PFAS are under regulatory and legislative assault at the federal and state levels. In the zeal to eliminate some of these chemistries, however, regulators and lawmakers may undermine the ability to provide life-saving healthcare in the United States.
That’s because products with PFAS are used in a wide variety of ways in healthcare settings, such as medical devices, medicines and personal protective equipment. These uses improve healthcare outcomes and reduce costs.
The unique qualities of PFAS are what make them so important in the healthcare context. PFAS – per- and poly-fluoroalkyl substances – are a diverse family of chemistries with different varieties in solid, liquid, and gaseous forms. The carbon-fluorine bond in PFAS makes the chemistries uniquely durable and nonreactive, and therefore very difficult to substitute in healthcare settings.
Accordingly, without an alternative that is both scientifically and economically feasible, overly broad restrictions on PFAS could have grave public health consequences for America.
In medical implants and devices, PFAS help provide resistance to infections, friction, and clots. They are used in catheters that drain fluids collected in the body, stents that hold open coronary arteries, surgical meshes that repair hernias, as well as needles for surgical biopsies to diagnose cancer.
Without PFAS, these devices could be at a higher risk of implant failure or clogging, and may need to be replaced more often, resulting in higher medical costs and more potential pain and risk for patients.
In equipment used for diagnosis and treatment, PFAS are integral to everything from ventilators to COVID-19 test kits. PFAS are used in X-Ray film to identify internal injuries, video endoscopes to detect gastrointestinal issues, and protein-resistant and sterile components like filters, tubing, and seals for kidney dialysis machines.
For devices that rely on high-frequency signals like pacemakers, defibrillators, MRI imaging devices, and PET scan machines, PFAS are relied upon for use as insulators.
In many metered dose inhalers, PFAS serve as a propellant. These inhalers help treat lung conditions like asthma and chronic obstructive pulmonary disorder (COPD).
PFAS are also integral to maintaining the supply chain of ingredients needed to make life saving medications. In packaging, PFAS create a strong barrier against humidity that could otherwise damage medicines; their packaging role also helps extend the shelf life of dry pills and powders. For many widely-used medications, from cholesterol treatments to antidepressants, limiting PFAS could threaten their availability, affecting tens of millions of Americans. PFAS also allow for the high purity filtration needed in the manufacturing of pharmaceuticals and antibody-based therapies.
Beyond medicines and medical devices, PFAS are integral to maintaining the sterile environment required in hospitals. PFAS coatings on hospital gowns, drapes, and divider curtains to help create a barrier against infections and transmission of diseases in hospitals. PFAS in wall and floor paints allow for the effective use of biocides to help eliminate infections in hospitals.
Effective health care requires all these applications of PFAS. To keep people healthy, to treat disease, and to be ready for the next health crisis, policymakers must ensure that heavy-handed measures don’t send an avoidable shock through the healthcare system.
Federal and state policymakers should consider the lifesaving applications of PFAS and ensure that the responsible production, use, and management of this diverse family of chemistries can continue.
They must also consider the diversity of these chemistries, and how they have differing health and environmental profiles. In fact, many of these healthcare applications rely on a particular category of fluorinated chemistries (fluoropolymers) that meet key internationally recognized safety criteria for identifying polymers of low concern.
The alternative is a fulfillment of the laws of unintended consequences, where overly burdensome PFAS policies threaten healthcare quality and cost.