Blue Mountains residents could reduce PFAS by donating blood, GPs told
Ahead of its own expert panel reporting on the latest evidence on PFAS and public health, which is expected imminently, Chief Health Officer Dr Kerry Chant hosted an hour-long webinar with six other experts in late July to guide GPs and health practitioners in the Blue Mountains in 'supporting patients with concerns about PFAS exposure'.
Professor Nick Buckley, an expert in clinical pharmacology at the University of Sydney and one of six presenters besides Chant in the webinar, said the levels of PFAS exposure in humans were mostly 'tiny traces' and there was limited or no evidence for a strong link with human disease, including cancer and high cholesterol.
'People should not be getting terribly worried about PFAS – I know that's a really hard thing,' Buckley said. 'There's a lot of reasons to think that we're spending a lot of time on something that actually isn't very important for people's health.'
The webinar presented a case study of a 60-year-old woman who wanted to know if her high cholesterol was due to her high PFAS levels, measured at 19 nanograms per millilitre of blood for PFOS, 2 ng/ml for PFOA , and 11 ng/ml for PFHxS. If she were in the US, her total PFAS levels of 32 would be above the threshold of 20 set by the National Academies of Sciences, Engineering and Medicine (NASEM) and she would be given further testing and screening.
Professor Alison Jones, executive director at the Sunshine Coast Health Institute, told the webinar that she would focus on the patient's cholesterol and cardiovascular risk. 'I would not be doing anything about the PFOS, PFOA or any other thing that starts with P and has F to follow – because of relative risk,' Jones said.
PFAS – or per- and polyfluoroalkyl substances – are a family of synthetic chemicals prized for their resistance to heat, grease and water, and used in a wide range of everyday products such as stain-resistant fabrics, cleaning products and firefighting foams. They are often dubbed 'forever chemicals' because they don't break down naturally, and can persist in the environment and human body for decades.
NASEM has conducted a systematic review of the evidence and found that certain PFAS, specifically PFOA, are carcinogenic to humans. The International Agency for Research on Cancer (IARC) has classified PFOA as carcinogenic to humans and PFOS as possibly carcinogenic.
However, Buckley said the NASEM guidelines on sensible screening for an individual were 'pretty terrible' and amounted to a recommendation that patients should have cholesterol testing, which was already routine. He noted that the 'strongest conclusions' that PFAS was carcinogenic came from IARC, but said this was 'just some subgroup of the WHO', not WHO itself.
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The panel, which released its recommendations on Tuesday, found "there is no clinical benefit for an individual to have a blood test for PFAS". The panel has 13 members, including Hunter New England Health public health physician Tony Merritt. John Hunter Hospital clinical director of endocrinology Shamasunder Acharya was also on the panel. PFAS contamination has been an issue at Williamtown since 2012. In more recent years, health concerns have risen across the country, amid reports of PFAS contamination of drinking water and the food chain. The panel's report said "many health conditions potentially associated with PFAS are common in the community and associated with well-established risk factors". Nonetheless, the report noted that studies had "reported an association between PFAS exposure and high cholesterol and reduced kidney function". Further associations were made between PFAS exposure and changes to the immune system, hormone levels, liver enzymes and menstruation. Additionally, these "forever chemicals" had been linked to "lower birthweight, high blood pressure in pregnancy and some cancers". But the panel said there were "inconsistent findings across different studies, with limited evidence of a dose-response relationship". "The amount of PFAS measured in some studies was low, similar to levels found in the general population. "These studies are unable to distinguish any effects of PFAS from the many other factors that can affect health." The report said there were "few high-quality studies of workers exposed to high levels of PFAS". It added that health effects associated with PFAS "may instead result from factors such as poor kidney function". "PFAS are partly excreted by the kidneys. This means people with poor kidney function will have higher levels of PFAS, which may result in apparent associations between PFAS and other health conditions." The International Agency for Research on Cancer has classified PFOA as carcinogenic to humans and PFOS as possibly carcinogenic. The panel examined these findings, but said it was "confident that the absolute cancer risk from PFAS was low". It also stated that authorities should avoid using "currently available human epidemiological studies" to obtain PFAS threshold levels due to a high risk of bias. Research shows forever chemicals are in the blood of most people. A University of Newcastle paper, published last year, said mounting epidemiological evidence supports "negative associations between PFAS exposure and an array of human health conditions". The paper acknowledged that it was "challenging to definitively link PFAS exposure to impacts on human health". However, it found that "the balance of evidence" supports the potential for PFAS exposure to lead to adverse health outcomes. The Newcastle Herald reported in June that Hunter Water had welcomed revised Australian drinking water guidelines for PFAS. Tests confirmed that Hunter Water-supplied drinking water was safe and met the revised guidelines. Dr Kerry Chant, the chief health officer, said "updated NSW Health advice provides consumers with guidance on how to reduce PFAS exposure". "There is considerable concern, particularly in the Blue Mountains community, about exposure to PFAS through drinking water, and NSW Health takes these concerns very seriously," Dr Chant said. Nonetheless, NSW Health said it accepted all the expert panel's recommendations, which included "how to communicate risk in the context of evolving evidence". The health effects of PFAS "appear to be small", a NSW Health expert panel has found. The panel, which released its recommendations on Tuesday, found "there is no clinical benefit for an individual to have a blood test for PFAS". The panel has 13 members, including Hunter New England Health public health physician Tony Merritt. John Hunter Hospital clinical director of endocrinology Shamasunder Acharya was