PFAS in medicines can often be replaced with alternatives

The exclusively synthetic substances known as per- and polyfluoroalkyl substances (PFAS) are characterised by their persistence. This is because they degrade only very slowly under natural conditions. One of the typical persistent end products is trifluoroacetate (TFA). However, the term ‘forever chemicals’ often associated with them does not mean that fluorinated hydrocarbons are chemically inactive. Many PFAS accumulate in tissue. Some are known to interfere with hormone-regulated processes. Others are suspected of being carcinogenic.

PFAS are used, for example, in fire-fighting foams, as coatings and impregnating agents (paints, food packaging, textiles), as biocides and plant protection products, and also in cosmetics and medical products. In the case of veterinary medicines, these are primarily certain analgesics, anaesthetics and antiparasitic agents. According to a 2021 report by the German Environment Agency, around a quarter of TFA emissions from human medicines originate from anaesthetics, with almost 180 tonnes of these gases being released into the atmosphere in Germany each year. Almost three-quarters of TFA emissions are attributable to the diabetes medication sitagliptin, the painkiller celecoxib, the heart medication flecainide, the antidepressant fluoxetine, the cancer medication bicalutamide and the HIV medication efavirenz. Due to demographic trends, pharmaceutical consumption is generally expected to rise.

The report now presented by a research team at the University of Freiburg, Germany, examined 111 active ingredients in human medicines and 28 in veterinary medicines that are officially classified as PFAS. They showed that active ingredients without PFAS-related issues are already available for 87 per cent of these human medicines and 65 per cent of these veterinary medicines, whilst PFAS-free alternatives are currently under development for almost all of the remaining human medicines. From a pharmacological perspective, therefore, per- or polyfluorination is not strictly necessary, the report states.

However promising this analysis may seem, it only goes part of the way. For it must be concluded that avoiding such medicines is clearly the safest and most effective option. Research into cellular medicine has repeatedly demonstrated that this is possible by treating diseases at their root cause rather than merely addressing the symptoms.