File:US Navy 060420-N-9928E-079 Damage Controlman 3rd Class - inspects the Aqueous Film Forming Foam (AFFF) system
aboard the Nimitz-class aircraft carrier USS John C. Stennis
You're likely hearing a lot about PFAS, PFOS, and PFOA, which are all acronyms associated with Fire-Fighting Foam. Countless news articles have been generated because the health impacts associated with these substances are an explosive topic. The medical literature has also exploded in the last few years and it continues to accumulate. One clear indication of importance is the fact that currently, the EPA has identified some 180 Superfund Sites.
Superfund Sites Identified by EPA to have PFAS Contamination:
For accuracy and clarification, PFAS (Per- and Polyfluoroalkyl Substances), which includes PFOS (Perfluorooctane Sulfonate) and PFOA (Perfluorooctanoic acid) have historically been present in certain formulations of Firefighting Foam, particularly in Aqueous Film-Forming Foams (AFFF). AFFF is a type of foam used to extinguish flammable liquid fires, such as those involving gasoline, oil, or jet fuel. These foams contain PFAS compounds due to their ability to create a strong barrier between the fuel and the fire, which is highly effective, and as such, they have been used in military installations for decades.
The health impacts of PFOA and PFOS (the most common types of PFAS) are an explosive topic today, with countless news articles being generated. The medical literature on PFAS has also exploded in the last few years and continues to accumulate.
In addition to direct exposure to AFFF (Aqueous film-forming foams for firefighting), another potential source of PFAS is the contamination of drinking water and specifically, the contamination of ground and surface water due to the use of (AFFF) at airports, military installations, and fire-fighting training sites. In 2020, the International Journal of Hygiene and Environmental Health, Volume 223, Issue 1, reported that “PFAS had been recently detected in hundreds of public water systems in more than half of U.S. states (Anderson et al., 2016; Hu et al., 2016; Weiss et al., 2012)”.
PFAS (including PFOA & PFOS) are called ‘Forever Chemicals’ because they persist in the environment for many decades, and in human tissue for many years.
Of scientific note, currently, the EPA warned that PFOA and PFOS can cause health issues with rates as low as 0.004 and 0.02 parts per trillion, an incredibly low concentration. Most current environmental assays can’t even measure such low levels. It should also be noted that previously, the agency said 70 parts per trillion could pose risks marking a clear indication that knowledge of the subject has evolved with considerable implication.
The half-life of PFAS (including PFOA & PFOS) in human tissues is in the 5-8 years range, translating into long disease latencies of at least 15-20 years.
From recent news items, military bases often mentioned in conjunction with PFAS include Fort Benning, Georgia; Fort Campbell, Kentucky; Fort Bragg, North Carolina; Fort Bliss and Fort Hood in Texas; and Joint Base Lewis-McChord in Washington state.
In addition, and as previously mentioned, the EPA had identified some 180 Superfund Sites with contamination of PFAS. (See link above)
Veteran Connections
Cancers and Oncology are clearly at the top of the list of diseases linked to PFAS. There are currently enough epidemiological studies and meta-analyses to support strong Veteran connections for:
Prostate cancer
Thyroid cancer
Kidney cancer
Testicular cancer
Breast cancer
Exposure to PFAS (PFOA-PFOS) has also been associated with a wide range of health risks. PFAS are medically categorized as Endocrine Disrupting Chemicals (EDC) and there are non-cancer diseases currently linked with it as well, including Hypothyroidism, Obesity, and Diabetes.
While the medical details of every case are different, there are additional diseases and health issues that have been linked to PFAS exposure including:
Neurological Effects: Studies have suggested a possible association between PFAS exposure and cognitive impairments, behavioral changes, and developmental delays in children.
Cardiovascular Disease: Emerging research indicates that there might be a link between PFAS exposure and increased risk of cardiovascular disease, including heart attacks and strokes.
Liver Disease: PFAS exposure has been associated with liver damage, including non-alcoholic fatty liver disease and changes in liver enzyme levels.
Kidney Disease: There is evidence that PFAS exposure may contribute to kidney dysfunction, including decreased kidney function and increased risk of kidney disease.
Immune System Dysfunction: PFAS exposure has been shown to affect immune system function, potentially leading to increased susceptibility to infections and autoimmune disorders.
Reproductive and Developmental Effects: PFAS exposure has been linked to adverse reproductive outcomes, such as reduced fertility, delayed onset of puberty, and developmental issues in infants.
Thyroid Dysfunction: PFAS exposure can interfere with thyroid hormone regulation, potentially leading to thyroid disorders and related health problems.
The medical community predicts that literature and known health risks will escalate significantly over the upcoming years. However, we have enough information today that supports Veterans and their struggle with the diseases caused by their exposure to these 'Forever Chemicals'. Therefore, Veteran Advocates should understand the serious health risks surrounding PFAS, and also considering the very long latency of these toxins, be keenly aware that Veterans whose exposure was years ago, might still deserve service connection.