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narrative_review·environmental_health, public_health, toxicology, occupational_medicine, epidemiology·PMC10184764

Per- and polyfluoroalkyl substances in water and wastewater: A critical review of their global occurrence and distribution

The Science of the total environment · 8 authors, 6 centres

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Per- and polyfluoroalkyl substances (PFAS) are a family of over 4,000 fluorinated compounds that persist in the environment and have been detected worldwide in water, soil, air, and human blood. This critical review of global studies finds PFAS contamination across all continents regardless of industrial development, with concentrations ranging from ng/L to μg/L in surface and groundwater, and documents links to adverse health effects including cancer, thyroid disease, and immunosuppression. The paper provides baseline data showing that even after voluntary phase-outs, PFAS remain widespread due to long-range atmospheric transport and ongoing use of novel replacements whose toxicity profiles remain poorly understood.

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**Background:** Per- and polyfluoroalkyl substances (PFAS) are a diverse group of ≥4,000 partially or fully fluorinated organic compounds of anthropogenic origin, first synthesized in the 1940s. Due to their hydrophobic and oleophobic properties, they are used in adhesives, fire-fighting foams (aqueous film-forming foams, AFFFs), cosmetics, paper products, textiles, semiconductors, and pesticides. Their strong carbon-fluorine bonds confer extreme thermal and chemical stability, making them highly persistent in the environment. PFAS have been classified as persistent organic pollutants of significant concern because of their widespread production, environmental distribution, long-term persistence, bioaccumulative potential, and associated human health risks. PFOS (perfluorooctane sulfonic acid) and PFOA (perfluorooctanoic acid) are the most commonly used and most frequently detected PFAS. The review aims to provide comprehensive continental-scale coverage of PFAS occurrence and distribution, which prior reviews had not addressed.

**Methods:** The authors conducted a targeted literature review focusing on studies published since 2000, prioritizing the most common PFAS (PFOA and PFOS) while also briefly reviewing novel PFAS. Keyword searches included PFAS, PFOA, PFOS, perfluorochemicals, occurrence, distribution, persistent organic pollutants, and emerging contaminants. Information was gathered from academic sources and reputable non-academic sources including federal, state, and local government records. Studies were screened based on relevance, rigor, and substance of focus, with preference given to large-scale studies analyzing multiple samples across multiple countries.

**Key Results:** PFAS were detected across all five continents irrespective of industrial development. In the Asia-Pacific region, PFOS concentrations in surface waters ranged from non-detect (ND) to 47 ng/L in China, 0.02–230 ng/L in Japan, and 0.12–33 ng/L in South Korea. The highest PFOA concentration (1,590 ng/L) was detected in China's Huangpu River. In India, PFOS in untreated wastewater was 12.0 ng/L, and the highest PFOS in water (3.91 ng/L) was from the Cooum River. In Australia, AFFF-contaminated groundwater at a military base in Williamtown reached 1,800 ng/L PFOA and 5,560 ng/L PFOS, while in Oakey, Queensland, PFOS reached 14,000 ng/L. In North America, the US EPA's UCMR 3 survey (2013–2015) found 4% of public water systems positive for at least one PFAS, with 1.3% exceeding the Lifetime Health Advisory (LHA) of 70 ng/L. PFOA and PFOS concentrations exceeded the LHA in 0.3% and 0.8% of systems, respectively. An estimated 6 million US residents had drinking water exceeding the LHA. At the 3M Cottage Grove facility in Minnesota, groundwater PFOA reached 1,836,000 ng/L and PFOS reached 324,000 ng/L. The Washington County landfill registered PFOA at 42,000 ng/L and PFOS at 2,700 ng/L. In the Great Lakes, PFOA ranged from 0.75–70 ng/L and PFOS from 0.14–50 ng/L across the five lakes. In Europe, the Moehne River in Germany had PFOA at 654 ng/L and PFOS at 17 ng/L; the upper Moehne reached 3,640 ng/L PFOA and 193 ng/L PFOS due to biosolid application. GenX chemicals were detected at 812 ng/L near a fluorochemical plant in the Netherlands, with drinking water concentrations up to 11 ng/L. In Africa, PFOS concentrations were lower: 4.7 ng/L in the Niger River (Mali) and 4.6 ng/L in the Sabaki River estuary (Kenya). The US NHANES survey (2003–2004) detected PFAS in 98% of human serum samples. Epidemiological studies have linked PFOA exposure to high cholesterol, ulcerative colitis, thyroid disease, testicular cancer, kidney cancer, and pregnancy-induced hypertension. PFOS bioaccumulation in aquatic species reached mean concentrations up to 1,900 ng/g in seals, porpoises, whales, dolphins, and polar bears.

