Can PFAS threaten the health of fish consumers? A comprehensive analysis linking fish consumption behaviour and health risk

Despite being phased out for decades, per- and polyfluoroalkyl substances (PFAS) are still widely detected in the environment and accumulated in many aquaculture organisms for human consumption. Thus, there is growing concern about whether fish consumption can cause PFAS-associated health impacts on humans since fish is a vital protein source for global populations. Here, we assess the potential driving factors of fish consumption by analysing the aquaculture, demographic and socio-economic data across 31 provinces/municipalities in China, followed by estimating the health risk of PFAS via fish consumption. We found that per capita fish consumption was primarily driven by fish production and total area for freshwater aquaculture, while urbanization rate and median age of consumers were also important. The health risk of PFAS was low (hazard quotient <1) in most provinces, while urban consumers were more prone to PFAS than rural consumers across all provinces. Since PFAS have been phased out worldwide, their health risk to humans through fish consumption would be lower than previously thought. To reduce PFAS intake for the high-risk populations, we recommend that fish should be well cooked before consumption, preferably using water-based cooking methods, and that alternative protein sources should be consumed more as the substitute for fish.