Occurrence and dietary intake of Perfluoroalkyl substances in foods of the residents in Beijing, China

Research Progress in Current and Emerging Issues of PFASs' Global Impact: Long-Term Health Effects and Governance of Food Systems

Per- and polyfluoroalkyl substances (PFASs) are found everywhere, including food, cosmetics, and pharmaceuticals. This review introduces PFASs comprehensively, discussing their nature and identifying their interconnection with microplastics and their impacts on public health and the environment. The human cost of decades of delay, cover-ups, and mismanagement of PFASs and plastic waste is outlined and briefly explained. Following that, PFASs and long-term health effects are critically assessed. Risk assessment is then critically reviewed, mentioning different tools and models. Scientific research and health impacts in the United States of America are critically analyzed, taking into consideration the Center for Disease Control (CDC)'s PFAS Medical Studies and Guidelines. PFAS impact and activities studies around the world have focused on PFAS levels in food products and dietary intake in different countries such as China, European countries, USA and Australia. Moreover, PFASs in drinking water and food are outlined with regard to risks, mitigation, and regulatory needs, taking into account chemical contaminants in food and their impact on health and safety. Finally, PFAS impact and activities briefings specific to regions around the world are discussed, referring to Australia, Vietnam, Canada, Europe, the United States of America (USA), South America, and Africa. The PFAS crisis is a multifaceted issue, exacerbated by mismanagement, and it is discussed in the context of applying the following problem-solving analytical tools: the Domino Effect Model of accident causation, the Swiss Cheese Theory Model, and the Ishikawa Fish Bone Root Cause Analysis. Last but not least, PFASs' impacts on the Sustainable Development Goals (SDGs) of 2030 are rigorously discussed.

PFAS profiles in biosolids, composts, and chemical fertilizers intended for agricultural land application in Quebec (Canada)

Biosolids, sewage sludge, and composts are applied to agricultural land for nutrient recovery and soil organic matter replenishment, aligning with sustainable development goals. However, they may contain per- and polyfluoroalkyl substances (PFAS) that can enter the food chain through plant bioaccumulation and leaching into the groundwater. This study analyzed 80 PFAS compounds in sewage sludge, biosolids, commercial composts, and chemical fertilizers in Quebec, Canada, using UHPLC-HRMS (Orbitrap Q-Exactive). PFAS concentrations ranged from 18 to 59 µg/kg in commercial composts, 9.8 to 213 µg/kg in pulp and paper sludge, 15 to 705 µg/kg in sewage sludge, 12 to 1310 µg/kg in biosolids, and 14.6 µg/kg on average in biosolids ash. Dominant PFAS classes included diPAPs, sulfonamides, PFCAs, and PFSAs. High diPAPs concentrations indicated widespread use in domestic, commercial, or industrial applications. This study also observed a negligible correlation between soil organic carbon and PFAS concentration in the biowastes signifying a stronger influence due to different WWTP configurations, the quality of the wastewater inputs and other medium's properties that could affect PFAS partitioning to the biowastes. Environmental assessments showed PFAS loads of up to 30 µg/kg soil from a single application, within some regulatory limits. However, repeated applications could lead to PFAS accumulation in soil, posing risks to crops and groundwater.

Legacy and alternative per- and polyfluoroalkyl substances spatiotemporal distribution in China: Human exposure, environmental media, and risk assessment

In recent decades, China's rapid development has led to significant environmental pollution from the widespread use of chemical products. Per- and polyfluoroalkyl substances (PFAS) are among the most concerning pollutants due to their persistence and bioaccumulation. This article assesses PFAS exposure levels, distribution, and health risks in Chinese blood, environment, and food. Out of 4037 papers retrieved from November 2022 to December 31, 2023, 351 articles met the criteria. Findings show perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) as the main PFAS in both Chinese populations and the environment. The highest PFOA levels in Chinese populations were in Shandong (53.868 ng/mL), while Hubei had the highest PFOS levels (43.874 ng/mL). Similarly, water samples from Sichuan (2115.204 ng/L) and Jiangsu (368.134 ng/L) had the highest PFOA and PFOS levels, respectively. Although localized areas showed high PFAS concentrations. Additionally, developed areas had higher PFAS contamination. The researches conducted in areas such as Qinghai and Hainan remain limited, underscoring the imperative for further investigation. Temporal analysis indicates declining levels of some PFAS, but emerging alternatives require more research. Limited studies on PFAS concentrations in soil, atmosphere, and food emphasize the need for comprehensive research to mitigate human exposure.

