Assessing the utility of healthcare claims data to determine potential health impacts of PFAS exposure with public drinking water.

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.