Namulanda Gonza, Condon Suzanne, Palmer Terri Lynn, Ellis Elizabeth, Yip Fuyuen, Reh Christopher M, Breysse Patrick
Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA.
National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA.
Environ Epidemiol. 2025 Mar 3;9(2):e368. doi: 10.1097/EE9.0000000000000368. eCollection 2025 Apr.
Healthcare claims data can support the timely surveillance of health outcomes from exposures to emerging and established environmental contaminants such as per- and polyfluoroalkyl substances (PFAS). PFAS are widely used in a variety of consumer products and industrial applications. They are detected in almost all Americans. PFAS exposure has been associated with several health outcomes including high cholesterol and thyroid disease. In 2014, PFAS were detected in five drinking water wells in New Castle City, New Castle County, Delaware. Perfluorooctane sulfonate and perfluorooctanoic acid were measured above the then Environmental Protection Agency's lifetime health advisory of 70 parts per trillion. This study uses healthcare claims data to show that healthcare plan members living in the ZIP code served by the five wells were at higher risk for type 2 diabetes, hypertension, hypertensive diseases, coronary artery disease, and hyperthyroidism based on new claims compared with healthcare plan members living elsewhere in the county. Healthcare claims data provided timely information on health outcomes not captured by traditional public health surveillance systems and at finer geographic levels.
医疗保健理赔数据有助于及时监测接触新兴和已确认的环境污染物（如全氟和多氟烷基物质（PFAS））后的健康状况。PFAS广泛应用于各种消费品和工业应用中。几乎在所有美国人身上都能检测到它们。接触PFAS与多种健康状况有关，包括高胆固醇和甲状腺疾病。2014年，在特拉华州纽卡斯尔县纽卡斯尔市的五口水井中检测到了PFAS。全氟辛烷磺酸和全氟辛酸的测量值超过了当时美国环境保护局规定的万亿分之70的终身健康咨询水平。本研究利用医疗保健理赔数据表明，与居住在该县其他地区的医疗保健计划成员相比，居住在这五口水井所在邮政编码区域的医疗保健计划成员，基于新理赔情况，患2型糖尿病、高血压、高血压疾病、冠状动脉疾病和甲状腺功能亢进的风险更高。医疗保健理赔数据提供了传统公共卫生监测系统未涵盖的、更精细地理层面上的健康状况及时信息。
