AUGUSTA — As Maine compiles thousands of test results for soil and water contamination from an emerging class of toxic substances, consumers need look no further than their own homes for the most immediate – and persistent – exposure to these “forever chemicals.”

You won’t find them listed on many labels, but the chemicals known as PFAS are literally everywhere in the modern household.

“From the moment that we wake up in the morning to the moment we go to bed, we are encountering products that contain these chemicals,” said Mike Schade, who tracks PFAS and other chemicals in consumer products for the nonprofit Safer Chemicals, Healthy Families’ “Mind the Store” campaign.

They are in cosmetics, shampoos and dental floss. Grabbing pizza, a burger or hot-and-ready dinner from a grocery store? Your food may come with a side order of PFAS-laced packaging.

From the Gore-Tex jacket or boots that keep you cozy in winter, to the stain-resistant couches and nonstick cookware that make life less messy, many of the modern products so common in American households are made with a diverse class of chemical now at the center of a growing health concern.

Studies have linked two specific types of the chemical – PFOA and PFOS – to cancer, kidney disease and other serious aliments. But while the chemical industry says newer varieties are safer, medical and public health experts say the developing science strongly suggests otherwise.

“These are serious concerns about human health across the population,” said Dr. Leonardo Trasande, director of New York University School of Medicine’s environmental pediatrics program and author of the book “Sicker Fatter Poorer” on hormone-disrupting chemicals. “The reality is we always have gaps in our understanding, but at the same time there is enough data for us to take action.”

WHAT ARE PFAS?

The term PFAS refers generally to a broad category of synthetic chemicals, per- and polyfluoroalkyl substances, the first of which were developed in the 1940s by companies such as Dupont and 3M.

The chemicals helped usher in a new era of consumer convenience, perhaps best illustrated by the revolutionary nonstick cookware coated by Teflon. Dubbed “the slickest substance known to man,” the key chemical component in Teflon, polytetrafluoroethylene or PTFE, and another chemical PFOA work by essentially preventing water and water-based substances from penetrating.

Those “hydrophobic” qualities have made the two chemicals – and thousands of subsequent varieties – extremely popular with manufacturers. In addition to creating nonstick surfaces on frying pans, types of PFAS make ski jackets water-repellent, help prevent spilled wine from immediately staining carpet or upholstery, and keep fast food wrappers or takeout containers from becoming soggy, greasy messes before you can finish the food.

But their function goes beyond consumer convenience. These chemicals also serve lifesaving roles.

A type of PFAS is the critical ingredient in the foam that airport and military firefighters use – and are required by the Federal Aviation Administration to keep in supply – to smother the ferociously hot fires created by burning jet fuel. Dozens of municipal fire departments in Maine as well as petroleum companies also keep PFAS foam on hand.

Fluoropolymers that are part of the PFAS family are also commonly used in lifesaving medical devices such as stents and pacemakers as well as some brands of dental floss.

EMERGING HEALTH CONCERNS

The complex and hardy chemical compounds that make PFAS so useful in consumer products also mean, however, that the chemicals do not easily break down in the environment or the body. Some compounds are believed to linger for decades – centuries, even – in soils and take years to exit the body after exposure, hence the nickname “forever chemicals.”

Concerns over the health effects of PFOA began surfacing in the 1980s among workers at a DuPont factory in West Virginia that produced Teflon products. But the company kept quiet about the growing evidence of PFOA’s toxicity even after workers began being diagnosed with higher rates of leukemia and kidney cancer, as well as birth defects among the children of female workers.

Then in 1998, a neighboring farmer whose livestock were mysteriously dying sued the company in a landmark environmental lawsuit that showed DuPont knew for years about the health risks of the chemical. The farmer won that lawsuit, and a subsequent class-action case targeted the company for contaminating local drinking water.

Both PFOA and another toxic chemical cousin, PFOS, are no longer allowed to be manufactured in the U.S., Europe or Japan or used in products made here, although the compounds are still reportedly used in some foreign manufacturing.

The primary manufacturers of PFAS in the U.S. – 3M, DuPont and its spinoff, Chemours – are also facing dozens of lawsuits filed by plaintiffs claiming the chemicals have caused cancer or other health problems.

