Alan Ducatman

West Virginia University | WVU · School of Public Health

Journal Pre-proof Association of per- and polyfluoroalkyl substance exposure with fatty liver disease risk in US Adults Xinyuan Zhang, PhD, Longgang Zhao, MS, Alan Ducatman, MD, Chuanjie Deng, MS, Katherine Ellen von Stackelberg, ScD, Christopher J. Danford, MD, Xuehong Zhang, MBBS, ScD PII: S2589-5559(23)00025-3 DOI: https://doi.org/10.1016/j.jhep...

Background: Per- and polyfluoroalkyl substances (PFAS) are human-made compounds with a widespread presence in human blood and other organs. PFAS have been associated with multiple health effects, including higher serum cholesterol and LDL cholesterol. Objective: Potential population differences in serum PFAS attributable to ezetimibe, a medicati...

Background Environmental health agencies are critical sources of information for communities affected by chemical contamination. Impacted residents and their healthcare providers often turn to federal and state agency webpages, fact sheets, and other documents to weigh exposure risks and interventions. Main body This commentary briefly reviews sci...

Appalachia’s health outcomes are inextricably linked to its political and environmental development. Many former lumber yards and coal towns are now ageing communities with diminished environments and few opportunities for employment. ARC Appalachia has faced deforestation, widescale fires, coal-related pollution and water contamination as a direct...

Background Hospital work environment contains various biological and chemical exposures that can affect indoor air quality and have impact on respiratory health of the staff. The objective of this study was to investigate potential effects of occupational exposures on the risk of respiratory symptoms and lung function in hospital work, and to evalu...

The aim of this study was to estimate the associations of blood manganese and selenium with serum concentrations of selected perfluoroalkyl substances (PFAS). The presence or absence of this association is important because PFAS have documented pro-oxidant properties, whereas manganese and selenium are critical to antioxidant responses. For this pu...

Gender-age specific linear statistical models were fitted to analyze gender-based differences in serum concentrations of PFOA, PFNA, PFHxS, and PFOS for US adults and adolescents (N = 17,932) and children age < 12 years (N = 637) using nationally representative data for US for 2003–2018. Around the age of about 11–12 years for PFOS, PFNA, and PFNA,...

Exposures to per- and polyfluoroalkyl substances (PFAS) cause oxidative stress, a risk factor for tissue damage leading to kidney and cardiovascular diseases. The antiaging protein klotho is known to act as an anti-oxidative agent, and how klotho homeostasis interacts with PFAS has not been reported. This study among 3981 US adults aged 40–79 years...

Appalachian Health explores major challenges and opportunities for promoting the health and well-being of the people of Appalachia, a historically underserved population. It considers health's intersection with social, political, and economic factors to shed light on the trends affecting mortality and morbidity among the region's residents. Editors...

Background: The hospital work environment contains various biological and chemical exposures that can affect indoor air quality and have impact on respiratory health of the staff. The objective of this study was to investigate potential effects of occupational exposures on the risk of respiratory symptoms and lung function in hospital work, and to...

Objective: To evaluate if serum perfluoroalkylated substances (PFAS) were associated with abdominal aortic calcification (AAC). Methods: We used weighted logistic regression to investigate the gender-specific association between PFAS serum levels and AAC ≥ 6 from DXA scans of the thoraco-lumbar spine from NHANES 2013-2014 survey participants age...

Exposures to per- and polyfluoroalkyl substances (PFAS) cause oxidative stress, a risk factor for tissue damage leading to kidney and cardiovascular diseases. The antiaging protein klotho is known to act as an anti-oxidative agent, and how klotho homeostasis interacts with PFAS has not been reported. This study among 3981 US adults aged 40-79 years...

Objective Exposures at hairdressers’ work have been reported to lead to an increased risk of several health outcomes. The present study aimed to investigate the relations between occupational exposures and respiratory symptoms and lung function among hairdressers in Iran. Methods We conducted a cross-sectional study to compare potential respirator...

