When GenX contacts water, it releases the ammonium group to become HFPO-DA. Because HFPO-DA is a strong acid, it deprotonates into its conjugate base, which can then be detected in the water.
HFPO-DA was first reported to be in the Cape Fear River in 2012 and an additional eleven polyfluoroalkyl substances (PFAS) were reported 2014. These results were published as a formal paper in 2015. The following year, North Carolina State University and the EPA jointly published a study demonstrating HFPO-DA and other PFAS were present in the Wilmington-area drinking water sourced from the Cape Fear river.
GenX has been shown to cause a variety of adverse health effects. While it was originally marketed as a safer alternative to legacy PFAS, research suggests that GenX poses significant health risks similar to those associated with its predecessor.
Studies have demonstrated that the liver is especially vulnerable to GenX exposure. Animal research has shown that even low doses of GenX can cause liver enlargement and damage. Similarly, the kidneys are also sensitive to GenX, with chronic exposure leading to renal toxicity. These effects highlight the potential dangers of prolonged exposure to even small amounts of the chemical.
There is increasing concern about the carcinogenic potential of GenX. Research in animal models has linked exposure to various cancers, including liver, pancreatic, and testicular cancers. Although data on humans are limited, the results from these studies have prompted further investigation into the possible cancer risks posed by GenX.
Two 2023 studies have identified potential neurotoxic effects of GenX, particularly during critical developmental windows. Pre-differentiation exposure of human dopaminergic-like neurons (SH-SY5Y cells) to low-dose GenX (0.4 and 4 μg/L) resulted in persistent alterations in neuronal characteristics. The study reported significant changes in nuclear morphology, chromatin arrangement, and increased expression of the repressive marker H3K27me3, which is associated with neurodegeneration.
These changes were accompanied by disruptions in mitochondrial function and an increase in intracellular calcium levels, which are critical markers of neuronal health. Notably, GenX exposure led to altered expression of α-synuclein, a protein closely linked to the development of Parkinson's disease. The findings suggest that developmental exposure to GenX may pose a long-term risk for neurodegenerative disorders, particularly Parkinson's disease, due to its impact on key neuronal processes.
Recent research has also underscored the potential for GenX to disrupt glucose and lipid metabolism during critical developmental periods. A 2021 study published in Environment International investigated the effects of prenatal exposure to GenX in Sprague-Dawley rats, revealing significant maternal and neonatal adverse outcomes, such as increased maternal liver weight, altered lipid profiles, and reduced glycogen accumulation in neonatal livers, resulting in hypoglycemia. Additionally, neonatal mortality and lower birth weights were observed at higher doses of GenX .
A 2024 study in Science of the Total Environment expanded upon these findings in mice, demonstrating that gestational exposure to GenX led to increased liver weight, elevated liver enzyme levels (e.g., ALT and AST), and decreased glycogen storage capacity in the liver. Disruptions in gut flora and the intestinal mucosal barrier were also noted, further linking GenX exposure to hepatotoxicity.
Both studies revealed significant alterations in gene expression, particularly in pathways regulating glucose and lipid metabolism. Genes such as CYP4A14, Sult2a1, and Igfbp1 were upregulated, which may have long-term implications for metabolic health. These findings suggest that gestational GenX exposure could trigger metabolic disorders and liver toxicity, posing potential health risks for populations exposed to GenX through contaminated water sources .
Studies have demonstrated that exposure to GenX, a replacement for long-chain PFAS chemicals, can lead to complex health effects. GenX has been linked to alterations in immune responses and metabolic processes, as observed in both human and animal studies. For instance, in a study using Monodelphis domestica, GenX exposure upregulated genes associated with inflammation and fatty acid transport. Another study on mice showed that GenX suppressed innate immune responses to inhaled carbon black nanoparticles, while simultaneously promoting lung cell proliferation, including macrophages and epithelial cells. These findings suggest that GenX may have immunosuppressive effects, potentially increasing susceptibility to respiratory agents while encouraging cellular growth in the lungs, raising concerns about respiratory health risks.
This research highlights the potential health implications of GenX exposure, particularly its impact on immune system function and cell proliferation, which may contribute to both immune suppression and adverse health outcomes like inflammation or respiratory diseases. These findings raise concerns about the long-term impact on human health, especially in vulnerable populations.
