Frequently Asked Questions

Overview

Per- and polyfluoroalkyl substances (PFAS) are a large group of man-made chemicals that have been used in industry and consumer products worldwide since the 1940s due to their unique properties, such as resistance to high and low temperatures, resistance to degradation, and nonstick characteristics. These chemicals have been used to make products that resist stains, grease, oil, and water.

Common Uses of PFAS:

• Non-stick cookware
• Food packaging
• Stain-resistant carpet and fabrics
• Water-repellent clothing
• Some firefighting foams
• Some cosmetics

The most commonly studied PFAS are perfluorooctanoic acid (PFOA or C8) and perfluorooctane sulfonic acid (PFOS). The next most commonly studied are perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA). Most uses of PFOA and PFOS were phased out by U.S. manufacturers in the mid-2000s, although there are a limited number of ongoing uses. In addition, other countries may still manufacture and use them.

PFAS do not occur naturally but are widespread in the environment. PFAS can be found in the environment near areas where they are manufactured or where products containing PFAS are often used. During production and use, PFAS can migrate into the soil, water, and air. Most PFAS (including PFOA and PFOS) do not break down, so they remain in the environment. Because of their widespread use and their persistence in the environment, PFAS are found in the blood of people, animals, and fish all over the world and are present at low levels in a variety of food products and in the environment. Some PFAS can build up in people and animals with repeated exposure over time and can stay in people’s bodies for a long time.

In April 2024, the U.S. Environmental Protection Agency (EPA) established new drinking water regulations known as maximum contaminant levels (MCLs) for six PFAS in drinking water: PFOA, PFOS, PFHxS, PFNA, and HFPO-DA as contaminants with individual MCLs, and PFAS mixtures containing at least two or more of PFHxS, PFNA, HFPO-DA, and PFBS using a Hazard Index MCL. The MCLs are part of the National Primary Drinking Water Regulations (NPDWRs), which are legally enforceable primary standards and treatment techniques that apply to public water systems. 

PFOA

Perfluorooctanoic acid (PFOA) has been a manufactured perfluorochemical and a byproduct in producing fluoropolymers. Perfluorochemicals (PFCs) are a group of chemicals used to make fluoropolymer coatings and products that resist heat, oil, stains, grease, and water. PFOA was used particularly for manufacturing polytetrafluoroethylene, but since 2002, manufacturers have used a new process not requiring this chemical. PFOA persists in the environment and does not break down. PFOA has been identified in bodies of water and in a variety of land and water animals.

PFOS

Perfluorooctane sulfonic acid (PFOS) (PDF) is a synthetic, fully fluorinated organic acid; it is used in a variety of consumer products and is generated as a degradation product of other perfluorinated compounds. Because of strong carbon-fluorine bonds, PFOS is stable to metabolic and environmental degradation. PFOS is one of a large group of perfluoroalkyl substances (PFAS) that are used to make products more resistant to stains, grease, and water. These compounds have been widely found in consumer and industrial products, as well as in food items. Water resources contaminated by PFOS have been associated with releases from manufacturing sites, industrial sites, fire/crash training areas, and industrial or municipal waste sites where products are disposed of or applied.

GenX Chemicals

GenX is a trade name for a man‐made processing aid technology used to make high-performance fluoropolymers without the use of PFOA. Hexafluoropropylene oxide dimer acid (HFPO-DA) and its ammonium salt are together referred to as “GenX chemicals” because they are the two major chemicals associated with the GenX processing aid technology.

Because GenX chemicals can be used as a replacement for PFOA, they may be used in a similar fashion in the manufacture of the same or similar fluoropolymer end products (e.g., nonstick coating for cookware). GenX chemicals have been found in surface water, groundwater, drinking water, rainwater, and air emissions.

GenX is well-known in North Carolina. Chemours' facility in Fayetteville began producing GenX commercially in 2009 as a replacement for PFOA. The same chemical is also produced as a byproduct during other manufacturing processes, and it may have been present in the environment for many years before being produced commercially as GenX.

PFBS

Perfluorobutane sulfonic acid and its potassium salt (together referred to as “PFBS”) is considered a replacement for PFOS in chemical and product manufacturing. PFOS is a chemical that was voluntarily phased out (with some exceptions) by its primary U.S. manufacturer (3M Company) between 2000 and 2002.

