Volume , Issue

I have a perfluoroalkyl and polyfluoroalkyl substances (PFAS) problem. PFAS are chemicals commonly found in modern waterproof fabrics and other products. Over the last few years a few things have become increasingly clear about PFAS — they are causing harm to humans and the environment. In light of this news, I offer my sincere apology to you. I have been a naive consumer of PFAS products for years.

My gear room is full of PFAS soaked garments — rain jackets, rain pants, snow gear, and shoes. I even have a camp pan with nonstick PFAS coating. Maybe you can relate. Having learned over the last years about the health and environmental impacts, I am wondering: what now? Should I throw it all away to confine the chemicals to the landfill? The traditional waterproof garment of Native Alaskans, a seal gut parka, might serve as a wonderful solution as it is compostable and natural, if only it didn’t require the harvesting of seals. Maybe it is better to maintain the gear in order to maximize the life of the product, perhaps offsetting the harm of PFAS with a reduction in my carbon footprint. And if I do replace my gear, what are the alternatives? After all, this gear is immensely useful at preventing human harm, namely keeping me warm and dry. And we all know that wet and cold in the outdoors can be a serious problem. I cannot simply avoid bad weather — some of my time outdoors is part of rescue efforts and other necessary ventures. Moving to the desert is an option, although I am quite happy with my own geography and seasons. I don’t think I can solve this problem simply. But I’d like to share what I know, to help us all make the best decisions.

First, let me tell you where you might find PFAS. These chemicals might be applied to carpets, cosmetics, furniture, cookware, and outdoor gear. Outdoor gear that might contain PFAS includes anything waterproof like apparel, shoes, tents, and backpacks as well as waterproofing sprays, liquids, and gels. You might even find it in the down inside jackets and sleeping bags. Some gear with PFAS includes fishing line, climbing ropes, ski wax, non-stick cookware, and bicycle lubricants.


Now, a little bit about the PFAS family.  The term describes a class of about 4,700 chemicals distinguished by fluorine substituted for hydrogen along a carbon chain.  Two infamous PFAS family members are perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS).  These are 8-carbon chain substances that are no longer manufactured in the US but have been manufactured and studied the most.  Manufacturers now prefer 6-chain PFAS substances, hoping these will be less harmful or break down faster.  However, this is likely a chemical whack-a-mole, and experts believe the substitution is not likely to improve the harms.  In large part, that is why many scientific advisory groups advocate a class ban on PFAS chemicals — to avoid the easy substitution of the of these chemicals for any of the thousands available to replace it.

In a bit of biting irony, the most useful properties of PFAS also lends unique difficulty.  The carbon-fluorine bond that makes them resistant to oils and water but also makes them impossibly difficult to break down naturally in the environment.  So PFAS are persistent “forever” chemicals in the environment.  They leak out from our products or during manufacture into the environment. PFAS can be found in 99% of US citizens, and in such wild environments as remote little-trafficked mountain peaks.  They are found in animals worldwide, although most concentrated in apex predators as it can bio-accumulate up the food chain.  The humans most at-risk from exposure to these chemicals are those involved in the manufacture of them or living nearby manufacturing facilities.  Several communities, such as Parkersburg, WV, home of a Teflon manufacturing facility, have seen and documented the negative health effects that come from saturating a community in these chemicals.

The human effects of PFAS are thought to include such problems as renal and testicular cancers, liver dysfunction, hypothyroidism, lower birth weight and size, obesity, reduced immune response to vaccines, and reduced hormone levels and delayed puberty.  The data is based on observational studies in humans, largely involving PFOA and PFOS exposures.  There will never be double-blinded studies on this, nor studies on every individual compound in the PFAS family.  The best data is from population studies linking blood or placental level to outcomes, and from cohorts of exposed populations documenting high risk of disease with exposure.  These effects are not easily noticed on an individual basis.  They are patterns that emerge across populations.  This makes them harder to study, and harder to contemplate your individual risk and the risk to the world at large.

We are considering a trade-off. On an individual level, the risk of health effects from wearing PFAS raingear is low.  We can see the benefit of staying dry on that bushwhack in the rain or floating a river on a chilly day.  But each time we are buying new PFAS coated gear, we are introducing a little more PFAS into the world.  As this does not breakdown, you could expect increasing levels of PFAS worldwide.  Manufacturing communities experience disproportionate impacts.  Avoiding PFAS products is a choice you can make to improve the health of people and the environment.

Manufacturers have been slow to move away from PFAS.  Alternative products that are equally waterproof have performance trade-offs, like shorter lifespan or less breathability.  Some of the known alternative options include:  PVC materials (poor breathability, cancer risks from phthalates) and polyurethane coated nylon (less breathability, more easily soaked).  The challenge here is to find a product that performs as well as PFAS without the trade-offs.  So far, there hasn’t been a clear solution, but there are some options emerging.  Check out PFAS Central for lists of products and companies committed to PFAS-free gear.

When you are buying gear, make sure you check for PFAS-free labeling.  Companies often do not clearly mark their products with a complete list of components.  Many have their own in-house waterproof technology that contains PFAS but do not label as such.  Even more confusing, certifications from third parties, like bluesign or OKEO-TEX, do not mean a product is PFAS-free.  These third-party safety and environmental health certifications are allowing PFAS products to pass certification if there is not an alternative with acceptable performance.  The simplest solution is to avoid waterproof products unless they are specifically labeled PFAS-free.

So now you are an informed consumer. Collectively we have a voice, one that is amplified as leaders in the wilderness medicine community.  We can seek out PFAS-free products and talk to others about our choices.  As this gathers momentum, we hope manufacturers will catch on and follow the customers wherever we lead them.

You Might Also Be Interested in

We Got Cubed!

Elan Small, MD4/16/2024

The Institute of Mountain Emergency Medicine held an unforgettable training day at terraXcube

WMS at the International Commission for Alpine Rescue (ICAR)

Martin Musi, MD, FAWM, DiMM Alison Sheets MD, FAWM, DiMM 3/5/2024

The Wilderness Medical Society was voted by 256 delegates to advance its membership status to an organization with voting rights

Sobering Rise of Urban Bicyclist Mortality

Brad L. Bennett, PhD, Paramedic, WEMT, MFAWMTony Islas, MD, MPH, FAWM, FAMSSM11/16/2023

Is mountain bike riding a safer alternative?

America’s Most Notorious Pitviper Unmasked

Michael Cardwell, MS9/29/2023

Rattlesnake envenomated patients have many different presentations and toxic effects