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Maternal Health in the US: Should PFAS be a Concern?

Written by Tess Amore


The maternal health crisis in the United States has been a rising concern for many policy makers, doctors, and mothers in the past decade. Of all developed nations, the US has one of the highest maternal mortality rates. According to a recent maternal morbidity and mortality report from the White House, “every year, people in the United States die of pregnancy-related causes at more than double the rate among nations with similar levels of income”(2021). Furthermore, these fatal implications are even more prominent for Black and Native women and those living in rural areas. While the number of these reported maternal deaths have steadily decreased around the world, the United States has seen them almost double since 1987.


Much of the current policy surrounding maternal health focuses on racism in the healthcare system, access to prenatal care, and inclusive health coverage lasting through the entirety of postpartum, but one new concern that needs to be addressed is the dangerous effects of PFAS chemicals.


Per- and polyfluoroalkyl substances, otherwise known as PFAS, are chemicals composed of long carbon chains, each bonded to fluorine atoms and a functional group (Buck et al., 2011). This bond is one of the strongest that exists in nature which means that these chemicals are extremely long lasting giving them the nickname “forever chemicals.” These forever chemicals were first synthesized in the 1930s and were eventually used in non-stick coatings starting in the 1940s (Muller & Yingling, 2017). Today, they can be found in thousands of products we use in our daily lives.


Because they have water resistant, stain resistant, and nonstick properties, PFAS are used in the production of items including fire fighting equipment, food packaging, furniture, and kitchenware. Although commercially convenient, research has shown that PFAS have dangerous implications for human health. Long term exposure and contamination can result in immunosuppression, reduced response to vaccines, liver disease, kidney cancer, and testicular cancer (Pelch et al., 2019).


This is particularly concerning because PFAS contamination affects an overwhelming majority of people in the United States– in fact, 97% of Americans tested have PFAS in their blood (CDC, 2022). These health implications become even more dire when placed in the context of the maternal health crisis in the United States. Pregnant mothers, who face numerous dangerous health outcomes throughout their pregnancy, are particularly concerned about a condition called preeclampsia. Preeclampsia is defined by the Mayo Clinic as a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys (2019). While it only affects 5% to 7% of all pregnant women, it is responsible for over 70,000 maternal deaths and 500,000 fetal deaths worldwide every year (Rana et al., 2019).


So what does all of this have to do with PFAS? A recent study conducted by Brigham and Women’s Hospital concluded that there is an association between PFAS exposure and late onset preeclampsia in pregnant women.


The study found that PFAS disrupt placental and immune function, cause oxidative stress, and disrupt lipid metabolism. These disruptions, researchers concluded, may be the mechanisms through which PFAS lead to a number of hypertensive disorders (Bommarito, 2022). Researchers in Denmark have previously concluded that PFAS are associated with increased risk for preterm birth, and excessive gestational weight gain (Meng, Inoue, Ritz, Olsen, & Liew 2018). In combination with the already dismal status of maternal health in the United States, this data is frightening. Therefore, it should be a priority for policy makers and health professionals across the country to seriously address the dangers of PFAS before it is too late.


Considering the overwhelming scientific support surrounding the elimination of PFAS, this new research only emphasizes the need for change. Currently there are bills in the Massachusetts state legislature (H2348/S1387) insisting that PFAS are removed from food packaging and other consumer products. We urge legislators to take this problem seriously and pass this legislation as quickly as possible.



References


Bommarito, Paige A. et al., “Maternal Levels of Perfluoroalkyl Substances (PFAS) during Early Pregnancy in Relation to Preeclampsia Subtypes and Biomarkers of Preeclampsia Risk,” National Institute of Environmental Health Sciences (U.S. Department of Health and Human Services), accessed February 12, 2022, https://ehp.niehs.nih.gov/doi/10.1289/EHP9091


Buck, Robert C, et al. “Perfluoroalkyl and Polyfluoroalkyl Substances in the Environment: Terminology, Classification, and Origins.” Integrated Environmental Assessment and Management, vol. 7, no. 4, 19 July 2011, pp. 513–541., doi:10.1002/ieam.258.


Meng Q, Inoue K, Ritz B, Olsen J, Liew Z. Prenatal Exposure to Perfluoroalkyl Substances and Birth Outcomes; An Updated Analysis from the Danish National Birth Cohort. Int J Environ Res Public Health. 2018 Aug 24;15(9):1832. doi: 10.3390/ijerph15091832. PMID: 30149566; PMCID: PMC6164159.


Mueller, Robert, and Yingling, Virginia. “History and Use of Per- and Polyfluoroalkyl Substances (PFAS).” PFAS Fact Sheet, Interstate Technology Regulatory Council, Nov. 2017, pfas-1.itrcweb.org/wp-content/uploads/2017/11/pfas_fact_sheet_history_and_use__11_13_17.pdf


Pelch, Katherine E. et al., “Pfas Health Effects Database: Protocol for a Systematic Evidence Map,” Environment International (Pergamon, July 5, 2019), https://www.sciencedirect.com/science/article/pii/S0160412019305380?via%3Dihub.


“Per- and Polyfluorinated Substances (PFAS) Factsheet,” Centers for Disease Control and Prevention (Centers for Disease Control and Prevention, February 2, 2022), https://www.cdc.gov/biomonitoring/PFAS_FactSheet.html.


“Preeclampsia,” Mayo Clinic (Mayo Foundation for Medical Education and Research, March 19, 2020), https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745.


Rana, Sarosh et al., “Preeclampsia,” Circulation Research, March 28, 2019, https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.118.313276.


White House. (2021, December 7). Fact sheet: Vice president Kamala Harris announces call to action to reduce maternal mortality and morbidity. The White House. Retrieved December 12, 2021, from https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/07/fact-sheet-vice-president-kamala-harris-announces-call-to-action-to-reduce-maternal-mortality-and-morbidity/.



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