Per- and Polyfluoroalkyl Substances (PFASS)

THIS PAGE IS CURRENTLY UNDERGOING UPDATES.

What are PFASs and where do they come from?

Per- and polyfluoroalkyl substances (PFASs) are manmade chemicals used in many industries to make things waterproof, non-stick, and stain resistant. Some examples of materials that may contain PFASs include firefighting foam, carpet, furniture, waterproof clothing, and certain types of food packaging. These chemicals are often described as “forever chemicals” because they do not breakdown over time and can build up in the environment and our bodies.

There are thousands of PFASs, but only a small number have been evaluated for their risk to human health and the environment. In addition, little is known about the health and environmental risks of exposure to combinations of these chemicals. Early studies focused on two specific compounds: perfluoro octane sulfonate (PFOS-) and perfluoro octanoate (PFOA-). These compounds were phased out of use by US manufacturers in the 1990s, however they remain a problem because they can still persist in the environment. Other PFASS of concern have been found to be widespread in the environment and require further study, including PFBS-, PFHxS-, PFPeA- PFHxA-, PFHpA-, PFNA- and PFDA-. Some of the newer replacement compounds, such as HFPO-DA (GenX) and ADONA, are also being evaluated for potential risks.

When the National Health and Nutrition Examination Survey (NHANES) tested the blood of volunteers in 2016, they concluded that 98% of Americans have detectable PFASs in their blood. PFASs have also been found in sea turtles, whales, dolphins, and Hawaiian monk seals around Hawaiʻi.

How do PFASs get into the environment?

PFASs can contaminate the environment in many different ways. When aqueous film-forming foam (AFFF) is used for fire-fighting training or to fight fires, it soaks into the ground and can reach ground water and drinking water and can end up in the ocean. PFASs accumulate in landfills from food packaging, personal and household products. PFASs can collect in wastewater from personal and household product use. They are not filtered out in wastewater treatment and can be discharged into the ocean with the treated wastewater. Some treated wastewater containing PFASs is re-used to irrigate golf courses, agricultural fields and road medians. Once the PFASs end up in the environment, they can get into fish and other animals.

Spills and dumping from PFASS manufacturing plants have been a major source of PFASs contamination on the U.S. mainland. Fortunately, in Hawaiʻi we do not have industrial plants that manufacture PFASs.

How might I be exposed to PFASs?

The main ways that people in Hawaiʻi may be exposed to PFASs are through food, personal products, contaminated drinking water and contaminated dust.

· Food: PFASs can contaminate food in a number of ways that can lead to human exposure when eating the contaminated food. PFAS can get into food through:

o Contact with certain types of grease-resistant or water-resistant food packaging made with PFASs;

o Inhaling vapors from burned non-stick cookware made with PFASs;

o Accumulation in fish from PFASs in their diet and the surrounding water;

o Accumulation in fruits and vegetables grown in PFAS-contaminated soils or watered with PFAS-contaminated water.

· Personal Products: Many personal and household products contain PFASs and their use may create situations where they are unintentionally ingested or inhaled.

o Stain-resistant coatings used on carpets, upholstery, and other fabrics;

o Water-resistant clothing;

o Cleaning products;

o Personal care products (shampoo, dental floss) and cosmetics (nail polish, eye makeup);

o Paints, varnishes, and sealants.

· Contaminated Drinking Water: PFASs can contaminate food in a number of ways that can lead to human exposure when eating the contaminated food. PFAS can get into food through:

o Drinking water contaminated with PFASs is a common source of PFAS exposure.

o Most cases of contaminated drinking water in the U.S. are the result of contamination from fire-fighting training sites, military installations, or manufacturing facilities.

· Contaminated Dust: Dust can be contaminated with PFASs through the breakdown of products containing PFASs. This dust can then be unintentionally swallowed by people when it gets on their hands, silverware, or toys. This is especially concerning for young children who put objects or their hands in their mouth frequently.

Because PFASs can cross the placenta and be transferred to breastmilk, babies born to mothers exposed to PFASs can be exposed during pregnancy and while breastfeeding.

From: ATSDR PFAS and Your Health

What are the potential health effects of exposure to PFASs?

