Managing PFAS in Sewage Sludge: Exposure Pathways, Impacts, and Treatment Innovations.

Per- and polyfluoroalkyl substances (PFAS) are a global concern due to their persistence, ubiquity, and accumulation in living organisms. Found in soils, biosolids, water, and the food chain, they pose health risks such as hormone disruption, immune damage, reproductive issues, and cancer. Regulations mainly target older PFAS like PFOA and PFOS, while many newer PFAS, including breakdown products, are poorly understood in terms of distribution, behavior, and toxicity. To address this complex issue, this review offers a detailed overview of human exposure to PFAS and their toxic effects. It highlights biosolids as a key, understudied source of PFAS in the environment. The review also discusses limitations of testing, missing long-term cleanup data, and regulatory issues that neglect total exposure and vulnerable populations. Additionally, it evaluates, in the specific context of biosolids management, the effectiveness, scalability, benefits, and drawbacks of various treatment technologies, such as thermal processes (pyrolysis, incineration, smoldering combustion), advanced oxidation, adsorption, hydrothermal liquefaction, and biological degradation. This work combines environmental science, toxicology, and engineering to outline PFAS management in biosolids and proposes a research and policy plan. Focusing on regulating PFAS as a group, validating real-world results, and employing adaptable treatment strategies underscores the need for a coordinated, science-based effort to reduce PFAS risks worldwide.