Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Biomonitoring of perfluoroalkyl and polyfluoroalkyl substances (PFAS) from the Survey of the Health of Wisconsin (SHOW) 2014–2016 and comparison with the National Health and Nutrition Examination Survey (NHANES)

Journal of Exposure Science & Environmental Epidemiology volume 33, pages 766–777 (2023)Cite this article

Abstract

Background

Per- and polyfluoroalkyl substances (PFAS) are a growing class of manufactured chemical compounds found in a variety of consumer products. PFAS are ubiquitous in the environment and were found in many humans sampled in the United States (U.S.). Yet, significant gaps in understanding statewide levels of exposure to PFAS remain.

Objective

The goals of this study are to establish a baseline of exposure at the state level by measuring PFAS serum levels among a representative sample of Wisconsin residents and compare to United States National Health and Nutrition Examination Survey (NHANES).

Methods

The study sample included 605 adults (18+ years of age) selected from the 2014–2016 sample of the Survey of the Health of Wisconsin (SHOW). Thirty-eight PFAS serum concentrations were measured using high-pressure liquid chromatography coupled with tandem mass spectrometric detection (HPLC-MS/MS) and geometric means were presented. Weighted geometric mean serum values of eight PFAS analytes from SHOW were compared to U.S. national levels from the NHANES 2015–2016 sample (PFOS, PFOA, PFNA, PFHxS, PFHpS, PFDA, PFUnDA), and the 2017–2018 sample for Me-PFOSA, PFHPS using the Wilcoxon rank-sum test.

Results

PFOS, PFHxS, PFHpS, PFDA, PFNA, and PFOA were detected in over 96% of SHOW participants. In general, SHOW participants had lower serum levels across all PFAS when compared to NHANES. Serum levels increased with age and were higher among males and whites. Similar trends were seen in NHANES, except non-whites had higher PFAS levels at higher percentiles in NHANES.

Impact statement

The present study conducts biomonitoring of 38 PFAS among representative sample of residents in the state of Wisconsin. Results suggest that while the majority of Wisconsin residents tested have detectable levels of PFAS in their blood serum, they may have a lower body burden of some PFAS compared to a nationally representative sample. Older adults, males, and whites may have a higher body burden of PFAS relative to other groups, both in Wisconsin and the wider United States.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: United States Geological Survey (USGS) land cover map of Wisconsin, USA, depicting SHOW participants by the shaded U.S.

Data availability

The datasets generated during and analyzed during the current study are not publicly available due to HIPAA protections for SHOW participants but may be available from the corresponding author on reasonable request with IRB approval.

References

  1. Ghisi R, Vamerali T, Manzetti S. Accumulation of perfluorinated alkyl substances (PFAS) in agricultural plants: a review. Environ Res. 2019;169:326–41.

    Article  CAS  PubMed  Google Scholar 

  2. Sunderland EM, Hu XC, Dassuncao C, Tokranov AK, Wagner CC, Allen JG. A review of the pathways of human exposure to poly- and perfluoroalkyl substances (pfass) and present understanding of health effects. J Exposure Sci Environ Epidemiol. 2018;29:131–47.

    Article  Google Scholar 

  3. Panieri E, Baralic K, Djukic-Cosic D, Buha Djordjevic A, Saso L. PFAS molecules: a major concern for the human health and the environment. Toxics. 2022;10:44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Haukås M, Berger U, Hop H, Gulliksen B, Gabrielsen GW. Bioaccumulation of per- and polyfluorinated alkyl substances (PFAS) in selected species from the Barents Sea Food web. Environ Pollut. 2007;148:360–71.

    Article  PubMed  Google Scholar 

  5. Per- and polyfluorinated substances (PFAS) factsheet [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2022. Available from: https://www.cdc.gov/biomonitoring/PFAS_FactSheet.html.