Information about the adverse health effects from PFASs is still being gathered through scientific studies and a lot is unknown. There is evidence that high exposure to PFOA and PFOS can cause reproductive, developmental, liver, kidney, and immunological problems in laboratory animals. Human studies have shown problems with cholesterol levels, the immune system and response to vaccines, thyroid gland function, and decreased weight at birth. Some human studies have also shown carcinogenic effects, meaning high, long-term exposures to some of these chemicals may lead to certain types of cancer. Little is known about the health impacts from exposure to combinations of these chemicals (aggregate exposure).

ARE THERE ACTION LEVELS FOR PFASs IN WATER OR SOIL TO TELL ME WHETHER THE CONTAMINATION IS HAZARDOUS TO HUMAN HEALTH OR THE ENVIRONMENT?

Hawaii DOH Environmental Action Levels (EALs) for PFASs

HDOH’s has published Environmental Action Levels (EALs) for over 20 PFAS compounds. An EAL is intended to represent a threshold level below which no adverse health effects are anticipated. The EALs incorporate toxicity factors published by federal and state agencies, including the USEPA and include uncertainty factors to ensure they are human and environmental health protective. There are different EALs calculated for soil, groundwater that is a source of drinking water, groundwater that is not a source of drinking water, vapor under building foundations and indoor air. The technical memorandum outlining the EAL process and calculations is periodically updated as new information becomes available. The most current edition of the guidance can be accessed on the HEER Office EHE-EAL webpage. The HDOH EAL guidance is currently the most comprehensive set of PFAS screening levels available in the United States and includes an HDOH-specific calculator for assessment of cumulative risk posed by exposure to complex mixtures of these compounds.

ARE THERE SPECIFIC REQUIREMENTS FOR THE COLLECTION AND TESTING OF SAMPLES FOR PFASs?

Guidance for the collection of soil, water, air, and other environmental samples is provided in the HDOH Technical Guidance Manual. The guidance follows Decision Unit and Multi Increment Sample (DU-MIS) principles associated with Pierre Gy’s Theory of Sampling. Information on Gy’s Theory of Sampling and links to additional information and posted webinars can be found on the HEER Office DU-MIS webpage.

Recommendations for laboratory testing of samples are included in HDOH EAL guidance for PFASs. Multiple tests are normally required to fully identify the types of PFASs present and assess potential risk to human health and the environment.

DOES HAWAI’I FOLLOW USEPA AND OTHER FEDERAL GUIDANCE FOR ASSESSMENT OF PFAS CONTAMINATION?

HDOH guidance represents a compilation of research and guidance published by federal agencies as well as other states and countries. Hawaii’s guidance uses USEPA models to develop action levels for exposure to PFASs in soil, air, and water, including USEPA Maximum Contaminant Levels (MCLs) for drinking water. With the exception of promulgated drinking water standards (MCLs), USEPA and other federal guidance is provided to states as one of many potential sources of information. Although USEPA research is referenced throughout HDOH guidance documents, states are not obligated to follow recommendations in the documents and in many cases carry out research to expand and update earlier USEPA studies.

HDOH regularly participates in development and review of research and guidance published by the USEPA. Links to HDOH comments on USEPA and other federal agency guidance specific to PFASs are provided below.

HDOH comments on the USEPA’s January 2025 Draft Sewage Sludge Risk Assessment for Perfluoro-octanoic acid (PFOA) and Perfluoro-octane sulfonic acid (PFOS), prepared by the Health and Ecological Criteria Division with the Office of Water’s Office of Science and Technology (EPA-820P25001; Docket ID: EPAHQ-OW-2024-0504)

HIDOH comments on the above US Environmental Protection Agency draft document can be downloaded from the below link. The document reviews methods for the assessment of a broad range of potential risks to human health and the environment posed by per- and polyfluoroalkyl substances (PFASs) in sludges and biosolids generated at wastewater treatment plants. Potential concerns reviewed include direct exposure to contaminated soil, leaching of PFASs from soil and impacts to underlying aquifers and uptake into food crops and livestock feed. In summary, HIDOH found the document to be well written and presented. Focus on only the compounds perfluoro octanoic acid (PFOA) and perfluoro octane sulfonic acid (PFOS), however, fails to recognize potential environment concerns posed by the myriad of other long-chain PFASs typically found in sewage sludge and biosolids as well as risks posed by short-chain and ultrashort PFASs and PFAS-related precursor compounds. Field and laboratory studies have demonstrated that the latter groups of compounds are significantly more mobile in the environment than long-chain PFASs and can pose a significant risk even in the absence of risk posed by PFOA and PFOS.

