PFAS Health Study
PFAS Health Study
The Per- and Polyfluoroalkyl Substances (PFAS) Health Study will investigate the exposure levels and potential health effects of PFAS in areas of known contamination in the communities of Williamtown in New South Wales, Oakey in Queensland, and Katherine in the Northern Territory, Australia.
Areas in Williamtown, Oakey, and Katherine have been contaminated with PFAS due to firefighting activities on nearby Defence Force bases. Members of these communities have been potentially exposed to PFAS primarily through the use of contaminated water including bore and river water on their properties, and via eating locally grown foods.
What are PFAS?
PFAS chemicals are very resistant to heat and to degradation in the environment, and they persist for quite long periods in the human body. They have been manufactured since the 1950s and used in a variety of consumer products such as non-stick cookware, water-proof clothing, and fabric stain protection. PFAS were also an ingredient in Aqueous Film-Forming Foam (AFFF) used for firefighting activities.
PFOS (perfluorooctane sulfonic acid) and PFOA (perfluorooctanoic acid) were the two most commonly used PFAS chemicals. These two PFAS are no longer used in AFFF, however the chemicals that have previously been used for firefighting activities can remain in ground water, sediment and soil in the areas surrounding their use. AFFF containing PFAS chemicals have been used in Australia for firefighting capacities since the 1970’s, including on Defence Force bases.
Find out how what is involved in the study and read questions frequently asked by the community.
The PFAS Health Study was commissioned by the Australian Government Department of Health.
The PFAS Health Study has five main components over two phases. Each component aims to inform the following components in the study. Each component has protocols.
Phase I - Systematic Literature Review
Scientific studies have investigated a range of possible health outcomes resulting from exposure to PFAS. During Phase I we conducted a systematic review to examine the evidence on the human health effects related to PFAS exposure reported in scientific literature. A systematic review assesses the current evidence for a research question using specific methods to collect and evaluate research studies.
Your can read the findings of the systematic review on the Reports tab.
Phase I - Study Protocols for Phase II
The PFAS Health Study aims to investigate the exposure levels and potential health effects of PFAS in areas of known contamination in the communities of Williamtown, Oakey, and Katherine, Australia. During Phase I we developed the study protocols for the PFAS Health Study Phase II epidemiological study.
Phase II – Focus Groups Study
The first component of Phase II of the PFAS Health Study was a series of focus group discussions in Oakey, Williamtown, and Katherine between January and August 2018. The main aim of this study was to understand participants’ views and experiences of PFAS contamination in their local area, with a focus on participants’ health concerns. Focus group discussions facilitate discussion of public knowledge, underlying attitudes, perceptions and opinions and are well suited to exploring a range of views on community topics.
The findings of the focus group study are available on the Reports tab.
Phase II – Cross-sectional Survey and Blood Serum Study
The PFAS Health Study will test blood specimens of people living or working in an area contaminated with PFAS and compare it to people not living in those areas. The Study will also conduct a survey of these same people to understand the blood test results, along with health effects and other concerns.
People who have already had their blood collected through the Australian Government Department of Health Voluntary Blood Testing Program for PFAS and have agreed to participate in the ANU-led study were invited to particpate in October 2019. Participants were be able to complete a paper copy of the survey and mail it to the study team, or complete it online.
The study began in November 2016 with the Voluntary Blood Testing for PFAS.
The final report for the Cross-sectional Survey and Blood Serum Study is expected to be released in mid-2021.
Read more about Voluntary blood testing for PFAS on the Department of Health website.
Phase II – Data Linkage Study
The data linkage study will examine whether adverse health outcomes potentially linked with PFAS exposure are more common among people who have lived in areas contaminated with PFAS compared to those who have never lived in those areas. Data linkage brings together information about individuals across multiple datasets. Researchers only have access to these data after identifying details have been removed.
The study will use routinely-collected data. Routinely-collected data are data collected for purposes other than research, such as information collected by hospitals or for Government services.
The final report for the Data Linkage Study is expected to be released in mid-2021.
What is the PFAS Health Study?
The PFAS Health Study is investigating the exposure levels and potential health effects of PFAS in three towns that have high levels of PFAS contamination of the environment—Oakey (Qld), Williamtown (NSW) and Katherine (NT). To find out if the health of these communities has been affected by PFAS, we will compare the results with information from people who live in similar towns that do not have high levels of PFAS in the environment— Dalby (QLD), Kiama and Shellharbour (NSW), and Alice Springs (NT). Each of these comparison towns is matched to an exposed town based on socioeconomic factors, such as income, employment and education levels, and the remoteness of the area. Participants of the study will be asked to complete a survey and provide a blood serum sample for testing PFAS levels and a range of biomarkers.
