In their daily job of protecting lives, firefighters are exposed to a lot of hazards — not just smoke and fire, but unsafe traffic, violence and vicious cats in trees. However, one of the most perilous risks in firefighting can be somewhat invisible: so-called "forever chemicals," the substances that are used to suppress fires, such as in fire extinguishers and foams dumped on wildfires.
One common class of forever chemicals are PFAS, which stands for per- and polyfluoroalkyl substances, and they are compounds made of chlorine and fluorine nicknamed "forever chemicals" because they essentially never break down.
This resilience is exactly what makes them so popular. PFAS are greatly resistant to water, grease, oil and stains, and as such are ubiquitous in products like food packaging, fast food wrappers, receipt paper, umbrellas, stain-resistant clothing, stain-resistant furniture and nonstick cookware. PFAS have even been found in our food and drinking water.
"If this becomes a common way to treat PFAS exposure we will need to look at the implications for recipients."
Because they are in all of the products we regularly use, they are constantly getting into our bodies, which seems to have a harmful effect on us. They've been linked to cancers, liver diseases, reproductive diseases, type-2 diabetes, hypertension and immune disorders.
The 285 firefighters who worked for Fire Rescue Victoria — a fire department in the Australian city of Melbourne — continued their public service despite the crises that surrounded them. They were diligent about their work during the Black Summer Bushfires that spanned 2019 to 2020. They persisted even as the COVID-19 outbreak became one of the worst pandemics in modern history.
But these firefighters were also participating in a study to see if scientists could remove so-called "forever chemicals" from their bodies. As a result of the firefighters' efforts and those of the scientists who conducted the research, the public now knows a little more about whether these controversial chemicals — which are absolutely everywhere — can even be escaped.
The parameters of the study, which was published in the journal JAMA Open in 2022, were straightforward: The firefighters were divided into three groups so that the amount of PFAS in their blood could be measured over the course of 12 months. During the 12 months of the experiment, one group of firefighters donated plasma every six weeks; a second group donated whole blood every 12 weeks; and the final group did not donate blood at all.
"Because PFAS bind to serum proteins in the blood, removing blood or plasma containing these proteins could reduce the level of PFAS in the blood. But we don't know for sure."
After the results were analyzed, scientists learned that "plasma and blood donations caused greater reductions in serum PFAS levels than observation alone over a 12 month period."
In other words: Donating blood or plasma can actually extract PFAS from your body. That said, the researchers behind the study admit that the mechanisms behind these PFAS reductions are murky.
"Our hypothesized mechanism is that because PFAS bind to serum proteins in the blood, removing blood or plasma containing these proteins could reduce the level of PFAS in the blood," Miriam K. Forbes, PhD, an associate professor at Macquire University and a co-author of the paper, wrote to Salon. "But we don't know for sure."
Forbes added that "to our knowledge, this is the only study that has identified a method for reducing serum PFAS levels: Both blood and plasma donations resulted in significant reductions in PFAS, and plasma donations resulted in a more substantial decrease than blood donations."
Dr. Anna Reade and Dr. Katie Pelch are environmental scientists at the Natural Resources Defense Council, where they both have background in studying PFAS. They were not involved in the PFAS blood study, but they agreed it "makes sense." In a joint email, they told Salon "certain PFAS, especially PFOA [Perfluorooctanoic Acid] and PFOS [Perfluorooctane sulfonic acid], stay in our bodies for a long time because our bodies are generally unable to break them down to be eliminated."
At the same time, it is known that PFAS can be directly eliminated in women through menstruation, placental transfer during pregnancy and breastmilk transfer.
University of Michigan epidemiologist Sung Kyun Park, who was also not involved in the study, told Salon by email that his reaction to it was "positive" as it demonstrates that forever chemicals "are stored in blood and blood loss is an important elimination pathway of PFAS." Like Reade and Pelch, he mentioned how this is consistent with the existing medical knowledge that women of reproductive age have lower PFAS levels than men of the same age because they menstruate.
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"Contamination of the blood supply is yet another reason we need to address widespread exposure to toxic chemicals."
"One caveat is that donated blood is not monitored for PFAS concentrations," Park added. "To my knowledge, no study has been conducted on the impact of blood transfusions on PFAS exposure. Young children may be more susceptible to blood transfusions with high levels of contaminants, not only PFAS but also other toxicants such as lead."
Liz Costello, a PhD student at the University of Southern California who has studied PFAS and was likewise not involved in the study, praised its science as "interesting and relatively straightforward" but also expressed ethical concerns in her email to Salon.
"If this becomes a common way to treat PFAS exposure we will need to look at the implications for recipients," Costello said. "Someone in need of a blood donation may also be more vulnerable to PFAS-related health effects. This study, perhaps inconveniently, also highlights the need to understand how PFAS in blood donations might impact the safety of the blood supply and what threshold(s) might be acceptable."
Indeed, Costello expressed reservations that the study could be used to encourage people to donate blood simply to eliminate the PFAS in their own body.
"Reading this study certainly left me with some new and unexpected ethical concerns," Costello concluded. "As we learn more about the health impacts of PFAS and other environmental chemicals, I do think the implications for blood and other donations will become more important to consider."
"Reading this study certainly left me with some new and unexpected ethical concerns."
Costello added that 'if we can find ways to remove PFAS from donated blood, we might go a long way towards reducing overall PFAS exposure and make the blood supply even safer for recipients."
Simon Fraser University health sciences professor Dr. Bruce Lanphear, who contributed to the study along with Dr. Forbes, expressed his own ethical concerns about the way humans today are dealing with PFAS pollution.
"Not surprisingly, blood banks have not wanted to deal with the inconvenient questions about blood donations having high concentrations of PFAS, lead or other toxic chemicals," Lanphear wrote to Salon. "Still, contamination of the blood supply is yet another reason we need to address widespread exposure to toxic chemicals. Not only are toxic chemicals widespread, our regulatory agencies are failing to regulate chemicals (e.g., pesticides, heavy metals, flame retardants) to protect the public."
Lanphear is in a good position to know about insufficient chemical regulation; he resigned from Health Canada's Pest Management Regulatory Agency in July 2023 because he asserted it had a "flawed" way of regulating of "pesticides and other toxic chemicals," as Lanphear explained to Salon. "I already knew it was flawed, but I could no longer be silent about it."
He insisted that there are many commonly used chemicals which are dangerous to human health but are not widely recognized as such due to inadequate regulation.
So what can one do to get PFAS out of your body? At present, nothing — but you can at least reduce your exposure.
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"You can test your water (or ask your water provider if they have tested for PFAS)," Reade and Pelch said. They also suggested water treatments that can treat for PFAS and avoiding PFAS containing substances by "avoiding water, stain, and oil resistant products, look for 'PFAS-free' labels, ask your favorite brands if they are PFAS free."
Reade and Pelch also suggested that people who wish to learn about the extent of their PFAS exposure "have your blood tested and to compare this to the screening levels set by the National Academies of Science Engineering and Medicine (NASEM) committee. NASEM and other authoritative bodies have linked PFAS exposure to kidney, testicular and breast cancer, decreased immune system function, changes in blood lipid levels, thyroid disease and dysfunction, changes in liver enzymes and gestational hypertension and pre-eclampsia."
In other words, if blood donation doesn't work to remove PFAS, we definitely better find other solutions as quickly as possible.