Bioaccumulation and the One Nature/One Health Impacts of PFAS

PFAS (per- or poly-fluoroalkyl substances) chemicals, also known as ‘forever chemicals’, do not naturally break down in the environment. During the pandemic alone, over 3600 peer-reviewed scientific papers on the human health effects of PFAS were published despite the limitations created by the COVID-19 pandemic and related shutdowns. These articles demonstrate that the over 4000 PFASs are abundant, extremely persistent, and highly mobile in the environment. Our previous articles in this series have identified the risks of exposure to PFAS in the air, soil, water, and Food. Today we will discuss the One Nature/One Health impacts of PFAS and how these risks are magnified by bioaccumulation.

The scientific literature shows that PFAS bioaccumulates (builds up) in plants, animals, and humans. Scientific studies report that aquatic and land animals in PFAS-contaminated habitats suffer immunocompromise, cancers, and failure to reproduce. One study of freshwater turtles found that blood PFAS levels were a shocking 235 times higher than the PFAS level in their natural habitat.

Studies estimate that 97% of people in the United States have PFAS in their blood. Every time we drink water and eat food, we risk ingesting increasingly more PFAS chemicals. PFAS exposure is linked to many diseases and health issues, including the following: cancer, thyroid disease, congenital disabilities, endocrine disruption, miscarriage, preeclampsia, asthma, diabetes, and high cholesterol. Other effects are detrimental changes in total cholesterol, glucose metabolism, body mass index (BMI), thyroid function, fertility, breast milk, uric acid, and attention-deficit/hyperactivity disorder (ADHD). Exposure to these chemicals can lead to a buildup of these toxins in our blood, compounding the many serious health concerns.

In the Mid-Ohio Valley, a recent study of 69,000 people drinking PFAS-contaminated water for at least one year linked PFAS to high cholesterol, ulcerative colitis, thyroid disease, testicular and kidney cancers, and pregnancy-induced hypertension. Other studies have reported decreased vaccine response, liver damage, and decreased birth weight from exposure to PFAS. In animal studies, the effects of PFAS similar to those in humans: liver toxicity, suppressed immune function, altered mammary gland development, obesity, and cancer.

Scientists believe that we have the power to phase out direct exposure to PFAS by using alternative compounds in product production. Still, PFAS accumulation in our bodies, food chains, and drinking water will persist until environmental contamination is remediated. Some PFASs are no longer used or manufactured (legacy PFAS), and blood levels of legacy PFAS in humans are declining globally. Unfortunately, total PFAS levels are rising due to exposure as PFAS use expands.

Many organizations, including the WHO and EPA, have issued guidelines for PFAS environmental exposure levels. However, these are non-enforceable voluntary standards. Despite the well-documented health impacts of PFAS exposure, no regulatory agency has issued enforceable standards called Maximum Contaminant Levels, or MCLs, for PFAS exposure.

Several ongoing studies are investigating the long-term health effects of PFAS contamination. Not surprisingly, interim data analyses confirm the negative impacts PFAS has on our physical and mental health. The scientific literature has demonstrated that environmental PFAS remediation reduces the rate of PFAS bioaccumulation, but other sources of PFAS exposure are unavoidable; PFAS in plants, animals, and our bodies lasts for many years. Studies confirm that people moving into formerly PFAS-contaminated locations after remediation have a lower risk of PFAS-related health complications than people who lived there originally. The same is true for people who move away from a PFAS-contaminated area to live in a locale with minimal PFAS exposure. What has yet to be determined is the degree to which health risks are reduced for those who live in the same region before and after PFAS remediation.

While the scientific evidence continues to build, the logical conclusion is that reducing exposure and bioaccumulation will reduce the health impacts of PFAS. Individuals can reduce their personal PFAS exposure through careful product selection, which avoids PFAS-containing products. The larger PFAS health risks related to environmental and food chain exposures will not be solved until regulatory agencies issue MCLs and testing requirements for PFAS in air, water, soil, and food. Individuals and businesses have the power to influence change through their purchases and by supporting environmental organizations calling for PFAS regulation and remediation.

About the Authors:

Untitled design (6)

Maurice A. Ramirez, D.O., Ph.D.

Maurice A. Ramirez, D.O., Ph.D. is the recipient of the Lifetime Achievement Award in Disaster Medicine and Co-Founder of the High Alert Institute, a 501c3 not-for-profit educational public charity dedicated to providing disaster readiness education and resources to unserved and underserved communities, industries and charitable organizations in an All Hazards, One Health/One Nature, One Framework paradigm. Learn more about the High Alert Institute at


Alyssa Middleton, Ph.D.

Alyssa Middleton, Ph.D., has over 20 years of experience working with cancer patients and their families and conducting cancer research.  She is the co-author of Five Bugles Institute's PFAS remediation and replacement educational program.  Learn more about Five Bugles Institute's research at

We look forward to seeing you in class!

Scroll to Top