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

项目概要/摘要 宾夕法尼亚州巴克斯县沃明斯特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车站被发现是广泛传播的病毒源头 饮用水中未被检测到的全氟烷基物质和多氟烷基物质 (PFAS) 污染 几十年。饮用水污染归因于使用含有 PFAS 的水成膜泡沫 (AFFF)，一种用于军事训练演习的灭火剂。 PA位点的特点是高 规模大、持续时间长、暴露范围广。 RTI International、宾夕法尼亚州卫生部 （卫生部）、布朗大学和天普大学提议在 PA 地点联合开展研究，作为 ATSDR 的多地点研究。拟建地点人口稠密（>80,000）并已验证全氟辛烷 公共供水系统 (PWS) 和私人水井中的磺酸盐和全氟辛酸污染。符合资格 成人和 4 至 17 岁的儿童在过去 15 年中曾接触过该病毒。成年人因职业接触 化学制造中、消防员或使用 AFFF 的消防训练演习中的 PFAS 将被排除在外 从研究中。同样，生母受到职业暴露的孩子也不符合资格。一个 采用两阶段整群抽样设计，第一阶段选择住户，然后 对家庭中所有成人和儿童进行抽样。与试点生物监测结果一致 根据 PA DOH 的努力，距离两个军事基地最近的 PWS 服务的住宅的血清含量较高 PFAS 水平并将被过采样。总共将招募2000名成人和800名儿童 参与研究并将完成 ATSDR 的核心协议，包括同意和访谈， 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，还重建了 PFAS 的历史水源 将对现场周围的饮用水进行浓度监测。药代动力学模型将 旨在估计非职业暴露人群的历史血清浓度。两名调查员—— 还提议启动研究活动。首先，先进的空间分析方法将应用于 随着时间的推移，与一系列癌症相关的 PFAS 暴露和其他潜在癌症决定因素模型 端点。其次，将利用暴露估计对肾脏和肾脏进行重点调查。 使用基于家庭的设计来治疗甲状腺癌。 PA 站点的纳入和研究者发起的 本申请中提出的研究将对 ATSDR 多站点的范围和严格性做出重大贡献 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.