For members


PFAS pollution: What do people living in Denmark need to know?

The issue of pollution with chemicals known as PFAS has returned to the fore in Denmark after an expert said they did not agree with parts of government advice. What should people living across the country know about the problem?

PFAS pollution: What do people living in Denmark need to know?
Thousands of locations in Denmark are being tested for high levels of the PFAS group of chemicals. If water supplies are affected, local authorities must inform residents. Photo by Bluewater Sweden on Unsplash

What are PFAS? 

PFAS (per- and polyfluoroalkyl substances) are a large group of synthetic chemicals used in various products since the early 1950s. Their past uses include foam in fire extinguishers, food packaging and in textiles, carpets and paints. Also known as ‘forever chemicals’, they persist in water and soil and can cause harm to human health. 

Due to their chemical properties, they take a long time to break down and can be found in very low concentrations in blood samples from populations all over the world.

They are, however, unwanted in the environment because they have been found to have concerning links to health complications. Their use in materials which come into contact with foods, like paper and card, has been banned in Denmark since 2020.

PFAS have been linked to a series of health complications and, if ingested in high enough amounts, are suspected of causing liver damage, kidney damage, elevated cholesterol levels, reduced fertility, hormonal disturbances, weaker immune systems, negatively affecting foetal development and being carcinogenic.

Last year, high concentrations of PFOS, a subgroup of PFAS, were detected in waste water from a treatment plant at Korsør on Zealand, and later at a field where cattle had grazed.

That led to high levels of the substance being detected in 118 people who lived in the area.

The issue led to several locations across Denmark, mostly in the vicinity of fire service training locations, undergoing investigations for presence of the chemical.

In May, a report by the Danish Regions, the country’s regional health authorities, found that up to 14,607 places in Denmark are suspected of being contaminated by PFAS.

Who is dealing with the problem? 

On its website, the Danish Health Authority states that the responsibility for managing PFAS pollution is shared between several authorities including Regions, Municipalities, the Environmental Agency, the Veterinary and Food Administration, the Patient Safety Authority and the Danish Health Authority.

The tasks of these authorities include localising places with suspected PFAS pollution, finding the source of the contamination and bringing in relevant advice from other authorities; monitoring the levels of PFAS in water and food; giving appropriate health advice to local governments in areas where PFAS is found in local environments; and investigating possible health effects of PFAS exposure and offering the appropriate advice, investigations and treatment to members of the public.

You say there’s suspected PFAS pollution at 14,607 locations. What does this mean?

The Danish Regions in May said they had identified almost 15,000 locations across Denmark where there “could be” PFAS pollution.

The figure comes from “localities in the regions’ databases which have had an activity which can result in pollution with PFAS”. These include fire service exercises and locations used by industries such as waste disposal, iron and metal or wood and furniture.

The localities are “in an area where it can affect housing or important groundwater” the Regions said in a statement published on their website.

Each of the locations would have to be analysed and potentially cleansed, should PFAS contamination be confirmed, the Regions said, calling for a 100 million kroner state investment to pay for this.

Around 8 percent of the 15,000 locations had already been analysed as of May, with PFAS confirmed at around 900 places.

How does this affect drinking water?

“All waterworks in Denmark must be tested for PFAS, both in boreholes and in in the water that is sent out to people’s taps – this has been the case since 2015,” Susan Münster, director of Danske Vandværker, the industry organisation for Denmark’s water suppliers, told The Local in a written comment.

“From January 2022, the threshold values for four PFAS substances were changed [reduced, ed.] to two nanograms per litre,” she said.

Testing programmes are set out by local municipalities in accordance with national directives, and independent analysis companies carry out the tests, she explained.

“Both the water supplier and the municipality will be informed if thresholds are exceeded in connection with the testing,” Münster said.

The Environmental Agency stated in a September 2021 memorandum that municipal authorities, along with the Danish Patient Safety Authority, should assess potential health risks in water, if contamination is suspected. The safety authority should then advise municipalities, who should then inform residents of the situation and what actions they should take.

In other words, if your tap water is considered to be contaminated following testing, your local municipality is required to inform you.

Do I need to do anything? Should I stop drinking my tap water?

