Per- and polyfluoroalkyl substances (PFAS) occurrence and associations with dyslipidemia among community-based U.S. volunteer firefighters - PROJECT SUMMARY Per- and polyfluoroalkyl substances (PFAS) are biologically and environmentally persistent anthropogenic chemicals. Over 98% of the U.S. population has detectable levels of PFAS in their blood (serum). People may be exposed to PFAS through contaminated drinking water and food, house dust, or consumer products. Some populations may experience additional PFAS exposures from their jobs or hobbies. PFAS are of public health concern because of their associations with numerous adverse health outcomes including dyslipidemia, an imbalance of blood lipids such as high cholesterol. Dyslipidemia is a primary risk factor for ischemic heart disease (IHD), the leading cause of cardiovascular disease (CVD) in the U.S. and globally. Volunteer firefighters are community members who fill a critical public safety function, particularly in suburban and rural areas. Firefighters can be exposed to PFAS through combustion products, firefighting foams, and firefighter protective clothing. The association between PFAS exposure and dyslipidemia is of major concern in this population because cardiac events are the primary cause of line-of-duty deaths among all firefighters. However, the extent and pathways of volunteer firefighters’ PFAS exposures, and the ways these exposures may affect their blood lipid levels, are unknown. While 65% of the over 1 million U.S. firefighters are volunteers, they are understudied, creating critical knowledge gaps in evidence-based efforts to protect and improve the health of volunteer firefighters and the communities they serve. To address these gaps, we will leverage existing data from the Rutgers Firefighter Cancer Assessment and Prevention Study (CAPS), a cohort of volunteer firefighters from 8 U.S. states. This F31 fellowship builds upon the applicant’s preliminary work with CAPS data using pilot funding. Two specific aims will be used to achieve the objectives of identifying (a) predictors of serum PFAS concentrations including sociodemographic, firefighting, and occupational characteristics, and (b) associations between PFAS and lipid concentrations in volunteer firefighters. Aim 1: Assess the seroprevalence, predictors, and possible exposure sources of PFAS among U.S. volunteer firefighters. We hypothesize that heterogeneous distributions and concentrations of serum PFAS will be associated primarily with community-related exposure sources. Aim 2: Examine associations between serum PFAS and dyslipidemia among U.S. volunteer firefighters. We hypothesize that serum PFOA and PFOS (the most frequently detected and studied PFAS) will be positively associated with total cholesterol and LDL. We will also assess associations between less commonly studied PFAS and seven lipid measures. We will use single-pollutant and mixture models to characterize the effects of multiple simultaneous PFAS exposures. This work will advance our understanding of the health impacts of this environmental exposure in a critical population of community-based first responders.
