Phoebe Nadeau

Title: PFAS and Fish Consumption: A Review of Blood PFAS Concentrations and Public Health Guidelines

Abstract:

Per- and polyfluoroalkyl substances (PFAS) are a class of ubiquitous and persistentorganic pollutants that are used in a wide variety of applications such as in foodpackaging, waterproof materials, and personal care products. It is estimated that 97% ofpeople living in the United States have measurable concentrations of PFAS in their blood.1Exposure 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 testicularcancer. The main exposure route of PFAS is through ingestion, although dermalabsorption and inhalation are also possible. PFAS have been detected in highconcentrations in aquatic species, due to their ability to bioaccumulate and biomagnify aswell as their widespread contamination of bodies of fresh water. This implicates anexposure pathway for communities fishing for and consuming species out of thesewaters, as well as creates a potential occupational exposure hazard for fish processingprofessionals.A literature review was conducted to capture relevant information regarding thedifferences 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 criteriawere 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 closelyto race/ethnicity, highlighting potential disparities among populations. This literaturereview revealed differences in PFAS concentrations in high fish diet populations whencompared to lower fish diet populations. This highlights a potential exposure pathway forPFAS to enter the body through the consumption of contaminated fish.Based on findings of this literature review, recommendations include establishingcommunity outreach events to fishermen in areas with a high rate of self-caught fishconsumption, implementing community PFAS biomonitoring events, developing andcommunicating fish advisories in areas with a high rate of self-caught fish consumption,further researching occupational PFAS exposures in fish processing workers, andintegrating PFAS biomonitoring into routine care for potentially exposed populations.