PFOA, with medians being highest in the Tokai/Hokuriku/ Kinki region. Conclusions: These findings suggest that the concentrations of PFOS in blood were mainly associated with fish consumption and that the levels of PFOS and PFOA were associated with the serum levels of liver enzymes in Japanese populations. Further investigations are required to clarify the reason for the regional differences in blood levels of PFOS and PFOA in Japan. (J Occup Health 2013; 55: 184−194) Key words: Blood, Fish intake, Perfluorooctanesulfonate (PFOS), Perfluorooctanoate (PFOA), Serum liver enzymes Perfluorochemicals (PFCs) are man-made chemical substances containing C-C and C-F bonds. PFCs are extremely resistant to degradation, and accumulate in the environment. Perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) are two of the main PFCs. PFOS and PFOA have both hydrophilic and lipophilic properties. PFOS bioaccumulates in animal tissues through the food web 1) , and exposure to PFOA occurs in part through drinking water and beverages 2) . The geometric mean elimination half-lives of PFOS and PFOA from human serum are approximately 4.8 and 3.5 years, respectively 3) . Recently, it has been reported that PFOS and PFOA have toxic effects on wildlife and humans. The toxicity includes neurobehavioral defects 4) , hepatotoxicity 5) , immune toxicity and carcinogenicity 6) . A reduction in human exposure to PFCs has been reported following the phasing-out of perfluorosulfonyl-based compounds and the Environmental Protection Agency's program The purpose of the present study was to examine the factors associated with the blood levels of PFOS and PFOA. Methods: A cross-sectional study was performed on 307 men and 301 women (aged 16−76 years) living in 15 prefectures in Japan. Blood levels of PFOS and PFOA were measured by liquid chromatography-mass spectrometry. Hepatic enzymes (γ -GTP, GOT, and GPT) and ω -3 polyunsaturated fatty acids (DHA and EPA) levels in serum were also measured. Associations between the levels of PFOS and PFOA in blood and the intake frequency of 41 kinds of dishes, foods and beverages and the serum levels of liver enzymes and ω -3 polyunsaturated fatty acids were examined using rank correlations. Results: Frequency of intake of boiled fish in broth, sliced raw fish and coastal fish showed significant positive correlations with PFOS concentrations in blood after adjustments for potential confounders. Serum levels of GOT, GPT, DHA and EPA showed significant positive correlations with PFOS and PFOA in blood. There was also a significant regional difference in the blood levels of PFOS and