In April 2024 EPA published final drinking water standards for GenX and five other PFAS compounds, pursuant to the Safe Drinking Water Act. The standards, enforced by EPA and state agencies, require all public water systems in the U.S. to monitor for GenX and treat their water, if necessary to meet the 10 ppt standard. EPA also announced the availability of grant funds to assist small and disadvantaged communities in testing for and treating PFAS contamination in their water systems.
"C3 Dimer Acid and PFAS". Chemours. Retrieved January 23, 2020. https://www.chemours.com/en/about-chemours/global-reach/fayetteville-works/fayetteville-works-toxicology
Beekman, M.; et al. (December 12, 2016). "Evaluation of substances used in the GenX technology by Chemours, Dordrecht" (PDF). National Institute for Public Health and the Environment (RIVM, The Netherlands). Retrieved July 23, 2017. https://www.rivm.nl/bibliotheek/rapporten/2016-0174.pdf
Hogue, Cheryl (February 12, 2018). "What's GenX still doing in the water downstream of a Chemours plant?". American Chemical Society (ACS). Retrieved August 21, 2019. https://cen.acs.org/articles/96/i7/whats-genx-still-doing-in-the-water-downstream-of-a-chemours-plant.html
Gillam, Carey (June 2, 2023). "Top US chemical firms to pay $1.2bn to settle water contamination lawsuits". The Guardian. Retrieved October 14, 2024. https://www.theguardian.com/environment/2023/jun/02/dupont-pfas-settlement-water-chemical-contamination
Rich, Nathaniel (January 6, 2016). "The Lawyer Who Became DuPont's Worst Nightmare". The New York Times. Archived from the original on January 6, 2016. Retrieved October 14, 2024. https://www.nytimes.com/2016/01/10/magazine/the-lawyer-who-became-duponts-worst-nightmare.html
"US EPA deems two GenX PFAS chemicals more toxic than PFOA". Chemical & Engineering News. Retrieved October 14, 2024. https://cen.acs.org/environment/persistent-pollutants/US-EPA-deems-two-GenX-PFAS-chemicals-more-toxic-than-PFOA/99/i40
"Fact Sheet: Human Health Toxicity Assessment for GenX Chemicals" (PDF). United States Environmental Protection Agency. March 2023. Retrieved October 14, 2024. https://www.epa.gov/system/files/documents/2023-03/GenX-Toxicity-Assessment-factsheet-March-2023-update.pdf
"Basic Information on PFAS". PFOA, PFOS and Other PFASs. Washington, D.C.: U.S. Environmental Protection Agency (EPA). February 18, 2018. https://www.epa.gov/pfas/basic-information-pfas
"GenX Frequently Asked Questions" (PDF). GenX Investigation. Raleigh, NC: North Carolina Department of Environmental Quality (NCDEQ). February 15, 2018. https://files.nc.gov/ncdeq/GenX/SAB/FAQ_updated_021518.pdf
Beekman, M.; et al. (December 12, 2016). "Evaluation of substances used in the GenX technology by Chemours, Dordrecht" (PDF). National Institute for Public Health and the Environment (RIVM, The Netherlands). Retrieved July 23, 2017. https://www.rivm.nl/bibliotheek/rapporten/2016-0174.pdf
"What is the difference between PFOA, PFOS and GenX and other replacement PFAS?". PFOA, PFOS and Other PFASs. EPA. February 18, 2018. https://www.epa.gov/pfas/basic-information-pfas#difference
"What is GenX? | Get the Facts". https://www.chemours.com/en/about-chemours/genx
Hogue, Cheryl (February 12, 2018). "What's GenX still doing in the water downstream of a Chemours plant?". American Chemical Society (ACS). Retrieved August 21, 2019. https://cen.acs.org/articles/96/i7/whats-genx-still-doing-in-the-water-downstream-of-a-chemours-plant.html
Beekman, M.; et al. (December 12, 2016). "Evaluation of substances used in the GenX technology by Chemours, Dordrecht" (PDF). National Institute for Public Health and the Environment (RIVM, The Netherlands). Retrieved July 23, 2017. https://www.rivm.nl/bibliotheek/rapporten/2016-0174.pdf