“Unless you specifically receive information from either the water supplier or the municipality telling you not to drink the local water, you can comfortably continue to drink water from the tap in Denmark,” Münster told The Local.

“But if you are pregnant or breastfeeding and, for example, live on an island, it may be a good idea to follow the advice of Professor Phillippe Grandjean,” she added, referring to senior researcher and professor of environmental medicine at the University of Southern Denmark, Philippe Grandjean.

Earlier this week, the Danish Health Authority said it had recalled an expert advice group for further consultation, following criticism of guidelines issued for pregnancy and breastfeeding following exposure to PFAS.

The guidelines are part of a broader set of advisories on PFAS exposure issued by the Danish Health Authority earlier this year.

The Health Authority faced criticism from experts for failing to go far enough with existing recommendations, which state there is not considered to be any cause to delay pregnancy or breastfeeding following exposure to PFAS.

That recommendation is incorrect, according to 14 experts which formed part of the group that advised the Health Authority on its recommendations.

“It seems completely wrong when our conclusion states that women exposed to PFAS can safely get pregnant and breastfeed. Because it’s not our view that there is scientific documentation for this,” Grandjean told TV2.

A number of political parties have called for blood tests to be offered to women considering pregnancy and breastfeeding if they live in areas where PFAS is detected above threshold levels.

Member comments

Log in here to leave a comment.
Become a Member to leave a comment.
For members


What exactly is wrong with the Danish health system?

The Danish government has implemented an emergency plan to improve the country's health system, which is currently under strain. But what exactly are the problems facing Denmark's health service and what is being done about it?

What exactly is wrong with the Danish health system?

What’s going on with the Danish health system?

The government in Denmark is trying to tackle a health system under pressure. Nurses are leaving the profession, waiting times for operations have increased by 50 percent over the last three years and there’s concern that soon patients’ health will be compromised.

“Perhaps we are actually seeing the end of the welfare society as we know it”, warned Kristian Antonsen, hospital director of Bispebjerg and Frederiksberg Hospital, earlier this year in the doctors’ journal Ugeskrift for Læger.

Jes Søgaard, professor of health economics at the University of Southern Denmark told The Local he believes there are four factors why the Danish health system is under pressure.

“Over the last ten years, there’s been increased patient pressure. The population is getting older and the budget hasn’t increased accordingly since 2016. Nurses are the ones who have especially felt the burden, with fewer nurses and an increasing number of patients.

“The second reason is the Covid-19 crisis. With additional patients, nurses felt they took a lot of the extra pressure. They often felt working conditions were unsafe, they didn’t have the necessary protection but also felt they were transferred to wards, for example intensive care, where they weren’t qualified and that created additional frustration among nurses. They feel underpaid.

“Thirdly, the nurses’ strike during the summer of 2021 created more tension,” Søgaard explained. 

Nurses began a strike over pay and working conditions in June 2021. A collective bargaining deal rejected by the nurses’ trade union DSR was eventually enforced by government intervention and a pay agreement was imposed. This then caused more nurses to leave the profession and there’s since been an increase in hospital waiting lists.

“A fourth factor could be the increasing number of patient referrals, especially among the elderly, that are complicated because the patient has more diseases than the one they’ve been referred for. This is time consuming, so over the last twelve months, the hospitals haven’t been able to cope with that demand and that creates tension in the population,” Søgaard said.

How bad is the situation?

“It’s bad. Not as bad as the NHS in the UK, but quite bad. This is not the time to have a stroke,” Søgaard said, referring to the number of therapy treatments that would be delayed.

Kjeld Møller Pedersen, professor of health economics and health policy at the University of Southern Denmark, told The Local he’s never seen the healthcare system so pressurised.

“Increased waiting lists, recruitment problems and in general the whole health system is very much stressed, from what I can recall, more than it’s ever been,” he said. 

But Pedersen added that patients should not be concerned about the quality of care they receive.

“The pressure is reflected in waiting times and lists but once you’re in hospital, you get sufficient care,” he said.

The Danish public health system guarantees patients an appointment within 30 days of referral. If this is not possible, the patient can be referred for private treatment. The guarantee was suspended during the coronavirus crisis but since it resumed, there has been a backlog, increased by the nurses’ strike.