Background Longer serum half-lives of perfluoroalkyl substances (PFAS) in humans compared to other species has been attributed to differences in the activity of organic anion transporters (OAT). Methods Among 56,175 adult participants in the community-based C8 Health Project, 23 subjects were taking the uricosuric OAT-inhibitor probenecid, and 36...

Previous population investigation of perfluoroalkyl substances (PFAS) features associations with lipids in a number of populations; these investigations have seldom included consideration of apolipoproteins. Apolipoprotein B (Apo B) fractions were considered in this descriptive analysis because they are essential to the assembly, transport, and cel...

Background: The current coronavirus disease 2019 (COVID-19) is spreading globally at an accelerated rate. There is some previous evidence that weather may influence the incidence of COVID-19 infection. We assessed the role of meteorological factors including temperature (T) and relative humidity (RH) considering the concentrations of two air pollut...

Objective The objective of this study was to investigate the potential effects of occupational exposures among fruit and vegetable market workers on the occurrence of respiratory symptoms and on the level of lung function parameters. Methods We conducted a cross-sectional study of 140 men working as fruit and vegetable market workers (response rat...

Objective: To evaluate if serum polyfluoroalkyl substances (PFAS) were associated with cardiometabolic markers. Methods: Serum PFAS were evaluated in 38 Arizona firefighters and 49 participants from the 2009 to 2010 National Health and Nutrition Examination Survey (NHANES). Cardiometabolic markers including carotid intima-medial thickness (CIMT)...

Reports of environmental and human health impacts of per- and polyfluoroalkyl substances (PFAS) have greatly increased in the peer-reviewed literature. The goals of this review are to assess the state of the science regarding toxicological effects of PFAS, and to develop strategies for advancing knowledge on the health effects of this large family...

The transition to a value-based payment system offers pathologists the opportunity to play an increased role in population health by improving outcomes and safety as well as reducing costs. Although laboratory testing itself accounts for a small portion of health-care spending, laboratory data have significant downstream effects in patient manageme...

Data for US adults aged ≥20 years for 2007-2012 (N = 7020) were used to study concentrations of thyroid stimulating hormone (TSH), free (FT3) and total triiodothyronine (TT3), free (FT4) total thyroxine (TT4), and thyroglobulin (TGN) across stages of glomerular function (GF). Data for 2007-2008 and 2011-2012 (N = 2549) were used to study associatio...

We report participant perceptions of the 2005–2006 C8 Health Project, a massive medical monitoring effort in response to perfluorooctanoic acid (C8) in West Virginia and Ohio. The C8 Health Project consisted of a health survey (n = 69,030), blood testing for ten per- and polyfluoroalkyl substances, and 50+ laboratory tests (n = 66,899). A randomly...

Associations between selected perfluoroalkyl acids (PFAAs)and biomarkers of renal function were evaluated for US adult aged ≥ 20 years (N = 8220)in the National Health and Nutrition Examination Survey for 2005–2014. Glomerular filtration (GF)stage-stratified regression models were classified by estimated glomerular filtration rate (eGFR)with GF-1 (...

Exposures to perfluoroalkyl substances (PFAS) including perfluoroalkyl acids (PFAAs) are associated with increased liver enzymes in cohort studies including the C8 Health Study. In animal models, PFAAs disrupt hepatic lipid metabolism and induce apoptosis to cause nonalcoholic fatty liver disease (NAFLD). PFAAs are immunotoxic and inhibit pro-infla...

National Health and Nutrition Examination Survey 2007–2014 data (N = 6844) for adults aged ≥ 20 years were analyzed to estimate associations of perfluoroalkyl substances (PFAS), namely, PFOA, PFOS, PFDA, PFHxS, and PFNA with uric acid across stages of declining glomerular function. The population was stratified by the estimated glomerular filtratio...