  6. Hu XC, Andrews DQ, Lindstrom AB, Bruton TA, Schaider LA, Grandjean P, et al. Detection of poly- and perfluoroalkyl substances (pfass) in U.S. drinking water linked to industrial sites, military fire training areas, and wastewater treatment plants. Environ Sci Technol Lett. 2016;3:344–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Faithfull NS, Weers JG. Perfluorocarbon compounds. Vox Sanguinis. 1998;74:243–8.

    Article  CAS  PubMed  Google Scholar 

  8. Sinclair GM, Long SM, Jones OAH. What are the effects of PFAS exposure at environmentally relevant concentrations? Chemosphere 2020;258:127340.

    Article  CAS  PubMed  Google Scholar 

  9. Fenton SE, Ducatman A, Boobis A, DeWitt JC, Lau C, Ng C, et al. Per‐ and polyfluoroalkyl substance toxicity and human health review: current state of knowledge and strategies for informing future research. Environ Toxicol Chem. 2020;40:606–30.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kurwadkar S, Dane J, Kanel SR, Nadagouda MN, Cawdrey RW, Ambade B, et al. Per- and polyfluoroalkyl substances in water and wastewater: a critical review of their global occurrence and distribution. Sci Total Environ. 2022;809:151003.

    Article  CAS  PubMed  Google Scholar 

  11. DeWitt JC. Toxicological effects of perfluoroalkyl and polyfluoroalkyl substances. Cham, New York: Springer International Publishing; 2015.

  12. Nelson JW, Hatch EE, Webster TF. Exposure to polyfluoroalkyl chemicals and cholesterol, body weight, and insulin resistance in the general U.S. population. Environ Health Perspect. 2010;118:197–202.

    Article  CAS  PubMed  Google Scholar 

  13. Bassler J, Ducatman A, Elliott M, Wen S, Wahlang B, Barnett J, et al. Environmental perfluoroalkyl acid exposures are associated with liver disease characterized by apoptosis and altered serum adipocytokines. Environ Pollut. 2019;247:1055–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Wikström S, Lin P-I, Lindh CH, Shu H, Bornehag C-G. Maternal serum levels of perfluoroalkyl substances in early pregnancy and offspring birth weight. Pediatr Res. 2019;87:1093–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. von Holst H, Nayak P, Dembek Z, Buehler S, Echeverria D, Fallacara D, et al. Perfluoroalkyl substances exposure and immunity, allergic response, infection, and asthma in children: review of epidemiologic studies. Heliyon. 2021;7:e08160.

    Article  Google Scholar 

  16. Borghese MM, Walker M, Helewa ME, Fraser WD, Arbuckle TE. Association of perfluoroalkyl substances with gestational hypertension and preeclampsia in the MIREC study. Environ Int. 2020;141:105789.

    Article  CAS  PubMed  Google Scholar 

  17. Granum B, Haug LS, Namork E, Stølevik SB, Thomsen C, Aaberge IS, et al. Pre-natal exposure to perfluoroalkyl substances may be associated with altered vaccine antibody levels and immune-related health outcomes in early childhood. J Immunotoxicol. 2013;10:373–9.

    Article  CAS  PubMed  Google Scholar 

  18. Brennan NM, Evans AT, Fritz MK, Peak SA, von Holst HE. Trends in the regulation of per- and polyfluoroalkyl substances (PFAS): a scoping review. Int J Environ Res Public Health. 2021;18:10900.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Chen J, Tang L, Chen W-Q, Peaslee GF, Jiang D. Flows, stock, and emissions of poly- and perfluoroalkyl substances in California carpet in 2000–2030 under different scenarios. Environ Sci Technol. 2020;54:6908–18.

    Article  CAS  PubMed  Google Scholar 

  20. Podder A, Sadmani AHMA, Reinhart D, Chang N-B, Goel R. Per and poly-fluoroalkyl substances (PFAS) as a contaminant of emerging concern in Surface Water: a transboundary review of their occurrences and toxicity effects. J Hazard Mater. 2021;419:126361.

    Article  CAS  PubMed  Google Scholar 

  21. US EPA. Lifetime Drinking Water Health Advisories for Four Perfluoroalkyl Substances. 2022; 87 FRL 9855–01–OW. (To be codified and 87 C.F.R. pts. 36848, 36849).

