Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perspective
  • Published:

Advancing per- and polyfluoroalkyl substances (PFAS) research: an overview of ATSDR and NCEH activities and recommendations

Journal of Exposure Science & Environmental Epidemiology volume 31, pages 961–971 (2021)Cite this article

Abstract

The National Center for Environmental Health (NCEH), part of the Centers for Disease Control and Prevention (CDC), and the Agency for Toxic Substances and Disease Registry (ATSDR) support and conduct research advancing national, state, and local public health response to per- and polyfluoroalkyl substances (PFAS). PFAS are a group of manufactured chemicals used in industry and consumer products that persist in the environment. Given the growing evidence linking PFAS with adverse health effects in humans, NCEH and ATSDR developed a public health research framework to capture the broad range of PFAS research activities being conducted and supported by the agency to determine future research priorities and identify opportunities for interagency collaboration. The framework was conceptualized via a multidisciplinary visioning process designed to identify compelling questions and research activities that span five scientific domains: toxicology, exposure, human health, public health action, and cross-cutting priorities. This paper presents a framework, compelling questions and research activities to help NCEH and ATSDR advance scientific discovery in partnership with federal, state, and local stakeholders as part of a comprehensive public health response to PFAS contamination.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Summary of NCEH/ATSDR PFAS Research Initiatives, 1999–2019.
Fig. 2: NCEH/ATSDR Research Framework for PFAS.

Similar content being viewed by others

References

  1. Kudo N, Kawashima Y. Toxicity and toxicokinetics of perfluorooctanoic acid in humans and animals. J Toxicol Sci. 2003;28:49–57. https://doi.org/10.2131/jts.28.49.

    Article  CAS  PubMed  Google Scholar 

  2. Taves DR. Evidence that there are two forms of fluoride in human serum. Nature. 1968;217:1050–1. https://doi.org/10.1038/2171050b0.

    Article  CAS  PubMed  Google Scholar 

  3. Buck RC, Franklin J, Berger U, Conder JM, Cousins IT, de Voogt P, et al. Perfluoroalkyl and polyfluoroalkyl substances in the environment: terminology, classification, and origins. Integr Environ Assess Manag. 2011;7:513–41. https://doi.org/10.1002/ieam.258.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Wang Z, DeWitt JC, Higgins CP, Cousins IT. A never-ending story of per- and polyfluoroalkyl substances (PFASs)? Environ Sci Technol. 2017;51:2508–18. https://doi.org/10.1021/acs.est.6b04806.

    Article  CAS  PubMed  Google Scholar 

  5. Lau C, Anitole K, Hodes C, Lai D, Pfahles-Hutchens A, Seed J. Perfluoroalkyl acids: a review of monitoring and toxicological findings. Toxicol Sci. 2007;99:366–94. https://doi.org/10.1093/toxsci/kfm128.

    Article  CAS  PubMed  Google Scholar 

  6. Hu XC, Andrews DQ, Lindstrom AB, Bruton TA, Schaider LA, Grandjean P, et al. Detection of poly- and perfluoroalkyl substances (PFASs) in U.S. drinking water linked to industrial sites, military fire training areas, and wastewater treatment plants. Environ Sci Technol Lett. 2016;3:344–50. https://doi.org/10.1021/acs.estlett.6b00260.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Agency for Toxic Substances and Disease Registry. Toxicological Profile for Perfluoroalkyls. (Draft for Public Comment). Atlanta, GA: Agency for Toxic Substances and Disease Registry; 2018.

  8. Sunderland EM, Hu XC, Dassuncao C, Tokranov AK, Wagner CC, Allen JG. A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects. J Expo Sci Environ Epidemiol. 2019;29:131–47. https://doi.org/10.1038/s41370-018-0094-1.

    Article  CAS  PubMed  Google Scholar 

  9. Calafat AM, Wong L-Y, Kuklenyik Z, Reidy JA, Needham LL. Polyfluoroalkyl chemicals in the U.S. population: data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and comparisons with NHANES 1999-2000. Environ Health Perspect. 2007;115:1596–602. https://doi.org/10.1289/ehp.10598.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Steenland K, Fletcher T, Savitz DA. Epidemiologic evidence on the health effects of perfluorooctanoic acid (PFOA). Environ Health Perspect. 2010;118:1100–8. https://doi.org/10.1289/ehp.0901827.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Agency for Toxic Substances and Disease Registry. How is ATSDR involved investigating PFAS in the environment? 2019. https://www.atsdr.cdc.gov/pfas/atsdr_sites_involvement.html.

  12. United States. Congress. House. Committee on Armed Services. National Defense Authorization Act For Fiscal Year 2018 : Report of the Committee on Armed Services, House of Representatives on H.R. 2810 Together with Dissenting Views (Including Cost Estimate of the Congressional Budget Office). Washington: U.S. Government Publishing Office; 2017.

