You might want to eye that fast food container a little closer. A new study has linked exposure to two common perfluorinated chemicals (PFCs) with osteoarthritis (OA). PFCs are used in numerous products, including certain stain- and water-resistant fabrics, grease-proof paper food containers, personal care products, and other items. The study, published in Environmental Health Perspectives, is the first to look at the associations between perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), and OA, in a study population representative of the United States.
Common Chemicals Causing Osteoarthritis?
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“We found that PFOA and PFOS exposures are associated with higher prevalence of osteoarthritis, particularly in women, a group that is disproportionately impacted by this chronic disease, ” said Sarah Uhl in the February 15, 2013 news release. Uhl was a co-author on the study, along with Yale Professor Michelle L. Bell and Tamarra James-Todd, an epidemiologist at the Harvard Medical School and Brigham and Women’s Hospital. The research was the focus of Uhl’s Master’s of Environmental Science Program at the Yale School of Forestry and Environmental Studies.
When the researchers looked at men and women separately, they found clear, strong associations for women, but not men. Women in the highest 25% of exposure to PFOA had about two times the odds of having osteoarthritis compared to those in the lowest 25% of exposure.
Uhl told OTW, “We found that higher levels of exposure to PFOA and PFOS were associated with higher prevalence of osteoarthritis, particularly in women, a group that is disproportionately impacted by this chronic disease. We observed these associations in group of about 4, 100 participants in the National Health and Nutrition Examination Survey (NHANES), which is designed to represent the U.S. population as a whole.”
“While we do not have any follow-up research planned at this time, future studies could examine the biological mechanisms that may explain what we observed. A prospective study in which exposure is measured and then study participants are followed through time for development of osteoarthritis would be necessary to establish temporality.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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