U.S. veterans ages 20 to 39 had higher levels of per- and polyfluoroalkyl substances, or PFAS, in their bloodstream compared with civilians of comparable age, according to a new study published Monday by Brown and Harvard researchers.
Known as “forever chemicals” because they resist breaking down and can accumulate in the body over time, PFAS are used in a host of products and equipment such as firefighting foam, weapons systems and textiles in military settings and food packaging, cookware, makeup, stain repellent and more.
At least one type of PFAS — PFOS — has been linked directly to testicular cancer, while another type, PFOA, is associated with kidney issues and increased risk of kidney cancer.
PFAS chemical exposure has also been connected to cardiovascular disease, thyroid dysfunction, low birth weight, developmental delays in children and reduced response to immunizations.
According to the study published Monday in Environmental Health Perspectives, young veterans had 13% to 24% higher concentrations of PFAS in their blood than non-veterans the same age.
Male veterans had higher PFAS concentrations than female veterans, while older veterans had levels comparable to their civilian counterparts.
The study reviewed the PFAS blood serum results of participants in National Health and Nutrition Examination Surveys from 2003 to 2018.
According to the review, 58% of the 22.8 million veterans who participated, or 13 million, had blood PFAS levels above a threshold set by the National Academies of Sciences, Engineering and Medicine of 20 micrograms per liter.
Lead study author Christian Hoover, a National Institutes of Health Research Fellow at Brown’s School of Public Health and Harvard’s T.H. Chan School of Public Health, said the National Academies recommends that those who exceed the threshold be monitored by their physicians.
Having high PFAS levels in their blood does not mean a person will develop cancer or cardiovascular disease, Hoover said, but blood tests and monitoring can provide data that may be useful in the future.
“[Testing] gives people helpful context … as they age for some of the things that might happen to their bodies over time,” Hoover said. “If they don’t get tested now between [ages] 20 and 39 and they get to 55, and they’re having all of these health effects, they won’t know why.”
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The surveys at the heart of the cross-sectional study did not ask about possible sources of PFAS exposure.
Hoover said previous research has shown that aqueous film-forming foam, related groundwater contamination on military bases, munitions, treated uniforms and even the burn pits used to dispose of industrial waste in combat zones could be responsible.
Younger veterans are more affected because they are most likely to have had recent exposure as a result of military service.
Older veterans are less likely to have acute exposure and PFAS that may have accumulated will be excreted over time, according to Joseph Braun, a professor of epidemiology at Brown University.
“The common PFAS chemical PFOA, for example, has a half-life of about one and a half to two years, which means that if someone drank a jar of PFOA today, it would take 10 years for their body to get rid of it,” Braun said in a statement.
The Department of Veterans Affairs does not provide or cover the cost of blood tests for PFAS. The Defense Department is required by law to offer blood tests for PFAS to active-duty and civilian DoD firefighters.
The 2020 legislation that mandated the testing does not include retired military firefighters, other active-duty personnel or dependents.
Hoover said all veterans, even those 40 and above, may want to talk to their doctors about exposure and possible health consequences.
“Even though our study wasn’t able to pick this up, it doesn’t mean that older veterans weren’t at the same risk when they were younger,” Hoover said.
Nearly 600 military installations, former defense sites and National Guard facilities have some degree of PFAS contamination. Since the late 2010s, the DoD has reviewed 727 installations and found that 590 require some type of cleanup.
The timeline for completing the review and remediation process has been extended for some installations to 2066.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.