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Open Access
Abstract Per- and polyfluoroalkyl substances (PFAS) are a human health concern associated with increased incidence of specific cancers, reproductive health eects, immune eects, and developmental eects on children, among other issues. One study found that 45% of municipal water in the U.S. contains at least ≥1 PFAS; according to the Centers for Disease Prevention and Control, nearly all people in the U.S. have measurable amounts of PFAS in their blood (U.S. Environmental Protection Agency, 2024a). Many people first turn to the internet for health- related questions. For public health communicators to successfully educate communities about PFAS exposure from water supplies, it is helpful to know what questions people are already asking online about PFAS. For this research, we used a search engine analytics tool called Semrush to identify common questions asked and to inform subsequent outreach messages. Using Semrush, we categorized the type of questions and search terms online that information seekers used related to PFAS in their water and ranked the questions and search terms based on search volume. Overall, the highest search volume was related to how to reduce risk for exposure to PFAS, followed by general questions about PFAS in water. These insights on search terms can help health professionals create informational resources tailored to address what people want to know about PFAS. Keywords: per- and polyfluoroalkyl substances, PFAS, human health concerns, public health communication, online search behaviors What People in the United States Are Asking About Per- and Polyfluoroalkyl Substances in Their Drinking Water Based on Online Search Behaviors
and Disease Registry, 2024), with previous research results finding that 97% to 100% of human blood samples tested contain PFAS (Lewis et al., 2015). Although there is a growing understand- ing of the sources of water contamination and how PFAS contaminants can aect the environment and personal health, large research gaps remain. Among the general public, awareness of personal exposure to PFAS remains low (Berthold et al., 2023), and little research has been conducted to identify best practices for communicating PFAS information to the public to improve awareness. Additionally, 85% of people in the U.S. rely on public water, and thus we focus this research on public exposure to PFAS from municipal water supplies (U.S. Geological Survey, 2019). Further, as press coverage and public interest in PFAS increase, people are searching for additional information about PFAS (Google Trends, n.d.). Given that individuals frequently use internet searches as an initial step to seek information about health threats (Powell et al., 2011), it is important to understand what PFAS-related search terms people might use so that outreach messages align with com- mon concerns as indicated by search terms (Kidd et al., 2019). In our study, we used Google search data to explore the use of PFAS-related keywords and questions by individuals conducting internet searches. Timothy E. Holland, MA Nelson Institute for Environmental Studies, University of Wisconsin–Madison Bret R. Shaw, PhD Department of Life Science Communication and Division of Extension, University of Wisconsin–Madison Rachel Hutchins, MSc Department of Communication Arts, University of Wisconsin–Madison Lyn M. van Swol, PhD Department of Communication Arts, University of Wisconsin–Madison Gavin K. Dehnert, PhD Wisconsin Sea Grant, Aquatics Science Center, University of Wisconsin–Madison
Introduction According to the U.S. Environmental Pro- tection Agency (U.S. EPA), there are nearly 15,000 per- and polyfluoroalkyl substances (PFAS), which are the synthetic chemicals that are widely used in many manufactured products and are highly resistant to break- down in the environment (National Institute
of Environmental Health Sciences, 2025; U.S. Environmental Protection Agency [U.S. EPA], 2024a). PFAS have a long half-life, are found ubiquitously in the environment, and have been linked to adverse human health eects (U.S. EPA, 2024b, 2025). Nearly all people in the U.S. have measurable amounts of PFAS in their blood (Agency for Toxic Substances
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Volume 88 • Number 1
https://doi.org/10.70387/001c.142101
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