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NC Division of Public Health
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Occupational & Environmental Epidemiology

Per- and Polyfluoroalkyl Substances (PFAS)

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 1950s.

  • PFAS do not occur naturally but are widespread in the environment.
  • PFAS are found in people, wildlife, and fish all over the world.
  • Some PFAS can stay in people’s bodies a long time.
  • Some PFAS do not break down easily in the environment.

Perfluorooctanoic acid (PFOA or C8) and perfluorooctane sulfonic acid (PFOS) are two common examples of PFAS. PFOA and PFOS have been used to make carpets, clothing, fabrics for furniture, paper packaging for food, and other materials (e.g., cookware) that are resistant to water, grease or stains. They are also used for firefighting at air-fields and in a number of industrial processes.

How can I be exposed to PFAS?

PFAS are man-made, so there are no natural sources in the environment. However, PFAS can be found near areas where they are manufactured, where products containing PFAS are used, or where materials containing PFAS are disposed.

PFAS contamination may be in drinking water, food, indoor dust, consumer products, and workplaces. Most non-worker exposures occur through drinking contaminated water or eating food that contains PFAS.

How can PFAS affect my health?

The potential for health effects from PFAS in humans is not well understood. PFOA and PFOS have been studied more than other PFAS. In general, animal studies have found that exposure of animals to PFAS at high levels resulted in changes in the function of the liver, thyroid, pancreas, and hormone levels.

The U.S. Centers for Disease Control and Prevention (CDC) is working with various partners to better understand how exposure to PFAS might affect people’s health—especially how exposure to PFAS in water and food may be harmful. Although more research is needed, some studies in people have shown that certain PFAS may:

  • affect growth, learning, and behavior of infants and older children;
  • lower a woman’s chance of getting pregnant;
  • interfere with the body’s natural hormones;
  • increase cholesterol levels;
  • affect the immune system; and,
  • increase the risk of cancer.

At this time, scientists are still learning about the health effects of exposures to mixtures of PFAS.

What is the Division of Public Health doing about PFAS?

The Health Assessment, Consultation & Education (HACE) program within DHHS works with other state, local, and federal partners to evaluate health concerns and provide recommendations to protect human health. The HACE program is:

  • Reviewing environmental data regarding exposure to PFAS to better understand potential public health implications.
  • Conducting public health assessments for the affected communities.
  • Continuing to monitor and help answer questions about the results (when available) of a North Carolina State University GenX Exposure Study and any other PFAS biomonitoring studies.
  • Continuing to provide affected communities with health information and assisting with outreach and health education.
  • Evaluating all new health and toxicity information as it becomes available. This includes frequent coordination with our federal partners at the Centers for Disease Control and Prevention (CDC), EPA, and the National Institute of Environmental Health Sciences (NIEHS), as well as discussions with other states dealing with PFAS contamination.
  • Continuing to provide requested information to the SAB for their review and recommendations.

In addition to these activities, DHHS has completed investigations into the prevalence of certain types of cancer and birth defects in the Lower Cape Fear Region. Overall, most cancer and birth defects rates were similar to state rates. Only a comprehensive research study can provide information about whether a specific exposure might be associated with an elevated prevalence of a specific birth defect or type of cancer.

DHHS has also worked with the Cumberland and Bladen County Health Departments and the CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) to test for GenX and other PFAS in blood and urine samples from approximately 30 residents living close to the Fayetteville Works facility. This summary report details the results of this investigation.


GenX and other PFAS in the Cape Fear River Basin

For Additional Information