Study: Young military veterans have higher ‘forever chemical’ levels than non-veterans

PROVIDENCE, R.I. [Brown University] - Per- and polyfluoroalkyl substances (PFAS), often called forever chemicals because of their long-lasting presence in humans and the environment, are commonly found in consumer and industrial products. When Brown University researchers examined PFAS levels in the blood serum of United States military veterans, they found that younger veterans had higher PFAS concentrations and a higher prevalence of elevated PFAS compared with civilians of similar ages.

Because PFAS are associated with a range of health effects, including kidney and testicular cancers, liver and cardiovascular disease and thyroid dysfunction, the researchers said the findings can be helpful in guiding healthcare decisions for veterans.

"From a public health perspective, the critical thing about this work is that it comes with a recommendation," said lead study author Christian Hoover, a pre-doctoral fellow in epidemiology at Brown's School of Public Health. "If you're a male veteran between the ages of 20 and 39, it would be advisable to speak to a physician about getting tested for PFAS levels. It's also a good idea for people in this category to have a conversation about the health conditions associated with elevated PFAS levels, to see if screening for those conditions makes sense."

The findings were published in Environmental Health Perspectives.

The researchers don't know for sure what caused the elevated levels, but they said PFAS sources could include past exposure to firefighting foams, munitions and groundwater contamination.

The potential for elevated exposure in veterans was one of the reasons the researchers decided to investigate whether there was an association, said study author Joseph Braun, a professor of epidemiology at Brown. This is not something that had previously been explored, despite the fact that the National Health and Nutrition Examination Survey includes questions about military service.

The researchers analyzed eight survey cycles from 2003 to 2018, representing an estimated 22.8 million U.S. adults over age 20 with prior military service, after applying national survey weights. They found that younger veterans, aged 20 to 39, had greater PFAS concentrations (13% to 24% higher, depending on the specific chemical) than non-veterans of the same age.

The National Academies of Sciences, Engineering and Medicine recommend monitoring by a health care professional for individuals with PFAS levels above 20 ng/mL, given the potential for adverse health risks. The study found that young veterans were 18% more likely to exceed that threshold than young non-veterans.

The age of the veterans matters because younger veterans are more likely to have recent acute exposure to PFAS in the course of their work and training, Braun said.

"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. "So as veterans get older and less actively involved with the military, they not only have less exposure, but the PFAS have time to be excreted out of the body."

While younger veterans can get tested early and identify health risks before they become a health issue, Hoover noted that older veterans may still want to talk to their doctors.

"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.

Hoover added that the findings may inform Veterans Health Administration policies regarding coverage for PFAS testing.

Elizabeth Costello, a research scientist at Brown's School of Public Health, contributed to the study, which was supported by grants from the National Institute of Environmental Health Sciences (F31ES036867, R01ES037335 and R21ES036946).