AOCOPM 2024 Midyear Educational Conference-346719

346719 - Article 5

Pdf Summary

The presentation, given by Alan Philippi, DO, MS, addresses the Department of Defense (DoD) initiative beginning in October 2020 to include PFAS (perfluoroalkyl and polyfluoroalkyl substances) testing for its firefighters as part of their annual physical examinations. This initiative follows the provision outlined in Section 707 of the National Defense Authorization Act of 2020, aimed at documenting potential PFAS exposure among DoD firefighters. The testing is executed by a CLIA-certified laboratory, which analyzes blood samples for PFAS exposure, with results subsequently documented in firefighters' medical records.<br /><br />Learning objectives of this initiative include understanding the rationale behind the introduction of PFAS testing, identifying specific PFAS compounds tested, comparing testing results with the general population through NHANES data, addressing the challenges in correlating PFAS levels to health outcomes, and highlighting ongoing projects aimed at characterizing occupational PFAS exposures.<br /><br />Key challenges include comparability issues with general population data due to differing testing methodologies and a lack of comprehensive data on specific firefighter PFAS exposures. The current PFAS tests cover a limited range of substances, such as PFOS, PFOA, and PFHxS, among others.<br /><br />The initiative recognizes that while PFAS levels cannot yet inform medical treatments due to limited evidence on health impacts and no established exposure limits, associations have been noted with various health conditions such as increased cholesterol and liver enzyme levels, altered vaccine response in children, and cancer risks.<br /><br />Future directions involve expanding the PFAS panels, refining methodologies to align more closely with CDC standards, and developing an electronic questionnaire to better assess exposure pathways. The presentation also emphasizes NASEM's guidance on PFAS testing and the new ATSDR guidelines, aiming to address gaps in occupational exposure understanding and community concerns.

Keywords

PFAS testing

Department of Defense

firefighters

National Defense Authorization Act

CLIA-certified laboratory

NHANES data

occupational exposure

health outcomes

NASEM guidance

ATSDR guidelines