The information from the PFAS Health Study informs our understanding of the effects of PFAS on health. Overall, there was clear evidence of elevated blood serum concentrations of PFAS in residents and workers in the PFAS-affected communities and increased psychological distress in the three exposed communities.

The evidence for other adverse health outcomes was generally limited. For most health outcomes studied, we did not find evidence that health was worse in PFAS-affected communities than non-affected communities. Rates of some adverse outcomes were higher among people in individual PFAS areas, but this does not necessarily mean that PFAS was the cause. Overall, our findings were consistent with previous studies that have not conclusively identified causative links between PFAS and adverse health outcomes. The association between higher PFAS levels and elevated cholesterol levels was consistent with the previous evidence. Study findings emphasise the importance of support for communities where environmental contamination has occurred. The PFAS Health Study can be used to guide future research efforts on PFAS and health.

This report was released in December 2021.

PFAS Health Study Frequently Asked Questions

PFAS Health Study Systematic Literature Review

This review examined 221 scientific publications into the human health effects of exposure to perfluoroalkyl and polyfluoroalkyl substances, known collectively as PFAS. The key findings were:

• Sufficient evidence that higher levels of PFOS or PFOA in a person’s blood are associated with higher blood cholesterol levels.
• Limited evidence that higher levels of PFAS in the blood are associated with higher levels of uric acid in the blood.
• Limited evidence that high PFAS levels in the blood are associated with reduced kidney function and chronic kidney disease.
• Limited evidence in a small number of relevant studies that PFAS is associated with kidney and testicular cancers.
• Limited evidence that higher levels of PFAS in the blood are associated with lower levels of antibodies than usual following vaccination against some vaccine-preventable infections.

This review was released in May 2018.

PFAS Health Study Focus Groups Study

The primary aim of the Focus Groups Study was to gather a range of social and health-related experiences and perceptions from current residents and workers exposed to PFAS in Katherine, Oakey and Williamtown. Focus groups discussions were conducted between January and August 2018, with a total of 180 participants across the three regions, including 69 participants from Aboriginal communities in Katherine. Participants:

• were concerned about the potential health risks from exposure to PFAS, particularly for their families and children
• were worried about cancers and aggravation of existing health conditions
• discussed the psychological stress and anxiety they experienced as a result of living in an area with PFAS contamination, along with the associated uncertainty about health and financial implications
• indicated that they would like greater transparency and support in their interactions with government representatives.

This report was released in March 2019.

The Focus Groups Report was used in the development of a poster for the Aboriginal communities in Katherine (PDF 2.7MB) which was presented in May 2019.

PFAS Health Study Blood Serum Study

The Blood Serum Study examined blood PFAS levels, biochemical markers of health and exposure to PFAS in 2,587 people living or working in PFAS Management Areas in Katherine, Oakey and Williamtown, and 702 people living in three similar comparison communities without known environmental PFAS contamination—Alice Springs, NT, Dalby, Qld, and Kiama and Shellharbour, NSW. The key findings were:

• Average blood serum concentrations of PFOS and PFHxS (the main types of PFAS in firefighting foam) were higher in residents and workers of PFAS Management Areas than in residents of comparison communities, which was not observed for PFOA.
• The main risk factors for elevated blood concentrations of PFAS were the length of residence in an exposed community, at least weekly consumption of bore water or certain locally grown foods, and occupational exposure to firefighting foams.
• A higher concentration of PFAS in blood serum was associated with elevated blood cholesterol levels in participants from Williamtown and uric acid levels (a marker of kidney function) in participants from Williamtown and Katherine. However, these differences were small and unlikely to be important to health.

This report was released in December 2021.

