In this Thursday Aug. 15, 2019 photo, dairy cows stand in the milking chamber at Stoneridge Farm in Arundel, Maine. The farm has been forced to shut down after sludge spread on the land was linked to high levels of PFAS in the milk. Credit: Robert F. Bukaty / AP

The story of PFAS is like a children’s fairy tale —- a miraculous gift from a benevolent genie that comes with hidden dangers. It is a tale with a moral that your parents told you many times when you were young: be careful what you wish for.

The miraculous gift is a variety of chemicals known as PFAS. They make pots and pans perfect, allow you to outdistance all your competitors in a cross-country ski race with your amazing ski wax, smooth your dental floss, help astronauts land on the moon and more. They’re brought to you by the modern-day genies of chemistry at Dupont and 3M. But watch out! The danger is that they may sicken you and other living things.

You can imagine PFAS as a tiny hot dog with a bump on the end surrounded by greasy tin foil. They come in many sizes and shapes (over 8,000 and counting as of 2019), and they all have the same basic structure: a group of carbon atoms (the “hot dog”); the “bump,” which may be many different compounds; and one or more fluorine atoms on the outside (the “tin foil”). Most PFAS molecules fiercely repel oil and water, are strongly bound together and do not break down easily. Some last a very long time and are called “forever chemicals.” God and Mother Nature never saw fit to fabricate PFAS but now even a chemistry grad student with access to some good equipment can make a new variety.

What do these chemicals actually do to people?

I knew that they are present in 60 to 95 percent of us, can be associated with a number of nasty diseases and stay around for a long time. I knew that they recently made headlines when the Department of Environmental Protection reported high levels in deer in the Fairfield area where sludge had been spread on farmers’ fields (local venison is now off limits). Also, the eggs of chickens supplied with water with high levels of PFAS are contaminated. But I knew little else.

It turns out that these little “hot dogs” find their way into all sorts of places in our bodies where they don’t belong, sometimes as innocent bystanders, sometimes as bad actors. They have been associated with liver, kidney, thyroid, pancreatic, endocrine, cholesterol, renal, neurological and developmental problems — and more. They are likely linked to some cancers and decreased response to vaccines in kids.

There is a great volume of research looking at the effects of PFAS in people, laboratory animals and cells. Some of the best comes from the Division of Cancer Epidemiology and Genetics of the National Cancer Institute. For example, in one study, there were 324 cases of renal cell cancer in employees of PFAS plants, a level twice that of the control population. Another study showed an increased incidence of kidney cancer in an Ohio community with PFAS-contaminated water. Other studies are currently underway looking at endometrial, testicular, prostate, and thyroid cancer as well as non-cancerous illnesses.


All these studies — and there are many, many more — raise questions. They suggest but do not prove that PFAS cause these problems. It is unknown whether the levels of PFAS present in many of us are high enough to be harmful. Companies generally consider use of one of the 8,000 PFAS variants a “proprietary secret,” making it even harder to get at the truth. In a way, the current PAFS story parallels that of smoking in the 1950s when the association with cancer and other illnesses was strongly suggested but not proven.

In light of this uncertainty, what should we do?

Eight years ago, I was part of a study that sampled the blood levels of PFAS in Mainers. Mine were somewhat elevated but I was told not to worry. Laboratory results could not predict whether I was likely to be sickened, only that I had been exposed like most Mainers. Had I become ill then (or even now) there would be no way to know if PFAS had caused my illness, made it worse, or was simply another one of life’s unknowns.

The situation is different for those with very high levels of PFAS, because the associations with serious illnesses are much stronger. It is crucial to find the source of PFAS and eliminate it.

Homeowners with high levels of PFAS in their well water should work carefully with the Department of Environmental Protection, which will offer assistance with appropriate filters and recommend other steps if needed.

Farmers with fields treated with contaminated organic sludge may have to change to crops that absorb less PFAS. Agencies like the U.S. Environmental Protection Agency and the state agriculture and environmental protection departments offer guidance for these difficult situations.

As a doctor, I adhere to the “precautionary principle” —- we should avoid substances unless they are proven safe.

The idea of banning entire classes of chemicals is not new. In the late 1970s governments around the world banned the use of chlorofluorocarbons after scientists showed that these substances depleted atmospheric ozone. PFAS are now widespread, and their safety is in question. Manufacturers who want to use PFAS in a product should have to prove its use is essential and that there are no alternatives. Government must act; its job is to do for us together what we cannot do alone.

Maine is currently leading the world (yes, you read it right, the world!) in restricting the use of at least some PFAS compounds. This is the result of a great deal of hard work by citizen groups and legislators. We can be proud that Maine is leading the pack but there is still a long way to go to ensure our safety.

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Geoff Gratwick, Health contributor

Geoff Gratwick is a retired rheumatologist who represented Bangor and Hermon in the Maine Senate from 2012 to 2020. He chaired the Health and Human Services Committee while in the Legislature. He is also...