OBJECTIVE: Perfluoroalkyl substances (PFAS) and liver function biomarkers were reexamined for relatively lower serum concentrations of PFAS observed in recent years. METHODS: National Health and Nutrition Examination Survey 2011-14 data were analyzed for obese and nonobese participants for serum perfluorooctanoic acid (PFOA), perfluorooctane sulfo...

Data (N=6844) from National Health and Nutrition Examination Survey for US adults aged ≥20 years for the years 2007–2014 were analyzed to evaluate distributional characteristics of selected perfluoroalkyl substances (PFAS) - perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorodecanoic acid (PFDA), perfluorohexane sulfonate (PFHxS)...

Data from National Health and Nutrition Examination Survey (NHANES) for 2005–2014 for those aged ≥20 years fasting for ≥8 h (N = 3629) were analyzed to evaluate the role that gender and obesity play in defining correlations between selected perfluoroalkyl substances (PFAS) and total cholesterol (TC), low density lipoprotein cholesterol (LDL), high...

Observed levels of lipid/lipoproteins are known to be associated with exposure to perfluoroalkyl substances (PFAS). In order to evaluate and update these associations among US children aged 6-11 years, data (N = 458) from National Health and Nutrition Examination Survey for 2013-2014 were used. The associations between the observed levels of total...

Compares the weak effect of OAT inhibition with the strong effect of resin binding on PFAS excretion in a community setting.

Cross-sectional data from National Health and Nutrition Examination Survey for the years 1999–2012 for those aged ≥20 years, fasting for at least 8 h, and classified as smokers and nonsmokers on the basis of observed serum cotinine levels were used to evaluate the impact of smoking on the adjusted and unadjusted concentrations of low-density lipopr...

Aims: Diabetes is linked with decreases in lung elasticity and in capacity to transfer carbon monoxide. Systemic inflammation, a common concern with diabetes, may contribute to airflow obstruction. We examined the association of self-reported diabetes with self-reported respiratory diseases (RDs) among 53,146 adults from the C8 Health Project. Me...

The poster reviews lung disease clusters in workers since the early 1990s.

This supplementary material supports the initial project description by Frisbee et al.

Elevated emissions of volatile organic compounds, including benzene, toluene, ethylbenzene, and o, p, and m-xylenes (BTEX), are an occupational health concern at oil transfer stations. This exploratory study investigated personal exposure to BTEX through environmental air and urine samples collected from 50 male workers at a major oil distribution...

The aim of this study was to evaluate benzene, toluene, ethylbenzene, and xylene (BTEX) exposure among workers at four stations of a major oil distribution company. Personal BTEX exposure samples were collected over working shift (8 h) for 50 workers at four stations of a major oil distribution company in Iran. Measured mean values for workers acro...

Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (−) test pairs in order to address anticipated clinician concerns about potential l...

Background: Older yet still abundant munitions such as tetryl present easily forgotten health hazards and associated needs for worker protection. Case presentation: Symptoms and findings from 22 workers who were exposed to tetryl are summarized. Conclusions: This study highlights the health hazards from exposure to tetryl. Occupational health...

We investigated the influence of pathology data to improve patient outcomes in the treatment of high-grade cervical neoplasia in a joint pathology and gynecology collaboration. Two of us (B.S.D. and M.D.) reviewed all cytology, colposcopy and surgical pathology results, patient history, and pregnancy outcomes from all patients with loop electrosurg...

IARC Technical Report concerning the carcinogenicity of some industrial chemicals

Abstract and Full Report including Research recommendations are available at http://www.healtheffects.org/ and the PDF is available at http://www.healtheffects.org/UOGD/UODG-Research-Agenda-Nov-4-2015.pdf. Posted on-line November 4, 2015

Unconventional oil and natural gas development is a driving force behind significant economic and energy policy shifts in the United States and the world today. Technological advances in development are substantially increasing energy supplies, while at the same time outpacing the scientific research that can answer questions about the development’...

