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. PFAS are associated with deleterious health endpoints, including kidney and testicular cancer, thyroid disease, increased cholesterol levels, lowered immune response, reproductive harm, and developmental delays, even at low levels of exposure (7)
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Agencies including the Michigan DOT, Minnesota DOT, and New Hampshire DOT are navigating PFAS-related issues at significant expense. Situ         ations include the following: •	 DOT-owned legacy sites contaminated with PFAS; •	 Road construction and improvement through soil and groundwater impacted by PFAS from aerial deposition, stormwater runoff, and groundwater migration; •	 Increased assessment and analytical costs for soils to be graded, cut, or excavated; •	 Storage and disposal of spoil materials from roadway maintenance in areas with PFAS aerial deposition; •	 PFAS being found in dewatered construction groundwater, in excess of the requisite parts per trillion treatment goals; and •	 Landfill testing requirements and restrictions leading to increased transportation and disposal costs.
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First, an extensive literature review on PFAS provided the initial understanding of the current state of research and practice regarding the identification and mitigation of the effects of PFAS on highway construction projects and maintenance operations. The existing literature and previous discussions with DOTs assisted with the development of the survey questionnaire.
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6   Practices to Identify and Mitigate PFAS Impacts on Highway Construction Projects and Maintenance Operations •	 Chapter 3 summarizes the survey results, •	 Chapter 4 provides the case example selection criteria and interviews with DOTs selected based on their procedures for identifying and mitigating PFAS contamination, •	 Chapter 5 draws conclusions based on findings in previous chapters, •	 Appendix A contains the survey questionnaire for state DOTs, •	 Appendix B contains the results of the survey questionnaire, and •	 Appendix C contains the case example interview questions.
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