Studying the relationship between PFAS contamination and human health to support intervention strategies

Per- and polyfluoroalkyl substances (PFAS) are a large class of synthetic chemicals widely used in industrial and consumer applications due to their chemical stability and surfactant properties. This same stability, however, makes PFAS highly persistent in the environment, leading to widespread contamination of water resources and near-universal human exposure. Growing epidemiological evidence has linked exposure to several legacy PFAS, particularly perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), to adverse health outcomes, prompting regulatory restrictions and increased environmental monitoring. Despite this progress, translating evidence from highly contaminated settings to regions characterized by spatially heterogeneous, low-to-moderate PFAS contamination remains challenging, leaving uncertainty about population-level health impacts at the local scale. This study investigates the relationship between PFAS contamination in multiple water bodies, and selected human health outcomes in the Lombardia region of Northern Italy. Publicly available monitoring water data collected between 2018 and 2023 were compiled, harmonized, and analyzed to characterize the spatial and temporal distribution of multiple PFAS compounds across municipalities. These environmental data were integrated with administrative hospital discharge records to explore potential associations between PFAS occurrence and selected cancer and non-cancer outcomes, including malignancies previously associated with PFAS exposure in epidemiological studies. The analysis adopts a population-based, exploratory framework that reflects realistic exposure scenarios involving mixtures of PFAS rather than isolated compounds. By linking environmental monitoring data with health information at the municipal level, this study aims to contribute to a more integrated understanding of PFAS contamination and its potential public health implications. The findings are intended to support regional risk assessment efforts and inform future monitoring strategies and intervention planning in areas affected by diffuse PFAS contamination.