PFBS is used primarily in the manufacture of paints, cleaning agents, and water- and stain-repellent products and coatings. PFBS has been detected in surface water, groundwater, and drinking water and has been found in dust, carpeting and carpet cleaners, and floor wax, foods including seafood (fish and shellfish) and vegetables, food packaging, indoor and outdoor air, soil, biosolids, and some consumer products.

PFOA and PFOS

On April 10, 2024, the U.S. Environmental Protection Agency (EPA) published the final human health toxicity assessments for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) and the final PFAS National Primary Drinking Water Rule (NPDWR) for six per- and polyfluoroalkyl substances (PFAS). The final 2024 PFOA and PFOS toxicity assessments report toxicity values that reflect the best available science and health effects information. The 2022 PFOA and PFOS interim drinking water health advisories (iHAs) no longer reflect the best available scientific information.

The EPA’s NPDWR established legally enforceable levels, called Maximum Contaminant Levels (MCLs), including individual MCLs for PFOA, PFOS, PFHxS, PFNA, and HFPO-DA, and a PFAS mixtures MCL containing at least two or more of PFHxS, PFNA, HFPO-DA, and PFBS.

GenX and PFBS

On June 15, 2022, the EPA published final drinking water health advisories (HAs) for perfluorobutane sulfonic acid and its potassium salt (PFBS) and hexafluoropropylene oxide dimer acid (HFPO-DA) and its ammonium salt (GenX Chemicals). In chemical and product manufacturing, GenX chemicals are considered a replacement for PFOA, and PFBS is considered a replacement for PFOS.

• EPA issued a lifetime noncancer drinking water health advisory (HA) for GenX checmicals of 10 nanograms per liter (ng/L) or 10 parts per trillion (ppt).
• EPA issued a lifetime noncancer drinking water HA for PFBS of 2,000 nanograms per liter (ng/L) or 2,000 parts per trillion (ppt).

Drinking water health advisory levels are non-enforceable and non-regulatory health-based values that are provided for informational purposes. While unenforceable, these advisories indicate the level of drinking water contamination below which adverse health effects are not expected to occur over specific exposure durations (e.g., one-day, ten-days, and a lifetime). Health advisories provide technical information that federal, state, and local officials can use to inform the development of monitoring plans, investments in treatment solutions, and future policies to protect the public from PFAS exposure.

HAs Currently Under Development

As stated in EPA’s PFAS Strategic Roadmap, PFAS contamination has impacted drinking water quality across the country, including in underserved rural areas and communities of color. Going forward, EPA anticipates developing HAs for additional PFAS or categories of PFAS as the Agency publishes toxicity assessments.

Under the Safe Drinking Water Act, the U.S. Environmental Protection Agency (EPA) has the authority to set enforceable National Primary Drinking Water Regulations (NPDWRs) for drinking water contaminants and require monitoring of public water systems.

On April 10, 2024, EPA established legally enforceable levels, called Maximum Contaminant Levels (MCLs), for several PFAS known to occur individually and as mixtures in drinking water.

EPA set enforceable MCLs for five individual PFAS: PFOA, PFOS, PFNA, PFHxS, and HFPO-DA (also known as GenX Chemicals). EPA is also regulating, through a hazard index (HI), mixtures of four PFAS: PFNA, PFHxS, HFPO-DA, and PFBS.

EPA also finalized health-based, non-enforceable Maximum Contaminant Level Goals (MCLGs) for these PFAS.

Maximum Contaminant Level Goal (MCLG): The level of a contaminant in drinking water below which there is no known or expected risk to health. MCLGs allow for a margin of safety and are non-enforceable public health goals.

Maximum Contaminant Level (MCL): The highest level of a contaminant that is allowed in drinking water. MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration. MCLs are enforceable standards.

ppt: parts per trillion

Hazard Index (HI): The Hazard Index is a long-established approach that EPA regularly uses to understand health risk from a chemical mixture (i.e., exposure to multiple chemicals). The HI is made up of a sum of fractions. Each fraction compares the level of each PFAS measured in the water to the health-based water concentration.

Based on the NPDWRs implemented in April 2024, water systems must take action to reduce the levels of these PFAS in drinking water if the levels exceed MCLs. Public water systems have 5 years to meet this new requirement.

Learn about additional actions taken by EPA since January 2021 on their Key EPA Actions to Address PFAS webpage.

