WHO Identifies 18 Priority PFAS for Future Health Assessment Based on Dietary Exposure
The World Health Organization (WHO) has published a landscape review identifying 18 ingested priority per- and polyfluoroalkyl substances (PFAS) and six health effect categories for further evaluation as part of efforts to support the development of health-based values for the “forever chemicals.”
WHO commissioned the review to systematically collect and assess available evidence on PFAS occurrence and associated health effects, with the goal of determining which compounds and health outcomes should be prioritized for more detailed review. According to WHO, widespread human exposure to PFAS through drinking water, food, and other sources, coupled with the growing volume of scientific literature, necessitated a structured prioritization process.
To support the review, WHO assembled two comprehensive databases:
- Health effects database: Approximately 57,000 observations covering 66 individual PFAS from 48 data sources.
- Occurrence database: Nearly 300,000 observations across 77 PFAS from 49 data sources, focusing on exposure through drinking water, food, and human biomonitoring.
Using a transparent prioritization framework, WHO recommended 18 PFAS for further assessment, 16 of which were prioritized based on occurrence data:
- Perfluorooctanesulfonic acid (PFOS)
- Perfluoroundecanoic acid (PFUnDA)
- Perfluoroheptanoic acid (PFHpA)
- Perfluorooctanoic acid (PFOA)
- Perfluoroheptanesulfonic acid (PFHpS)
- Perfluorobutanoic acid (PFBA)
- Perfluorotridecanoic acid (PFTrDA)
- Perfluorohexanoic acid (PFHxA)
- Perfluorotetradecanoic acid (PFTeDA)
- Perfluorobutanesulfonic acid (PFBS)
- Perfluorohexanesulfonic acid (PFHxS)
- Perfluoropentanoic acid (PFPeA)
- Perfluorododecanoic acid (PFDoDA)
- Perfluorononanoic acid (PFNA)
- Perfluorodecanoic acid (PFDA)
- Perfluorodecanesulfonic acid (PFDS).
WHO also recommended including two additional PFAS for further consideration, which may have been underrepresented in the reviewed data because of limitations in the literature search strategy or the availability of unpublished studies:
- Trifluoroacetic acid (TFA)
- Perfluoro(2-propoxypropanoic acid), also known as GenX acid.
WHO also identified six priority health effect categories for future evaluation:
- Cancer
- Developmental effects
- Hepatic effects
- Immune effects
- Metabolic effects
- Reproductive effects.
According to WHO, the landscape review establishes a foundation for more detailed systematic evidence reviews that will support the derivation of health-based values for PFAS. The agency said the prioritization framework provides a robust and transparent approach for focusing future assessments on compounds and health outcomes with the greatest relevance to human exposure.
The full review can be accessed here.
The PFAS Problem: Environmental Persistence and Health Harms
Often called “forever chemicals” due to their inability to break down in the environment or human body over time, PFAS are a diverse family of synthetic compounds used in numerous consumer and industrial products, including nonstick cookware, textiles, packaging, and firefighting foams. The exact number of PFAS is unknown, but by some estimates, there are more than 14,000.
Once introduced to the environment, PFAS continue to accumulate in soil, surface and ground water, and air, leading to their contamination of crops, food animals and their products, and drinking water, and subsequently, resulting in human exposure.
The body of evidence demonstrating the harms PFAS pose to human and environmental health is growing. Many health conditions—including cancers and thyroid and cardiovascular diseases—are associated with PFAS exposure, and more are suspected. WHO’s International Agency for Research on Cancer (IARC) has already declared two types of pervasive PFAS—perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS)—as carcinogenic and possibly carcinogenic to humans, respectively.
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