  22. Kidd J, Fabricatore E, Jackson D. Current and future federal and state sampling guidance for per- and polyfluoroalkyl substances in environmental matrices. Sci Total Environ. 2022;836:155523.

    Article  CAS  PubMed  Google Scholar 

  23. Chang CJ, Ryan PB, Smarr MM, Kannan K, Panuwet P, Dunlop A, et al. Serum per-and polyfluoroalkyl substance (PFAS) concentrations and predictors of exposure among pregnant African American women in the Atlanta area, Georgia. Environ Res. 2021;157:106843. Available from: https://www.sciencedirect.com/science/article/pii/S0160412021004682?via%3Dihub.

  24. Birnbaum LS, Grandjean P. Alternatives to pfass: perspectives on the science. Environ Health Perspect. 2015;123:A104–5.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Aylward LL, Seiber JN, Hays SM. California biomonitoring data: comparison to NHANES and interpretation in a risk assessment context. Regulatory Toxicol Pharmacol. 2015;73:875–84.

    Article  Google Scholar 

  26. Graber JM, Alexander C, Laumbach RJ, Black K, Strickland PO, Georgopoulos PG, et al. Per and polyfluoroalkyl substances (PFAS) blood levels after contamination of a community water supply and comparison with 2013–2014 NHANES. J Exposure Sci Environ Epidemiol. 2018;29:172–82.

    Article  Google Scholar 

  27. Graber JM, Black TM, Shah NN, Caban-Martinez AJ, Lu SE, Brancard T, et al. Prevalence and predictors of per- and polyfluoroalkyl substances (PFAS) serum levels among members of a suburban US volunteer fire department. Int J Environ Res Public Health. 2021;18:3730.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Petriello MC, Mottaleb MA, Serio TC, Balyan B, Cave MC, Pavuk M, et al. Serum concentrations of legacy and emerging per- and polyfluoroalkyl substances in the Anniston Community Health Surveys (ACHS I and ACHS II). Environ Int. 2022;158:106907.

    Article  CAS  PubMed  Google Scholar 

  29. Yu CH, Weisel CP, Alimokhtari S, Georgopoulos PG, Fan ZT. Biomonitoring: a tool to assess PFNA body burdens and evaluate the effectiveness of drinking water intervention for communities in New Jersey. Int J Hyg Environ Health. 2021;235:113757.

    Article  CAS  PubMed  Google Scholar 

  30. Multiple state agencies responding to PFAS contamination on French Island [Internet]. Wisconsin Department of Natural Resources. Wisconsin Department of Natural Resources; 2021. Available from: https://dnr.wisconsin.gov/newsroom/release/42441.

  31. Pfas contamination in the Marinette and Peshtigo Area [Internet]. PFAS Contamination in the Marinette and Peshtigo Area | | Wisconsin DNR. Wisconsin Department of Natural Resources; 2022. Available from: https://dnr.wisconsin.gov/topic/PFAS/Marinette.html.

  32. Jha G, Kankarla V, McLennon E, Pal S, Sihi D, Dari B, et al. Per- and polyfluoroalkyl substances (PFAS) in integrated crop–livestock systems: environmental exposure and human health risks. Int J Environ Res Public Health. 2021;18:12550.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Johnson GR. Pfas in soil and groundwater following historical land application of Biosolids. Water Res. 2022;211:118035.

    Article  CAS  PubMed  Google Scholar 

  34. Water utility [Internet]. City of Madison, Wisconsin. Available from: https://www.cityofmadison.com/water/water-quality/water-quality-testing/perfluorinated-compounds.

  35. Staff AC. Wisconsin population increased 3.6% since 2010 [Internet]. Census.gov. United States Census Bureau; 2021. Available from: https://www.census.gov/library/stories/state-by-state/wisconsin-population-change-between-census-decade.html.

