Firefighters and the liver: Exposure to PFAS and PAHs in relation to liver function and serum lipids (CELSPAC-FIREexpo study)

Pálešová, Nina; Maitre, Léa; Stratakis, Nikos; Řiháčková, Katarína; Pindur, Aleš; Kohoutek, Jiří; Šenk, Petr; Polcrová, Anna; Gregor, Petr; Vrijheid, Martine; Čupr, Pavel

doi:10.1016/j.ijheh.2023.114215

Cited by 7 publications

(4 citation statements)

References 87 publications

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“…Negative association between PFOS and TG was found by Liu et al (7). In the Czech study on the exposure of young male professional firefighters in relation to liver function and serum lipids CELSPAC-FIREexpo study (28) the authors observed a significant negative association of PFAS mixture with TG. They found a positive association between the mixture of serum PFASs together with mixture of Continued from the previous page urine polycyclic aromatic hydrocarbons and total/LDL cholesterol by Bayesian weighted quantile sum regression.…”

Section: Discussionmentioning

confidence: 86%

Association among serum per- and polyfluoroalkyl substances, lipid profile and metabolic syndrome in Czech adults, HBM-EHES survey 2019

Puklová,

Čapková,

Fialová

et al. 2023

Cent Eur J Public Health

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Objectives: Per-and polyfluoroalkyl substances (PFASs) are a large group of persistent synthetic chemicals widely used commercially. They accumulate increasingly in all environmental components and enter the organisms, including humans. Some of them are associated with the risk of harm to health, among others with metabolic disorders. To test the associations between blood serum levels of PFASs and blood lipid profile as well as metabolic syndrome, we linked human biomonitoring with the Czech Health Examination Survey (CZ-EHES) conducted in 2019.Methods: A total of 168 participants of the CZ-EHES survey aged 25-64 years were examined including anthropometrical data and analyses for serum PFAS and blood lipid levels. Extended model approach in multiple linear regression models was used for identification of the associations between serum levels of 11 PFASs and lipid profile components. The relation between PFAS serum levels and metabolic syndrome prevalence was tested using a logistic regression model.Results: Six PFASs were detected over the limit of quantification in at least 40% cases and were examined in subsequent analyses: perfluorodecanoic acid (PFDA), perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUdA). The most dominant was PFOS with the mean value amounting to 4.81 ng/ml. After adjusting for potential confounders, we found a significant positive association between serum PFHxS and blood total cholesterol (p = 0.005) as well as LDL-cholesterol (p = 0.008). Significant positive association was also found between PFDA and HDL-cholesterol levels (p = 0.010). No significant associations were detected between PFASs and triglycerides, and between PFASs and metabolic syndrome.Conclusions: We found some evidence of a significant association between blood serum PFAS levels and blood cholesterol levels. Our results did not confirm an association between serum PFASs and the metabolic syndrome prevalence.

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Section: Discussionmentioning

confidence: 86%

Association among serum per- and polyfluoroalkyl substances, lipid profile and metabolic syndrome in Czech adults, HBM-EHES survey 2019

Puklová,

Čapková,

Fialová

et al. 2023

Cent Eur J Public Health

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“…Moreover, several studies in the literature demonstrate the increased levels of organic pollutants and/or their main metabolites (e.g., xylene, toluene, styrene, acrolein, PAHs, per- and polyfluoroalkyl substances, etc.) in the urine and blood of firefighters after their active participation in firefighting activities [ 13 , 101 , 102 , 103 , 104 , 105 , 106 ].…”

Section: Discussionmentioning

confidence: 99%

Characterization of Wildland Firefighters’ Exposure to Coarse, Fine, and Ultrafine Particles; Polycyclic Aromatic Hydrocarbons; and Metal(loid)s, and Estimation of Associated Health Risks

