PFAS Contaminated Groundwater and Prevalence of Chronic Health Conditions among Medicare Beneficiaries
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Per- and polyfluoroalkyl substances (PFAS) are a class of persistent organic pollutants with emerging environmental and regulatory concerns. The California Water Board’s Groundwater Ambient Monitoring and Assessment (GAMA) water quality database was used to estimate PFAS contamination within California’s groundwater resources but non-systematic testing for PFAS may have introduced a selection bias. For each ZIP code population centroid, we calculated an inverse distance squared weighted estimate of PFAS groundwater contamination for all tested wells within 20 km and then Windsorized to the 95th percentile to reduce the influence of outliers. The Centers for Medicare and Medicaid Services’ (CMS) Chronic Conditions Database was used to calculate the prevalence of 27 chronic health conditions among US Medicare beneficiaries aged 65 and older by ZIP code of residence. We restricted our analyses to California counties that derived 25 percent or more of their drinking water from groundwater. A Poisson regression model was used to estimate associations between PFAS concentration in groundwater and prevalence of chronic conditions adjusting for a PFAS-testing propensity score, demographic characteristics, and the prevalence of lung cancer as a negative control. Preliminary results suggest an association between PFAS contaminated groundwater and several chronic health conditions including hypertension, hypothyroidism, glaucoma, and hyperlipidemia. In addition to strengthening our understanding of the chronic health impacts of PFAS, this project demonstrates the utility of synthesizing data across multiple disciplines to explore these emerging contaminants within the broader context of environmental justice. This abstract does not represent EPA policy.