PFAS Contaminated Groundwater and Incidence of Chronic Health Conditions among Medicare Beneficiaries in California
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Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants with emerging environmental and regulatory concerns. We estimated PFAS groundwater concentrations for every ZIP code tabulated area (ZCTA) in 40 California counties where 25 percent or more of the population’s drinking water was derived from groundwater. We calculated the annual incidence of 27 chronic health conditions among Medicare beneficiaries aged 65 and older by residential ZCTA over the seven-year study period (2011-2017). A Poisson regression model was used to estimate associations between PFAS groundwater concentration and chronic condition incidence with an offset for the number of beneficiary-years at risk and adjusting for sampling bias, use of groundwater for drinking water, demographic characteristics, and lung cancer incidence as a control for smoking. Results suggest an association between a 10 ng/L increment in PFAS contaminated groundwater and chronic health conditions including hypertension (+1.15%, 95% CI 1.01, 1.30), chronic kidney disease (+0.83%, 95% CI 0.68, 0.99) and cataracts (+1.50%, 95% CI 1.35, 1.66). This small increment in the incidence rate would produce an additional 1,700 new cases of hypertension each year in the study area.