PFAS Contaminated Groundwater and Prevalence of Chronic Health Conditions among Medicare Beneficiaries
Citation:
Rappold, A., H. Hill, W. Steinhardt, R. Short, E. Hubal, AND A. Sheng. PFAS Contaminated Groundwater and Prevalence of Chronic Health Conditions among Medicare Beneficiaries. International Society of Exposure Science, Chicago, IL, August 21 - 25, 2023.
Impact/Purpose:
This abstract is part of the pilot to prioritize site investigation of PFAS contamination and screen for PFAS chemicals of concern to support Columbia River Basin Tribes and States in EPA Regions 8 and 10¿. This proposal will develop cost-effective screening methods to identify, characterize and prioritize clean-up of PFAS contaminated sites. Predicting PFAS contaminated sites by applying statistical modeling techniques to existing data sources (e.g., industry sector locations) will also evaluate risk and inform waste and sustainable materials management leading to the prevention of future contamination and the clean-up of existing contamination. Additionally, this research will identify and map vulnerabilities to healthy and resilient communities where gaps in knowledge currently exist on PFAS contamination and exposure. This project also complements SHC Research Area 5: Chemicals of Concern, including outputs 5.3 “Identification and Characterization of PFAS Sites and Sources”, and 5.5 "Methodology for estimating PFAS multi-media human exposure to identify locations of high potential exposure."
Description:
Per- and polyfluoroalkyl substances (PFAS) are a class of persistent organic pollutants with emerging environmental and regulatory concerns. The California Water Board’s Groundwater Ambient Monitoring and Assessment (GAMA) water quality database was used to estimate PFAS contamination within California’s groundwater resources but non-systematic testing for PFAS may have introduced a selection bias. For each ZIP code population centroid, we calculated an inverse distance squared weighted estimate of PFAS groundwater contamination for all tested wells within 20 km and then Windsorized to the 95th percentile to reduce the influence of outliers. The Centers for Medicare and Medicaid Services’ (CMS) Chronic Conditions Database was used to calculate the prevalence of 27 chronic health conditions among US Medicare beneficiaries aged 65 and older by ZIP code of residence. We restricted our analyses to California counties that derived 25 percent or more of their drinking water from groundwater. A Poisson regression model was used to estimate associations between PFAS concentration in groundwater and prevalence of chronic conditions adjusting for a PFAS-testing propensity score, demographic characteristics, and the prevalence of lung cancer as a negative control. Preliminary results suggest an association between PFAS contaminated groundwater and several chronic health conditions including hypertension, hypothyroidism, glaucoma, and hyperlipidemia. In addition to strengthening our understanding of the chronic health impacts of PFAS, this project demonstrates the utility of synthesizing data across multiple disciplines to explore these emerging contaminants within the broader context of environmental justice. This abstract does not represent EPA policy.