‘CHEMICAL WHACK-A-MOLE’

Chemical companies have since switched to differently structured forms of PFAS (chemically speaking, six-chain compounds versus the eight-chain versions in PFOS and PFOA) that manufacturers say break down faster and avoid the toxicity problems of their predecessors.

“The body of evidence reviewed shows they are not carcinogenic, they do not have developmental or reproductive concerns, the toxicity is much approved over the toxicity of PFOA and PFOS that we’ve spent a lot of time talking about,” Renee Lani of FluoroCouncil told members of Maine’s PFAS task force in September. “The don’t bioaccumulate and … an evidence analysis that was just published last year demonstrates that they are not an endocrine disruptor.”

Environmental health groups and medical professionals strongly dispute industry claims that the next-generation, short-chain PFAS compounds are less problematic. And they point to the widespread development and use of new PFAS varieties as evidence of a federal regulatory system that they say is ill-equipped to keep up with industry and failing to protect public health.

“This is chemical whack-a-mole in action,” said Trasande, who is vice chairman for research in the NYU School of Medicine’s Pediatric Department. “Just because the chemical has a short half-life, that helps if the exposure is a single point in time. But these are ongoing chemicals with consistent, ongoing exposure.”

Trasande, who specializes in endocrine-disrupting chemicals in children, said evidence suggests that the newer, shorter-chain PFAS compounds stay in the body long enough to have health impacts. Laboratory animal studies have shown potential liver and kidney toxicity from some of the newer generation of compounds.

And he said there are “serious gaps in our knowledge and toxicology” in figuring out how PFAS interact with the hundreds of hormones in the body, particularly among children and adolescents.

“There is what we know and what we haven’t studied,” Trasande told Maine lawmakers in March during an appearance before the Legislature’s Environment and Natural Resources Committee.

Industry representatives have urged Maine lawmakers as well as members of Congress not to group-label all PFAS as potentially hazardous substances. Companies that make PFAS say the newer, most common types of chemicals are safer and less “forever” than the now-banned versions definitely linked to cancer, kidney disease and other ailments.

“My fear is that an overgeneralization is leading to a lot of misinformation, a lot of fear and a lot of confusion over a chemistry that is not even being used anymore,” Brady Pitts, an application chemist for PFAS manufacturer Daikin America, told Maine lawmakers at the same March hearing.

And then there is the potential health threat posed by contamination from the legacy, now-banned versions.

Dr. Abby Fleisch, an attending physician in pediatric endocrinology and diabetes at Maine Medical Center, recently received a five-year, $2.2 million federal grant to study whether childhood or pre-birth exposure to PFAS can contribute to development of diabetes or lower bone densities.

Fleisch and her team is still in the earlier stages of that research, but initial findings suggest that children between the ages of 6 and 10 who had higher PFAS levels in the blood also had lower bone density. That is important because adolescence is peak bone-formation time, and low bone mineral density during teenage years may predispose those individuals to osteoporosis later in life, Fleisch said.

The research team also plans to follow up on earlier work examining the same group of women and children that suggested girls exposed to higher PFAS levels in utero could be predisposed to childhood obesity.

“Research suggests that PFAS exposure may impact multiple health outcomes,” Fleisch said in an interview. “However, we don’t have all of the answers and I believe it is important to continue exploring these fields.”

REGULATORY ACTION – AND INACTION

There’s been a flurry of activity at the state and federal level in recent years, spurred initially by the discovery of PFAS hotspots around military bases.

In Maine, high levels of PFAS have been found at the former Brunswick Naval Air Station, former Loring Air Force Base and around the Maine Air National Guard base at Bangor International Airport. But the chemicals have also turned up on an Arundel dairy farm, at former tanneries, near landfills and other industrial sites in Maine.

Congress and the federal government are exploring a variety of actions, ranging from adopting tighter health standards for contamination to adding PFAS to the list of chemicals eligible for federal cleanup under the Superfund program. There is also an effort to add at least some forms of PFAS to the list of chemicals that companies are required to report emitting or discharging under the federal Toxics Release Inventory.

Maine’s PFAS task force is expected to recommend a host of legislative or administrative actions. Those potential actions include expanded statewide tests for contamination, required reporting whenever a fire department uses PFAS-laden foam and mandatory screening for PFAS among all public water systems.

The Maine Department of Environmental Protection, meanwhile, is seeking legislative authority to order companies to clean up PFAS-contaminated sites, something it currently lacks because the federal government doesn’t list PFAS as a hazardous material.