"DuPont GenX Processing Aid for Making Fluoropolymer Resins" (PDF). February 9, 2016. Archived from the original (PDF) on February 8, 2018. Retrieved August 21, 2019. https://web.archive.org/web/20180208165313/https://www.ozhz.nl/fileadmin/user_upload/2016-02-09_Brief_gedeputeerde_Janssen_en_beantwoording_vragen_BenW_Sliedrecht_over_historische_PFOA-emissies_Chemours_voorheen_Dupont_de_Nemours_bijlagen__nazending_2_.pdf
Hogue, Cheryl (February 12, 2018). "What's GenX still doing in the water downstream of a Chemours plant?". American Chemical Society (ACS). Retrieved August 21, 2019. https://cen.acs.org/articles/96/i7/whats-genx-still-doing-in-the-water-downstream-of-a-chemours-plant.html
"N.C. drinking water tainted with chemical byproduct for decades?". CBS News. June 26, 2017. https://www.cbsnews.com/news/wilmington-nc-cape-fear-river-water-tainted-genx-dupont-chemours/
Strynar, Mark J.; Dagnino, Sonia; Lindstrom, Andrew; Andersen, Eric; Mcmillan, Larry; Thurman, Michael; Ferrer, Imma; Ball, Carol (2012). Identification of novel polyfluorinated compounds in natural waters using accurate mass TOFMS. SETAC. Long Beach, CA – via ResearchGate. https://www.researchgate.net/publication/358128921
Strynar, Mark J.; McMahen, Rebecca; Liang, Shuang; Dagnino, Sonia; Lindstrom, Andrew; Andersen, Erik; McMillan, Larry; Thurman, Michael; Ferrer, Imma; Ball, Carol (November 9–13, 2014). Determination of perfluoroalkyl ether carboxylic acids (PFECAs) and sulfonic acids (PFESAs) in North Carolina surface water using high resolution mass spectrometry. SETAC. Vancouver, BC – via ResearchGate. https://www.researchgate.net/publication/358128738
McCord, James; Strynar, Mark (May 7, 2019). "Identification of Per- and Polyfluoroalkyl Substances in the Cape Fear River by High Resolution Mass Spectrometry and Nontargeted Screening". Environmental Science & Technology. 53 (9): 4717–4727. Bibcode:2019EnST...53.4717M. doi:10.1021/acs.est.8b06017. ISSN 0013-936X. PMC 7478245. PMID 30993978. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478245
Sun, Mei; Arevalo, Elisa; Strynar, Mark; Lindstrom, Andrew; Richardson, Michael; Kearns, Ben; Pickett, Adam; Smith, Chris; Knappe, Detlef R. U. (December 13, 2016). "Legacy and Emerging Perfluoroalkyl Substances Are Important Drinking Water Contaminants in the Cape Fear River Watershed of North Carolina". Environmental Science & Technology Letters. 3 (12): 415–419. Bibcode:2016EnSTL...3..415S. doi:10.1021/acs.estlett.6b00398. /wiki/Bibcode_(identifier)
"GenX Timeline". NCDEQ. Archived from the original on December 24, 2018. Retrieved April 22, 2018. https://web.archive.org/web/20181224080952/https://deq.nc.gov/news/hot-topics/genx-investigation/genx-timeline
Clabby, Catherine (November 2, 2017). "Newest GenX Lawsuit Attacks DuPont Science". Chapel Hill, NC: North Carolina Health News. https://www.northcarolinahealthnews.org/2017/11/02/newest-genx-lawsuit-attacks-dupont-science/
"PFAS - Cape Fear River Watch". September 20, 2019. https://capefearriverwatch.org/genx/
Alder, Cole (May 16, 2018). "Cape Fear River Watch to file suit against Chemours". Per- and Polyfluoroalkyl Substances; News. Boston, MA: Northeastern University, Social Science Environmental Health Research Institute. https://pfasproject.com/2018/05/16/cape-fear-river-watch-to-file-suit-against-chemours/
"PFAS - Cape Fear River Watch". September 20, 2019. https://capefearriverwatch.org/genx/
"Consent Order Compliance". https://www.chemours.com/en/about-chemours/global-reach/fayetteville-works/compliance-testing
"PFAS - Cape Fear River Watch". September 20, 2019. https://capefearriverwatch.org/genx/
"Str_Error_Page_Title". https://edocs.deq.nc.gov/WaterResources/DocView.aspx?id=611983&dbid=0&repo=WaterResources&searchid=627d7915-27f4-4e8b-beb3-ec53cd75941b