Assessment of risk posed by PFASs is furthermore highly complex and dependent on a multitude of site-specific factors, including the physical and microcosm characteristics of soil, hydrogeology, climate and plant species. Modeling exercises presented in the draft document should therefore be taken as examples only and not used for blanket policy decisions other than to highlight the need to assess risks posed by PFAS-impact media on a case-by-case basis. Refer to the HIDOH PFAS webpage and Environmental Action Level webpage for additional guidance.

· USEPA PFOA PFOS Sludge Risk Assessment (January 2025)

· HDOH Comments (April 11, 2025)

HDOH Review of PFAS Toxicity Factors published by federal and state agencies

Studies of the toxicity of PFAS compounds have been carried out by numerous federal and state agencies as well as entities in other countries. Toxicity factors used to develop safe levels of PFASs in water, soil, food, air and other media vary widely in some cases. HDOH contracted private experts in epidemiology and toxicology to review published studies of potential cancer and systemic (noncancer) health effects posed by exposure to PFASs. The reviews can be downloaded from the below links. The reviews were used to guide development of HDOH EALs for the noted PFAS compounds.

Fluorotelomer Alcohols (FTOHs) and “Modern” AFFF (FtTAoS) (Gibb and O’Leary 2023)

PFEtA (“Trifluoroacetate”) (Gibb and O’Leary 2024)

PFOA and PFOS Carcinogenicity (Gibb and O’Leary 2024)

PFASs Noncancer Toxicity Factors (Gibb and O’Leary 2025)

HDOH Comments on the US Department of Defense January 2025 Environmental Data Quality Workgroup Memorandum: Issues with Applying the Incremental Sampling Methodology (ISM) to PFAS Investigations

HIDOH comments on the above Department of Defense memorandum can be downloaded from the below link. In summary, HIDOH strongly disagrees with the DoD Environmental Data Quality Workgroup recommendations against the use of ISM-type sampling methods, including HIDOH “Decision Unit” and “Multi Increment Sample” investigation guidance (DU-MIS), and the continued use of “grab” or “discrete” sampling methods to characterize sites impacted by per- and polyfluoroalkyl substances (PFASs). No field-based science is provided to support this recommendation. The memorandum fails to acknowledge the inherent and well-documented unreliability of “grab” or “discrete” sample collection methods and decades of science and field data supporting Gy’s Theory of Sampling and the use of ISM and DU-MIS sampling methods. Reliance on grab/discrete sample data for decision making poses a significant risk to human health and the environment, including potential risks associated with direct exposure to contaminated soil, leaching of PFASs from soil and impacts to underlying aquifers and uptake of PFASs into food crops. Use of traditional grab/discrete sample data for final decision making is not allowed in the State of Hawaii. Refer to the HIDOH DU-MIS webpage for additional information.

· DoD Environmental Data Quality Workgroup Memorandum (January 2025)

· HDOH Comments (May 1, 2025)

USEPA DRINKING WATER STANDARDS FOR PFASs

The USEPA has promulgated drinking water Maximum Contaminant Levels (MCLs) for six PFAS compounds, including (parts per trillion): PFOA (4 ng/L), PFOS (4 ng/L), PFHxS (10 ng/L), PFNA (10 ng/L), HFPO-DA or “GenX” (10 ng/L) and PFBS (2,000 ng/L).

The MCLs are incorporated in the HDOH EAL guidance for PFASs. The HDOH EAL guidance provides non-regulatory drinking water action levels for an additional twenty PFAS compounds. The EALs reflect toxicity studies carried out by other federal and state agencies and other entities and were calculated using the USEPA model for “tapwater” screening levels.