To inform questions raised by inconsistent findings regarding an association between perfluoroalkyl acids (PFAAs) and prostate cancer by assessing the relationship of PFAAs in human serum to prostate-specific antigen (PSA). Using 2005 to 2006 survey data from a large survey population, we compared serum PFAA concentrations in adult males with PSA c...

Waste from coal cleaning processes includes coarse size fractions (i.e., coarse refuse) and small particles (i.e., fine refuse). The aqueous suspension of fine refuse, referred to as coal slurry, frequently contains potentially toxic substances, including hydrocarbons, heavy metals, and coal cleaning chemicals. Disposal of coal slurry using undergr...

Wet coal cleaning produces fine coal slurry, which is commonly disposed of in surface impoundments. Following impoundment failures in the early 1970s, regulatory agencies encouraged placement of coal slurry in underground mine voids. That option was not without environmental risk, since it placed slurry in direct contact with mine water, a major co...

Background: Gilbert syndrome (GS) is an inherited defect of bilirubin conjugation, most commonly caused by a gene mutation for the enzyme UGT1A. GS is known to affect the metabolism and excretion of drugs and xenobiotics. Perfluorocarbon compounds (PFCs) are bio-persistent environmental contaminants that affect metabolic regulation. In this study,...

The aim of the current study is to investigate the association of polycyclic aromatic hydrocarbons (PAHs), a group of environmental pollutants, with diabetes mellitus. Animal studies link PAHs to inflammation and subsequent development of diabetes mellitus. In addition, occupational studies suggest that exposure to other aromatic hydrocarbons such...

Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) are persistent environmental contaminants that affect metabolic regulation, inflammation, and other factors implicated in the development and progression of colorectal cancer (CRC). However, the link between these compounds and CRC remains unknown. In this cross-sectional study, we inve...

Perfluoroalkyl substances are manmade chemicals used in many consumer products and have become ubiquitous in the environment. Animal studies and a limited number of human studies have demonstrated developmental effects in offspring exposed to perfluoroalkyl substances in utero, but the implications of timing of in utero exposure have not been syste...

Purpose/Objectives: To examine how routine laboratory biomarkers and clinical parameters available within medical records related to overall survival in patients with non-small cell lung cancer (NSCLC). Design: Retrospective chart review. Setting: University-based cancer center in rural West Virginia. Sample: 110 patients from the U.S. Appalachian...

Butyl Acrylate (BA) (2-propionic acid; CH2=CHCOOC4H9) is a colorless liquid commonly used in impregnation agents and adhesives. Dermal contact with BA has previously been reported to cause moderate skin irritation with skin sensitizing potential in humans. Health effects of inhalation of BA have not been previously reported. Accordingly, we documen...

Five realistic tabletop scenarios were designed to facilitate threat preparedness training of Medical, Public Health, Nursing, Emergency Services, Mental Health, Allied Health, and Pharmacy personnel. Training scenarios were (1) student contaminates lettuce (Act) in a state university with Shigella sonnei (Agent), (2) dismissed athlete contaminates...

Background: Cardiovascular disease (CVD) is a major public health problem. Identifying novel risk factors for CVD, including widely prevalent environmental exposures, is therefore important. Perfluorooctanoic acid (PFOA) is a manmade chemical used in the manufacture of common household consumer products. Biomonitoring surveys have shown that PFOA...

The authors compared rates of tooth loss between adult residents of Appalachian coal-mining areas and other areas of the nation before and after control for covariate risks. The authors conducted a cross-sectional secondary data analysis that merged 2006 national Behavioral Risk Factor Surveillance System data (BRFSS) (N = 242 184) with county coal...

The increasing prevalence of childhood obesity has been well documented & is predictive of increased severity in obesity-related CVD risk factors & metabolic disorders, such as systemic inflammation & oxidative stress. While the poor long-term vascular consequences of these conditions are better understood in adults, the consequences of these obesi...

