Abstract
BACKGROUND AND AIM: Elevated serum levels of the persistent perfluoroalkyl acids (PFAAs); perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS) and perfluorooctane sulfonate (PFOS) have been reported in firefighters who have used aqueous film-forming foam in occupational practices. The aim of the present investigation was to examine the association between potential health outcomes and serum concentrations of these three PFAAs, as well as perfluorooctanoic acid (PFOA), also frequently detected in human serum, in Australian firefighters. METHODS: The relationship between PFAA serum concentration and cardiovascular disease, kidney-, liver- and thyroid function (assessed as biochemical marker serum concentrations, as well as self-reported health conditions), were assessed cross-sectionally in 782 firefighters. The relationships between PFAAs and biomarkers for cardiovascular disease and kidney function were further assessed longitudinally in a subset of the firefighters, where serum measurements were available from two timepoints, approximately five years apart (n=<130). RESULTS: Increasing levels of one or several PFAAs were significantly associated with increasing levels of biomarkers for cardiovascular disease (total-cholesterol, and LDL-cholesterol), and biomarkers for kidney (urate) and thyroid function (TSH), in the cross-sectional analysis. However, increasing levels of PFAAs were not associated with biomarker levels outside the clinical reference values, or associated self-reported health conditions. No significant relationships were observed in the longitudinal analysis. CONCLUSIONS: PFAAs may alter the homeostasis of several biomarkers. Further research is needed to determine if the associations observed in the present investigation are causal and if they are of clinical significance. KEYWORDS: Occupational Exposure Outcome Assessment Biomarkers Cholesterol Uric Acid
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