Laura Anderko, PhD, RN, co-director of the Region 3 Pediatric Environmental Health Specialty Unit - the Mid-Atlantic Center for Children’s Health and the Environment (MACCHE) - housed at Villanova University M. Louise Fitzpatrick College of Nursing, has co-authored “Guidance on PFAS Exposure, Testing, and Clinical Follow-Up (2022)," from the National Academies of Sciences, Engineering, and Medicine (NASEM) released July 28 during NASEM’s online public briefing. The report provides advice to the Centers for Disease Control on who, when, how, and what to test, as well as the benefits and harms of testing.
Over the past 7 years, Dr. Anderko, an educator and scholar in public health, nursing, and environmental health who served on the report’s committee, has educated communities and health providers about potential health impacts and risk reduction strategies for perfluoroalkyl substances (PFAS). She has published extensively on PFAS, focusing on clinicians' role in addressing health impacts and strategies for reducing risks.
PFAS are chemicals with almost ubiquitous exposure in the United States. They are used in such products as stain and water-resistant treatments, nonstick cookware, firefighting foam, waterproof apparel, takeout containers and more.
Dr. Anderko notes, “Because of their widespread use, most people in the United States have some PFAS in their body, with a recent study finding that all children have PFAS in their bodies. There is sufficient evidence that exposure to PFAS can lead to adverse health outcomes such as kidney cancer, pre-eclampsia, or immunosuppression.”
When humans ingest contaminated food, water, or dust, the PFAS are absorbed. “These chemicals can accumulate in the body, remaining in the human body for long periods of time. Using current evidence, the NASEM report offers clear guidance to clinicians and communities about preventing exposures, testing, and clinical approaches to address potential health effects based on PFAS blood levels,” she explains.
Dr. Anderko shares that the report is unique “because guidelines were informed not only by empirical research, but also by the lived experiences of residents in communities impacted by exposures to high levels of PFAS, as a credible and important source of evidence. These voices helped to shape the recommendations for clinicians in addressing concerns, such as criteria for PFAS testing and clinical follow up.”
Nurses play a critical role in educating communities on how to reduce the risk of exposure and offering comprehensive clinical care in partnership with patients. Dr. Anderko describes another unique and important contribution of the report being the development of the “’principles for decision-making under uncertainty,’ such as justice or autonomy, which guides decision making by clinicians, where sufficient evidence is lacking for some of the health effects from PFAS exposure. An emphasis on informed decision making between clinician and patient is an example of how the principles can be incorporated into a clinical encounter, for example, autonomy.”
The environmental health experts at the Mid-Atlantic Center for Children's Health and the Environment at Villanova University offer consultations and education to communities and health providers on PFA exposures and health effects, testing, clinical follow up, and risk reduction strategies. A webinar is planned for August 23 at 9:00 AM. Please use this link to attend.