"Welcome to the GenX Exposure Study". GenX Exposure Study. North Carolina State University. Retrieved June 23, 2025. https://genxstudy.ncsu.edu/
Matheny, Keith (August 3, 2020). "Michigan's drinking water standards for these chemicals now among toughest in nation". Detroit Free Press. Archived from the original on January 31, 2022. Retrieved March 31, 2022. https://www.freep.com/story/news/local/michigan/2020/08/03/tougher-pfas-standards-drinking-water-michigan/5574268002/
"New state drinking water standards pave way for expansion of Michigan's PFAS clean-up efforts". Michigan.gov. August 3, 2020. Archived from the original on January 3, 2022. Retrieved April 5, 2022. https://www.michigan.gov/egle/0,9429,7-135--535602--,00.html
"Source of 'forever chemical' in the Roanoke River traced to Elliston plant". November 10, 2022. https://roanoke.com/news/local/source-of-forever-chemical-in-the-roanoke-river-traced-to-elliston-plant/article_e7953262-613e-11ed-baad-bb83787f5da8.html
Ahearn, Ashley (March 24, 2019). "A Regrettable Substitute: The Story of GenX". Podcasts: The Researcher's Perspective. 2019 (1). doi:10.1289/EHP5134. ISSN 2169-2181. https://doi.org/10.1289%2FEHP5134
"US EPA deems two GenX PFAS chemicals more toxic than PFOA". Chemical & Engineering News. Retrieved October 14, 2024. https://cen.acs.org/environment/persistent-pollutants/US-EPA-deems-two-GenX-PFAS-chemicals-more-toxic-than-PFOA/99/i40
"Fact Sheet: Human Health Toxicity Assessment for GenX Chemicals" (PDF). United States Environmental Protection Agency. March 2023. Retrieved October 14, 2024. https://www.epa.gov/system/files/documents/2023-03/GenX-Toxicity-Assessment-factsheet-March-2023-update.pdf
"Basic Information on PFAS". PFOA, PFOS and Other PFASs. Washington, D.C.: U.S. Environmental Protection Agency (EPA). February 18, 2018. https://www.epa.gov/pfas/basic-information-pfas
Caverly Rae, JM; Craig, Lisa; Stone, Theodore W.; Frame, Steven R.; Buxton, L. William; Kennedy, Gerald L. (2015). "Evaluation of chronic toxicity and carcinogenicity of ammonium 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)-propanoate in Sprague–Dawley rats". Toxicology Reports. 2: 939–949. Bibcode:2015ToxR....2..939C. doi:10.1016/j.toxrep.2015.06.001. PMC 5598527. PMID 28962433. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598527
Caverly Rae, JM; Craig, Lisa; Stone, Theodore W.; Frame, Steven R.; Buxton, L. William; Kennedy, Gerald L. (2015). "Evaluation of chronic toxicity and carcinogenicity of ammonium 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)-propanoate in Sprague–Dawley rats". Toxicology Reports. 2: 939–949. Bibcode:2015ToxR....2..939C. doi:10.1016/j.toxrep.2015.06.001. PMC 5598527. PMID 28962433. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598527
Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225
Zhang, Qin-Yao; Xu, Ling-Ling; Zhong, Mei-Ting; Chen, Yu-Kui; Lai, Ming-Quan; Wang, Qi; Xie, Xiao-Li (2024). "Gestational GenX and PFOA exposures induce hepatotoxicity, metabolic pathway, and microbiome shifts in weanling mice". Science of the Total Environment. 907. Elsevier BV: 168059. Bibcode:2024ScTEn.90768059Z. doi:10.1016/j.scitotenv.2023.168059. ISSN 0048-9697. PMID 37884144. /wiki/Bibcode_(identifier)
Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225
Xu, Ling-Ling; Chen, Yu-Kui; Zhang, Qin-Yao; Chen, Li-Jian; Zhang, Kai-Kai; Li, Jia-Hao; Liu, Jia-Li; Wang, Qi; Xie, Xiao-Li (2022). "Gestational exposure to GenX induces hepatic alterations by the gut-liver axis in maternal mice: A similar mechanism as PFOA". Science of the Total Environment. 820. Elsevier BV: 153281. Bibcode:2022ScTEn.82053281X. doi:10.1016/j.scitotenv.2022.153281. ISSN 0048-9697. PMID 35066053. /wiki/Bibcode_(identifier)
