Nonstick Pans: The Convenience Is Not Worth the Risk

Ultimately, we are trading possible cancer or other long term health problems for a way to keep eggs from sticking in the pan. Is this a trade you are willing to make?

A couple of years ago, we got rid of all our nonstick cookware, including a skillet or two, a rice cooker, and some assorted bakeware. I’ll be honest, I was prompted to do so by this fairly horrifying investigative journalism series by the hard-hitting researchers at the online magazine The Intercept.

The nonstick chemicals are part of a class of substances known as perfluorinated compounds (PFCs). These chemicals are 100% synthetic, and their name comes from the fact that fluorine atoms have been chemically substituted for a hydrogen atoms along the carbon chain of carboxylic acid. They are used in the manufacture of such extremely common substances as nonstick coating on cookware, the lining of microwave popcorn bags and fast-food wrappers, and stain resistant coatings applied to furniture and carpets.

DuPont, the manufacturer of Teflon, recently settled a lawsuit for $671 million regarding  pollution of the water supply from a Teflon-manufacturing plant in West Virginia. Thousands of area residents who were sickened by PFOA (one type of PFC, and the chemical formerly used to make Teflon) sued for damages. DuPont was separately fined $16.5 million by the EPA for its knowing release of PFOA at the same site.

In the lawsuit, DuPont agreed not to contest the evidence that PFOA causes various cancers. In fact, DuPont’s own panel concluded that there was a probable link with six illnesses: kidney and testicular cancer, ulcerative colitis, thyroid disease, pregnancy-induced hypertension, and high cholesterol. An external review panel appointed by the FDA and a science panel funded by the DuPont settlement later declared that PFOA is a “likely” cause of cancer. For the backstory on the federal enforcement action and lawsuits, see here.

When I learned about the DuPont/Teflon lawsuits, I’d just had our daughter, and I resolved to minimize the potential for any further nonstick chemicals to enter her body through the food she ate, including my breastmilk. Further research led me to reduce my family’s exposure to other products made with chemicals in the same toxic class, including stainproofing and grease-resistant coatings.

In 2009, as a result of the information brought to light in the legal challenges, the Obama EPA issued a provisional (meaning non-enforceable) safe drinking water limit on PFOA (used to make Teflon) at 0.4 ppb (parts per billion) and for PFOS (used to make other coatings) at 0.2 ppb. In 2014, EPA started the process of implementing a permanent lower 0.1 ppb safe limit for PFOA, but never finalized it. The gist is that PFOA and PFOS are extremely toxic even at the tiniest imaginable doses. In light of the fact that our current EPA administrator’s stated goal is to dismantle the EPA, I’d hazard a guess that this limit will not be put in place anytime soon.

And even if it were? More recent research has shown that 0.1 ppb may be 333 times too high. A Harvard toxicologist and a U Mass cancer epidemiologist recently proposed a maximum safe limit of 0.001 ppb, which is 100 times lower than the limit the EPA was considering. An independent re-evaluation of their data determined that their numbers actually suggested an upper safe limit of 0.0003 ppb, which is a significant reduction.

In light of this new data, the Environmental Working Group received a large National Science Foundation grant to partner with Northeastern University to gain an idea of how pervasive PFOA and the other PFCs are in our nation’s water supplies. They’ve published an interactive map that citizens can use to evaluate their own risk of exposure through drinking water:

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What about the “official” line that Teflon is safe? The American Cancer Society’s evaluation of risk regarding Teflon and PFOA is fairly reserved. It states “there are no known risks to humans from using Teflon-coated cookware.” I emphasize “no known risks.” Let’s not forget unknown, or unproven risks.

And even despite this statement, the Cancer Society concedes that PFOA is present in “extremely small amounts” in Teflon cookware. A study showed that a residual 4-75 ppb of PFOA was present in Teflon cookware. Yes, that is an “extremely small amount.” Well, as the safety data have shown, an extremely small amount of PFOA is enough to make people sick, and this is why eventually, a safe drinking water limit of somewhere in the range of 0.001 ppb (a really, really “extremely small amount,” which is thousands of times lower than the residual amount found in Teflon) will be put in place.