  13. Post GB, Gleason JA, Cooper KR. Key scientific issues in developing drinking water guidelines for perfluoroalkyl acids: contaminants of emerging concern. PLoS Biol. 2017;15:e2002855–e2002855. https://doi.org/10.1371/journal.pbio.2002855.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Hu XC, Dassuncao C, Zhang X, Grandjean P, Weihe P, Webster GM, et al. Can profiles of poly- and perfluoroalkyl substances (PFASs) in human serum provide information on major exposure sources? Environ Health. 2018;17:11 https://doi.org/10.1186/s12940-018-0355-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Rappazzo KM, Coffman E, Hines EP. Exposure to perfluorinated alkyl substances and health outcomes in children: a systematic review of the epidemiologic literature. Int J Environ Res Public Health. 2017;14:691 https://doi.org/10.3390/ijerph14070691.

    Article  CAS  PubMed Central  Google Scholar 

  16. Guelfo JL, Marlow T, Klein DM, Savitz DA, Frickel S, Crimi M, et al. Evaluation and management strategies for per- and polyfluoroalkyl substances (PFASs) in drinking water aquifers: perspectives from impacted U.S. Northeast communities. Environ Health Perspect. 2018;126:65001 https://doi.org/10.1289/EHP2727.

    Article  Google Scholar 

  17. Cariou R, Veyrand B, Yamada A, Berrebi A, Zalko D, Durand S, et al. Perfluoroalkyl acid (PFAA) levels and profiles in breast milk, maternal and cord serum of French women and their newborns. Environ Int. 2015;84:71–81. https://doi.org/10.1016/j.envint.2015.07.014

    Article  CAS  PubMed  Google Scholar 

  18. Worley RR, Yang X, Fisher J. Physiologically based pharmacokinetic modeling of human exposure to perfluorooctanoic acid suggests historical non drinking-water exposures are important for predicting current serum concentrations. Toxicol Appl Pharmacol. 2017;330:9–21. https://doi.org/10.1016/j.taap.2017.07.001.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. D’eon JC, Mabury SA. Is indirect exposure a significant contributor to the burden of perfluorinated acids observed in humans? Environ Sci Technol. 2011;45:7974–84. https://doi.org/10.1021/es200171y.

    Article  CAS  PubMed  Google Scholar 

  20. Shankar A, Xiao J, Ducatman A. Perfluorooctanoic acid and cardiovascular disease in US adults. JAMA Intern Med. 2012;172:1397–403. https://doi.org/10.1001/archinternmed.2012.3393.

    Article  CAS  Google Scholar 

  21. Grandjean P, Heilmann C, Weihe P, Nielsen F, Mogensen UB, Timmermann A, et al. Estimated exposures to perfluorinated compounds in infancy predict attenuated vaccine antibody concentrations at age 5-years. J Immunotoxicol. 2017;14:188–95. https://doi.org/10.1080/1547691X.2017.1360968.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. National Toxicology Program. Monograph on immunotoxicity associated with exposure to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS). Research Triangle Park, NC: National Toxicology Program; 2016. https://ntp.niehs.nih.gov/ntp/ohat/pfoa_pfos/pfoa_pfosmonograph_508.pdf.

  23. Buekers J, Colles A, Cornelis C, Morrens B, Govarts E, Schoeters G. Socio-economic status and health: evaluation of human biomonitored chemical exposure to per- and polyfluorinated substances across status. Int J Environ Res Public Health. 2018;15:2818 https://doi.org/10.3390/ijerph15122818.

    Article  CAS  PubMed Central  Google Scholar 

  24. Finch KC, Snook KR, Duke CH, Fu KW, Tse ZTH, Adhikari A, et al. Public health implications of social media use during natural disasters, environmental disasters, and other environmental concerns. Nat Hazards. 2016;83:729–60. https://doi.org/10.1007/s11069-016-2327-8.

    Article  Google Scholar 

  25. English PB, Richardson MJ, Garzón-Galvis C. From crowdsourcing to extreme citizen science: participatory research for environmental health. Annu Rev Public Health. 2018;39:335–50. https://doi.org/10.1146/annurev-publhealth-040617-013702.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This report was by supported by funds from the Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services.

Author information

Authors and Affiliations

  1. Agency for Toxic Substances and Disease Registry, Atlanta, Georgia

    Rachel D. Rogers, Christopher M. Reh & Patrick Breysse

  2. National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia

    Patrick Breysse

Authors
  1. Rachel D. Rogers
    View author publications

    Search author on:PubMed Google Scholar

  2. Christopher M. Reh
    View author publications

    Search author on:PubMed Google Scholar

  3. Patrick Breysse
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Rachel D. Rogers.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rogers, R.D., Reh, C.M. & Breysse, P. Advancing per- and polyfluoroalkyl substances (PFAS) research: an overview of ATSDR and NCEH activities and recommendations. J Expo Sci Environ Epidemiol 31, 961–971 (2021). https://doi.org/10.1038/s41370-021-00316-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41370-021-00316-6

This article is cited by

Search

Advanced search

Quick links