Determination of per- and polyfluoroalkyl substances (PFAS) in plasma of Italian firefighters

Per- and polyfluoroalkyl substances (PFAS) are highly persistent chemicals widely used in industrial processes and associated with extensive environmental contamination. Due to their bioaccumulative properties, PFAS exposure has been linked to adverse health effects, and some compounds have been classified as carcinogenic or possibly carcinogenic to humans. Some groups of workers are considered at risk, and particularly firefighters are considered a potentially high-risk occupational group because of repeated exposure to hazardous substances, such as PFAS. Therefore, this study aimed to evaluate PFAS exposure among firefighters operating in central and northern Italy by measuring plasma concentrations of PFAS and investigating anamnestic determinants. A total of 378 firefighters were voluntarily recruited and completed an anamnestic questionnaire. Plasma samples were analyzed using validated liquid chromatography–tandem mass spectrometry (LC–MS/MS) for 24 PFAS congeners from the EPA 533 list. Of the 24 PFAS investigated, 12 were detected in the analyzed samples: PFBA, PFHxS, PFOA, PFOS, PFDA, PFUnA, PFNA, PFHpS, PFHpA, 6:2 FTS, PFPeA, and 9Cl-PF3ONS. The mean summed concentration of the detected PFAS was 7.26 ng/mL (SD = 4.58 ng/mL). PFOS and PFOA were the predominant compounds, with mean concentrations of 4.34 ng/mL and 1.27 ng/mL, respectively. In primary analyses, significant differences emerged according to different headquarters, age, sex, fish and seafood consumption, use of waterproof clothing outside the workplace, qualification, years of service, and type of service. In age- and sex-adjusted sensitivity analyses, the association with different headquarters remained significant, and fish and seafood consumption, type of service, and qualification also remained associated with total PFAS levels, whereas the associations with years of service and use of waterproof clothing outside the workplace were attenuated. No significant associations emerged in the primary analysis for BMI, smoking habits, living environment, or organic food consumption.