What should individuals do after exposure to Aqueous Film Forming Foam (AFFF) and Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS)?

Management After PFAS and AFFF Exposure

Individuals exposed to Aqueous Film Forming Foam (AFFF) and Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS) should seek medical evaluation to assess immune system function and implement protective measures against potential immunotoxic effects.

Immediate Actions After Exposure

• Thoroughly wash exposed skin areas with soap and water to minimize dermal absorption of PFAS 1
• Remove and properly dispose of contaminated clothing to prevent continued exposure 1
• Document the exposure incident, including duration, concentration, and protective equipment used at the time of exposure 1

Medical Evaluation

• Assess for immune system effects, which are the most sensitive and well-documented health impacts of PFAS exposure 2, 3
• Monitor antibody response to vaccines, particularly tetanus and diphtheria, as this represents the strongest evidence of PFAS-related immunotoxicity 3
• Consider additional vaccine boosters if inadequate antibody response is detected, especially in highly exposed individuals 2
• Screen for early signs of conditions associated with PFAS exposure:
  • Lipid panel abnormalities 2
  • Liver function tests 2
  • Thyroid function 1

Risk Management for Exposed Individuals

• Implement behavioral modifications similar to those recommended for immunocompromised patients, particularly during infectious disease outbreaks 2
• Take extra precautions during pandemic situations or seasonal illness outbreaks 2
• Maintain up-to-date vaccination status and consider monitoring vaccine response effectiveness 3
• Be vigilant for signs of infection that may indicate compromised immune function 2

Special Considerations for Vulnerable Populations

• Children exposed to PFAS require particular attention due to heightened vulnerability of developing immune systems 3
• Pregnant women should be monitored closely as PFAS can affect placental function through immune-mediated mechanisms 2
• Individuals with pre-existing immune conditions may need more intensive monitoring 3

Long-term Monitoring

• Regular follow-up is warranted due to the persistence and bioaccumulation of PFAS in the human body 1
• Monitor for potential long-term health effects, including:
  • Increased risk of infections 2
  • Reduced vaccine efficacy 3
  • Potential cancer risks, particularly kidney, thyroid, and testicular cancers 3, 1

Prevention of Further Exposure

• Identify and eliminate potential ongoing sources of PFAS exposure 3
• Consider testing drinking water if the exposure occurred near water sources 1
• Avoid products containing PFAS when possible (certain food packaging, stain-resistant fabrics, non-stick cookware) 3

Advocacy and Information Sharing

• Healthcare providers should inform patients about PFAS exposure when community contamination is known 2
• Encourage communication between environmental agencies and healthcare providers about local PFAS contamination 2
• Support efforts to phase out non-essential uses of PFAS 2

Pitfalls and Caveats

• Do not wait for clinical disease to appear before taking action; biochemical measures of immune effects should be considered valid markers of health risk 2
• Avoid focusing solely on PFOA and PFOS (the most studied PFAS); thousands of PFAS compounds exist with similar concerning properties 3
• Recognize that standard blood tests may not detect all relevant PFAS compounds 4
• Be aware that PFAS exposure effects may be additive with other environmental toxicants 1