Teixeira,

Sousa,

Azevedo

et al. 2024

Toxics

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Firefighters’ occupational activity causes cancer, and the characterization of exposure during firefighting activities remains limited. This work characterizes, for the first time, firefighters’ exposure to (coarse/fine/ultrafine) particulate matter (PM) bound polycyclic aromatic hydrocarbons (PAHs) and metal(loid)s during prescribed fires, Fire 1 and Fire 2 (210 min). An impactor collected 14 PM fractions, the PM levels were determined by gravimetry, and the PM-bound PAHs and metal(loid)s were determined by chromatographic and spectroscopic methodologies, respectively. Firefighters were exposed to a total PM level of 1408.3 and 342.5 µg/m3 in Fire 1 and Fire 2, respectively; fine/ultrafine PM represented more than 90% of total PM. Total PM-bound PAHs (3260.2 ng/m3 in Fire 1; 412.1 ng/m3 in Fire 2) and metal(loid)s (660.8 ng/m3 versus 262.2 ng/m3), distributed between fine/ultrafine PM, contained 4.57–24.5% and 11.7–12.6% of (possible/probable) carcinogenic PAHs and metal(loid)s, respectively. Firefighters’ exposure to PM, PAHs, and metal(loid)s were below available occupational limits. The estimated carcinogenic risks associated with the inhalation of PM-bound PAHs (3.78 × 10−9 − 1.74 × 10−6) and metal(loid)s (1.50 × 10−2 − 2.37 × 10−2) were, respectively, below and 150–237 times higher than the acceptable risk level defined by the USEPA during 210 min of firefighting activity and assuming a 40-year career as a firefighter. Additional studies need to (1) explore exposure to (coarse/fine/ultrafine) PM, (2) assess health risks, (3) identify intervention needs, and (4) support regulatory agencies recommending mitigation procedures to reduce the impact of fire effluents on firefighters.

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“…116 Finally, a cross-sectional analysis of occupationally exposed firefighters (Czech Republic, 127 participants) showed only an association of total PFAS with a lower triglyceride level. 117 It is important to note that although uncommon and typically in small studies with lower exposures, some studies reported completely null associations between PFOA, PFNA, PFDA, PFNA, PFHxS, or PFOS and total cholesterol or LDL-C. 53,55,90,[116][117][118] Rarely, PFASs were reported to be associated with a decrease in cholesterol. 47 Few studies have specifically examined the association between PFAS and overt atherosclerosis, coronary artery disease, or acute coronary syndromes (Table 5; Figure ).…”

Section: Dyslipidemia and Atherosclerosismentioning

confidence: 99%

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Schlezinger,

Gokce

2024

Circulation Research

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Conservative estimates by the World Health Organization suggest that at least a quarter of global cardiovascular diseases are attributable to environmental exposures. Associations between air pollution and cardiovascular risk have garnered the most headlines and are strong, but less attention has been paid to other omnipresent toxicants in our ecosystem. Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are man-made chemicals that are extensively used in industrial and consumer products worldwide and in aqueous film-forming foam utilized in firefighting. As such, our exposure to PFAS is essentially ubiquitous. Given the long half-lives of these degradation-resistant chemicals, virtually, all people are carrying a body burden of PFAS. Health concerns related to PFAS are growing such that the National Academies of Sciences, Engineering and Medicine has recommended standards for clinical follow-up of individuals with high PFAS blood levels, including prioritizing screening for dyslipidemia. The link between PFAS and dyslipidemia has been extensively investigated, and evidence for associations is compelling. However, dyslipidemia is not the only cardiovascular risk factor with which PFAS is associated. Here, we review the epidemiological evidence for links between PFAS of concern identified by the National Academies of Sciences, Engineering and Medicine and risk factors for cardiovascular disease, including overweight/obesity, glucose intolerance, hypertension, dyslipidemia, and hyperuricemia. Moreover, we review the potential connections of PFAS with vascular disease and atherosclerosis. While observational data support associations between the National Academies of Sciences, Engineering and Medicine PFAS and selected cardiac risk factors, additional research is needed to establish causation and better understand how exposure to PFAS leads to the development of these conditions.

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Firefighters and the liver: Exposure to PFAS and PAHs in relation to liver function and serum lipids (CELSPAC-FIREexpo study)

Cited by 7 publications

References 87 publications

Association among serum per- and polyfluoroalkyl substances, lipid profile and metabolic syndrome in Czech adults, HBM-EHES survey 2019

Association among serum per- and polyfluoroalkyl substances, lipid profile and metabolic syndrome in Czech adults, HBM-EHES survey 2019

Characterization of Wildland Firefighters’ Exposure to Coarse, Fine, and Ultrafine Particles; Polycyclic Aromatic Hydrocarbons; and Metal(loid)s, and Estimation of Associated Health Risks

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

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