  36. Malecki KM, Nikodemova M, Schultz AA, LeCaire TJ, Bersch AJ, Cadmus-Bertram L, et al. The survey of the Health of Wisconsin (show) program: an infrastructure for advancing population health. Front Public Health. 2022;10:818777.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Minnesota Dept. of Public Health, Public Health Laboratory Division. Document DOC-563, Detection of PFAS in serum and Plasma via LC-MS/MS. Unpublished methods.

  38. Centers for Disease Control & Prevention, National Center for Environmental Health. Laboratory Procedure manual NHANES 2015-16, method 6304.08. Perfluoroalkyl and Polyfluoroalkyl Substances.

  39. New York State Dept. of Health, Division of Environmental Health Sciences, Laboratory of Organic Analytical Chemistry. Analysis of Perfluoroalkyl Substances In Human Serum by Solid Phase Extraction and Ultra High Performance Liquid Chromatography Tandem Mass Spectrometry. Unpublished methods.

  40. Michigan Dept. of Community Health, Bureau of Laboratories. Document AC-54. Analysis of serum for PFAS by RP-HPLC-MRM-MS/MS. 2018. Unpublished methods.

  41. Centers for Disease Control and Prevention. Nhanes - about the National Health and Nutrition Examination Survey. 2017. https://www.cdc.gov/nchs/nhanes/about_nhanes.htm (accessed 2 May 2022).

  42. Prior HHS Poverty Guidelines and Federal Register references [Internet]. ASPE. 2022. Available from: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines/prior-hhs-poverty-guidelines-federal-register-references.

  43. Yu CH, Riker CD, Lu SE, Fan ZT. Biomonitoring of emerging contaminants, perfluoroalkyl and polyfluoroalkyl substances (PFAS), in New Jersey Adults in 2016–2018. Int J Hyg Environ Health. 2020;223:34–44.

    Article  CAS  PubMed  Google Scholar 

  44. Brunn H, Arnold G, Körner W, Rippen G, Steinhäuser KG, Valentin I. PFAS: forever chemicals—persistent, bioaccumulative and mobile. Reviewing the status and the need for their phase out and remediation of contaminated sites. Environ Sci Eur. 2023;35:1–50.

    Google Scholar 

  45. Yao Y, Burgess J, Volchek K, Brown C. Short-Chain PFAS Their Sources, Properties, Toxicity, Environmental Fate, and Treatment. In: Kempisty D, Xing Y, Racz L, editors. Perfluoroalkyl Substances in the Environment Theory, Practice, and Innovation [Internet]. Boca Raton: CRC Press; 2018. p. 447–67. Available from: https://www.taylorfrancis.com/chapters/edit/10.1201/9780429487125-20/short-chain-pfas-yuan-yao-justin-burgess-konstantin-volchek-carl-brown?context=ubx&refId=afa9c083-21ea-4dae-9c6e-4050e54eb255.

  46. Nair AS, Ma ZQ, Watkins SM, Wood SS. Demographic and exposure characteristics as predictors of serum per- and polyfluoroalkyl substances (pfass) levels – a community-level biomonitoring project in Pennsylvania. Int J Hyg Environ Health. 2021;231:113631.

    Article  PubMed  Google Scholar 

  47. Sagiv SK, Rifas-Shiman SL, Webster TF, Mora AM, Harris MH, Calafat AM, et al. Sociodemographic and perinatal predictors of early pregnancy per- and polyfluoroalkyl substance (PFAS) concentrations. Environ Sci Technol. 2015;49:11849–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Wattigney WA, Savadatti SS, Liu M, Pavuk M, Lewis-Michl E, Kannan K, et al. Biomonitoring of per- and polyfluoroalkyl substances in minority angler communities in Central New York State. Environ Res. 2022;204:112309.

    Article  CAS  PubMed  Google Scholar 

  49. Olsen GW, Mair DC, Lange CC, Harrington LM, Church TR, Goldberg CL, et al. Per- and polyfluoroalkyl substances (PFAS) in American Red Cross Adult Blood Donors, 2000–2015. Environ Res. 2017;157:87–95.

