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Research article - Peer-reviewed, 2023

Quantitative relationships of perfluoroalkyl acids in drinking water associated with serum concentrations above background in adults living near contamination hotspots in Sweden

Johanson, Gunnar; Gyllenhammar, Irina; Ekstrand, Carl; Pyko, Andrei; Xu, Yiyi; Li, Ying; Norstrom, Karin; Lilja, Karl; Lindh, Christian; Benskin, Jonathan P.; Georgelis, Antonios; Forsell, Karl; Jakobsson, Kristina; Glynn, Anders; Vogs, Carolina


Contaminated drinking water (DW) is a major source of exposure to per-and polyfluoroalkyl substances (PFAS) at locations around PFAS production/use facilities and military airports. This study aimed to investigate quan-titative relationships between concentrations in DW and serum of nine perfluoroalkyl acids (PFAAs) in Swedish adult populations living near contamination hotspots. Short-chained (PFPeA, PFHxA, PFHpA, and PFBS) and long-chained PFAAs (PFOA, PFNA, PFDA, PFHxS and PFOS) were measured in DW and serum. We matched DW and serum concentrations for a total of 398 subjects living or working in areas receiving contaminated DW and in one non-contaminated area. Thereafter, linear regression analysis with and without adjustments for co-variates was conducted. This enabled to derive (i) serum concentrations at background exposure (CB) from sources other than local DW exposure (i.e. food, dust and textiles) at 0 ng/L DW concentration, (ii) population-mean PFAA serum:water ratios (SWR) and (iii) PFAA concentrations in DW causing observable elevated serum PFAA con-centrations above background variability. Median concentrations of the sum of nine PFAAs ranged between 2.8 and 1790 ng/L in DW and between 7.6 and 96.9 ng/mL in serum. DW concentration was the strongest predictor, resulting in similar unadjusted and adjusted regression coefficients. Mean CB ranged from <0.1 (PFPeA, PFHpA, PFBS) to 5.1 ng/mL (PFOS). Serum concentrations increased significantly with increasing DW concentrations for all PFAAs except for PFPeA with SWRs ranging from <10 (PFHxA, PFHpA and PFBS) to 111 (PFHxS). Observed elevated serum concentrations above background variability were reached at DW concentrations between 24 (PFOA) and 357 ng/L (PFHxA). The unadjusted linear regression predictions agreed well with serum concen-trations previously reported in various populations exposed to low and high DW levels of PFOA, PFHxS and PFOS. The quantitative relationships derived herein should be helpful to translate PFAA concentrations in DW to concentrations in serum at the population level.


PFAS; Human biomonitoring; Tap water; Bioaccumulation; Toxicokinetics; Risk assessment

Published in

Environmental Research
2023, volume: 219, article number: 115024

Authors' information

Karolinska Institute
Gyllenhammar, Irina
National Food Agency
Gyllenhammar, Irina
Swedish University of Agricultural Sciences, Department of Biomedical Science and Veterinary Public Health
Pyko, Andrei
Karolinska Institutet
Xu, Yiyi
University of Gothenburg
Li, Ying
University of Gothenburg
Norström, Karin
Swedish environmental protection agency
Lilja, Karl
Swedish environmental protection agency
Lindh, Christian
Lund University
Benskin, Jonathan P.
Stockholm University
Georgelis, Antonios
Karolinska Institutet
Forsell, Karl
Umea University
Jakobsson, Kristina
University of Gothenburg
Jakobsson, Kristina
Sahlgrenska University Hospital

Sustainable Development Goals

SDG6 Clean water and sanitation

UKÄ Subject classification

Environmental Health and Occupational Health

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