PFAS in Tennessee: What Are the Potential Health Effects?

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What Are PFAS?  

Poly- and perfluoroalkyl substances (PFAS), often referred to as “forever chemicals,” are synthetic compounds known for their persistence in the environment and potential adverse health effects. These chemicals have been used extensively since the 1940s in various consumer, commercial and industrial products, including items like water-resistant clothing, fire extinguisher foams, electronics, cosmetic products, food packaging and nonstick cookware. PFAS have been widely used because of unique properties such as resistance to heat, water and oil.

PFAS are long-lasting in nature and break down very slowly over time. Because of their widespread use, PFAS can be found in the blood of people and animals around the world, at low levels in numerous food products and throughout the environment, including water, air, and soil.

Scientific studies indicate that exposure to certain PFAS may be linked to harmful health effects in humans and animals. Thousands of PFAS chemicals exist, which complicates the study and assessment of potential health and environmental risks.

Woman at stove using nonstick cookware, a risk for PFAS
Some nonstick cookware can contain PFAS.

How Are We Currently Exposed to PFAS?

According to the United States Environmental Protection Agency (EPA), people are most likely exposed to PFAS through:

  • Consuming PFAS-contaminated water or food.
  • Using products made with PFAS.
  • Using products packaged in materials made with PFAS.
  • Breathing air containing PFAS.
  • Working in occupations where PFAS are most exposed, such as firefighters, chemical processing and manufacturing.

This pervasive exposure stems from extensive use of PFAS in everyday items and industrial applications.

A report by the Centers for Disease Control and Prevention, based on data from the National Health and Nutrition Examination Survey, found that 97 percent of Americans have PFAS in their blood. Another NHANES report indicated that PFOS and perfluorooctanoic acid (PFOA) blood levels have decreased since these chemicals were removed from consumer products in the early 2000s. However, new PFAS chemicals have been introduced and assessing exposure to these new chemicals is challenging.

What Are the Health Risks of PFAS Exposure?  

The health risks associated with PFAS exposure are a significant concern and the subject of ongoing research. According to the Tennessee Department of Health, the exact impact of PFAS on health is not fully understood. But research by the federal Agency for Toxic Substances and Disease Registry suggests that certain PFAS may:

  • increase cholesterol levels.
  • decrease effectiveness of vaccines.
  • increase risk of thyroid disease.
  • decrease fertility in women.
  • increase risk of serious conditions like high blood pressure or preeclampsia in pregnant women.
  • lower infant birth weights (although the decrease is small and may not affect the infant’s health).

Given these potential health effects, it’s crucial to understand and reduce PFAS exposure. As more research is conducted, we learn that certain PFAS can cause risks even at lower levels.

Can a Medical Test Show Exposure to PFAS?   

Yes, a blood test can measure PFAS levels in your blood. However, this is not a routine test typically performed in a doctor’s office. While a blood test can confirm exposure, it cannot predict when or if you will develop health issues as a result. A healthcare provider can help patients consider the risks, benefits and potential limitations of PFAS blood testing and help determine the next steps based on specific needs.

EPA Actions to Address PFAS  

Tap water filling glass

In 2021, EPA released its PFAS Strategic Roadmap to highlight actions the agency planned to protect people and the environment from PFAS contamination. Since then, EPA has begun distributing $10 million in funding to address emerging contaminants, issued health advisories for PFAS, proposed legally enforceable Maximum Contaminant Levels (MCLs) in drinking water, updated interim guidance on PFAS destruction and disposal, laid the foundation to enhance data on PFAS and proposed two PFAS as Comrehensive Environmental Response, Compensation, and Liability Act (CERCLA) hazardous substances.

In April 2024, EPA announced the final National Primary Drinking Water Regulation for six PFAS, setting legally enforceable Maximum Contaminant Levels (MCLs) for these chemicals in drinking water. Public water systems must monitor these PFAS and provide the public with information on their levels in drinking water starting in 2027. By 2029, systems must implement solutions to reduce PFAS levels if they exceed the MCLs and notify the public of any violations.

The EPA also designated two PFAS chemicals, PFOA and PFOS, as hazardous substances under the CERCLA (also known as Superfund). The designation of PFOA and PFOS as hazardous substances:

  • Requires reporting when specified quantities of these chemicals are released into the environment.
  • Allows EPA to hold parties responsible for the cleanup of legacy pollution.
  • Requires PFOA and PFOS to be considered as recognized environmental conditions for certain real estate transactions.

PFAS Exposure in East Tennessee  

According to the Knoxville Utilities Board (KUB) 2023 Water Quality Report, no PFAS compounds were detected in the water tested in January 2024. Monitoring will continue, with results shown in future annual water quality reports.

For detailed information, the Tennessee Department of Environment and Conservation provides an interactive map showing testing results for specific areas, including the date of the latest tests and testing status across the state. This resource is valuable for understanding PFAS presence in local water supplies.

What Can We Do to Limit PFAS Exposure?   

Here are some steps you can take to reduce your exposure to PFAS:

Man eating pizza from cardboard pizza box that may contain PFAS
PFAS are often found in food packaging and storage containers.
  • Find out if PFAS are in your drinking water: Contact your local water utility to inquire about PFAS levels and any steps taken to address them. If needed, test your water using a state-certified laboratory. Compare your test results to Tennessee’s state standards for safe levels of PFAS in drinking water or to EPA’s Health Advisory Levels.
  • Use a water filter: EPA will require municipal water systems to remove six PFAS by 2029. In the meantime, consider using an NSF-certified water filter to reduce PFAS levels in your tap water. Originally known as National Sanitation Foundation, NSF provides risk assessments, testing, inspection and certification services for the water industry from source to tap.
  • Use sustainable water management practices in agriculture: These practices can significantly help reduce health risks
  • associated with PFAS. By ensuring water sources are free from PFAS contamination, farmers can prevent the transfer of these chemicals into the food supply.
  • Limit consumption of freshwater fish: Avoid eating fish from local sources known or suspected to be contaminated with PFAS.
  • Avoid nonstick cookware and utensils: Choose alternatives to nonstick products, which often contain PFAS.
  • Choose PFAS-free textiles: Select clothing and fabrics not treated with PFAS.
  • Avoid certain food packaging and storage containers: Avoid products known to contain PFAS.

“Avoiding the use of products containing PFAS is one way of reducing the forever chemicals; however, PFAS are omnipresent in our modern world and have been for decades,” said Nicole Shields, MD, a family physician at Claiborne Primary Care. “We are still learning about PFAS, the impacts and what we can do to help prevent further deleterious effects.”

Dr. Shields noted that Clemson University currently is conducting research to understand how environmental factors and farming practices affect the distribution and transport of PFAS in agroecosystems. The research also will help identify the best management practices to reduce the risk of PFAS in food crop production.


While exposure to PFAS is a widespread issue, ongoing efforts by EPA and other federal agencies aim to limit exposure and reduce production of these harmful chemicals. By staying informed and proactive, you can help reduce the impact of PFAS on your health and the environment. Contact your local health authorities and water utilities for more information and resources.

Understanding and taking steps to minimize your exposure to PFAS can help protect your health. If you suspect you have been exposed to harmful levels of PFAS, contact a medical provider for evaluation and guidance.

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About the Author

Covenant Health

Headquartered in Knoxville, Tennessee, Covenant Health is a community-owned, healthcare enterprise committed to providing the right care at the right time and place. Covenant Health is the area’s largest employer and has more than 11,000 compassionate caregivers, expert clinicians, and dedicated employees and volunteers.

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