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Co-Exposure to PFAS and Flame Retardants & Risk for Thyroid Disease

Award Number: R01ES038183
ORGANIZATION: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/20/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2031

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Co-Exposure to PFAS and Flame Retardants & Risk for Thyroid Disease - Abstract An estimated 12% of the US population will develop a thyroid disease during their lifetime, and 60% of individuals with thyroid disease are unaware of their condition. Individuals with undiagnosed thyroid disease are at a significantly higher risk of cardiovascular disease, osteoporosis, infertility and cancer. While there are likely multiple contributing factors to thyroid disease, some studies suggests that environmental exposures may be a critical driver. Exposure to per- and polyfluoroalkyl substances (PFAS) and flame retardants (FRs) have both separately been associated with changes in thyroid hormone levels and increased risk for thyroid disease. Firefighters are a vulnerable population with elevated exposure to both PFAS and FRs compared to the general population, potentially increasing their risk for thyroid dysfunction and disease, though studies remain limited. Our prior research, along with published studies, highlights a critical need to investigate chemical exposures in the fire service and risk for thyroid disease. We have shown that higher PFAS blood levels in firefighters have been linked to changes in miRNA pathways associated with thyroid health, including autoimmune thyroid conditions, thyroid cancer, and hormone regulation. Additionally, a recent study found an unusually high proportion of firefighters that were positive for thyroid antibodies, a known risk factor for thyroid disease. We hypothesize that co-exposure to PFAS and FRs will result in significant changes in thyroid hormone levels, and development of thyroid antibodies, ultimately elevating the risk of developing thyroid disease. We propose to test this hypothesis among 400 firefighters currently enrolled in the National Firefighter Cancer Cohort Study (FFCCS) using archived and prospective samples. This study will first examine predictors of PFAS and FR exposure among firefighters to identify exposure sources and help develop exposure mitigation strategies. Additionally, we will investigate associations between blood PFAS and FR levels with thyroid hormone levels, and with thyroid antibodies using longitudinal data collection while examining differences by sex and age. We plan to prospectively follow individuals in the FFCCS cohort to determine if they are diagnosed with thyroid disease in the future (after 5 years). Our long-term research goal is to elucidate the impact of chronic co-exposure to contaminants on thyroid disease risk and assist firefighters in developing strategies and policies to mitigate exposures and live longer and healthier lives.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $784,621 )
2026	2026	DUKE UNIVERSITY	2200 W MAIN ST	DURHAM	NC	27705	DURHAM	USA	Environmental Health	000	1	8/20/2026	NEW	$784,621
														Subtotal = $784,621

Grand Total All Awards = $784,621

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Co-Exposure to PFAS and Flame Retardants & Risk for Thyroid Disease

Award Number: R01ES038183

ORGANIZATION: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/20/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2031

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