Associations between serum perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) concentrations and thyroid disease; National Health and Nutrition Examination Survey (NHANES): 2007-2010. Open Access

Abstract

PURPOSE: A prior study found an association between serum concentrations of PFOA/PFOS and prevalent thyroid disease in the U.S. general adult population. The aim of this study was to determine if the association was still persistent, despite an expected decrease in PFOA/PFOS exposure in the same population.

METHODS: This study used a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) from 2007-2008 and 2009-2010. We had a final sample of n = 3,606, all of whom had measured serum concentrations of PFOA and PFOS, and otherwise met the inclusion criteria. Fully adjusted multivariable logistic regression models were used to calculate odds ratios comparing thyroid disease status across quartiles of serum PFOA/PFOS. We also used two-sample t-tests to compare geometric mean concentrations of PFOA/PFOS from our study population to a past NHANES cohort (2003-2006).

RESULTS: There was a significant decrease in survey-weighted geometric mean serum concentrations of PFOA from 3.96 ng/mL (95% confidence interval (CI): 3.69-4.24ng/mL) in the 2003-2006 population to 3.59 ng/mL (95% CI: 3.43-3.75 ng/mL) in 2007-2010 (p = 0.029). Likewise, geometric mean PFOS levels were significantly lower in the 2007-2010 sample (11.38 ng/mL, 95% CI: 10.52-12.24 ng/mL) than in 2003-2006 (19.01 ng/mL, 95% CI: 18.01-20.01 ng/mL) (p < 0.001). The highest quartile of serum PFOA concentration in women was associated with a significant increase in the odds of having a history of thyroid disease compared to the lowest quartile (OR = 2.12, 95% CI: 1.07-4.20; p = 0.031). There were no associations between PFOA exposure and thyroid disease in men, but serum PFOS concentrations were associated with a history of thyroid disease in the highest quartile versus the lowest two (OR = 2.12, 95% CI: 1.09-4.49; p = 0.029).

CONCLUSIONS: Serum concentrations of PFOA and PFOS continue to decrease in the U.S. general adult population. However, while exposure continues to decline, this study provides additional evidence that the highest serum concentrations of PFOA and PFOS are still associated with a history of thyroid disease in U.S. adults.

Table of Contents

Table of Contents

Background.......................................................................................................................... 1

Methods.............................................................................................................................. 5

Results.............................................................................................................................. 10

Discussion.......................................................................................................................... 15

References......................................................................................................................... 20

Tables............................................................................................................................... 24

Table 1: Demographic group survey-weighted geometric mean serum concentrations (95% CIs) of PFOA and PFOS. 24

Table 2: Sex-Specific, population-based serum PFOA/PFOS exposure quartiles and thyroid disease prevalence. 25

Table 3: Comparison of geometric mean concentrations (95% confidence intervals) of serum PFOA and PFOS from 2003-2006 and 2007-2010. 26

Table 4: Sex-specific, survey-weighted associations between serum PFOA/PFOS concentration quartiles and thyroid disease in fully adjusted logistic

regression models. 27

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	PFOS PFOA NHANES Thyroid Disease
Committee Chair / Thesis Advisor	Darrow, Lyndsey, Emory University
Partnering Agencies	CDC

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