Reality Check: Is stricter PFAS regulation a health win?

Abstract

Per- and polyfluoroalkyl substances (PFAS) have remained persistent environmental contaminants since the 1950s, despite ongoing efforts to curb their production and find alternatives. Most health studies have focused on Perfluorooctanoic acid (PFOA) and Perfluorooctane sulphonic acid (PFOS), leaving limited data on other PFAS compounds in water. The European Union, particularly the Netherlands, has implemented stringent measures to control PFAS in drinking water due to their uncertain health impacts on
humans. Recently, the Dutch Institute for Public Health and Environment (RIVM) proposed a new guideline of 4.4 ng PFOA equivalent (PEQ) per litre for PFAS in drinking water, a substantial reduction from the current European Drinking Water Directive standards of 100 ng/L for the sum of PFAS and 500 ng/L for total PFAS.

While improving drinking water quality is expected to have positive health outcomes, the advanced treatment technologies required to meet this new guideline can be harsh, potentially releasing emissions that may cause negative health effects. This research, centred on the Leiduin drinking water treatment plant operated by Waternet in the Netherlands, investigates whether the health benefits of the new guideline outweigh the potential harms caused by the treatment processes necessary to achieve it.

To explore this, the study first calculated the Disability-Adjusted Life Years (DALYs) lost due to PFAS exposure from drinking water at the current concentrations, exceeding the 4.4 ng PEQ/L guideline, using a literature review to link guidelines with PFAS health effects. The second step involved conducting a Life Cycle Assessment (LCA) of the treatment system at the Leiduin plant, focusing on the treatment steps necessary to meet the new guideline, and calculating the DALYs lost due to the environmental impact of achieving the 4.4 ng PEQ/L standard. These DALYs were then compared to assess whether adhering to the new guideline is justified in terms of health impacts.

The results indicate that the DALYs associated with the current and proposed guidelines fall within similar ranges, showing limited health benefits. Specifically, the health benefits (in DALYs) gained from implementing the new guideline range from 0.4 to 4 per year, while the DALYs lost due to the treatment technologies required at the Leiduin plant range from 1.55 to 3.25 per year for the population receiving drinking water from the Leiduin site, depending on the type of activated carbon used in the treatment process.

These findings suggest that the potential health benefits of stricter PFAS regulations in drinking water maybe counterbalanced by the negative health impacts of the treatment technologies required to achieve
these lower concentrations