Abstract:
Per- and polyfluoroalkyl substances (PFAS) are a class of ubiquitous and persistent
organic pollutants that are used in a wide variety of applications such as in food
packaging, waterproof materials, and personal care products. It is estimated that 97% of
people living in the United States have measurable concentrations of PFAS in their blood.1
Exposure to PFAS is linked to several adverse health outcomes, such as high cholesterol,
decreased thyroid function, and certain types of cancer, such as kidney and testicular
cancer. The main exposure route of PFAS is through ingestion, although dermal
absorption and inhalation are also possible. PFAS have been detected in high
concentrations in aquatic species, due to their ability to bioaccumulate and biomagnify as
well as their widespread contamination of bodies of fresh water. This implicates an
exposure pathway for communities fishing for and consuming species out of these
waters, as well as creates a potential occupational exposure hazard for fish processing
professionals.
A literature review was conducted to capture relevant information regarding the
differences in PFAS exposure by race/ethnicity, the relevance of PFAS exposure in
response to fish consumption, and published guidelines for clinicians working with PFAS-
exposed patients. The search engine PubMed was used to find relevant and reliable
literature. When relevant literature was found, appropriate inclusion and exclusion criteria
were applied to ensure relevance and uniformity among articles used in this review.
The conducted literature review revealed that there are differences in PFAS burden among
different race/ethnic groups. Articles reported that non-Hispanic Black (NHB), non-
Hispanic White (NHW), and Asian populations were found to have increased blood levels
of PFAS in different studies. Geographical location and built environment are tied closely
to race/ethnicity, highlighting potential disparities among populations. This literature
review revealed differences in PFAS concentrations in high fish diet populations when
compared to lower fish diet populations. This highlights a potential exposure pathway for
PFAS to enter the body through the consumption of contaminated fish.
Based on findings of this literature review, recommendations include establishing
community outreach events to fishermen in areas with a high rate of self-caught fish
consumption, implementing community PFAS biomonitoring events, developing and
communicating fish advisories in areas with a high rate of self-caught fish consumption,
further researching occupational PFAS exposures in fish processing workers, and
integrating PFAS biomonitoring into routine care for potentially exposed populations.