Limitations of PFAS blood testing
Blood testing for PFAS currently has no diagnostic or prognostic value for individuals and cannot be used to guide clinical management. This means that a blood test cannot determine if PFAS levels in a person’s blood will make them sick now or later in life, or if any current health problems are related to the PFAS levels found in their blood. There are no ‘normal’ or ‘abnormal’ ranges and most Australians are expected to have detectable levels of PFAS in their blood due to the widespread use of this chemical in a range of applications and products. The value of blood testing is limited to assessing exposure at the population level. A blood test can measure the level of PFAS in a person’s blood and can tell a person how their blood levels compare with the levels seen in the general Australian population.
While PFAS can persist in humans, animals and the environment, currently there is limited evidence of significant impacts on human health from exposure to PFAS chemicals. The Environmental Health Standing Committee (enHealth) issued revised guidance statements in 2019 to reflect the most current evidence relating to PFAS, including that PFAS exposure has been associated with mildly elevated levels of cholesterol, effects on kidney function and effects on the levels of some hormones. However, these effects are small and generally within ranges seen in the general population.
Avoiding PFAS exposure as a part of the precautionary principle
As a precaution, governments in Australia recommend that exposure to PFAS be minimised wherever possible while further research is undertaken on the potential health effects of PFAS exposure.
Information for GPs in Williamtown, Oakey and Katherine
Study participants in Williamtown, Oakey and Katherine have previously had a blood test for PFAS levels through the Australian Government Voluntary Blood Testing Program (VBTP) and have received their results during a post-test GP consultation. We have invited these participants to complete a survey about their health and wellbeing and potential exposure to PFAS. We have also sought permission to test their stored blood serum for biomarkers to better understand how PFAS levels influence specific biochemicals such as, blood lipids, and markers of liver, kidney and thyroid function.
This testing will be undertaken in early 2021 and results will be sent directly to participants. If participants consent, we will also send a copy of their results to their GP, for their records. If the participant’s results are outside the laboratory reference ranges we will recommend that they follow-up with their GP.
It is important to note that the blood serum samples being tested will be between 18 months and 4 years old.
Information for GPs in Alice Springs, Dalby, Kiama and Shellharbour
Residents will be randomly selected, through Services Australia, to participate in the study. In mid-2020 they will be invited to complete a survey about their health and wellbeing and potential exposure to PFAS and have a blood test for PFAS serum levels and a range of biomarkers.
Participants will be directed to a local pathology collection centre to have their blood taken. They are not required to consult with their GP prior to the test.
Blood serum samples will be stored until the end of the study period, before being tested in early 2021. Results of the tests will be sent directly to participants in early to mid-2021. If participants provide written consent at the time of blood collection, we will also send a copy of their results to their GP, for their records. If a participant’s biomarker results are outside of the laboratory reference ranges, we will recommend that they follow-up with their GP.
Further advice for GPs
While participants in the PFAS health study from comparison areas will not be required to see their GP, we understand that some individuals may wish to discuss their potential participation in the PFAS study or their results with their GP.
Similarly while participants of the PFAS health study from the Investigation areas had their blood specimens taken some time ago, they may return to their GP for further consultation following the receipt of their results from their additional biomarker tests completed as part of the study.
The following additional advice may assist GPs:
Reports have been published on the Systematic Literature Review and the Focus Groups Study.
Reports for the remaining parts of the PFAS Health Study will be available at the conclusion of each study component.
PFAS Health Study Systematic Literature Review
This review examined 221 scientific publications into the human health effects of exposure to perfluoroalkyl and polyfluoroalkyl substances, commonly known collectively as PFAS. The key findings were:
- Sufficient evidence that higher levels of PFOS or PFOA in a person’s blood can lead to higher blood cholesterol levels.
- Limited evidence that higher levels of PFAS in the blood resulted in slightly higher levels of uric acid in the blood.
- Limited evidence that high PFAS levels in the blood reduced kidney function or were associated with chronic kidney disease.
- Limited evidence in a small number of relevant studies that PFAS exposure caused kidney and testicular cancers.
- Limited evidence that higher levels of PFAS in the blood resulted in lower levels of antibodies than usual following vaccination against some vaccine preventable infections.
PFAS Health Study Systematic Review (PDF 1.7MB). This review was released in May 2018.
PFAS Health Study Focus Groups Study
The primary aim of the Focus Groups Study was to gather a range of social and health-related experiences and perceptions from current residents and workers exposed to PFAS in Williamtown, Oakey and Katherine. Focus groups discussions were conducted between January and August 2018, with a total of 180 participants across the three regions. The main topics of discussion were focused on both physical and mental health concerns, environmental and PFAS blood testing, financial concerns, community trust and cohesion, local conditions and exposure pathways, and the way forward.
