(NEW YORK) — In an announcement last week, Consumer Reports revealed results after it tested 118 food packaging materials from U.S. restaurants and grocery stores, and found evidence of dangerous per- and polyfluoroalkyl substances (PFAS) in more than half of those products. The items ranged from paper bags for french fries and wrappers for hamburgers, to molded fiber salad bowls and single-use paper plates.

PFAS are man-made chemicals, dubbed forever chemicals because they don’t break down easily, that persist in the environment for a long time and are used in various industries around the world. If exposed in sufficient levels, PFAS can pose potential health risks to humans. The chemicals used to reduce friction are used in applications from cookware to aerospace technology.

Director of Medical Toxicology at St. John’s Riverside Hospital Dr. Stephanie Widmer told Good Morning America that “PFAS chemicals are essentially everywhere, they are used, to varying degrees, in the manufacturing of a ton of everyday objects and appliances, things all of us use on a daily basis.”

The concern, she continued, is that “we can’t exactly get away from these potentially dangerous chemicals and they are extremely difficult to regulate, so the best we can do is try to limit our exposure.”

“Consuming and being exposed to small amounts of PFAS is unlikely to cause any harm, and just like anything else we are exposed to in the world, nothing is ever good in excess, moderation is key,” Widmer said. “Toxic doses for PFAS have not been well established, although the EPA has set ‘health advisory’ thresholds in drinking water.”

Other reports, including a 2019 report from New Food Economy, make similar claims about the public health risks from these products. However, reporting, so far, is insufficient to conclude that PFAS in food containers are definitively harmful to humans.

Consumer Reports tested for total organic fluorine content, a simple and cheap substance. However, there are multiple types of PFAS chemicals which could mean that the test from Consumer Reports may have underreported the true amount of PFAS in these materials.

The exposure in these sources alone is unlikely to cause adverse health effects. It is more likely that adverse health effects come from direct exposure such as through ingestion, inhalation or dermal exposure — from contaminated water, soil, workplaces or food, as well as, from the lifetime cumulative exposures from multiple sources.

While some reports suggest a harmful link between PFAS and health issues, that has yet to be proven.

In response to Consumer Reports’ testing, Restaurant Brands International, the parent company of Burger King, Popeyes and Tim Hortons, announced new bans on the use of PFAS in its food packaging.

“As a next step in our product stewardship journey, the Burger King, Tim Hortons and Popeyes brands have required that any added perfluoroalkyl and polyfluoroalkyl substances (PFAS) be phased out from all approved, guest-facing packaging materials globally by the end of 2025 or sooner,” the company said in a statement.

Chick-fil-A followed suit shortly after stating the brand has “eliminated intentionally added PFAS from all newly produced packaging going forward in its supply chain.” The fast food expects the chemicals “to be phased out by the end of this summer.”

According to the Centers for Disease Control and Prevention, toxicity is difficult to evaluate because each chemical variation of PFAS has different half-lives, or time that it takes to break down, combined with water solubility and varied effects on humans.

Regulations, protections and studies on PFAS

The Environmental Protection Agency has established a health advisory level for PFOA and PFOS in drinking water at 70 parts per trillion (ppt) (0.07μg/L) individually or combined.

Last year, California Gov. Gavin Newsom signed a bill into law that goes into effect in 2023 to ban PFAS in paper-based food packaging and require disclosure of toxic substances in cookware. While this will regulate a specific maximum level, tougher regulation is likely needed.

“The potential dangers that have been demonstrated in animal studies, don’t necessarily translate to humans, and possible links to illnesses in humans — are merely an association, a causal relationship is yet to be determined,” Dr. Widmer explained. “Think potential links that we are aware of at this time are kidney and genitourinary cancers, blood pressure disorders, hormone imbalances and high cholesterol.”

In animal studies results show PFAS exposure can cause enlargement and changes in the function of the liver; changes in hormone levels; suppression of adaptive immunity; and adverse developmental and reproductive outcomes.

In human studies, there have been disease associations found, but no causal links. Some of the associations include: high cholesterol; ulcerative colitis; thyroid toxicity; testicular cancer; kidney cancer; preeclampsia, and elevated blood pressure during pregnancy.

How to protect yourself?

“Again, do all things in moderation,” Widmer said. “Maintain variety in your diet and the sources where you obtain food and water. If you want to be proactive, you can look into the levels of PFAS in your local drinking water by visiting the EPA website.”

The EPA says to be aware of the water and food you consume and ensure they do not come from contaminated sources. A map with historical advisories can be found here from the EPA.

While individuals do not need to be tested for PFAS exposure, according to the United States Preventive Services Task Force (USPSTF), the agency recommends undergoing regular routine health screenings and following a physician’s guidance.

Dr. Matt Feeley, a resident physician in the ABC News’ Medical Unit, contributed to this report.

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