Serum Levels of Perfluoroalkyl Substances (PFAS) in Adolescents and Young Adults Exposed to Contaminated Drinking Water in the Veneto Region, Italy: A Cross-Sectional Study Based on a Health Surveillance Program

Abstract

BACKGROUND: In spring 2013, groundwater of a vast area of the Veneto Region (northeastern Italy) was found to be contaminated by perfluoroalkyl substances (PFAS) from a PFAS manufacturing plant active since the late 1960s. Residents were exposed to high concentrations of PFAS, particularly perfluorooctanoic acid (PFOA), through drinking water until autumn 2013. A publicly funded health surveillance program is under way to aid in the prevention, early diagnosis, and treatment of chronic disorders possibly associated with PFAS exposure. OBJECTIVES: The objectives of this paper are: a) to describe the organization of the health surveillance program, b) to report serum PFAS concentrations in adolescents and young adults, and c) to identify predictors of serum PFAS concentrations in the studied population. METHODS: The health surveillance program offered to residents of municipalities supplied by contaminated waterworks includes a structured interview, routine blood and urine tests, and measurement of 12 PFAS in serum by high-performance liquid chromatography-tandem mass spectrometry. We studied 18,345 participants born between 1978 and 2002, 14-39 years of age at recruitment. Multivariable linear regression was used to identify sociodemographic, lifestyle, dietary, and reproductive predictors of serum PFAS concentrations. RESULTS: The PFAS with the highest serum concentrations were PFOA [median 44:4 ng=mL, interquartile range (IQR) 19.3-84.9], perfluorohexanesulfonic acid (PFHxS) (median 3:9 ng=mL, IQR 1.9-7.4), and perfluorooctanesulfonic acid (PFOS) (median 3:9 ng=mL, IQR 2.6-5.8). The major predictors of serum levels were gender, municipality, duration of residence in the affected area, and number of deliveries. Overall, the regression models explained 37%, 23%, and 43% of the variance of PFOA, PFOS, and PFHxS, respectively. CONCLUSIONS: Serum PFOA concentrations were high relative to concentrations in populations with background residential exposures only. Interindividual variation of serum PFAS levels was partially explained by the considered predictors.

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

“…The study consist of 16,224 individuals aged 20-39 years recruited in the health surveillance program offered to the community of Veneto Region who was exposed for several decades to PFAS via drinking water distributed by contaminated public waterworks. The health surveillance program has been described in more detail elsewhere [6]. In brief, the target population was initially constituted by people born between 1951 and 2002 and residing in the municipalities where were identi ed as in the area served by PFAS-contaminated waterworks.…”

“…Smoking status was subdivided into current smokers, previous smokers and non-smokers. Degree of physical activity (Light, Moderate, or Heavy) was de ned based on an algorithm that combined information reported by the subject on intensity, duration, and frequency of all types of physical activity practiced during the week [6]. Countries of birth were classi ed in two categories based on geographical areas including: Italy plus other Highly Developed Countries, and High Migratory Pressure Countries.…”

“…Consequently, human exposure to PFAS is widespread and mainly occurs through ingestion of contaminated food and dust [2]. Drinking water has been identi ed as a major source of exposure for many populations living near industrial and contaminated sites [3][4][5][6].…”

“…Groundwater of a vast area of the Veneto Region (north-eastern Italy) was found to be contaminated by PFAS from a manufacturing plant active since the late 1960s. Residents were exposed to high concentrations of PFAS, particularly per uorooctanoic acid (PFOA) through drinking water, until autumn 2013 [6]. A publicly funded health surveillance program is established to aid in the prevention, early diagnosis, and treatment of chronic disorders possibly associated with PFAS exposure.…”

Perfluoroalkyl Substances Are Associated With Elevated Blood Pressure and Hypertension in Highly Exposed Young Adults

“…Serum concentrations of twelve PFAS were measured by HPLC MS/MS (Shimadzu UFLC XR 20 Prominence coupled to Sciex API 4000): per uorooctanesulfonate (PFOS), per uorooctanoic acid (PFOA), per uorohexanesulfonic acid (PFHxS), per uorononanoic acid (PFNA), per uoroheptanoic acid (PFHpA), per uorobutanesulfonic acid (PFBS), per uorohexanoic acid (PFHxA), per uorobutanoic acid (PFBA), per uoropentanoic acid (PFPeA), per uorodecanoic acid (PFDeA), per uoroundecanoic acid (PFUnA), and per uorododecanoic acid (PFDoA). Details of the analytical method have been described elsewhere [6].…”