Abstract
Background and Aim In 2013, high levels of perfluoroalkyl substances (PFAS) were identified in the drinking water of the Veneto region, Italy, primarily due to industrial emissions from a nearby PFAS manufacturer. For decades, the factory released wastewater into the ground, contaminating both surface water bodies and groundwater, mainly by perfluorooctanoic acid (PFOA), before charcoal filters were introduced. The groundwater contamination plume extends over 190 km2 and reached public waterworks serving 30 municipalities (roughly 130,000 inhabitants). This presentation will provide an overview of the Veneto health surveillance program and its impact. Methods The health surveillance program started in January 2017 and continues for the prevention, early diagnosis and treatment of chronic disorders possibly associated with PFAS. The target population included 105,000 residents of the contaminated area born between 1951 and 2014. Data are collected through a structured interview on socio-demographic characteristics, personal health history and lifestyle habits; routine blood and urine tests; and the measurements of 12 PFAS. The population is being recruited for a second round, which started in September 2020. Results By February 2022 55,597 individuals were recruited (60,5% of invited) in the 1st round, and 2,623 in the 2nd round. The PFAS with the highest serum concentrations was PFOA (median 36.8 ng/mL), about 20 times higher than in the Italian population with background exposures, followed by perfluorooctanesulfonic acid (PFOS) (median 3.8 ng/mL) and perfluorohexanesulfonic acid (PFHxS) (median 3.7 ng/mL). Conclusions This population is unique in that biomonitoring has been offered to the entire highly exposed population. The program includes a thorough assessment of individual exposure as well as behavioural and clinical risk factors for cardiometabolic disorders, providing tailored counselling for exposure and risk reduction, and the referral of subjects with altered biomarkers for subsequent diagnostic and therapeutic evaluation. Keywords: PFAS, biomonitoring, health surveillance program, PFOA contamination
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