Brunswick County Public Utilities Water Customers & Wholesale Municipal/Utility Water Customers

PFAS contamination is present throughout North Carolina. The North Carolina Department of Environmental Quality (NCDEQ) and North Carolina Department of Health and Human Service (NCDHHS) began investigating the presence of GenX chemicals in the Cape Fear River in June 2017. The Chemours Fayetteville Works Plant was identified as the company that produces the GenX chemicals for industrial processes.

Brunswick County Public Utilities regularly tests its raw and treated water for several PFAS compounds, including the six with National Primary Drinking Water Regulations (NPDWRs): PFOA, PFOS, PFNA, PFHxS, HFPO-DA, and PFBS. Test results are published on the County's website for transparency.

Note: As of June 2024, Brunswick County's current wholesale water customers include Bald Head Island, Holden Beach, Oak Island, and Ocean Isle Beach.

Private Well Users

If you live in the Fayetteville area or lower Cape Fear region, you may be eligible for free testing. Visit the North Carolina Department of Environmental Quality (NCDEQ) website or contact the Chemours Fayetteville Works Plant to request well testing:

• Brunswick, New Hanover, Pender, or Columbus counties: 910-678-1100
• Bladen, Cumberland, Robeson, and Sampson counties: 910-678-1101
• Those with GenX levels exceeding the EPA MCL or other PFAS contamination may be eligible for replacement drinking water supplies or filtration systems at no cost.

Other private well owners should regularly test their wells for various contaminants that may be impacting their well water. You can review NCDHHS’ PFAS Water Testing and Filtration Resources (PDF) list for more information on PFAS testing and filtration. Routine well testing information can be found on NCDHHS’ Well Water Testing FAQs webpage.

EPA provides training and technical assistance to private drinking water well owners. This includes test kits for emerging contaminants, including PFAS and assistance when test results indicate there is contamination.

Generally, the lower the levels, the lower the risk.

For GENX and PFBS:

• If above the Maximum Contaminant Level Goal (MCLG): The levels of GenX/PFBS in your water would increase the risk of health effects.
• If below the MCLG: The levels of GenX/PFBS in your water are not expected to increase the risk of health effects associated with these compounds.

For PFOA and PFOS:

The new EPA MCLGs for PFOA and PFOS are below levels that can be detected with current commercial laboratory testing. Therefore, any detection of either PFOA or PFOS in drinking water could represent an increased health risk.

Yes. Based on the current science, only a small amount of PFAS gets into your body through skin, so little PFAS exposure would come from showering, bathing, and similar activities.

Typical follow-up: What about brushing my teeth?

The amount of water ingested while brushing teeth is minimal relative to the amount of water typically consumed through eating and exposures from brushing teeth would present a minimal health risk.

Maximum Contaminant Levels (MCLs) and Maximum Contaminant Level Goals (MCLGs) are established for humans. It is up to each pet owner to decide whether to offer water with PFAS detections to pets or animals.

At this time, scientists are still learning about the health effects of exposure to mixtures of different PFAS. One way to learn about whether PFAS will harm people is to do studies on lab animals.

• Most of these studies have tested doses of PFAS that are higher than levels found in the environment.
• These animal studies have found that PFAS can cause damage to the liver and the immune system.
• PFAS have also caused birth defects, delayed development, and newborn deaths in lab animals.

Humans and animals react differently to PFAS, and not all effects observed in animals may occur in humans. Scientists have ways to estimate how the exposure and effects in animals compare to what they would be in humans.

Additional research may change our understanding of the relationship between exposure to PFAS and human health effects.

Breast milk from mothers with PFAS in their blood and formula made with water containing PFAS can expose infants to PFAS, and it may also be possible for children to be exposed in utero during pregnancy. Scientists continue to do research in this area. Based on current science, the benefits of breastfeeding appear to outweigh the risks for infants exposed to PFAS in breast milk. The U.S. Environmental Protection Agency (EPA) encourages women and people who are currently pregnant, nursing, or bottle feeding an infant with formula to consult with their physician regarding concerns related to feeding and potential exposure to chemicals such as PFOA, PFOS, GenX chemicals (i.e., HFPO-DA and its ammonium salt), PFHxS, PFNA, and PFBS. For more information about PFAS and breastfeeding, visit the Centers for Disease Control and Prevention (CDC)’s Agency for Toxic Substances and Disease Registry.

