EXPOSURE TO PFNA AND OTHER PFAS IN DRINKING WATER AND ASSOCIATIONS WITH HEALTH-RELATED OUTCOMES IN GLOUCESTER COUNTY NJ

PROJECT SUMMARYThe Agency for Toxic Substances and Disease Registry (ATSDR) has identified the need for additionalepidemiological research on the health effects of poly- and perfluoroalkyl substances (PFAS) exposures,particularly from contaminated drinking water and for compounds even less studied than perfluorooctanoic acid(PFOA) and perfluorooctane sulfonic acid (PFOS), such as perfluorononanoic acid (PFNA). The highest levelsof PFNA contamination in public and private water wells recorded anywhere in the world were found inPaulsboro and West Deptford New Jersey, where measurable levels of other poly- and perfluoroalkylsubstances (PFAS) were also detected. Contaminated drinking water is an important and growing source ofexposure to PFNA and other PFAS, and it estimated that millions of adults and children are exposed to PFASin drinking water. Associations between serum PFAS levels in the general population and a wide range ofhealth effects have been reported, but relatively little is known about health effects from consuming watercontaminated with PFAS. There is a critical need to better understand the health hazards and risks of PFNAand other PFAS in drinking water. The main objective of this proposal is to evaluate associations betweenhealth outcomes and multiple estimates of exposure to PFNA and other PFAS among members of thesecommunities and the other study sites in a multi-site study. A number of hypotheses will be tested, includingthat exposure to PFNA and other PFAS are associated with blood lipid levels, renal function and kidneydisease, thyroid hormones and disease, liver function and disease, glycemic parameters and diabetes, andimmune response and function in both children and adults. Additional hypothesized effects to be studiedinclude differences in sex hormones and sexual maturation, vaccine response, and neurobehavioral outcomesin children, as well as cardiovascular disease, osteoarthritis and osteoporosis, endometriosis, and autoimmunedisease in adults. The rationale for these multiple cross-sectional analyses is to test hypotheses for whichthere is sufficient statistical power based on prior reports, to develop new hypotheses, and to build afoundation for future knowledge generation with members of these communities. As part of the multi-site studywith a target enrollment of 6,000 adults and 2000 children, 1,000 adults and 350 children from the Paulsboroand West Deptford municipalities who consumed water from wells contaminated with PFNA and other PFASwill be enrolled. Assessment of exposure to PFAS will be based on blood concentrations of PFAS and drinkingwater exposure reconstruction and PBPK modeling of internal exposure, including development of novelmodels for PFNA. Estimation of associations between health outcomes and measured and modeled exposureto PFAS will be done for this site and across sites of this multi-site study. The proposed project is relevant topublic health, because our results will strengthen the evidence basis for making decisions about policies andactions to protect human health when people may be exposed to PFAS from drinking water.