Xu, Ling-Ling; Chen, Yu-Kui; Zhang, Qin-Yao; Chen, Li-Jian; Zhang, Kai-Kai; Li, Jia-Hao; Liu, Jia-Li; Wang, Qi; Xie, Xiao-Li (2022). "Gestational exposure to GenX induces hepatic alterations by the gut-liver axis in maternal mice: A similar mechanism as PFOA". Science of the Total Environment. 820. Elsevier BV: 153281. Bibcode:2022ScTEn.82053281X. doi:10.1016/j.scitotenv.2022.153281. ISSN 0048-9697. PMID 35066053. /wiki/Bibcode_(identifier)
"FACT SHEET: GenX Chemicals Toxicity Assessment - March 2023 Update" (PDF). US EPA. Retrieved October 15, 2024. https://www.epa.gov/system/files/documents/2023-03/GenX-Toxicity-Assessment-factsheet-March-2023-update.pdf
Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225
Caverly Rae, JM; Craig, Lisa; Stone, Theodore W.; Frame, Steven R.; Buxton, L. William; Kennedy, Gerald L. (2015). "Evaluation of chronic toxicity and carcinogenicity of ammonium 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)-propanoate in Sprague–Dawley rats". Toxicology Reports. 2: 939–949. Bibcode:2015ToxR....2..939C. doi:10.1016/j.toxrep.2015.06.001. PMC 5598527. PMID 28962433. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598527
Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225
"What do researchers know about the health impacts of GenX?". WVTF. January 25, 2023. Retrieved October 13, 2024. https://www.wvtf.org/news/2023-01-25/what-do-researchers-know-about-the-health-impacts-of-genx
Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225
"What do researchers know about the health impacts of GenX?". WVTF. January 25, 2023. Retrieved October 13, 2024. https://www.wvtf.org/news/2023-01-25/what-do-researchers-know-about-the-health-impacts-of-genx
Wasel, Ola; King, Hanna; Choi, Youn J.; Lee, Linda S.; Freeman, Jennifer L. (November 9, 2023). "Differential Developmental Neurotoxicity and Tissue Uptake of the Per- and Polyfluoroalkyl Substance Alternatives, GenX and PFBS". Environmental Science & Technology. 57 (48). American Chemical Society (ACS): 19274–19284. Bibcode:2023EnST...5719274W. doi:10.1021/acs.est.3c05023. ISSN 0013-936X. PMC 11299994. PMID 37943624. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299994
Wu, Shichen; Xie, Junkai; Zhao, Han; Sanchez, Oscar; Zhao, Xihui; Freeman, Jennifer L.; Yuan, Chongli (2023). "Pre-differentiation GenX exposure induced neurotoxicity in human dopaminergic-like neurons". Chemosphere. 332. Elsevier BV: 138900. Bibcode:2023Chmsp.33238900W. doi:10.1016/j.chemosphere.2023.138900. ISSN 0045-6535. PMID 37172627. https://doi.org/10.1016%2Fj.chemosphere.2023.138900
Wu, Shichen; Xie, Junkai; Zhao, Han; Sanchez, Oscar; Zhao, Xihui; Freeman, Jennifer L.; Yuan, Chongli (2023). "Pre-differentiation GenX exposure induced neurotoxicity in human dopaminergic-like neurons". Chemosphere. 332. Elsevier BV: 138900. Bibcode:2023Chmsp.33238900W. doi:10.1016/j.chemosphere.2023.138900. ISSN 0045-6535. PMID 37172627. https://doi.org/10.1016%2Fj.chemosphere.2023.138900
Wu, Shichen; Xie, Junkai; Zhao, Han; Sanchez, Oscar; Zhao, Xihui; Freeman, Jennifer L.; Yuan, Chongli (2023). "Pre-differentiation GenX exposure induced neurotoxicity in human dopaminergic-like neurons". Chemosphere. 332. Elsevier BV: 138900. Bibcode:2023Chmsp.33238900W. doi:10.1016/j.chemosphere.2023.138900. ISSN 0045-6535. PMID 37172627. https://doi.org/10.1016%2Fj.chemosphere.2023.138900
Conley, Justin M.; Lambright, Christy S.; Evans, Nicola; McCord, James; Strynar, Mark J.; Hill, Donna; Medlock-Kakaley, Elizabeth; Wilson, Vickie S.; Gray, L. Earl (2021). "Hexafluoropropylene oxide-dimer acid (HFPO-DA or GenX) alters maternal and fetal glucose and lipid metabolism and produces neonatal mortality, low birthweight, and hepatomegaly in the Sprague-Dawley rat". Environment International. 146. Elsevier BV: 106204. Bibcode:2021EnInt.14606204C. doi:10.1016/j.envint.2020.106204. ISSN 0160-4120. PMC 7775906. PMID 33126064. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775906
