PFAS and Protecting Your Health

Can you speak more about the challenges to conducting clinical research on the reproductive effects of these chemicals? What sort of studies can clinicians and scientists do in affected communities?

1. Fecundity research (think time to pregnancy as a measure) is hard and relatively intrusive. Not that many people are motivated to participate, yet the studies require large numbers of participants. 2. Sperm morphology/number/activity research is also technically difficult. The ovaries and the eggs are accessible only with invasive technology. 3. The outcomes of interest in newborns can be affected by many aspects of study design that are hard to account for. An aside about that: The measures of outcomes such as "pondural index" (just one of the technical outcome measures) can find potentially important differences associated with exposure, but the public can be unaware of these technical measures and their potential importance for characterizing risk. 4. The most dread outcomes such as fetal death and birth defects and childhood cancer are blessedly rare, so that very large populations need to be followed. For the PFAS, there is some evidence of one type of birth defect outcome, but the size population (with a wide range of low to high exposures) needed to pursue this potential hint about risk is very a very large number of pregnancies. 5. An outcome that society really cares about is whether exposure affects the mental performance of the developing human. Lead is an example of an element for which we know this is a problem. Even for lead, which is today notorious for causing developmental performance problems, the original studies were fraught with controversy and critics. The studies are hard to do, and, even when they are done well, acknowledgment that the research is sound can still be withheld. 6. The reproductive/developmental research faces difficulties that also pertain to the rest of the PFAS science community: mixtures, the presence of evolving PFAS which are introduced by a creative industry but not announced to the public, and the difficulty of assessing exposure for the PFAS which have short half lives and are not bioaccumulative - but may still be toxic. Here is one difficulty that is truly a barrier. There is insufficient funding for the extra expenses associated with reproductive and developmental studies. Acquiring a critical mass of data when the funding is insufficient is a real challenge for the developmental research community.