitudinal cohort of firefighters across California established in 2024 to advance knowledge on understudied cancer risk factors in firefighters. CAFF-CRS uses a community-based participatory research framework and is collaboratively led by an academic/fire service partnership. To date, >1,500 California firefighters have been tested for PFAS. We will present initial observations and discuss implications for firefighter health.

Joint Q&A with R. Bryan Ormond, PhD; Ana Maria Mora, MD, PhD; Shehnaz Hussain, PhD, ScM; and Derek Urwin, PhD

 Signatures of Exposure: Detecting Regrettable PFAS Replacements Through -Omic Signatures with Suzanne E Fenton, PhD, MS, Director, Center for Human Health and Environment, North Carolina State University

This presentation will explore how scientists are using new tools to identify PFAS chemicals, including newer “replacement” versions that companies have introduced in response to emerging health hazards, and to understand what these chemicals do in the body. Dr. Fenton will discuss how PFAS exposure can differ by sex and age, common health effects seen in people and animals, and types of studies that help us detect these impacts. Learn how these findings can be used to better understand human health risks, and how newer methods for profiling PFAS exposure can eventually support clinical decision-making.

Using Nature's Toolkit for PFAS Defluorination: Can Microbes Help Break the Unbreakable? with Yujie Men, PhD, MS, Associate Professor, UC Riverside

The carbon–fluorine (C–F) bond in PFAS is the strongest single bond in nature, making these chemicals extremely difficult to break down and earning them the nickname “forever chemicals.” This presentation will explore microbial defluorination, a process in which certain microorganisms can attack and break the C–F bond. Environmental Engineer Yujie Men will review recent progress in understanding which PFAS structures can be broken down, which microbes are involved, and the conditions that make breakdown possible, while also highlighting challenges and remaining unknowns. 

 Clinical Frontiers in PFAS Care: Early Research and Evolving Treatment Strategies with Sheri Belafsky, MD, MS, FACOEM, COEH, UC Davis; and Leena Pandya, ND, BCB, Associate Research Specialist, Osher Center for Integrative Health, UC San Francisco

In this presentation, Dr. Sheri Belafsky and Dr. Leena Pandya review emerging and potential treatment strategies for reducing body burden of per- and polyfluoroalkyl substances. Dr. Belafsky provides an overview of PFAS pharmacokinetics and summarizes evidence from observational studies and clinical trials examining blood removal (phlebotomy and plasma donation) and gastrointestinal interventions aimed at accelerating PFAS elimination. Dr. Pandya then focuses on occupational exposure among firefighters and presents the scientific rationale and design of an ongoing clinical trial investigating bile acid sequestrants—an established class of cholesterol-lowering medications—as a novel approach to PFAS reduction. Together, the speakers highlight promising therapeutic avenues, remaining evidence gaps, and the need for larger randomized trials to support future FDA-approved treatments.

Shaping the Future of PFAS Policy: Developments in California, Nationally, and Worldwide with Lisa M. Thompson, PhD, MS, RN, FNP, FAAN, Professor, School of Nursing, University of California, San Francisco

This presentation will provide an update on the current PFAS regulatory landscape across California and the United States, and will also explore related laws and regulations in Canada and the European Union.