Susceptibility to COVID-19 after High Exposure to Perfluoroalkyl Substances from Contaminated Drinking Water: An Ecological Study from Ronneby, Sweden

There is concern that immunotoxic environmental contaminants, particularly perfluoroalkyl substances (PFAS), may play a role in the clinical course of COVID-19 and epidemiologic studies are needed to answer if high-exposed populations are especially vulnerable in light of the ongoing pandemic. The objective was, therefore, to determine if exposure to highly PFAS-contaminated drinking water was associated with an increased incidence of COVID-19 in Ronneby, Sweden, during the first year of the pandemic. We conducted an ecological study determining the sex- and age-standardized incidence ratio (SIR) in the adult population relative to a neighboring reference town with similar demographic characteristics but with only background levels of exposure. In Sweden, COVID-19 is subject to mandatory reporting, and we retrieved aggregated data on all verified cases until 3 March 2021 from the Public Health Agency of Sweden. The SIR in Ronneby was estimated at 1.19 (95% CI: 1.12; 1.27). The results suggest a potential link between high PFAS exposure and susceptibility to COVID-19 that warrants further research to clarify causality.

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Breastfeeding Initiation and Duration after High Exposure to Perfluoroalkyl Substances through Contaminated Drinking Water: A Cohort Study from Ronneby, Sweden

ISEE Conference Abstracts ◽

10.1289/isee.2021.o-to-073 ◽

2021 ◽

Vol 2021 (1) ◽

Author(s):

Christel Nielsen ◽

Ying Li ◽

Magdalena Lewandowski ◽

Tony Fletcher ◽

Kristina Jakobsson

Keyword(s):

Drinking Water ◽

Cohort Study ◽

Perfluoroalkyl Substances ◽

Breastfeeding Initiation ◽

High Exposure ◽

Contaminated Drinking Water

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Associations between perfluoroalkyl substances and serum lipids in a Swedish adult population with contaminated drinking water

Environmental Health ◽

10.1186/s12940-020-00588-9 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 11

Author(s):

Ying Li ◽

Lars Barregard ◽

Yiyi Xu ◽

Kristin Scott ◽

Daniela Pineda ◽

...

Keyword(s):

Drinking Water ◽

Sulfonic Acid ◽

Serum Lipids ◽

Adult Population ◽

Serum Levels ◽

Control Area ◽

High Serum ◽

Perfluoroalkyl Substances ◽

Drinking Water Contamination ◽

Contaminated Drinking Water

Abstract Background Exposures to perfluoroalkyl substances (PFAS) have shown positive associations with serum lipids in previous studies. While many studies on lipids investigated associations with perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), there are only a few studies regarding other PFAS, such as perfluorohexane sulfonic acid (PFHxS). The purpose of the current study is to investigate if associations with serum lipids were present, not only for serum PFOS and PFOA, but also for PFHxS, and if the associations with PFAS remained also in a comparison based only on residency in areas with contrasting exposure to PFAS. Methods 1945 adults aged 20–60 were included from Ronneby, Sweden, a municipality where one out of two waterworks had been heavily contaminated from aqueous fire-fighting foams, and from a nearby control area. The exposure was categorized based on either been living in areas with contrasting PFAS exposure or based on the actual serum PFAS measurements. Regression analyses of serum lipids were fitted against serum PFAS levels, percentile groups, smooth splines and between exposed and reference areas, adjusting for age, sex and BMI. Results Drinking water contamination caused high serum levels of PFOS (median 157 ng/ml) and PFHxS (median 136 ng/ml) and PFOA (median 8.6 ng/ml). These serum PFAS levels in the exposed groups were 5 to 100-fold higher than in the controls. In this population with mixed PFAS exposure, predominantly PFOS and PFHxS, PFAS exposure were positively associated with serum lipids. This was observed both when quantifying exposure as contrast between exposed and controls, and in terms of serum PFAS. Due to high correlations between each PFAS, we cannot separate them. Conclusions In conclusion, the present study provides further evidence of a causal association between PFAS and serum lipids, especially for PFHxS.

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