Abstract P225: Association Between Perfluoralkyl Acids and Self-Reported Stroke or Cerebral Vascular Accident

Abstract

PFCs are a class of man-made compounds developed after WWII for use as plasticizers, wetting agents, and as emulsifiers during industrial manufacturing processes. Several lines of research suggest a direct and indirect role for PFCs in stroke and stroke outcome, including: detection in human brain tissue and cerebrospinal fluid and relationships to conditions known to affect stroke, including: homocysteine and blood pressure, thyroid function; immune function, and hypercholesterolemia. The C8 Health Project resulted from a pre-trial settlement of the class action lawsuit filed after PFOA was found to have infiltrated several local drinking water supplies along the mid-Ohio River valley. Final enrollment totaled 69,030 participants. We tested the hypothesis that PFCs were associated with self-reported stroke or cerebral vascular accident. The primary independent variables of interest were the serum concentrations (ng/mL) of 7 different PFCs (PFHxA, PFHS, PFHpA, PFOA, PFOS, PFNA, PFDA), partitioned into age and gender-specific quintiles. Covariates included in this analyses were: demographic; lifestyle / modifiable risk factors; and medical risk factors. We did not include race as a covariate (≥97% of C8 Health Project participants self-identified as white). The primary dependent variable of interest was self-reported stroke or cerebral vascular accident. In univariate analysis (ANOVA), PFHpA and PFOS levels were higher in participants with Stroke/CVA, but PFNA was lower in participants with Stroke/CVA. Results from logistic regression analysis are presented. For four of seven chemicals included in the analysis, there were statistically significant associations with prevalent Stroke/CVA. PFHxA was associated with increased prevalence of Stroke/CVA, whereas PFHS, PFOS, and PFNA were associated with a decreased prevalence of Stroke/CVA. Thus, results from this preliminary analysis support an associations between PFCs and prevalent Stroke/CVA that warrant further, more rigorous investigation.