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PFAS in Ronneby water tracks higher cholesterol

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Swedish adults on PFAS-contaminated water had 7–9% higher total cholesterol and LDL, with high odds of cholesterol >6.2 mmol/L as PFOS/PFHxS rose.

Source

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

Li Y, Barregard L, Xu Y, et al. · Environmental health : a global access science source · 2020

doi.org/10.1186/s12940-020-00588-9Read the full paper ↗114 citationscc by

Study at a glance

Design
Cross-sectional — Open sampling of Ronneby/Karlshamn adults comparing serum PFAS and lipids by exposure group
N
N=1945 · 1,945 adults aged 20–60
Population
Adults from PFAS-contaminated Ronneby and control Karlshamn, Sweden
Outcome
Serum cholesterol/LDL associated with PFOS and PFHxS

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

In 2013–2014 open sampling, 1,945 adults aged 20–60 from Ronneby and Karlshamn were grouped as controls, recently exposed, or uncertain/historical exposure; serum PFAS and lipids were compared with regression on ln-PFAS.

What they found

Exposed Ronneby sera were dominated by PFOS (median 157 ng/ml) and PFHxS (median 136 ng/ml). Cholesterol and LDL were 7–9% higher than in the control town. Odds of high cholesterol were about 1.3 per ln-PFAS unit. PFOS and PFHxS were too correlated (r≈0.9) to separate.

The limits

What it doesn't show

Cross-sectional lipids cannot prove that PFAS caused heart disease. Open sampling is not a random population sample, and highly correlated PFAS prevent compound-specific claims.

Key terms

PFOS / PFHxS / PFOA
Persistent PFAS; firefighting foam around Ronneby drove very high PFOS and PFHxS.
Ronneby
Swedish municipality whose one waterworks was found PFAS-contaminated in 2013.
High cholesterol
Serum total cholesterol >6.2 mmol/L, a Framingham-style cutoff used for odds ratios.
Karlshamn
Nearby control municipality without the contaminated waterworks.
Ln-PFAS
Natural-log serum concentration used in logistic models for high cholesterol.

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Ronneby serum PFAS were dominated by:

Common questions

Was PFOA the main compound?

No. Unlike many industrial PFOA sites, Ronneby exposure was dominated by PFOS and PFHxS from firefighting foam.

How big was the lipid contrast?

7–9% higher total cholesterol and LDL versus Karlshamn.

Can PFOS be separated from PFHxS?

Not really; Spearman correlation was 0.9 in the contaminated group.

Does 5% more cholesterol matter?

Authors cite that even a 5% rise in the normal range can raise ischemic heart-disease risk by at least 5%.

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