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. 2020 Feb;128(2):27007.
doi: 10.1289/EHP5337. Epub 2020 Feb 18.

Serum Levels of Perfluoroalkyl Substances (PFAS) in Adolescents and Young Adults Exposed to Contaminated Drinking Water in the Veneto Region, Italy: A Cross-Sectional Study Based on a Health Surveillance Program

Gisella Pitter  1 , Filippo Da Re  2 , Cristina Canova  3 , Giulia Barbieri  3 , Maryam Zare Jeddi  3 , Francesca Daprà  4 , Flavio Manea  4 , Rinaldo Zolin  5 , Anna Maria Bettega  5 , Giampaolo Stopazzolo  5 , Silvia Vittorii  5 , Lorena Zambelli  6 , Marco Martuzzi  7 , Domenico Mantoan  8 , Francesca Russo  2
Affiliations

Serum Levels of Perfluoroalkyl Substances (PFAS) in Adolescents and Young Adults Exposed to Contaminated Drinking Water in the Veneto Region, Italy: A Cross-Sectional Study Based on a Health Surveillance Program

Gisella Pitter et al. Environ Health Perspect. 2020 Feb.

Abstract

Background: In spring 2013, groundwater of a vast area of the Veneto Region (northeastern Italy) was found to be contaminated by perfluoroalkyl substances (PFAS) from a PFAS manufacturing plant active since the late 1960s. Residents were exposed to high concentrations of PFAS, particularly perfluorooctanoic acid (PFOA), through drinking water until autumn 2013. A publicly funded health surveillance program is under way to aid in the prevention, early diagnosis, and treatment of chronic disorders possibly associated with PFAS exposure.

Objectives: The objectives of this paper are: a) to describe the organization of the health surveillance program, b) to report serum PFAS concentrations in adolescents and young adults, and c) to identify predictors of serum PFAS concentrations in the studied population.

Methods: The health surveillance program offered to residents of municipalities supplied by contaminated waterworks includes a structured interview, routine blood and urine tests, and measurement of 12 PFAS in serum by high-performance liquid chromatography-tandem mass spectrometry. We studied 18,345 participants born between 1978 and 2002, 14-39 years of age at recruitment. Multivariable linear regression was used to identify sociodemographic, lifestyle, dietary, and reproductive predictors of serum PFAS concentrations.

Results: The PFAS with the highest serum concentrations were PFOA [median 44.4 ng/mL, interquartile range (IQR) 19.3-84.9], perfluorohexanesulfonic acid (PFHxS) (median 3.9 ng/mL, IQR 1.9-7.4), and perfluorooctanesulfonic acid (PFOS) (median 3.9 ng/mL, IQR 2.6-5.8). The major predictors of serum levels were gender, municipality, duration of residence in the affected area, and number of deliveries. Overall, the regression models explained 37%, 23%, and 43% of the variance of PFOA, PFOS, and PFHxS, respectively.

Conclusions: Serum PFOA concentrations were high relative to concentrations in populations with background residential exposures only. Interindividual variation of serum PFAS levels was partially explained by the considered predictors. https://doi.org/10.1289/EHP5337.

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Figures

Figure 1 is a portion of the map of the Southern part of the Veneto Region in north-eastern Italy. Some of the municipalities under Red Area A are Brendola, Sarego, and Montagnana. Some of the municipalities under Red Area B are Arcole, Veronella, Minerbe, Bonavigo, and Terrazzo. Some of the municipalities within the dashed white area are Zimella, Cologna Veneta, and Pressana. The pink spot represents the chemical plant that was the sourse of groundwater contamination, located in the municipality of Trissino. The yellow lines border municipalities such as Villaga, Sossana, and Caldiero. The red lines represent borders of the Provinces of Padova, Vicenza, Verona, and Rovigo. Some of the rivers are Brenta, Adige, and Bacchiglione. Some of the municipalities bordered with the Black thick line are Val Liona, Orgiano, and Urbana.
Figure 1.
Map of the PFAS-contaminated area of the Veneto Region. Note: Red Area: municipalities supplied by PFAS-contaminated waterworks. Red Area A (dark red): municipalities of the Red Area located on the groundwater contamination plume. Red Area B (light red): municipalities of the Red Area located outside the groundwater contamination plume. Dashed white area: groundwater contamination plume. Pink dot: location of the chemical plant that gave origin to groundwater contamination. Yellow lines: borders of municipalities. Red lines: borders of provinces. Blue lines: rivers. Black thick line: borders of the new areas included in the Red Area in 2018 (9 additional municipalities, some of them only partially included). The box on the lower right corner indicates the position of the represented area in the Veneto Region, northeastern Italy.
Figure 2 is a flow chart with six levels. The first level has subjects of birth cohorts 1978 to 2002 residing in the 21 municipalities originally included in the Red Area n equals 33793. The second level has two parts: subjects who agreed to participate in the health surveillance program n equals 21467 and subjects who did not agree to participate in the health surveillance program n equals 12326. The third level has two parts: subjects with complete reports n equals 20549 and subjects with incomplete reports n equals 918. The fourth level has two parts: subjects aged 14 to 39 years at recruitment n equals 19898 and subjects 40 years of age at recruitment n equals 651. The fifth level has subjects with at least 1 year of residence in the Red Area by 2013 n equals 18345 and subjects with less than 1 year of residence in the Red Area by 2013 n equals 1553. The sixth level has final study population n equals 18122 and subjects with missing values for any potential predictor n equals 223.
Figure 2.
Flow chart of the inclusion–exclusion process.
See this image and copyright information in PMC

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