**Clinical Implications:** PFAS exposure through drinking water represents a definite human exposure pathway, with contaminated drinking water documented globally. The US EPA LHA is 70 ng/L for combined PFOA and PFOS, while some states like Vermont set 20 ng/L. Several countries have published administrative guidelines including Canada, the UK, Sweden, Norway, Germany, and Australia. In 2009, PFOS was listed in Annex B, and in 2019 PFOA was listed in Annex A of the Stockholm Convention. Novel replacement PFAS (GenX, PFBS, F53B) are also persistent and toxic—the EPA set chronic reference doses at 3×10⁻⁴ mg/kg/day for PFBS and 3×10⁻⁶ mg/kg/day for GenX chemicals. The review emphasizes that regulatory agencies should define PFAS as a class rather than regulating individual compounds, and that future research must focus on PFAS precursors, degradation pathways, and the toxicity of novel PFAS whose environmental behavior remains poorly characterized.

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narrative_review

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environmental_health

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ORIGINAL PAPER

PMC10184764

Per- and polyfluoroalkyl substances in water and wastewater: A critical review of their global occurrence and distribution

The Science of the total environment

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ABSTRACT

Per - and polyfluoroalkyl substances (PFAS) are a family of fluorinated organic compounds of anthropogenic origin. Due to their unique chemical properties, widespread production, environmental distribution, long-term persistence, bioaccumulative potential, and associated risks for human health, PFAS have been classified as persistent organic pollutants of significant concern. Scientific evidence from the last several decades suggests that their widespread occurrence in the environment correlates with adverse effects on human health and ecology. The presence of PFAS in the aquatic environment demonstrates a close link between the anthroposphere and the hydrological cycle, and concentrations of PFAS in surface and groundwater range in value along the ng L −1 –μg L −1 scale. Here, we critically reviewed the research published in the last decade on the global occurrence and distribution of PFAS in the aquatic environment. Ours is the first paper to critically evaluate the occurrence of PFAS at the continental scale and the evolving global regulatory responses to manage and mitigate the adverse human health risks posed by PFAS. The review reports that PFAS are widespread despite being phased out—they have been detected in different continents irrespective of the level of industrial development. Their occurrence far from the potential sources suggests that long-range atmospheric transport is an important pathway of PFAS distribution. Recently, several studies have investigated the health impacts of PFAS exposure—they have been detected in biota, drinking water, food, air, and human serum. In response to the emerging information about PFAS toxicity, several countries have provided administrative guidelines for PFAS in water, including Canada, the United Kingdom, Sweden, Norway, Germany, and Australia. In the US, additional regulatory measures are under consideration. Further, many PFAS have now been listed as persistent organic pollutants. This comprehensive review provides crucial baseline information on the global occurrence, distribution, and regulatory framework of PFAS.

CITATION EXPORT

Sudarshan Kurwadkar, Jason Dane, Sushil R. Kanel et al.. Per- and polyfluoroalkyl substances in water and wastewater: A critical review of their global occurrence and distribution. The Science of the total environment. (2022). https://doi.org/10.1016/j.scitotenv.2021.151003

AUTHORS

8 · 6 CENTRES

Sudarshan Kurwadkar, Jason Dane, Sushil R. Kanel, Mallikarjuna N. Nadagouda, Ryan W. Cawdrey, Balram Ambade, Garrett C. Struckhoff, Richard Wilkin

aDepartment of Civil and Environmental Engineering, California State University, 800 N. State College Blvd., Fullerton, CA 92831, USA
bCenter for Environmental Solutions and Emergency Response, U.S. Environmental Protection Agency, 919 Kerr Research Drive, Ada, OK 74820, USA
cDepartment of Chemistry, Wright State University, 3640 Colonel Glen Highway, Dayton, OH 45435, USA
dPegasus Technical Services, Inc., 46 E. Hollister Street, Cincinnati, OH 45219, USA
eCenter for Environmental Solutions and Emergency Response, U.S. Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, USA
fDepartment of Chemistry, National Institute of Technology, Jamshedpur 831014, Jharkhand, India