PFAS Health Study Cross-sectional Survey

The Cross-sectional Survey investigated the exposure history, physical health, and mental health of 917 people living or working in PFAS Management Areas and 801 people living in the three comparison communities. We compared the prevalence of self-reported physical and mental health outcomes between exposed and comparison communities. We also examined associations between self-reported health outcomes and blood serum levels of PFAS. The key findings were:

• People who lived or worked in PFAS Management Areas were more likely to self-report various health outcomes than participants from comparison communities. Participation in the survey was voluntary, however, so survey findings may not accurately reflect the experience of the whole community.
• Participants from PFAS Management Areas reported higher levels of psychological distress than participants in comparison communities.
• PFAS concentrations in blood serum were largely not associated with a higher prevalence of self-reported health outcomes, nor were associations consistently observed across the three exposed communities.

This report was released in December 2021.

PFAS Health Study Data linkage study

The PFAS Data Linkage Study used historical health records collected overall several decades to examine whether rates of adverse health outcomes were higher among people who had lived in a PFAS Management Area than among people who had lived in comparison areas (areas not known to have PFAS contamination). We conducted three separate studies investigating a total of 48 health outcomes: Study 1 investigated maternal and infant (perinatal) health outcomes; Study 2 examined childhood development; and Study 3 investigated cancer and death from specific causes. The key findings were: 

• For most health outcomes, there was no evidence that rates were higher in the PFAS Management Areas relative to comparison areas or there was insufficient data to draw conclusions.
• We observed higher rates of some adverse health outcomes in individual (but not all) PFAS areas, but we could not reasonably rule out that these were due to chance or caused by factors other than exposure to PFAS.

This report was released in December 2021.

Publications

Banwell C, Housen T, Smurthwaite K, Trevenar S, Walker L, Todd K, Rosas M, & Kirk M. (2021). Health and social concerns about living in three communities affected by per- and polyfluoroalkyl substances (PFAS): A qualitative study in Australia. PLOS ONE, 16(1), e0245141. 10.1371/journal.pone.0245141. Law HD, Armstrong BK, D’Este C, Hosking R, Smurthwaite KS, Trevenar S, Lucas RM, Lazarevic N, Kirk MD & Korda RJ. (2023). Relative rates of cancers and deaths in Australian communities with PFAS environmental contamination associated with firefighting foams: A cohort study using linked data. Cancer Epidemiology, 82. 10.1016/j.canep.2022.102296. Lazarevic N, Smurthwaite KS, Batterham PJ, Lane J, Trevenar SM, D’Este C, Clements AC, Joshy AL, Hosking R, Gad I, Lal A, Law HD, Banwell C, Randall DA, Miller A, Housen T, Korda RJ & Kirk MK. (2023). Psychological distress in three Australian communities living with environmental per- and polyfluoroalkyl substances contamination. Science of the Total Environment, 874. 10.1016/j.scitotenv.2023.162503. Lazarevic N, Smurthwaite KS, D’Este C, Lucas RM, Armstrong B, Clements AC, Trevenar SM, Gad I, Hosking R, Law HD, Mueller J, Bräunig J, Nilsson S, Lane J, Lal A, Lidbury BA, Korda RJ & Kirk MD. (2023). Liver and cardiometabolic markers and conditions in a cross-sectional study of three Australian communities living with environmental per- and polyfluoroalkyl substances contamination. Environmental Research, 226. 10.1016/j.envres.2023.115621. Law HD, Randall DA, Armstrong BK, D'Este C, Lazarevic N, Hosking R, Smurthwaite KS, Trevenar SM, Lucas RM, Clements AC, Kirk MD, and Korda RJ. (2023). Relative Risks of Adverse Perinatal Outcomes in Three Australian Communities Exposed to Per-and Polyfluoroalkyl Substances: Data Linkage Study. International Journal of Environmental Research and Public Health, 20(19), p.6886. DOI: https://doi.org/10.3390/ijerph20196886. Law HD, Armstrong B, D'Estes C, Hosking R, Smurthwaite K, Trevenar S, Lazarevic N, Lucas R, Clements A, Kirk M, Korda R. (2024). Relative risks of childhood developmental vulnerabilities in three Australian communities with exposure to per- and polyfluoroalkyl substances: data linkage study. International Journal of Population Data Science, 9(1). doi: 10.23889/ijpds.v9i1.2180.