The U.S. Environmental Protection Agency (EPA) encourages women and people who are currently pregnant, nursing, or bottle feeding an infant with formula to consult with their physician regarding concerns related to feeding and potential exposure to PFAS.

GenX & PFBS

The EPA’s Maximum Contaminant Level Goals (MCLGs) for these compounds were calculated for the most sensitive populations (e.g., infants). 

• If your drinking water contains GenX chemicals or PFBS below the MCLGs, then it is not expected to increase risk of health effects and can be used.
• If your drinking water contains GenX chemicals or PFBS above the MCLGs, consider using an alternative or treated water source for any activity in which your infant might swallow water.

PFOA & PFOS

The EPA’s new MCLGs for PFOA and PFOS are below levels that can be detected with current commercial laboratory testing. Therefore, any detection of either PFOA or PFOS in drinking water could represent an increased health risk and we would recommend using an alternate source or filtered water.

Based on the EPA's review of the science, exposures to these four PFAS (PFOA, PFOS, GenX, PFBS) above the EPA MCLGs can cause:

• Decreased liver function
• Decreased immune response and reduced vaccine effectiveness
• Decreased birthweight, behavioral changes of infants and children
• Increased risk of high blood pressure for pregnant women
• Increased cholesterol levels
• Increased risk of kidney and/or testicular

If you are concerned about specific issues with your health, talk with your healthcare provider. Information for health care providers is available from NCDHHS (PDF) and from the CDC's Agency for Toxic Substances and Disease Registry.

Human health effects from exposure to low environmental levels of PFAS are uncertain. Studies of laboratory animals given large amounts of PFAS indicate that some PFAS may affect growth and development. Epidemiologic studies on PFAS exposure evaluated several health effects. See descriptions of these studies. More research is necessary to assess the human health effects of exposure to PFAS. (Information is from the CDC.)

Surveys conducted by the Centers for Disease Control and Prevention (CDC) show that most people in the United States have been exposed to some PFAS. Most known exposures are relatively low, but some can be high, particularly when people are exposed to a concentrated source over long periods of time. Some PFAS chemicals can accumulate in the body over time.

Most exposures occur through consuming contaminated food or water. Only a small amount of PFAS can get into your body through your skin, so very little PFAS exposure occurs during swimming, bathing, or showering in water contaminated with PFAS. Although some types of PFAS are no longer used, many products such as food packaging, firefighting foam, and stain-resistant treatments still contain PFAS.

According to the U.S. Environmental Protection Agency (EPA), people can be exposed to PFAS by:

• Working in occupations such as firefighting or chemicals manufacturing and processing.
• Drinking water contaminated with PFAS.
• Eating certain foods that may contain PFAS, including fish.
• Swallowing contaminated soil or dust.
• Breathing air containing PFAS.
• Using products made with PFAS or that are packaged in materials containing PFAS.

It is difficult to fully prevent PFAS exposure because PFAS are present at low levels in some foods and in the environment. However, there are steps you can take to reduce your PFAS exposure:

• If you live near known sources of PFAS contamination or your drinking water contains PFAS above the U.S. Environmental Protection Agency’s (EPA) maximum contaminant level goals (MCLGs), you may want to use a different water source or filter your water before drinking, cooking, and preparing infant formula.
• NC DHHS has developed a PFAS testing and treatment factsheet (PDF). This factsheet provides information on available treatment systems that have been shown to reduce PFAS concentrations in drinking water.
• Reduce your use of products containing PFAS (packaged foods, products with non-stick or stain-resistant coatings, and some personal care products). If you have questions about the products you use in your home, contact the Consumer Product Safety Commission at 800-638-2772.
• Boiling water will not remove PFAS.

Visit the CDC website to learn more about PFAS Exposure Reduction.

There are many ongoing PFAS health studies in North Carolina and across the country. Although we don't currently have one location for summarizing PFAS studies, NCDHHS continues to engage with researchers at the forefront of PFAS research to evaluate new health and toxicity information as it becomes available and update our public health guidance when needed. Ongoing studies include:

• PFAS Testing Network efforts to better understand the extent of exposure from drinking water across our state
• GenX Exposure Study at North Carolina State University
• PFAS UNITEDD multi-university project headed by the Colorado School of Mines
• Agency for Toxic Substances and Disease Registry (ATSDR) Exposure Assessments and Multi-Site Health Studies