PFAS Focus Groups Report (PDF 1.1MB) This report was released in March 2019.
The Focus Groups Report was used in the development of a poster for the Aboriginal communities in Katherine (PDF 2.7MB) which was presented in May 2019.
News and events
December progress report (PDF 229KB)
November progress report (PDF 231KB)
October progress report (PDF 140KB)
September progress report (PDF 140KB)
August progress report (PDF 138KB)
July progress report (PDF 138KB)
June progress report (PDF 108KB)
May progress report (PDF 108KB)
April progress report (PDF 108KB)
March progress report (PDF 137KB)
February progress report (PDF 137KB)
January progress report (PDF 123KB)
|16 May 2019||Community Consultations in Katherine, NT||
|6 December 2018||Community Consultations in Oakey, Qld||
|26 November 2018||Community Consultations in Williamtown Community, NSW||
|21 June 2018||Community Consultations in Katherine, NT||
|23 February 2017||Community Consultations in Oakey, Qld||
|17 February 2017||Community Consultations in Williamtown Community, NSW||
The PFAS Health Study survey is now closed for Williamtown, Oakey and Katherine residents.
Contacting the study team
The PFAS Health Study has a toll free number that can be contacted between 9am-5pm, Canberra time. This number is 1800 430 903.
Alternatively, you can email us at firstname.lastname@example.org
How to complete the survey
This study is focused on three PFAS Investigation and Management Areas surrounding Royal Australian Air Force (RAAF) Base Williamtown (New South Wales), RAAF Base Tindal (Northern Territory) and Army Aviation Centre Oakey (Queensland). We want to hear from people who may have been exposed to PFAS in these areas, as well as those who haven’t. In this survey a ‘PFAS Investigation or Management Area’ refers specifically to the Williamtown, Oakey and Katherine sites.
We would like to remind you that there are no right or wrong answers - it's your own thoughts and opinions that matter. Any comments you make will not be linked to you personally, but will be reported as a group. Please take your time in completing the survey.
Completing the survey online
For most questions, you will only need to click in a tick box with your mouse. Other questions will require you to type in a response or a value. Please select and type your answers carefully.
The survey will work in all browsers and is optimised for mobile devices. It will time out after 10 minutes of non-use.
- Please read each question and follow the instructions to record your reply.
- Please DO NOT use the 'Back' and 'Forward' buttons in the browser.
- Please use the buttons at the bottom of each screen.
- If you would like to pause the survey to return to it later, use the original link with your individual username and password details to return.
If you have any questions about the survey that are not answered in this guide, please call the Australian National University study helpline on 1800 430 903 (9am – 5pm Canberra time).
Can I review my answers at the end/can I go back to a previous section?
Can the survey be completed without internet access?
Yes, we can send you a paper copy of the survey, when you register your details to participate please let us know you would prefer to fill in a paper survey. You can contact the study team on 1800 430 903 or email email@example.com.
Completing the paper survey
- Only use black pen for your responses. Do not mark any areas outside boxes.
- Where lines are supplied, write your answer clearly on the space provided. Answer with as much detail as possible.
- When checkboxes are supplied, indicate the answer that is right for you by placing a tick.
- If you need to change an answer, completely fill in the wrong box and put a tick in the box with the answer that is right for you.
- Sometimes you are asked to write a number for your response. Where there is more than one box and your answer is a single digit, you do not need to insert zeros in front of your answer.
- Important information that will help you complete the survey will appear next to this symbol. Please read each question carefully
- Please answer questions in the order they appear. Where you may need to skip one or more questions you will see a symbol.
Participant Guidelines for the PFAS Health Study Survey
Adult Survey Guidelines (PDF 249KB)
Child Survey Guidelines (PDF 497KB)
Study Information Forms for Alice Springs, Dalby and Kiama/Shellharbour region residents.
A copy of the Consent Form for the PFAS Health Study Cross-sectional Survey and Blood Serum Study is available below.
Participant Information Sheet (PDF 179KB)
Consent Form (PDF 230KB)
Study Information Forms for Williamtown, Oakey and Katherine residents.
A copy of the Participant information Sheet and Consent Form for the PFAS Health Study Cross-sectional Survey and Blood Serum Study are available below.
Participant information Sheet - VBTP - Adult (PDF 203 KB)
Participant information Sheet - VBTP - Child (PDF 218KB)
Consent Form - VBTP - Adult (PDF 235KB)
Consent Form - VBTP - Child (PDF 235KB)
The PFAS Health Study Survey
Adult Survey (PDF 1.06MB)
Child Survey (PDF 1.01MB)