Sruthi Atluri, Mohammad Sukhera, Heidi Clarahan, Andrea K. Tokranov, Dana W. Kolpin, Zackary R. Hopkins, Rimas Nemickas, Xueshu Li, Devon Foster, Tayler Titterington, Jeonghyeon Ahn, Kim Sprenger, Alejandro Comellas-Freymond, Michelle M. Lorah, Hans-Joachim Lehmler, Robert J. Blount 

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants that can accumulate in lung tissue and disrupt pulmonary surfactant function which is critical for optimizing alveolar gas exchange. To help evaluate effects on human lung health, we designed a cross-sectional study to test if PFAS exposure in Iowans living within 50-km of a large electronics and internal materials manufacturing facility on the Iowa-Illinois (United States) border is deleteriously affecting lung health. The facility has manufactured PFAS since the 1970s and groundwater in the area has been found to have high PFAS concentrations. Home visits included an exposure questionnaire, the St. George’s Respiratory Questionnaire (SGRQ), the Modified Medical Research Council (mMRC) dyspnea scale, drinking water samples for PFAS analysis, and deployment of silicone bands to test for indoor volatile PFAS. In addition, participants came to the Clinical Research Unit at University of Iowa for pulmonary function testing (PFTs) and serum sample collection for PFAS analysis. We fit multivariable generalized estimating equation (GEE) regression models with lung measurements as outcomes and exposure variables as predictors, adjusting for biologically plausible potential confounders. 

We enrolled 99 participants from 48 households between June 2024 and January 2025. The cohort included 17 children (mean age 11 years) and 82 adults (mean age 61 years). Most participants were non-Hispanic White (99%) and evenly distributed by sex (52% female). A third of participants reported current or prior tobacco smoking. High inhalation exposure occupations were reported by 32%, and potential workplace PFAS exposure were reported by 28%. The median household distance from the manufacturing facility was 14 km (range: 2–48 km). Current and former smokers served as the positive control and had statistically significantly lower lung function and worse respiratory symptoms compared with never smokers, with reduced forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and diffusion capacity; and increased lung resistance at 5Hz and symptoms by SGRQ and mMRC respiratory questionnaires. In contrast, no statistically significant relationships were observed between well water exposure variables (well age, well distance from the manufacturing facility, volume of well water consumed per day, and use of water filtration and/or reverse osmosis) and lung outcomes. The next phase of this study will analyze the serum, drinking water, and silicone band samples for 34 PFAS and their relations with lung outcomes.