Becoming a parent raised my level of concern and caution regarding chemical safety. The concept of the “body burden” for synthetic chemicals in our bodies has gained quite a bit of traction in the scientific literature, and in the media. This is the idea that many synthetic chemicals to which we are exposed remain in our bodies for various lengths of time, often up to years. American babies are widely exposed to a variety of chemicals through their mothers’ cord blood and later, through breastmilk and chemicals in the food they eat, the air and dust they breathe, the things they touch, and the water they drink.

This is worrisome for many reasons, chief among them that no studies have shown what effects most of the chemicals in production in the United States have on infants and children. Further, children are developing and changing rapidly, and this process relies on an incredibly complex web of hormonal signals and epigenetic responses. (Think it’s not that complex? Take a look at an endocrinology text sometime. It’s actually a mindblowingly immense body of chemical reactions, and science has yet to identify the vast majority of the body’s chemical signaling pathways.)

Endocrine disruption is one major way that a large class of synthetic chemicals, including the ‘nonsticks,’ interact within the body. My goal is to minimize as much as possible the chance that a synthetic chemical will derail some important pathway of growth and development in my daughter’s body.

The other major concern with the body burden concept is that fact that chemicals act in synergy — and no lab is testing these interactions. What this means in the real world is that the effect in the body of a single chemical may be negligible, but in combination with our underlying body burden of (potentially) hundreds of other chemicals, an unknown and harmful cascade of events leading to cancer or other illness is possible, or even likely.

The US CDC (Centers for Disease Control), has reported that four nonstick chemicals (PFOA, PFOS, PFHxS, and PFNA), are present in small amounts in nearly all of Americans tested, indicating widespread exposure to these nonstick chemicals in the U.S. population.

PFOA alone was found in nearly all the blood samples collected by the CDC. PFOA was used to make Teflon from the 1940s until 2015. Some, but not all, drinking water supplies are contaminated with PFOA (contamination has been found in about half of US states). The CDC surmises the potential routes of exposure are drinking water and contaminated food. If only a portion of our water supplies are contaminated, the remaining route is contaminated food. How else would food be contaminated except by our cookware or packaging? It defies logic to accept at face value the proposition that nonstick cookware is not a significant route of exposure.

Researchers are working on the mechanisms of toxicity, but for now, the PFCs are thought to cause disease by interfering with the “peroxisome proliferator-activator receptors, thyroid hormone system, fatty acid homeostasis and cell communication.” Again, not things I wish to expose a growing kid to.

So how can scientists find out whether chemicals are harmful?

Because it is obviously unethical to dose people with chemicals then wait to see what happens, we have at least two ways to design studies to try to get at that information. One way is to dose lab animals with those chemicals and see how they respond. There are weaknesses with this approach (other than the ethical questions around killing lots of animals to test yet another unnecessary chemical product). One in particular is that the metabolic and hormonal pathways of other mammals are far different from ours. We can draw some conclusions from animal studies, but I consider them weak evidence at best.

The other way is to do a population-level study based on questionnaires and blood samples. This type of study would take a large group of people, test their blood or other tissues to see what chemicals are present, ask questionnaires about many lifestyle factors, and see what illnesses they acquire over their lifetime. If the researchers are able to fully account for the other disease-causing factors in their lives, they might be able to draw out a conclusion that “x chemical contributes to y disease.”

I consider this form of evidence to be much stronger. But the problem with this second approach is that it takes decades, because so many diseases occur many years after the triggering event, such as toxic exposure.

People in our culture have a hard time, cognitively, with far-off event horizons. The fact that something may increase our risk for cancer or another illness 30 years down the line is hard for us to internalize and act upon. It is especially hard for us to understand, much less act upon, the newly emerging research showing that epigenetic changes induced by synthetic chemicals may be passed to our offspring.

