How using AFFF may lead to liver damage: Association of PFAS with liver injury biomarkers

PFAS, which stands for per- and polyfluoroalkyl substances, is a term for a class of toxic chemicals made with chains of carbon-fluorine bonds. These chemicals are the key components of aqueous film-forming foam (AFFF), which was used by the military and fire departments for extinguishing liquid fires. These chemicals in AFFF have many unique properties. They are long-lasting and unreactive with other materials, but this also makes them dangerous when they find their way to soil, groundwater, and even inside human bodies. PFAS is found in the blood of 98% of US adults, as per the data from the National Health and Nutrition Examination Survey.

While PFAS exposure is affecting many Americans, some high-risk groups are more vulnerable than others, especially those who were regularly exposed to fluorine-based products like AFFF in their work. Civilian firefighters (career or volunteer) and military firefighters belong to these high-risk groups, and they may be facing higher risks of developing different types of cancer, including liver cancer.

Studies have linked higher PFAS levels to liver damage

Researchers have uncovered the link between long-term exposure to these toxic chemicals and liver damage. In a meta-analysis published in Environmental Health Perspectives that included more than 100 studies, PFAS exposure was correlated with an increase in hepatoxicity. PFOA was associated with high aspartate aminotransferase (AST) levels, a marker of potential liver damage. PFOA was one of the long-chain PFAS types that were detectable in all legacy AFFF stocks, which means it was highly likely that civilian and military firefighters were exposed to this PFAS type.

Liver damage caused by exposure to PFAS chemicals may be associated with non-alcoholic fatty liver disease (NAFLD). Results from a study that included 1420 participants found suggestive evidence that PFAS exposure may be associated with the development of NAFLD. In a study published in JHEP Reports in May 2023, higher serum PFAS was associated with worse liver function and increased risk of fatty liver disease.

The effects of chemicals found in AFFF: How does PFAS affect liver health?

PFAS is an endocrine-disrupting chemical, which means it interferes with our hormones. Because of its chemical structure, PFAS mimics fatty acids and activates the receptors, which fatty acids do, thus leading to the accumulation of fat and liver inflammation. In addition to ALT, PFAS exposure is linked to other biomarkers of fatty liver disease, such as triglycerides, cholesterol, and uric acid. A recent study from JHEP Reports suggests that high levels of perfluorooctane sulfonate (PFOS) in blood lead to metabolic changes in the liver. The presence of PFOS increases the risk of developing liver cancer by affecting fat metabolism and driving the deposition of fat in the liver. The most common symptoms of liver damage include:

• Yellow discoloration of the skin, the white part of the eyes
• Abdominal swelling
• Pain in the upper right part of the abdomen
• Itchy skin
• Fatigue
• Loss of appetite

File your AFFF exposure claim with the help of our legal team

We encourage all civilian and military firefighters who have been diagnosed with liver cancer due to AFFF exposure to contact us. Our attorneys can help you, starting with a free case evaluation.

To start the legal process, you must evaluate your AFFF exposure history through your military records (for military firefighters) and employment records (for civilian firefighters). You must also retrieve your health records stating your liver cancer diagnosis. ELG attorneys will evaluate your documents and determine whether you can file a claim.