Lazarevic Nina, Smurthwaite Kayla S, Batterham Philip J, Lane Jo, Trevenar Susan M, D'Este Catherine, Clements Archie C A, Joshy Amelia L, Hosking Rose, Gad Imogen, Lal Aparna, Law Hsei Di, Banwell Catherine, Randall Deborah A, Miller Adrian, Housen Tambri, Korda Rosemary J, Kirk Martyn D
National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT 2600, Australia.
National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT 2600, Australia.
Sci Total Environ. 2023 May 20;874:162503. doi: 10.1016/j.scitotenv.2023.162503. Epub 2023 Mar 1.
Environmental chemical contamination is a recognised risk factor for psychological distress, but has been seldom studied in the context of per- and polyfluoroalkyl substances (PFAS) contamination. We examined psychological distress in a cross-sectional study of three Australian communities exposed to PFAS from the historical use of aqueous film-forming foam in firefighting activities, and three comparison communities without environmental contamination.
Participation was voluntary following recruitment from a PFAS blood-testing program (exposed) or random selection (comparison). Participants provided blood samples and completed a survey on their exposure history, sociodemographic characteristics, and four measures of psychological distress (Kessler-6, Distress Questionnaire-5, Patient Health Questionnaire-15, and Generalised Anxiety Disorder-7). We estimated prevalence ratios (PR) of clinically-significant psychological distress scores, and differences in mean scores: (1) between exposed and comparison communities; (2) per doubling in PFAS serum concentrations in exposed communities; (3) for factors that affect the perceived risk of living in a community exposed to PFAS; and (4) in relation to self-reported health concerns.
We recruited 881 adults in exposed communities and 801 in comparison communities. We observed higher levels of self-reported psychological distress in exposed communities than in comparison communities (e.g., Katherine compared to Alice Springs, Northern Territory: clinically-significant anxiety scores, adjusted PR = 2.82, 95 % CI 1.16-6.89). We found little evidence to suggest that psychological distress was associated with PFAS serum concentrations (e.g., Katherine, PFOS and anxiety, adjusted PR = 0.85, 95 % CI 0.65-1.10). Psychological distress was higher among exposed participants who were occupationally exposed to firefighting foam, used bore water on their properties, or were concerned about their health.
Psychological distress was substantially more prevalent in exposed communities than in comparison communities. Our findings suggest that the perception of risks to health, rather than PFAS exposure, contribute to psychological distress in communities with PFAS contamination.
环境化学污染是公认的心理困扰风险因素，但在全氟和多氟烷基物质（PFAS）污染背景下的研究很少。我们在一项横断面研究中，调查了澳大利亚三个因历史上在消防活动中使用水成膜泡沫而接触PFAS的社区以及三个无环境污染的对照社区中的心理困扰情况。
从PFAS血液检测项目（暴露组）招募或随机选择（对照组）参与者，参与是自愿的。参与者提供血样并完成一项关于其暴露史、社会人口学特征以及四项心理困扰测量指标（凯斯勒6项心理困扰量表、苦恼问卷-5、患者健康问卷-15和广泛性焦虑障碍量表-7）的调查。我们估计了具有临床意义的心理困扰分数的患病率比（PR）以及平均分数差异：（1）暴露社区与对照社区之间；（2）暴露社区中PFAS血清浓度每增加一倍；（3）影响生活在PFAS暴露社区中感知风险的因素；以及（4）与自我报告的健康担忧相关。
我们在暴露社区招募了881名成年人，在对照社区招募了801名。我们观察到暴露社区中自我报告的心理困扰水平高于对照社区（例如，凯瑟琳与北领地的爱丽丝泉相比：具有临床意义的焦虑分数，调整后的PR = 2.82，95%CI 1.16 - 6.89）。我们几乎没有发现证据表明心理困扰与PFAS血清浓度有关（例如，凯瑟琳，全氟辛烷磺酸与焦虑，调整后的PR = 0.85，95%CI 0.65 - 1.10）。在职业上接触消防泡沫、在其房产上使用井水或担心自身健康的暴露参与者中，心理困扰程度更高。
暴露社区中的心理困扰比对照社区更为普遍。我们的研究结果表明，对健康风险的感知而非PFAS暴露，导致了PFAS污染社区中的心理困扰。