Epigeneticists are now showing that toxic exposures in our lifetimes can increase the risk of disease in our children’s — and even our grandchildren’s — lives. This seems to me like a pretty good reason to start to think intergenerationally — to consider the effects of our actions seven generations into the future, and not risk our great-great-great-grandchildren’s health without absolute proof of safety.

This is why I advocate for the precautionary principle. In practice, this means that until you have proof something DOESN’T cause harm, you don’t use it. This is how, for example, the environmental regulatory agency of the EU (European Union) evaluates new chemicals.

In contrast, the chronically underfunded underdog in the US, the EPA (Environmental Protection Agency) does not even have a mandate to test all chemicals or require proof of safety before approving them for the consumer market. EPA, sadly, allows a chemical to hit the market so long as it has not been made aware of a potential for harm. One can certainly imagine lots of ways in which the EPA might never be made aware of internal company research showing evidence of harm — and in fact, multiple lawsuits have been filed to challenge exactly this sort of chemical industry coverup.

Although new laws may change this (if the current administration actually enforces them), the EPA does not require safety testing unless it already has evidence that a chemical causes harm. For a brand-new chemical, you can see it is unlikely this would ever be the case. (And the current administration is actively and openly planning to further defund and defang the EPA, and is also openly and actively reversing its Obama-era safety decisions with a literal wink and a grin to the CEOs of big chemical companies. See here and here for information on EPA’s recent and shocking reversal on chlorpyrifos, a devastating neurotoxin, including a letter written by the American Academy of Pediatrics, 66,000 pediatricians, urging the EPA to ban that pesticide from food use.)

Why is the EPA’s “approval” process insufficient? Several reasons:

  1. Manufacturers perform their own research on their chemicals. Their in-house scientists have an incentive to provide results that fail to show harm.
  2. The EPA does not have the budget or mandate to perform its own independent research on each chemical.
  3. The EPA accepts the manufacturers’ data at face value; that is, the EPA has no way to know if a manufacturer has failed to present all its studies for EPA review. Product testing results that show harm are often held back from EPA oversight. And again, under current protocols, unless the EPA already has evidence that a new chemical causes harm, it can’t require a manufacturer to submit safety data.
  4. American chemicals companies have a long and tawdry history of putting profit over consumer safety. Civil lawsuits and criminal enforcement have brought to light a record of truly egregious behavior. See here and here for just two examples among many.

There are some 85,000 synthetic chemicals in circulation in the US market. Due to the weak laws governing the chemical industry, a mere handful of them have been independently tested for safety.

I trust independent research showing that a product is safe over a mere lack of evidence of harm (even if honestly provided by a manufacturer, which seems unlikely) anytime. But even if we had an EPA that was fully funded and directed to perform its own independent research on chemical safety prior to approval, without applying the precautionary principle, that safety data would still not be completely reliable.

This is because the kinds of studies that can give us really good information on the long-term effects of a new chemical take decades to yield their data. And, unless those long-term studies can take into account the body burden, or synergies of multiple chemical exposures, then they are not giving us the whole picture.

In sum, I am extremely skeptical of recommendations based on government or industrial safety data. I have been a government employee myself, and I am aware that the vast majority of government professionals are goodhearted people who really did get into public service to do just that: serve the public. Unfortunately, their work is frequently defunded or ignored by higher-level policymakers, depending on the whim of the administration.

So, should you stop using your nonstick cookware? In my opinion, yes, absolutely, especially if you cannot prove that it was manufactured after 2015 (the year DuPont stopped using PFOA to make Teflon).

Even if you buy brand-new cookware, I am going to recommend that you do not buy any with a non-stick coating. Why is this? Well, it goes back to the chemical structure of PFCs, the overall class of perfluorinated chemicals that includes the nonstick chemicals.

The phased-out chemicals PFOA and PFOC are long-chain PFCs. This means that they consist of a carbon chain that is at least 8 carbons long. Attached to it is a series of fluorine atoms. (Carboxylic acid is reacted with hydrofluoric acid, and the hydrogen atoms on the carbon chain are replaced with fluorine atoms.)

