A new study has found an association between cardiovascular disease and exposure to perfluorooctanoic acid (PFOA), a manmade chemical used in the manufacture of several common household products.
The study of 1,216 individuals was conducted by Anoop Shankar, MD, and colleagues, at the Department of Epidemiology, West Virginia University School of Public Health. It was published online in the September 3, 2012 issue of the Archives of Internal Medicine, a journal of the American Medical Association.
The study was supported by grants from the American Heart Association and the National Institutes of Health, National Institute of Environmental Health Sciences.
“Perfluorooctanoic acid has been widely used in the manufacture of industrial and consumer products such as surfactants, lubricants, polishes, paper and textile coatings, food packaging, and fire-retarding foams,” the authors state.
Other sources indicate that Perfluorooctanoic acid (also known as C8) has been used in the manufacture of such prominent consumer goods as Teflon (see image above) and Gore-Tex (a fabric best known for its use in protective, yet breathable, rainwear).
Surveys have shown that “PFOA has been detected in the blood of more than 98% of Americans,” the authors observe. “Recent evidence from retired employees in PFOA production facilities suggest a relatively long elimination half-life of approximately 3.8 years for PFOA,” they add.
Previous animal studies have shown a potential connection between exposure to PFOA and Cardiovascular Disease, but this was the first study to examine the connection between PFOA exposure and Cardiovascular Disease in humans, according to the authors.
“Cardiovascular disease (CVD) is a major public health problem,” the authors observe. In fact, as pointed out in commentary published with the study, Cardiovascular disease (CVD) remains the most common cause of death in the United States.
“Identifying novel risk factors for CVD, including widely prevalent environmental exposures, is therefore important,” the authors state.
For the study the authors used merged data from the 1999-2000 and 2003-2004 National Health and Nutrition Examination Survey (NHANES), and examined data from a nationally representative sample of 1,216 adults.
Based on the data collected in the NHANES Survey, the researchers examined and analyzed the association between serum (blood) levels of PFOA reported in the participants, and the presence of Cardiovascular Disease (CVD) and Peripheral Arterial Disease (PAD), an indicator of atherosclerosis.
The study results found that increasing serum (blood) levels of PFOA were positively and significantly associated with the presence of Cardiovascular Disease (CVD) and Peripheral Arterial Disease (PAD).
The association remained significant even after controlling for other factors which are known to be risk factors for CDV and PAD, including age, sex, race/ethnicity, smoking status, body mass index, diabetes mellitus, hypertension and serum cholesterol level, the authors reported.
The results showed that, “compared with the reference level of PFOA in quartile 1, the multivariable odds ratio among participants in quartile 4 was 2.01 for CVD and 1.78 for PAD,” according to a release issued by the Archives of Internal Medicine about the study.
In other words, study participants with the highest levels of PFOA in their blood were twice as likely to have Cardiovascular Disease and 1.78 times as likely to have Peripheral Arterial Disease as those with the lowest levels of PFOA in their blood.
“Our results contribute to the emerging data on health effects of PFCs [perfluoroalkyl chemicals], suggesting for the first time that PFOA exposure is potentially related to CVD [Cardiovascular Disease] and PAD [Peripheral Arterial Disease],” the authors concluded.
“However, owing to the cross-sectional nature of the present study, we cannot conclude that the association is causal,” they noted in comment.
“In summary, in a representative cross-sectional sample of the U.S. population, we found that higher PFOA levels are positively associated with self-reported CVD and objectively measured PAD. Our findings, however, should be interpreted with caution because of the possibility of residual confounding and reverse causality. Future prospective studies are needed to confirm or refute our findings,” the authors concluded.
In commentary accompanying the study, also published in the September 3 issue of the Archives of Internal Medicine, Debabrata Mukherjee, M.D., M.S., of Texas Tech University Health Sciences Center wrote: “These results contribute to the evolving data on the adverse health effects of PFOA, suggesting that PFOA exposure may be potentially related to CVD.”
“Although it seems clear that additional prospective research is needed to tease out the true adverse cardiovascular effects of PFOA, given the concerns raised by this and prior studies, clinicians will need to act now,” Dr. Mukherjee urges.
“From a societal point of view, it would make sense to limit or to eliminate the use of PFOA and its congeners in industry through legislation and regulation while improving water purification and treatment techniques to try and remove this potentially toxic chemical from our water supply,” Dr. Mukherjee concludes.
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