    Article  CAS  PubMed  Google Scholar 

  50. Ding N, Harlow SD, Batterman S, Mukherjee B, Park SK. Longitudinal trends in perfluoroalkyl and polyfluoroalkyl substances among multiethnic midlife women from 1999 to 2011: The study of women′s health across the nation. Environ Int. 2020;135:105381.

    Article  CAS  PubMed  Google Scholar 

  51. DeLuca, NM, Thomas, K, Mullikin, A, Slover, R, Stanek, LW, Pilant, AN, et al. Geographic and demographic variability in serum PFAS concentrations for pregnant women in the United States. J Exp Sci Environ Epidemiol. 2023:1–15. PMID: 36697764 https://doi.org/10.1038/s41370-023-00520-6.

  52. Chang CJ, Ryan PB, Smarr MM, Kannan K, Panuwet P, Dunlop AL, et al. Serum per-and polyfluoroalkyl substance (PFAS) concentrations and predictors of exposure among pregnant African American women in the Atlanta area, Georgia. Environ Res. 2021;198:110445.

    Article  CAS  PubMed  Google Scholar 

  53. Evans GW, Kantrowitz E. Socioeconomic status and health: The potential role of environmental risk exposure. Annu Rev Public Health. 2002;23:303–31.

Download references

Acknowledgements

The authors would like to thank all the SHOW investigators who made this work possible, WSLH staff who contributed to the creation of this data, and the SHOW participants. Special acknowledgement to the WSLH, NS for conceptualization and BS for sample analysis.

Funding

Funding for SHOW comes from the Wisconsin Division of Public Health, the Wisconsin Partnership Program (PERC) Award (223 PRJ 25DJ), the National Institutes of Health’s Clinical and Translational Science Award (5UL 1RR025011), and the National Heart Lunch and Blood Institute (1 RC2 HL101468) and a core grant to the Center for Demography and Ecology at the University of Wisconsin-Madison (P2C HD047873). Additional funding for this analysis came from the Association of Public Health Laboratories (APHL).

Author information

Authors and Affiliations

  1. Survey of the Health of Wisconsin (SHOW), University of Wisconsin Madison, Madison, WI, USA

    Amy A. Schultz, Rachel Pomazal & Kristen C. Malecki

  2. Wisconsin State Lab of Hygiene (WSLH), Madison, WI, USA

    Noel Stanton, Brandon Shelton & Meshel A. Lange

  3. Wisconsin Department of Health Services, Madison, WI, USA

    Roy Irving & Jonathan Meiman

  4. University of Illinois at Chicago School of Public Health, Chicago, IL, USA

    Kristen C. Malecki

Authors
  1. Amy A. Schultz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Noel Stanton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brandon Shelton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rachel Pomazal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meshel A. Lange
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Roy Irving
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jonathan Meiman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kristen C. Malecki
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: NS, BS, AAS, KCM. Methodology: NS, BS, ML, AAS. Sample analysis: BS, NS, ML. Data analysis: AAS, RP. Draft preparation: AAS, RP, NS, KCM. Review and Editing: AAS, RP, RI, JM, KCM. Supervision: KCM, NS. Funding acquisition: AAS, NS.

Corresponding author

Correspondence to Amy A. Schultz.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

The SHOW protocol and informed consent documents are approved by the Health Sciences Institutional Review Board of the University of Wisconsin-Madison. Participants in SHOW gave consent to their information being used for research prior to this study.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schultz, A.A., Stanton, N., Shelton, B. et al. Biomonitoring of perfluoroalkyl and polyfluoroalkyl substances (PFAS) from the Survey of the Health of Wisconsin (SHOW) 2014–2016 and comparison with the National Health and Nutrition Examination Survey (NHANES). J Expo Sci Environ Epidemiol 33, 766–777 (2023). https://doi.org/10.1038/s41370-023-00593-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41370-023-00593-3

Keywords

Search

Advanced search

Quick links