The replacement of hydrogen atoms with fluorine gives the PFC molecules their hydrophobic quality: that is, they repel water. In addition, they repel fat, which is why they are used to make nonstick cookware and stain-resistant coatings.

The chemicals now being used instead of PFOA and PFOS differ only in that the carbon chain is shorter: 6 or fewer carbon atoms versus the 8 or more in the older compounds. The hydrophobicity (water-repelling) and lipophobicity (fat-repelling) properties of the molecules are not affected by the carbon-chain length; those properties are characteristics of the fluorination. This suggests that the factors which make the longer chain compounds harmful would remain unchanged in the shorter chain compounds. And, although limited research has started to appear showing that these new PFCs are also harmful to human health, the chemicals are just too new and there hasn’t been time to present a full range of research.

Starting in 2009, DuPont phased in a compound called GenX to replace PFOA in Teflon and other products it manufactures. Research already shows that this substitute is toxic to humans in some of the same ways as the earlier generation of PFCs. Indeed, in the last couple of months, the Cape Fear (North Carolina) Public Utility authority and a conservative advocacy group called Civitas have separately issued notices of intent to sue DuPont over contamination of North Carolina drinking water with GenX.

To me, the precautionary principle and the EPA’s abdication of  its responsibility toward the public (not to mention the manufacturers’ appalling record of lying and coverups) mandate that consumers make the choice NOT to expose their families to these new compounds until they have been throughly vetted with perhaps decades of data proving their safety.

So, I hope I’ve convinced you to get rid of your nonstick cookware. Don’t worry, there are alternatives. For pans, you can choose enamel-coated iron or high-quality stainless steel. With a good application of cooking fat, you will be able to cook most things without sticking. For baking, there are regular metal pans or inert silicon cake pans and muffin tins which are close to nonstick. I was able to find a rice cooker that has a stainless steel bowl, instead of Teflon.

There are other places PFCs lurk that you will probably want to take a look at too. A group of scientists recently called on “the international community to cooperate in limiting the production and use of PFASs [PFCs] and in developing safer nonfluorinated alternatives.” They recommended manufacturers stop using all PFCs, and recommended consumers stop buying “products containing, or manufactured using, PFASs [PFCs]. These include many products that are stain-resistant, waterproof, or nonstick.”

  • Fast food wrappers contain PFCs. The residue has been shown to soak into the food. One third of fast food wrappers tested contained PFCs.
  • Coated “gliding” dental flosses are typically coated with PTFE. For floss, I substitute a natural string floss coated with beeswax. It works just as well.
  • Microwave popcorn bags are coated with a grease-repellant that is made with PFCs. Pop it the old-fashioned way. It tastes better with olive oil and sea salt, and is better for you anyway!
  • Carpets, upholstery, and clothes that have been treated to be stain-resistant (with Scotchgard or something similar) contain PFCs. When you recarpet, you can choose one that is wool (naturally stain-resistant) or another carpet that has not been treated with stain repellants. Many furniture manufacturers now refrain from treating their upholstery with stain repellants, and the ones that do so typically advertise it!
  • Studies show household dust is a major source of toxic exposure, especially for kids, who are often down on the floor among the dust bunnies. Molecules of volatilized PFCs (and many other synthetic chemicals and toxic heavy metals) collect in your household dust. Dusting with a damp cloth and vacuuming regularly with a HEPA filter are effective ways to reduce this exposure route.
  • Finally, view the Northeastern University map for whether your drinking water might be contaminated. When reviewing the numbers, remember, research now suggests that a level of no more than 0.001 ppb in your drinking water is safe. If your water district shows numbers higher than this, you might want to consider a reverse osmosis filter for your drinking water.

Ultimately, we are trading possible cancer or other long term health problems (for us and our kids) for a way to make eggs stick less in the pan. Is this a trade you are willing to make?