Zhang, Qin-Yao; Xu, Ling-Ling; Zhong, Mei-Ting; Chen, Yu-Kui; Lai, Ming-Quan; Wang, Qi; Xie, Xiao-Li (2024). "Gestational GenX and PFOA exposures induce hepatotoxicity, metabolic pathway, and microbiome shifts in weanling mice". Science of the Total Environment. 907. Elsevier BV: 168059. Bibcode:2024ScTEn.90768059Z. doi:10.1016/j.scitotenv.2023.168059. ISSN 0048-9697. PMID 37884144. /wiki/Bibcode_(identifier)
Zhang, Qin-Yao; Xu, Ling-Ling; Zhong, Mei-Ting; Chen, Yu-Kui; Lai, Ming-Quan; Wang, Qi; Xie, Xiao-Li (2024). "Gestational GenX and PFOA exposures induce hepatotoxicity, metabolic pathway, and microbiome shifts in weanling mice". Science of the Total Environment. 907. Elsevier BV: 168059. Bibcode:2024ScTEn.90768059Z. doi:10.1016/j.scitotenv.2023.168059. ISSN 0048-9697. PMID 37884144. /wiki/Bibcode_(identifier)
Conley, Justin M.; Lambright, Christy S.; Evans, Nicola; McCord, James; Strynar, Mark J.; Hill, Donna; Medlock-Kakaley, Elizabeth; Wilson, Vickie S.; Gray, L. Earl (2021). "Hexafluoropropylene oxide-dimer acid (HFPO-DA or GenX) alters maternal and fetal glucose and lipid metabolism and produces neonatal mortality, low birthweight, and hepatomegaly in the Sprague-Dawley rat". Environment International. 146. Elsevier BV: 106204. Bibcode:2021EnInt.14606204C. doi:10.1016/j.envint.2020.106204. ISSN 0160-4120. PMC 7775906. PMID 33126064. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775906
Cao, Wenqi; Horzmann, Katharine; Schemera, Bettina; Petrofski, Myra; Kendall, Trisha; Spooner, Jennifer; Rynders, Patricia E.; VandeBerg, John L.; Wang, Xu (February 15, 2023). "Blood transcriptome responses to PFOA and GenX treatment in the marsupial biomedical model Monodelphis domestica". Frontiers in Genetics. 14. Frontiers Media SA. doi:10.3389/fgene.2023.1073461. ISSN 1664-8021. PMC 9974665. PMID 36873954. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9974665
Lee, Ho Young; You, Dorothy J.; Taylor-Just, Alexia J.; Linder, Keith E.; Atkins, Hannah M.; Ralph, Lauren M.; De la Cruz, Gabriela; Bonner, James C. (June 15, 2022). "Pulmonary exposure of mice to ammonium perfluoro(2-methyl-3-oxahexanoate) (GenX) suppresses the innate immune response to carbon black nanoparticles and stimulates lung cell proliferation". Inhalation Toxicology. 34 (9–10). Informa UK Limited: 244–259. Bibcode:2022InhTx..34..244L. doi:10.1080/08958378.2022.2086651. ISSN 0895-8378. PMC 9731146. PMID 35704474. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9731146
"FACT SHEET: GenX Chemicals Toxicity Assessment - March 2023 Update" (PDF). US EPA. Retrieved October 15, 2024. https://www.epa.gov/system/files/documents/2023-03/GenX-Toxicity-Assessment-factsheet-March-2023-update.pdf
"EPA Announces New Drinking Water Health Advisories for PFAS Chemicals, $1 Billion in Bipartisan Infrastructure Law Funding to Strengthen Health Protections". EPA. June 15, 2022. News release. https://www.epa.gov/newsreleases/epa-announces-new-drinking-water-health-advisories-pfas-chemicals-1-billion-bipartisan
"Drinking Water Health Advisories". EPA. June 15, 2022. https://www.epa.gov/sdwa/drinking-water-health-advisories-has
"Meaningful and Achievable Steps You Can Take to Reduce Your Risk". PFOA, PFOS and Other PFAS. EPA. August 18, 2022. https://www.epa.gov/pfas/meaningful-and-achievable-steps-you-can-take-reduce-your-risk
EPA (2024-04-26). "PFAS National Primary Drinking Water Regulation." Federal Register, 89 FR 32532 /wiki/Federal_Register
"Final PFAS National Primary Drinking Water Regulation". EPA. January 16, 2025. https://www.epa.gov/sdwa/and-polyfluoroalkyl-substances-pfas