Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), known as the most detected per- and polyfluoroalkyl substances (PFAS) in various environmental compartments, have been associated with plastic pollution and endocrine dysfunction. Over the past 180 years (1839–2019), numerous emerging contaminants have been identified, with PFOA and PFOS receiving considerable attention based on scientific evidence and publications. Between 2018 and 2019, PFOA and PFOS experienced a relatively high increase rate of 18.8% and 13.6%, respectively. While developed countries have made progress in establishing stringent guidelines, developing and underdeveloped countries often lack regulations and mechanisms to address emerging PFAS. Furthermore, advancements in PFAS removal technologies are needed to improve their efficacy and feasibility. The establishment of regulatory compliances, along with exposure assessment and risk characterization, is essential for providing precautionary advice on water source protection, water supply security, health risks, treatment efficiency, and contamination forecasting. However, a more comprehensive approach and database for evaluating exposure and risks are still imperative to effectively combat PFAS contamination in drinking water. Therefore, this review aims to enhance environmental monitoring and management practices in response to the global crisis of PFAS contamination. The analysis of Needs, Approaches, Benefits, and Challenges (NABC) is grounded in the current trends of PFAS in the environment and human exposure through drinking water.

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals that have been widely utilized in various industries since the 1940s, and have now emerged as environmental contaminants. In recent years, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have been restricted and replaced with several alternatives. The high persistence, bioaccumulation, and toxicity of these substances have contributed to their emergence as environmental contaminants, and several aspects of their behavior remain largely unknown and require further investigation. The trace level of PFAS makes the development of a monitoring database challenging. Additionally, the potential health issues associated with PFAS are not yet fully understood due to ongoing research and inadequate evidence (experimental and epidemiological studies), especially with regard to the combined effects of exposure to PFAS mixtures and human health risks from drinking water consumption. This in-depth review offers unprecedented insights into the exposure pathways and toxicological impacts of PFAS, addressing critical knowledge gaps in their behaviors and health implications. It presents a comprehensive NABC-Needs, Approach, Benefits, and Challenges-analysis to guide future strategies for the sustainable monitoring and management of these pervasive environmental contaminants.