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. 2020 Jul;128(7):77005.
doi: 10.1289/EHP6837. Epub 2020 Jul 22.

Measurement of Novel, Drinking Water-Associated PFAS in Blood from Adults and Children in Wilmington, North Carolina

Nadine Kotlarz  1   2   3 , James McCord  4 , David Collier  3   5 , C Suzanne Lea  3   6 , Mark Strynar  4 , Andrew B Lindstrom  4 , Adrien A Wilkie  2   7 , Jessica Y Islam  2   7 , Katelyn Matney  8 , Phillip Tarte  8 , M E Polera  9 , Kemp Burdette  9 , Jamie DeWitt  3   10 , Katlyn May  3 , Robert C Smart  2   3 , Detlef R U Knappe  1   3 , Jane A Hoppin  2   3
Affiliations

Measurement of Novel, Drinking Water-Associated PFAS in Blood from Adults and Children in Wilmington, North Carolina

Nadine Kotlarz et al. Environ Health Perspect. 2020 Jul.

Erratum in

Abstract

Background: From 1980 to 2017, a fluorochemical manufacturing facility discharged wastewater containing poorly understood per- and polyfluoroalkyl substances (PFAS) to the Cape Fear River, the primary drinking water source for Wilmington, North Carolina, residents. Those PFAS included several fluoroethers including HFPO-DA also known as GenX. Little is known about the bioaccumulation potential of these fluoroethers.

Objective: We determined levels of fluoroethers and legacy PFAS in serum samples from Wilmington residents.

Methods: In November 2017 and May 2018, we enrolled 344 Wilmington residents ≥6 years of age into the GenX Exposure Study and collected blood samples. Repeated blood samples were collected from 44 participants 6 months after enrollment. We analyzed serum for 10 fluoroethers and 10 legacy PFAS using liquid chromatography-high-resolution mass spectrometry.

Results: Participants' ages ranged from 6 to 86 y, and they lived in the lower Cape Fear Region for 20 y on average (standard deviation: 16 y). Six fluoroethers were detected in serum; Nafion by-product 2, PFO4DA, and PFO5DoA were detected in >85% of participants. PFO3OA and NVHOS were infrequently detected. Hydro-EVE was present in a subset of samples, but we could not quantify it. GenX was not detected above our analytical method reporting limit (2 ng/mL). In participants with repeated samples, the median decrease in fluoroether levels ranged from 28% for PFO5DoA to 65% for PFO4DA in 6 months due to wastewater discharge control. Four legacy PFAS (PFHxS, PFOA, PFOS, PFNA) were detected in most (≥97%) participants; these levels were higher than U.S. national levels for the 2015-2016 National Health and Nutrition Examination Survey. The sum concentration of fluoroethers contributed 24% to participants' total serum PFAS (median: 25.3 ng/mL).

Conclusion: Poorly understood fluoroethers released into the Cape Fear River by a fluorochemical manufacturing facility were detected in blood samples from Wilmington, North Carolina, residents. Health implications of exposure to these novel PFAS have not been well characterized. https://doi.org/10.1289/EHP6837.

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Figures

Figure 1 is a map of the Cape Fear River Basin, North Carolina, United States, plotting Wilmington, Cape Fear Public Utility Authority raw water intake, Cape Fear River, PFAS manufacturing plant, Fayetteville, Deep River, Pittsboro, Haw River, Greensboro, Basin boundary, Raleigh, Durham, Chapel Hill, and Cape Fear Basin, North Carolina, United States. A scale at bottom-left ranges from 0 to 120 kilometers in increments of 30. According to the scale 30 kilometers will be 18.6 miles, 60 kilometers will be 37.3 miles, 90 kilometers will be 55.9 miles, and 120 kilometers will be 74.6 miles.
Figure 1.
Cape Fear River Basin, North Carolina, United States. Note: PFAS, per- and polyfluoroalkyl substances.
Figure 2 is a flow chart with four steps. Step 1: In November, 2017, 310 people were enrolled plus In May, 2018, 34 people were enrolled, which equals to 344 participants in the GenX exposure study. Step 2: 310 people enrolled leads to 310 participants provided blood and 34 people enrolled leads to 34 participants provided blood. Step 3: 310 participants provided blood which leads to 45 participants enrolled to provide a second blood sample. Step 4: 45 participants enrolled to provide a second blood sample, eliminating those who did not give a second blood sample (n equals 1) leads to 44 participants provided a second blood sample.
Figure 2.
Study enrollment and blood sample collection in the GenX Exposure Study: Wilmington, North Carolina. Note: GenX, hexafluoropropylene oxide dimer acid.
Figure 3 includes two box and whisker plots. First box and whisker plot plots Serum P F A S (nanograms per milliliter), ranging from 0 to 15 in increments of 2.5 (y-axis) across Nafion by-product 2 and P F O 4 D A (x-axis) for November 2017 and May 2018. Second box and whisker plot plots Serum P F A S (nanograms per milliliter), ranging from 0.25 to 1.00 in increments of 0.25 (y-axis) across P F O 5 D o A (x-axis) for November 2017 and May 2018.
Figure 3.
Box and whisker plot of Nafion by-product 2 and PFO4DA concentrations (ng/mL) in serum from 44 Wilmington, North Carolina, residents (42 adults and 2 children) who provided blood samples in November 2017 and May 2018. Boxes show median concentrations and the 25th and 75th percentiles; 5th and 95th percentiles are indicated by the whiskers. The MRL was 0.1 ng/mL. See Table S7 for corresponding numeric data. Note: MRL, method reporting limit; Nafion by-product 2, perfluoro-2-{[perfluoro-3-(perfluoroethoxy)-2-propanyl]oxy}ethanesulfonic acid; PFAS, per- and polyfluoroalkyl substances; PFO4DA, perfluoro-3,5,7,9-butaoxadecanoic acid.
Figure 4 includes two box and whisker plots. First box and whisker plot plots Serum P F A S (nanograms per milliliter), ranging from 0 to 12 in increments of 2 (y-axis) across P F H x S, P F O A superscript a and P F N A (x-axis) for U S population, 2015 to 2016 and Wilmington, N C, 2017 to 2018. Second box and whisker plot plots Serum PFAS (nanograms per milliliter), ranging from 0 to 30 in increments 5 (y-axis) across P F O S superscript b (x-axis) for U S population, 2015 to 2016 and Wilmington, N C, 2017 to 2018.
Figure 4.
Box and whisker plot of legacy PFAS concentrations (ng/mL) in sera from 344 Wilmington, North Carolina residents and the U.S. population based on NHANES data from the 2015–2016 survey year (CDC 2015–2016). Concentrations of Linear PFOA and linear PFOS were used for the U.S. population. Boxes show median concentrations and 25th and 75th percentiles; 5th and 95th percentiles are indicated by the whiskers. In the analysis of Wilmington residents’ sera, the median MRL for PFHxS, PFOA, and PFNA was 0.1 ng/mL, and PFOS was 0.2 ng/mL. For NHANES, the MRL was 0.1 ng/mL for the PFAS. See Table S8 for corresponding numeric data. PFHpA data are not presented because PFHpA is seldom detected in NHANES participants. For NHANES 2013–2014, which is the most recent PFHpA data available, the median was less than the MRL of 0.1 ng/mL. Note: MRL, method reporting limit; NHANES, National Health and Nutrition Examination Survey; PFAS, per- and polyfluoroalkyl substances; PFHpA, perfluoroheptanoic acid; PFHxS, perfluorohexane sulfonic acid; PFNA, perfluorononanoic acid; PFOA, perfluoroctanoic acid; PFOS, perfluorooctane sulfonic acid.
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