To What Extent Are the Long-Term Effects of Polyfluoroalkyl Substances and Microplastics in Freshwater Used in American Cities?

Abstract

Polyfluoroalkyl substances (PFAS) and microplastics have become widespread contaminants in freshwater systems across the United States, raising major concerns about public health, water infrastructure, environmental sustainability, and economic resilience. To examine the long-term impacts of these persistent pollutants on freshwater resources used by American cities, this literature review combines findings from government reports, reviewed studies, and scientific review articles. The review explores how PFAS and microplastics enter freshwater systems via wastewater, landfills, industrial discharges, and other human-made sources. These molecules’ resistance to degradation allows them to bioaccumulate and affect human populations primarily through drinking water. Current evidence connects long-term PFAS exposure with immune dysfunction, endocrine disruption, thyroid diseases, kidney disease, developmental effects, and certain cancers, although the underlying biological mechanisms remain an active area of investigation. Beyond human health, the review analyzes how these contaminants disrupt freshwater ecosystems, move through aquatic food webs, and reduce biodiversity, which creates long-lasting ecological consequences. It also analyzes the socioeconomic challenges associated with contamination, including the need for expensive advanced water technologies, increased healthcare expenses, declining property values, aging infrastructure upgrades, and financial pressures on local governments. Finally, the review analyzes PFAS and microplastic contamination through a public policy and economic perspective, explaining how cleanup costs are often shifted from polluting industries to local governments and taxpayers. Altogether, the evidence shows that PFAS and microplastic contamination is a complex interdisciplinary challenge requiring continued scientific research, stronger regulatory policies, improved environmental monitoring, and sustainable management strategies to protect freshwater resources and public well-being.