Below is a short summary and detailed review of this video written by FutureFactual:
CDC PFAS Guide for Physicians: Testing, Health Impacts, and Exposure Reduction
Physicians now have a practical framework for addressing PFAS exposure in patients. In this AMA Update, Dr. Aaron Bernstein from the CDC outlines the four most common PFAS compounds, major exposure routes (primarily drinking water), and additional sources such as non-stick cookware, stain-resistant clothing, firefighting foams, and food packaging. The guide emphasizes using exposure history to guide testing, the need for CLIA-certified laboratories, and careful interpretation since there is no proven treatment to remove PFAS from the body. It also highlights health concerns linked to PFAS, regulatory trajectories, and concrete exposure-reduction strategies including water filtration considerations and safer consumer products. The goal is to support patient-specific clinical decisions in clinics nationwide.
Overview and PFAS Basics
The CDC has issued a physician-focused guide on PFAS exposure, stressing that the nation can be more helpful to patients worried about PFAS than many clinicians realize. Dr. Aaron Bernstein notes that while there are thousands of PFAS chemicals, four are most commonly detected in people in the United States: PFOS, PFOA, PFNA, and PFHxS. These compounds are found in a range of consumer products and environmental media, with drinking water the primary exposure route for most people. Firefighting foams, food packaging, stain- and water-repellent products, and even certain dental floss can contribute to exposure. In some communities near airports or facilities, hotspots emerge where PFAS levels spike quickly. The guide emphasizes that regulatory actions and community experiences drove this updated information, aiming to support clinic-level decisions.
Health Impacts and Testing Guidance
According to the CDC review and the National Academy evaluation, PFAS exposure is associated with higher cholesterol, lower birth weights, kidney and testicular cancers, high blood pressure in pregnancy, preeclampsia, and liver inflammation. Some associations, such as thyroid disease, remain uncertain. Clinicians are encouraged to take a thorough exposure history, including occupation and local contamination, to determine whether testing will be informative for a patient. The guide outlines practical steps for testing: use a CLIA-certified lab, ensure the test targets the PFAS relevant to the exposure in question, and recognize that reducing exposure may be as clinically meaningful as monitoring associated health risks.
Testing Logistics and Management
There is no medically approved treatment to remove PFAS from the body, so management centers on exposure reduction and risk-based screening. Providers should consider targeted follow-up testing for cholesterol and potentially thyroid screening, guided by a patient’s health history and exposure context. The guide cautions against rigid cutoff values for action, noting that thresholds such as those proposed by the National Academy should be interpreted in the context of past exposures and individual risk. When tests are ordered, clinicians should verify that the laboratory is CLIA-certified and that the assay tests for the specific PFAS relevant to the patient’s exposure.
Exposure Reduction and Regulatory Outlook
Reducing exposure should be a primary clinical objective. The main exposure source, drinking water, is likely to be mitigated in part by forthcoming EPA rules mandating testing of municipal systems and establishing health-protective standards for PFAS. In the meantime, patients may consider practical steps such as selective water filtration, though equipment capable of removing PFAS can be costly and maintenance-intensive. Beyond water, clinicians can advise patients to replace PFAS-containing cookware, avoid stain- and grease-resistant products, and reduce exposure from food wrappers and other consumer products. The guide also points to broader regulatory actions, including sewage sludge considerations and other environmental pathways.
Practical Takeaways for Clinicians
Clinicians should begin with a careful exposure history, tailor testing to the exposure profile, and recognize that PFAS testing is a tool to inform exposure reduction and risk assessment rather than a standalone diagnostic path. When communicating results, frame them within the patient’s health history and discuss potential next steps in screening and lifestyle modifications. A coordinated approach—combining exposure reduction with judicious health monitoring—offers the best pathway to minimize PFAS-related health risks for patients across communities.