It is important to remember that these levels are for only drinking water and for a lifetime of exposure. In addition, interpretation of potential health risks for some PFAS compounds might be difficult if the action levels are lower than the levels at which a laboratory can detect these chemicals.

For more information on the EPA’s PFAS MCLs please see: https://www.epa.gov/sdwa/and-polyfluoroalkyl-substances-pfas

HAVE PFASs BEEN DETECTED IN DRINKING WATER IN HAWAII?

PFAS Detections in Drinking Water Reported to DOH as of March 31, 2025

Drinking water purveyors might test for a broad range of PFASs but are only required to test for PFASs with promulgated USEPA drinking water standards (MCLs). For unregulated contaminants, it is up to water system operators to decide if they want to test for these chemicals. If they decide to test for PFASs and find them for the first time (first detection), the water system is required to report these first detections to the Department of Health Safe Drinking Water Branch (SDWB). Upon receiving notice of these first detections, DOH SDWB issues a press release to further notify the public. Please see below for detections of PFASs in drinking water that have been reported to the DOH SDWB.

Location of PFAS Detection	Water System Operator	Chemicals Detected	Date	Link to Notification and More Information
Waipahu ʻEwa Waiʻanae Water System	Honolulu Board of Water Supply	PFHxA, PFPeA	March 31, 2025	DOH NEWS RELEASE – BWS ALERTS DOH TO PFAS IN WAIPAHU ʻEWA WAIʻANAE WATER SYSTEM Mar 31, 2025
Maui Business Park System	Maui Business Park Phase II Association	PFOA, PFHpA, PFHxA, PFPeA, PFBA	April 3, 2024	DOH NEWS RELEASE – PFAS DETECTED IN MAUI BUSINESS PARK SYSTEM Apr 17, 2024
Waialua Sugar Pump 2 System	Dole Food Co., Inc.	PFOA, PFOS, PFBS, PFPeA, PFHxS, PFHxA, PFHxA	August 30, 2023, November 13, 2023, Feb. 26, 2024	DOH NEWS RELEASE – PFAS DETECTED IN WAIALUA SUGAR PUMP 2 SYSTEM Nov 29, 2023 DOH NEWS RELEASE – PFAS DETECTED IN WAIALUA SUGAR PUMP 2 SYSTEM Mar 8, 2024
Halawa Wells	Honolulu Board of Water Supply	PFOA, PFHxS (2020), PFOA, PFHxS, PFHxA, PFOS, PFPeA (2023)	September 2020 February 2023	Halawa Wells News Release 2020 Halawa Wells News Release 2023
Aiea Halawa Shaft	Navy Joint Base Pearl Harbor Hickam	PFOA, PFOS, PFBS, PFHxS, PFHxA	November 2020 and 2021	JBPHH Water System Consumer Confidence Report
Aina Koa Well I	Honolulu Board of Water Supply	PFPeA	November 3, 2021	Aina Koa News Release
Kipapa Acres	Kipapa Acres C.P.R.	PFOA	December 19, 2022	Kipapa Acres News Release
Waipahu Wells II	Honolulu Board of Water Supply	PFHxA	January 6, 2023	Waipahu Wells News Release
Del Monte Kunia 3 Well	Kunia Village	PFBA, PFPeA, PFHxA, PFHpA, PFOA, PFBS, PFHpS, PFPeS, PFHxS, PFOS, 6:2 FTS	January 20, 2023	Kunia Village News Release
Makakilo Well	Honolulu Board of Water Supply	PFPeA	February 10, 2023	Makakilo Wells News Release
Waipio Heights Wells	Honolulu Board of Water Supply	PFOS, PFPeA	March 22, 2023	Waipio Heights Well News Release
Moanalua Wells	Honolulu Board of Water Supply	PFBA	March 31, 2023	Moanalua Wells News Release
Kunia Well #4	Kunia Village	PFBA, PFBS, PFHpA, PFHxA, PFHxS, PFOA, PFOS, PFPeA, PFPeS	April 26, 2023	Kunia Well #4 News Release
Ka‘amilo Wells Pumping Station	Honolulu Board of Water Supply	PFBS, PFHxA, PFHxS, PFOA, PFOS, PFPeA	April 26, 2023	PFAS Detected in Kaʻamilo Wells Pumping Station

What is HDOH doing to evaluate PFASs in Hawaiʻi?