Maine is among the handful of states – including Washington, Massachusetts, New Hampshire and Michigan – that are leading the regulatory charge on PFAS. For instance, Maine lawmakers passed the nation’s first phase-out of PFAS in food packaging earlier this year, although the law only takes effect when safer alternatives are available.

“We don’t anticipate a lot of progress in Washington regulating PFAS in food packaging … so it is really up to the states to step up,” said Schade, of the Safer Chemicals, Healthy Families nonprofit.

THE CUSTOMER IS ALWAYS RIGHT

Schade is also a firm believer in the power of the consumer. And he says recent decisions by retailers to act on PFAS before the federal government is proof of that power.

Through its “Mind the Store” campaign, Safer Chemicals, Healthy Families, and like-minded organizations nationwide have tested consumer products and food packaging for the presence of PFAS. They then used those results to attempt to pressure manufacturers or retailers to remove PFAS from products.

For instance, a 2018 report from Mind the Store and the group Toxic-Free Future showed likely PFAS ingredients in many store-brand products and packaging from the major grocery store chains Ahold Delhaize, Whole Foods, Albertson’s and Kroger.

Immediately after the report, Whole Foods announced plans to stop using takeout food packaging that contains PFAS. And in September of this year, the owner of Hannaford and Stop & Shop supermarket chains, Ahold Delhaize,  announced that it plans to begin removing PFAS from packaging for grocery items, baby products and personal care products.

Both the Lowe’s and Home Depot home improvement chains also recently announced that they would stop selling carpeting and rugs that contain PFAS. And two weeks ago, Staples announced that it would work with suppliers to begin transitioning to “safer alternatives” to PFAS and other chemicals in products.

Additionally, the maker of the water-repellent fabric Gore-Tex has committed to eliminate PFAS varieties “of environmental concern” from 85 percent of its consumer products by the end of next year and from the remaining products by 2023.

“So this is really a growing sustainability trend among major retailers and businesses,” Schade said. “At the same time, we have seen leadership from states such as Maine and Washington in recent years.”

PROTECTING YOURSELF

According to the Agency for Toxic Substances and Disease Registry within the U.S. Centers for Disease Control and Prevention, “exposure to PFOA and PFOS from today’s consumer products is usually low, especially when compared to exposures to contaminated drinking water.”

But PFAS awareness advocates say there are steps that consumers can take to educate – and potentially protect – themselves from exposure. They include:

• Avoid or reduce consumption of fast food or oily and greasy prepared foods because they often come in grease-resistant wrappers, boxes and other packaging coated with PFAS.
• Cook popcorn the old-fashioned way – on the stovetop – rather than in a microwaveable bag potentially lined with a type of PFAS.
• Avoid stain-resistant carpeting, furniture or other upholstery when buying new.
• If you already own such upholstered products (particularly products made before the final PFOA and PFOS phaseout in 2015) dust regularly because the chemicals as well as other now-banned flame retardants can get into dust.
• When shopping for cosmetics or personal care products, avoid items with PTFE or the word “fluoro” in the ingredients.
• Throw out old Teflon or nonstick cookware, particularly if it is scratched.

Organizations such the Environmental Working Group, Safer Chemicals, Healthy Families and Toxic-Free Future recommend avoiding nonstick cookware altogether. That’s because even newer versions marketed as PFOA-free could contain the shorter-chain chemical cousins that they maintain have not been proved safe.

Many of those organizations recommend using cast-iron or stainless steel. But advice to consumers on such topics as nonstick cookware can be contradictory and confusing.

In a 2016 fact sheet on PFOA, the American Cancer Society stated: “Other than the possible risk of flu-like symptoms from breathing in fumes from an overheated Teflon-coated pan, there are no known risks to humans from using Teflon-coated cookware. While PFOA is used in making Teflon, it is not present (or is present in extremely small amounts) in Teflon-coated products.”

Finding out whether a product was made with PFAS is difficult. But Schade with the “Mind the Store” campaign said consumers should ask manufacturers or retailers such questions, in part to educate themselves and in part to send a message to businesses.

“Consumers really need to be savvy and aware, but at the same time none of us should need to have a Ph.D. in chemistry, … which is why we need governments to act,” he said.