Occupational exposure and serum levels of per- and polyfluoroalkyl substances (PFAS): A review

Am J Ind Med. 2023 May;66(5):379-392. doi: 10.1002/ajim.23454. Epub 2022 Dec 27.

Abstract

Background: Per- and polyfluoroalkyl substances, or PFAS, are a class of chemicals used in nearly all sectors of industry and many consumer products. Their resistance to degradation, however, means that PFAS are ubiquitous in the environment and bioaccumulate. PFAS exposure has also been linked to a variety of adverse health effects. Occupational PFAS exposure is of particular concern as research on PFAS exposure in worker populations has historically been limited and generally restricted to fluorochemical plant workers involved in PFAS production.

Methods: A comprehensive review of peer-reviewed scientific literature was conducted to investigate which worker populations may experience occupational exposure to PFAS. Serum PFAS levels reported in various occupations were analyzed and compared to serum PFAS levels published on the general public exposed to PFAS-contaminated drinking water and the study population of the National Health and Nutrition Examination Survey (NHANES).

Results: Our analysis indicates that professional ski waxers and firefighters may be exposed to several different PFAS at levels often similar to or higher than levels among fluorochemical plant workers and individuals in communities with PFAS-contaminated drinking water, and higher than levels in the general public. PFAS serum level data on other occupations were largely absent.

Conclusions: Results highlight a need for additional research on occupational PFAS exposures and concomitant environmental exposures in these populations. Research on exposure levels in occupations and industries known or suspected to utilize PFAS is critically needed to foster informed recommendations for exposure mitigation measures to protect workers from adverse health effects of PFAS exposure.

Keywords: AFFF; PFAS; biomarkers; blood; firefighters; industry; occupational exposure; per- and polyfluoroalkyl substances; serum levels; ski waxers.

Publication types

  • Review

MeSH terms

  • Drinking Water* / analysis
  • Environmental Exposure / analysis
  • Fluorocarbons* / analysis
  • Humans
  • Nutrition Surveys
  • Occupational Exposure* / adverse effects
  • Occupational Exposure* / analysis

Substances

  • Drinking Water
  • Fluorocarbons