In 2021, there were more than 180,000 patient referrals to private hospitals from the regional public health services. In 2020, the number was almost 148,000.

The 30-day treatment guarantee comes at an extra cost for hospitals and has also led to more staff moving to private care, Pedersen warned.

“I think the government is hoping the increased use of private hospitals to carry out procedures is what will save them and is what may reduce the waiting lists,” he added.

Healthcare system Denmark

Ditte Hammer works at Bispebjerg and Frederiksberg Hospital. Nurses say they are increasingly pressured and also have to spend time on non-professional tasks such as emptying the dishwasher and cleaning. Photo: Asger Ladefoged/Ritzau Scanpix

What can be done?

According to both Søgaard and Pedersen, a solution to the staff shortage is essential to addressing the health system’s problems.

“In my mind, the real bottle neck is manpower. There’s a shortage of nurses and in particular specialised nurses in intensive care and anaesthesia and it’s this that is causing a waiting list for operations,” Pedersen explained to The Local.

There is currently a shortage of around 5,000 nurses, according to the Danish Nursing Council (DSR), the trade union for nurses in Denmark.

“We have seen a drop in productivity between six and seven percent in 2022 compared to 2019, on top of staff shortage. This is because experienced nurses have left and been replaced by young nurses or nursing assistants.

“The only way to solve this in the short-run, is to get the experienced nurses back and the only motivation for this, is raising salaries by 5,000 kroner, including pension. Nurses want to get to 43,000 kroner a month,” Søgaard explained.

Pedersen agrees that increased salaries will help recruit more nurses but said the solution is not simple.

“The government has used the term ’emergency plan’ to rectify what is happening at the moment, such as increasing recruitment, promising economic gain if nurses come back to the profession and increasing the capacity for training nurses to become specialised in anaesthesia and intensive care.

“Some nurses have moved into the private health sector with better conditions, others have left the health profession entirely and they are very difficult to get back. The stumbling block is salary and it’s difficult to increase nurses’ wages and not do the same for midwives, physiotherapists, nurse assistants.

“However, the number of nurses in [care] homes and those assisting GPs in the municipalities is increasing. This is because they are not plagued by the 24-hour requirement to be on rota. Working conditions are also just as important as pay,” Pedersen said.

There were 18 percent fewer applicants entering nursing training programmes last year compared to 2019, according to Ministry of Education admission figures. The national organisation for municipalities, KL, estimates that by 2030, there will be a shortage of almost 16,000 social and healthcare assistants (Social og sundhedsassistent – SOSUs) across the country. 

Recruitment is also affecting mental health services, with a national shortage of psychiatrists. An average of one in four patients had their referrals to mental health services rejected in several of Denmark’s regions, according to reports last summer.

What’s the long-term solution?

The government has formed a ten-year plan costing four billion kroner a year to overhaul the mental health sector. 

A wider review of the whole healthcare system is planned for this year. During government coalition negotiations last December, the three parties – the Social Democrats, Liberals (Venstre) and Moderates – were unable to form a proposal for health service reforms so instead appointed a commission of experts to make recommendations by spring 2024.

The Moderates, led by Lars Løkke Rasmussen, previously said they wanted the the Danish Regions, the elected bodies which operate hospitals in Denmark’s five regions, to be scrapped in favour of a new system.

“At the moment we have five regions and in a sense they run healthcare, including the hospitals, doctor’s surgeries, office-based specialists. Then the municipalities provide home nursing, nursing homes and extra services,” Pedersen explained.

“The regions get funding from central government and block grants and they are controlled at an economic level very tightly. They have to stick to the budgets and it’s very difficult to get extra funding during a fiscal year,” Pedersen added.

Søgaard believes the regional system is effective because it takes local geographical needs into account and the fact that regional representatives are elected means the public interest is more likely to be voiced on their boards.

“The decentralised structure has been in Denmark for almost forever. We would never have a state-run system,” he said.

Whether a restructure of the heath system solves the current pressures, remains to be seen. In the meantime, the government will hope its short-term strategies are enough to avert a healthcare crisis.