Per- and Polyfluoroalkyl Substances (PFAS) and Non-Fasting Total Cholesterol Serum Levels among New Jersey Volunteer Firefighters

BACKGROUND AND AIM: Increased serum levels of some PFAS have been reported among firefighters compared to the general population; we previously found increased levels of perfluorododecanoic acid (PFDoA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) among a group of volunteer firefighters. PFAS exposure has been associated with adverse health outcomes in humans including dyslipidemia (i.e., abnormal amount of lipids in the blood). Previous studies of career firefighters have found an inverse or null relationship between serum PFAS levels and serum cholesterol. This association is less studied among volunteer firefighters. We examined whether serum PFAS levels among members of a volunteer department are associated with non-fasting total serum cholesterol levels. METHODS: The Firefighters Cancer Prevention Study (CAPS) enrolled consenting participants from a large suburban New Jersey fire department who completed a survey and provided blood samples. Serum was tested for 11 PFAS and non-fasting total cholesterol serum levels; PFAS detected in 50% of respondents were included (perfluorooctanesulfonic acid (PFOS), perfluorooctanoicacid (PFOA), PFNA, perfluorohexanesulfonic acid (PFHxS), PFDA, and PFDoA)). Serum PFAS and cholesterol levels were log transformed and their associations assessed using linear regression. Each PFAS was modeled separately adjusting for age, sex, education, and firefighter service years. RESULTS:The 135 study participants were majority male (94.8%) and non-Hispanic white (91.1%). Their average cholesterol level was 187.9 mg/dL. There was no association observed between the six PFAS serum concentrations and the non-fasting total cholesterol serum levels. The effect estimates for the association between PFAS and cholesterol ranged from -0.01 (95% CI (-0.07, 0.06) for PFHxS to 0.08 (-0.02, 0.17) for PFDoA. CONCLUSIONS:Consistent with findings in career firefighters, we did not observe significant positive associations between PFAS serum levels and total serum cholesterol. Further research is needed to explore associations between PFAS serum levels, cholesterol, and other health outcomes among volunteer firefighters. KEYWORDS: PFAS, Occupational Exposures, Occupational Epidemiology