also on the panel. PFAS contamination has been an issue at Williamtown since 2012. In more recent years, health concerns have risen across the country, amid reports of PFAS contamination of drinking water and the food chain. The panel's report said "many health conditions potentially associated with PFAS are common in the community and associated with well-established risk factors". Nonetheless, the report noted that studies had "reported an association between PFAS exposure and high cholesterol and reduced kidney function". Further associations were made between PFAS exposure and changes to the immune system, hormone levels, liver enzymes and menstruation. Additionally, these "forever chemicals" had been linked to "lower birthweight, high blood pressure in pregnancy and some cancers". But the panel said there were "inconsistent findings across different studies, with limited evidence of a dose-response relationship". "The amount of PFAS measured in some studies was low, similar to levels found in the general population. "These studies are unable to distinguish any effects of PFAS from the many other factors that can affect health." The report said there were "few high-quality studies of workers exposed to high levels of PFAS". It added that health effects associated with PFAS "may instead result from factors such as poor kidney function". "PFAS are partly excreted by the kidneys. This means people with poor kidney function will have higher levels of PFAS, which may result in apparent associations between PFAS and other health conditions." The International Agency for Research on Cancer has classified PFOA as carcinogenic to humans and PFOS as possibly carcinogenic. The panel examined these findings, but said it was "confident that the absolute cancer risk from PFAS was low". It also stated that authorities should avoid using "currently available human epidemiological studies" to obtain PFAS threshold levels due to a high risk of bias. Research shows forever chemicals are in the blood of most people. A University of Newcastle paper, published last year, said mounting epidemiological evidence supports "negative associations between PFAS exposure and an array of human health conditions". The paper acknowledged that it was "challenging to definitively link PFAS exposure to impacts on human health". However, it found that "the balance of evidence" supports the potential for PFAS exposure to lead to adverse health outcomes. The Newcastle Herald reported in June that Hunter Water had welcomed revised Australian drinking water guidelines for PFAS. Tests confirmed that Hunter Water-supplied drinking water was safe and met the revised guidelines. Dr Kerry Chant, the chief health officer, said "updated NSW Health advice provides consumers with guidance on how to reduce PFAS exposure". "There is considerable concern, particularly in the Blue Mountains community, about exposure to PFAS through drinking water, and NSW Health takes these concerns very seriously," Dr Chant said. Nonetheless, NSW Health said it accepted all the expert panel's recommendations, which included "how to communicate risk in the context of evolving evidence". The health effects of PFAS "appear to be small", a NSW Health expert panel has found. The panel, which released its recommendations on Tuesday, found "there is no clinical benefit for an individual to have a blood test for PFAS". The panel has 13 members, including Hunter New England Health public health physician Tony Merritt. John Hunter Hospital clinical director of endocrinology Shamasunder Acharya was also on the panel. PFAS contamination has been an issue at Williamtown since 2012. In more recent years, health concerns have risen across the country, amid reports of PFAS contamination of drinking water and the food chain. The panel's report said "many health conditions potentially associated with PFAS are common in the community and associated with well-established risk factors". Nonetheless, the report noted that studies had "reported an association between PFAS exposure and high cholesterol and reduced kidney function". Further associations were made between PFAS exposure and changes to the immune system, hormone levels, liver enzymes and menstruation. Additionally, these "forever chemicals" had been linked to "lower birthweight, high blood pressure in pregnancy and some cancers". But the panel said there were "inconsistent findings across different studies, with limited evidence of a dose-response relationship". "The amount of PFAS measured in some studies was low, similar to levels found in the general population. "These studies are unable to distinguish any effects of PFAS from the many other factors that can affect health." The report said there were "few high-quality studies of workers exposed to high levels of PFAS". It added that health effects associated with PFAS "may instead result from factors such as poor kidney function". "PFAS are partly excreted by the kidneys. This means people with poor kidney function will have higher levels of PFAS, which may result in apparent associations between PFAS and other health conditions." The International Agency for Research on Cancer has classified PFOA as carcinogenic to humans and PFOS as possibly carcinogenic. The panel examined these findings, but said it was "confident that the absolute cancer risk from PFAS was low". It also stated that authorities should avoid using "currently available human epidemiological studies" to obtain PFAS threshold levels due to a high risk of bias. Research shows forever chemicals are in the blood of most people. A University of Newcastle paper, published last year, said mounting epidemiological evidence supports "negative associations between PFAS exposure and an array of human health conditions". The paper acknowledged that it was "challenging to definitively link PFAS exposure to impacts on human health". However, it found that "the balance of evidence" supports the potential for PFAS exposure to lead to adverse health outcomes. The Newcastle Herald reported in June that Hunter Water had welcomed revised Australian drinking water guidelines for PFAS. Tests confirmed that Hunter Water-supplied drinking water was safe and met the revised guidelines. Dr Kerry Chant, the chief health officer, said "updated NSW Health advice provides consumers with guidance on how to reduce PFAS exposure". "There is considerable concern, particularly in the Blue Mountains community, about exposure to PFAS through drinking water, and NSW Health takes these concerns very seriously," Dr Chant said. Nonetheless, NSW Health said it accepted all the expert panel's recommendations, which included "how to communicate risk in the context of evolving evidence".
