Pennsylvania: Multi-Site Study of the Health Implications of Exposure to PFAS-Contaminated Drinking Water

项目概要/摘要 位于宾夕法尼亚州巴克斯县沃瑟姆镇的前海军空战中心和霍舍姆空军警卫队 宾夕法尼亚州蒙哥马利县霍舍姆镇的一个加油站被发现是广泛传播的 全氟烷基和多氟烷基物质（PFAS）对饮用水的污染， 几十年饮用水污染是由于使用含PFAS的水性成膜泡沫 （AFFF），用于军事训练演习的灭火剂。PA位点的特征在于高 强度大，持续时间长，暴露范围广。RTI国际，PA卫生部 (DOH)，布朗大学和坦普尔大学提议在PA现场联合进行研究，作为 ATSDR的多地点研究。拟议场址人口密集（> 80，000），已核实全氟辛烷 公共供水系统和私人威尔斯井中的磺酸盐和全氟辛酸污染。资格 成人和4-17岁的儿童在过去15年中将受到辐射。成年人职业暴露 在化学品制造中的PFAS，作为消防员，或在使用AFFF的消防训练演习期间，将被排除在外 从研究中。同样，其生母因职业暴露的儿童也不符合资格。一 调查将采用两阶段整群抽样设计，第一阶段抽取住户， 通过对家庭中的所有成人和儿童进行抽样。与试点生物监测的结果一致 在PA DOH进行的努力中，最接近两个军事基地的PWS服务的住宅血清浓度较高 PFAS水平，并将进行过采样。总共将招募2,000名成年人和800名儿童， 参与研究，并将完成ATSDR的核心协议，包括同意和采访， 人体测量、神经行为评估和生物样本（血液和尿液）采集。 除了收集2，800名参与者的核心数据外，PFAS的历史水重建 将对现场周围饮用水中的浓度进行检测。药代动力学建模将 估计非职业暴露人群的历史血清浓度。两名调查员- 还提议开展研究活动。首先，先进的空间分析方法将应用于 模型PFAS暴露和其他潜在的癌症决定因素随着时间的推移与一系列癌症 端点。其次，将利用暴露估计值对肾脏和 甲状腺癌使用基于家庭的设计。纳入PA研究中心和研究者发起的 本申请中提出的研究将大大有助于美国毒物与疾病登记署多地点 PFAS环境健康研究。

PROJECT SUMMARY/ABSTRACT A former Naval Air Warfare Center in Warminster Township, Bucks County, PA, and the Horsham Air Guard Station in Horsham Township, Montgomery County, PA, have been found to be the source of widespread drinking water contamination from per- and polyfluoroalkyl substances (PFAS) that went undetected for decades. Drinking water contamination was attributed to use of PFAS-containing aqueous film-forming foam (AFFF), a fire suppressant used in military training exercises. The PA site is characterized by high magnitude, long duration, and wide-ranging exposure. RTI International, the PA Department of Health (DOH), Brown University, and Temple University propose to jointly conduct research at the PA site as part of ATSDR's multisite study. The proposed site is densely populated (>80,000) and has verified perfluorooctane sulfonate and perfluorooctanoic acid contamination in public water systems (PWS) and private wells. Eligible adults and children ages 4–17 will have been exposed in the last 15 years. Adults occupationally exposed to PFAS in chemical manufacture, as a firefighter, or during fire training exercises using AFFF, will be excluded from the study. Likewise, children whose birth mothers were occupationally exposed will not be eligible. A two-stage clustered sampling design will be employed, with households selected in the first stage, followed by the sampling of all adults and children in households. Consistent with findings from a pilot biomonitoring effort conducted by PA DOH, residences served by PWS closest to the two military bases had higher serum PFAS levels and will be oversampled. A total of 2,000 adults and 800 children will be recruited for participation in the study and will complete ATSDR's core protocol, including consenting and interviewing, anthropometric measurements, neurobehavioral assessments, and biospecimen (blood and urine) collection. In addition to collecting core data on 2,800 participants, historical water reconstruction of PFAS concentrations in drinking water around the site will be conducted. Pharmacokinetic modeling will be conducted to estimate historical serum concentrations of nonoccupational-exposed people. Two investigator- initiated research activities are also proposed. First, advanced spatial analysis methods will be applied to model PFAS exposure and other potential cancer determinants over time in relation to a range of cancer endpoints. Second, exposure estimates will be leveraged to conduct a focused investigation of kidney and thyroid cancers using a family-based design. The inclusion of the PA site and the investigator-initiated research proposed in this application will contribute significantly to the scope and rigor of ATSDR's multisite PFAS environmental health study.