Spotting early symptoms of PFAS toxicity in railroad workers

Detecting early warning signs can help you obtain medical attention and document any changes in your health if you later develop cancer or a chronic illness.

Elevated cholesterol and metabolic disruption

One of the most consistently reported early signals of PFAS exposure is changes in blood lipid profiles. Large population studies using NHANES data have found associations between PFAS exposure and higher total cholesterol and HDL levels, as well as increases in LDL cholesterol. These changes can occur before overt disease and matter because high cholesterol is a risk factor for cardiovascular disease, which may be an early metabolic response to long-term PFAS accumulation.

If you have a history of AFFF exposure, get regular lipid panels including total cholesterol, LDL, HDL, and triglycerides as part of routine check-ups. An increase in cholesterol levels without explanation, especially if you follow a healthy diet and exercise regularly, could indicate you have been exposed to occupational chemicals.

Thyroid and hormonal disruption

It has been shown that PFAS can interfere with thyroid hormone regulation. It has been shown that PFAS mixtures disrupt thyroid hormones, including TSH, especially with time as exposure accumulates. Thyroid dysfunction often presents early with fatigue, weight changes, mood shifts, cold intolerance, or hair changes. These symptoms may be subtle before a full clinical disease diagnosis.

Ask your clinician for TSH testing, and possibly T4 and T3 testing, if you experience unexplained fatigue or metabolic symptoms. Many railroad workers dismiss these symptoms as normal aging, but when combined with documented AFFF exposure history, they can indicate PFAS-related thyroid disruption.

Liver stress and enzyme elevations

PFAS accumulate in the liver and may cause subclinical liver dysfunction before symptoms become obvious. Public health summaries note that PFAS exposure is associated with altered liver enzyme levels, including ALT and AST, which are markers clinicians use to detect liver stress. Persistent liver stress can precede conditions like non-alcoholic fatty liver disease or other chronic hepatic conditions.

Include liver function tests such as ALT, AST, and GGT in regular health screenings if you have long-term PFAS exposure. Elevated liver enzymes without other explanation, such as alcohol use or viral infection, should prompt discussion about occupational chemical exposure.

Immune system effects

The early changes in the immune system may be subtle, but they are measurable. It has been shown that exposure to PFAS can reduce antibody responses to certain vaccines and potentially dampen immune responses. Having a weakened immune system can lead to more frequent or prolonged infections.

Pay attention to patterns such as frequent colds, a slow recovery from illness, or a poor response to routine vaccinations. If you notice you're getting sick more often than coworkers or family members, or that minor infections linger longer than expected, mention your AFFF exposure history to your doctor.

Fatigue and non-specific symptoms

There is no specific cause of fatigue, but it is commonly associated with metabolic and endocrine dysfunctions. Low energy and persistent fatigue are often early symptoms of thyroid dysfunction, immune suppression, and metabolic stress caused by PFAS exposure. Because these symptoms are common in the general population, combining them with exposure history, such as decades of AFFF use or high PFAS body burden, strengthens the clinical suspicion of PFAS-related health impacts.

Don't dismiss persistent fatigue as simply getting older. The presence of fatigue along with other symptoms of exposure to PFAS, such as elevated cholesterol, thyroid changes, or immune problems, may indicate that the chemicals have developed systemic effects.

When to seek medical evaluation

Railroad workers who have been exposed to PFAS and AFFF may need routine blood tests, including lipid panels, liver function tests, and thyroid panels. Infection patterns and vaccine responses should be discussed in relation to your immune function history. Document any occupational exposures to AFFF, contaminated drinking water near rail yards, or environmental testing results from facilities where you worked.

A 2022 expert panel recommended PFAS blood testing for people with high exposure levels, as well as regular monitoring if PFAS levels are associated with health problems.

Why early detection matters for your health and legal rights

The detection of early signs of PFAS toxicity can lead to lifestyle and medical interventions that reduce secondary risks, such as aggressive cholesterol management. Early detection of exposure-related health changes facilitates timely documentation necessary to monitor workers' health and file claims under the Federal Employees Liability Act.

The risk of complications can be reduced if you routinely screen for conditions that have established associations, such as thyroid disorders and metabolic problems.

ELG Law can help you file your FELA claim

We can help you pursue compensation under the Federal Employers' Liability Act if you have developed PFAS toxicity symptoms or have been diagnosed with more serious conditions after railroad work involving AFFF. For over 35 years, we've been representing victims affected by toxic exposure. In order to file your claim, you will need employment records documenting your railroad AFFF exposure and medical records showing your symptoms and diagnoses. Contact us today to learn how early symptom documentation can benefit you.