The increasing prevalence of childhood obesity has been well documented and is predictive of an increased severity in obesity-related CVD risk factors and metabolic disorders, such as non-alcoholic fatty liver disease (NAFLD). This study determined the association between obesity and risk for altered liver function and NAFLD in 12,476 children (≤18...

A stress-induced myocardial perfusion abnormality (MPS), in the absence of angiographically significant epicardial coronary artery disease, is considered a "false-positive" test result. We hypothesized that echocardiography would provide complementary prognostic and pathophysiologic data relevant to the management of patients with MPS and normal co...

Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) persist in the environment and are found in relatively high concentrations in animal livers. Studies in humans have reported inconsistent associations between PFOA and liver enzymes. We examined the cross-sectional association between serum PFOA and PFOS concentrations with markers of l...

Background: Serum gamma-glutamyl transferase (GGT), a marker of oxidative stress has been associated with diabetes and hypertension, which are risk factors for chronic kidney disease (CKD). However, it is unclear whether serum GGT is independently associated with CKD. Methods: We analyzed data from a population-based study of Appalachian adults...

Perfluoroalkyl chemicals, including perfluorooctanoic acid and perfluorooctane sulfonate, are man-made chemicals that have been detected in the blood of over 98% of the US population. Serum uric acid is a novel biomarker, even mild elevations of which has been implicated in the development of hypertension, diabetes mellitus, cardiovascular disease,...

Chronic kidney disease (CKD) is a major public health problem. Identifying novel risk factors for CKD, including widely prevalent environmental exposures, is therefore important. Perfluoroalkyl chemicals (PFCs), including perfluorooctanoic acid and perfluorooctane sulfonate, are manmade chemicals that have been detected in the blood of more than 98...

Perfluorocarbons from common household products such as food containers, stain- resistant protection for clothing, furniture and carpets, paints, and fire-fighting foams are found in soil, water, plants, animal and human serum worldwide. Previous research has shown a significant association between these chemicals and thyroid disease in women. The...

Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) are persistent environmental contaminants that affect metabolic regulation, inflammation, and other factors implicated in the pathogenesis of osteoarthritis (OA). However, the link between these compounds and OA remains unknown. In this study, the authors investigated the association of...

Birth defects are examined in mountaintop coal mining areas compared to other coal mining areas and non-mining areas of central Appalachia. The study hypothesis is that higher birth-defect rates are present in mountaintop mining areas. National Center for Health Statistics natality files were used to analyze 1996-2003 live births in four Central Ap...

Animal studies suggest that perfluorocarbons (PFCs) may alter sexual maturation. Relationships of human PFC exposure with puberty are not clear. We conducted a cross-sectional study to investigate whether perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) were associated with indicators of sexual maturation in a 2005-2006 survey of...

Perfluorocarbons (PFC) are man-made chemicals used in numerous household products. They have a long half-life in humans and complex animal toxicity, and accumulating evidence points toward associations with multiple human health endpoints. Our objective was to investigate whether PFC are associated with endocrine disruption in women. Cross-sectiona...

Firefighters were likely exposed to perfluorooctane sulfonate since it was a component of extinguishing foams and perfluorohexane sulfonate (PFHxS), a surfactant coating carpet and other building materials, during firefighting. The objective of the study is to evaluate serum concentrations of perfluoroalkyl acids (PFAAs) in firefighters. A total of...

To determine factors associated with pain/injury related to practicing ophthalmic plastic and reconstructive surgery. A 29-question electronic survey was sent to the American Society of Ophthalmic Plastic and Reconstructive Surgery's listserv. The Chi-Squared Automatic Interaction Detector technique was used to generate a decision tree using SPSS s...

An increased risk of lung cancer has been observed at exposure to certain industrial chemicals in occupational settings; however, less is known about their carcinogenic potential to the general p