Do you use non-stick cookware – or have stain-resistant furniture, order take-out or floss your teeth? Do you drink water? These, and other everyday products, may contain PFAS – synthetic substances that are known as “forever chemicals” because they resist breaking down in the environment or the human body. These chemicals accumulate over time, and exposure can cause serious health problems, including immune disfunction and cancer. But there are ways to lessen your exposure and protect your health.
Non-stick pans are popular because they do their job well: Food slides across the pans’ surfaces easily, making it easy to cook in them without oil and easy to clean them afterward. But their safety has been questioned.
Polytetrafluoroethylene (PTFE), also known as Teflon, is the most common non-stick coating. PTFE falls under the category of per- and polyfluoroalkyl substances (PFAS), synthetic chemicals that are resistant to both water and oils, which makes them useful for many industrial applications. In addition to non-stick cookware, PFAS are found in thousands of consumer products including cleaners, fire extinguisher foam, water-resistant clothing, stain-resistant furniture and carpets, dental floss, food packaging, and take-out containers.
PFAS are problematic because of their reputation as “forever chemicals.” They are persistent organic pollutants; they resist breaking down in the environment and the human body and accumulate over time. And because of their wide variety of applications, they are everywhere. Drinking water is frequently contaminated with PFAS; earlier this year, the EPA proposed new regulations to limit levels of six specific PFAS in drinking water. So it’s not surprising that when the CDC looked for 12 different PFAS in blood samples from the National Health and Nutrition Examination Survey (NHANES), they found that more than 98% of Americans had detectable PFAS in their blood.1
PFAS exposure has been linked to immune dysfunction, elevated cholesterol and triglycerides, cancers, and thyroid hormone disruption.2-5
Polyfluoroalkyl chemicals in the U.S. population
A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects
United States Environmental Protection Agency. Basic Information on PFAS
Per- and polyfluoroalkyl substances (PFAS)-contaminants of emerging concern
It is widely known that metal utensils can damage non-stick pans, and scratches in the surface might lead to PTFE getting into food. But Teflon cookware may be less strong and durable than many consumers realize. Less known is that manufacturers of non-stick pans often recommend not to heat them above medium, and that pans should not be pre-heated empty. At high temperatures (above 500 degrees F), PTFE-coated pans give off harmful fumes.6
Workers exposed to overheated PTFE have developed “polymer fume fever,” which includes flu-like symptoms, fever, chills, joint pain, and fatigue.7 There are also case reports of home cooks exposed to overheated Teflon-coated cooking pans for several hours developing fever, cough, pulmonary edema, and labored breathing.8,9
What about PTFE microplastics entering food, even if cookware is used at the proper temperature? There is a puzzling lack of research on PTFE or other PFAS particles entering food after heating on non-stick cookware. Although brand new, intact pans did not release detectable levels of PFAS in one cooking simulaton study,10 a recent study of pans with damaged coatings estimated that a surface crack in a PTFE-coated pan could leave 9100 microplastic and nanoplastic particles in a food during the cooking process, and a broken coating could leave over 2 million.11
PTFE-coated non-stick cookware and toxicity concerns: a perspective
Polytetrafluoroethylene fume-induced pulmonary edema: a case report and review of the literature
Investigation into the migration potential of coating materials from cookware products
Raman imaging for the identification of Teflon microplastics and nanoplastics released from non-stick cookware
Two PFAS, PFOA (perfluorooctanoic acid also called C8) and PFOS (perfluorooctane sulfonate), have been phased out in the United States. Most uses of PFOA and PFOS were phased out in the mid-2000s because of very clear evidence of harm to human health. For example, after years of PFOA being discharged from an industrial facility along the Ohio River and contaminating drinking water in Ohio and West Virginia, a legal battle followed, and researchers linked PFOA exposure in residence to higher rates of high cholesterol, ulcerative colitis, thyroid disease, testicular cancer, kidney cancer, and hypertension during pregnancy.12
The CDC reported that blood levels of PFOA and PFOS have declined by more than 70% following their phase-out,13 but they remain in the environment since they are resistant to degradation, and these PFAS have been replaced with other PFAS (called GenX chemicals and PFBS) in industrial uses. According to the EPA, these PFAS, which are made up of fewer carbon atoms, are eliminated more quickly than PFOA and PFOS. However, they are still persistent in the environment, and the EPA has concerns about their health effects. The EPA released health advisories for these PFAS in drinking water in 2022, based on animal studies suggesting negative effects on the liver, kidneys, immune system, and thyroid, and reproductive organs. The animal studies also suggested effects on development, and an increased risk of cancer.
In short, these short-chain PFAS could be damaging to health too. So when newer Teflon-coated pans claim they are “PFOA-free” on their labels, this could confuse customers. The labels do not mean that the pans are free of PFAS – only that they are not made with PFOA. And of course, they still contain PTFE (Teflon), which is a PFAS. Also, according to Consumer Reports, “PFOA-free” claims may not be reliable for PTFE-coated cookware, because products made without PFOA may still contain PFOA because it can be produced as a byproduct of other PFAS.
Stainless steel cookware not coated with Teflon is a good option for cooking, but is not non-stick. For a non-stick option, ceramic-coated pans made without Teflon (or other PFAS) make it easy to water-sauté your veggies. Non-stick hard anodized aluminum pans are non-stick because they are most often coated with PTFE or other PFAS. The most non-stick option among the safe alternatives is ceramic or ceramic-coated pots and pans.
The bottom line is that you purchase cookware once or twice in a lifetime, so it pays to purchase something of quality that is not going to place your health at risk.
Joel Fuhrman, M.D. is a board-certified family physician, seven-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 30 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.
*There is no guarantee of specific results. Results can vary. All material provided on the DrFuhrman.com website is provided for informational or educational purposes only. Consult a physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.