The Hawaiʻi Department of Health has a number of projects in progress to better understand the presence of PFAS contamination in Hawaiʻi and the associated risks. Details will be added as results from these projects become available.

PFAS in fish and sea water in the near-shore environment at 11 high-risk sites around Oʻahu. Partnership with Hawaiʻi Pacific University and United States Geological Survey (USGS). Sample collection and laboratory analyses complete. Data evaluation and publication in progress. More details and data coming soon. See fish results: PFAS in Manybar Goatfish around Oʻahu, 2021 (ND Sawickij)
PFAS in frequently-eaten fish purchased from markets. Species tested include pelagic (ocean-going) fish like ʻahi, ono, and marlin. Sample collection and laboratory analyses complete. Data evaluation and publication in progress. More details and data coming soon.
PFAS in wastewater, biosolids and landfill leachate. Evaluating PFAS concentrations statewide in wastewater and biosolids from wastewater treatment plants plus landfill leachate. Hawaii PFAS Study, HIDOH Nov 2024
PFAS in Drinking Water
- The Third Unregulated Contaminant Monitoring Rule (UCMR 3) conducted by EPA in calendar years 2013-2015 looked for 6 PFAS chemicals in public drinking water systems serving 10,000 people or more. UCMR 3 did not identify any large drinking water systems in Hawaiʻi with PFAS contamination. For more information about UCMR-3 including the data, please visit EPA’s UCMR 3 website.
- PFAS in high-risk drinking water wells: Monitoring for PFAS in groundwater at 20 county and military drinking water wells on Oʻahu, Kauaʻi, Hawaiʻi, and Maui. Sample collection is complete with data analysis in progress. More details and data coming soon.
- The Fifth Unregulated Contaminant Monitoring Rule (UCMR 5) will evaluate public drinking water systems across the country for 29 PFAS chemicals. All public drinking water systems in Hawaii that serve over 3,300 people will be tested in calendar years 2023-2025. For more information on UCMR 5, visit EPA’s UCMR 5 website.
- Additional drinking water systems that are not tested in UCMR 5 will be tested for PFAS in a drinking water project funded by the Bipartisan Infrastructure Law.
PFAS Releases – Environmental Emergency Response. The HEER Office responds to environmental releases of chemicals containing PFAS such as the release of firefighting foam near Adit 6 at the Red Hill Bulk Fuel Storage Facility in November 2022. Oversight of the Navy’s sampling and remediation actions continue to ensure full characterization of the contamination and remediation of this risk.
PFAS in Red Hill Groundwater Monitoring Wells. 10 Groundwater monitoring wells around the Red Hill Bulk Fuel Storage Facility are currently being regularly monitored for the presence of PFAS.
PFAS in compost and food crops grown in compost. Evaluating PFAS concentrations and risks in compost made from compostable food containers and food crops grown in compost. Project expected to begin in 2025.
PFAS EAL Updates. Continued evaluation and updates to the PFAS EALs are anticipated when EPA releases its planned draft Maximum Contaminant Level (MCL) for PFOA and PFOS, expected in January 2023.
PFAS Contaminated Sites – Evaluation and Long-term clean-up oversight. The HEER Office oversees the evaluation and remediation of chemically contaminated sites. Identified sites in Hawaii that have potential PFAS contamination include firefighting training sites, airports, and military sites. Sites with potential PFAS contamination have been specially labeled in the HEER Office’s public database of sites called iHEER. To view these sites, visit https://health.hawaii.gov/heer/siteinfo/iheer-information/ and follow the links to the iHEER map-based viewer. Once in the iHEER viewer, type “Potential PFAS” into the keywords search box.
Partnerships Working with partners in Hawaiʻi, Honolulu, Kauaʻi, and Maui Counties, the Department of Defense, the U.S. EPA, CDC’s Agency for Toxic Substances and Disease Registry (ATSDR), Hawaiʻi Pacific University, the U.S. National Institute of Standards and Technology, the U.S. Geological Survey, and other federal, state, and local stakeholders to combine resources and further investigate and understand PFAS in Hawaiʻi.