Perfluoroalkyl substances in the meat of Polish farm animals and game - Occurrence, profiles and dietary intake

Meat from farm animals (pigs, cattle and poultry) and game (wild boar and deer) was analysed in terms of thirteen perfluoroalkyl substances (PFASs). Wild boar muscle tissue was statistically significantly more contaminated than muscle tissue from other animals, and the species order of the lower-bound (LB) sum of four (∑4) PFAS (perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid, perfluorononanoic acid and perfluorohexanesulfonic acid) concentrations was wild boar > cattle > deer > pigs > poultry. None of the samples exceeded the maximum levels set by Commission Regulation (EU) 2023/915. Linear PFOS was the most frequently detected compound (in 21 % of all samples analysed and 100 % of wild boar samples), reaching its highest concentration of 1.87 μg/kg wet weight in wild boar. Dietary intake was estimated on the basis of the average per-serving consumption of pork, beef and poultry, and in the absence of such data for game, a 100 g portion was used for the calculation. Mean LB∑4 PFAS concentrations led to intakes between 0.000 and 1.75 ng/kg body weight (BW) for children and 0.000 and 0.91 ng/kg BW for adults. The potential risk to consumers was assessed in relation to the tolerable weekly intake (TWI) of 4.4 ng/kg BW established by the European Food Safety Authority in 2020. Exposure associated with the consumption of poultry, pork, beef and venison was negligible, being only <1 % of the TWI for children and adults; higher exposure was found to associate with the consumption of wild boar, being 63 % and 21 % of the TWI for children and adults, respectively. The findings of this research suggest that the intake of PFASs through the consumption of meat from Polish livestock and deer is unlikely to be a health concern. However, frequent consumption of wild boar meat could be a significant source of PFASs.

Bio-accumulation and health risk assessments of per- and polyfluoroalkyl substances in wheat grains

Per- and polyfluoroalkyl substances (PFASs) have been widely detected in various food, which has attracted worldwide concern. However, the factors influencing the transfer and bio-accumulation of PFASs from soils to wheat in normal farmland, is still ambiguous. We investigated the PFASs accumulation in agricultural soils and grains from 10 cites, China, and evaluated the health risks of PFASs via wheat consumption. Our results show that ∑PFASs in soils range from 0.34 μg/kg to 1.59 μg/kg with PFOA and PFOS dominating, whilst ∑PFASs in wheats range from 2.74 to 6.01 μg/kg with PFOA, PFBA and PFHxS dominating. The lower pH conditions and high total organic carbon (TOC) could result in the higher accumulation of PFASs in soils and subsequently in wheat grains, whilst the bioaccumulation factors of PFASs increase with increasing pH conditions but not with TOC. The estimated daily intake (EDI) values of PFBA, PFOA, and PFHxS are relatively high, but data supports that ingesting wheat grains does not result in any potential risk to the human beings. Our studies provided more information about PFASs accumulation in wheat grains, and help us understand the current potential risks of PFASs in food.

Per- and polyfluoroalkyl substances (PFASs) in bivalve molluscs from Shandong Province, China: Occurrence, distribution, and implications for human consumption

We examined the occurrence and levels of 19 legacy and emerging per- and polyfluoroalkyl substances (PFASs) in 7 species of marine bivalve molluscs collected from four coastal cities of Shandong Province, China. Perfluorooctanoic acid (PFOA) was the most prevalent component, accounting for 68.1 % of total PFASs. The total PFASs in bivalve molluscs ranged from 0.86 to 6.55 ng/g wet weight, with the highest concentration found in Meretrix meretrix L. The concentration of total PFASs in bivalve molluscs showed the following trend: clams > scallops > oysters > mussels. Estimation on the human intake of PFASs from consumption of bivalve molluscs resulted in hazard ratios (HR) ranging from 0.12 to 6.40. Five of the seven species had HR >1, indicating high exposure risks associated with PFASs. Therefore, the occurrence of PFASs in marine biota is particularly concerning and further investigations on the sources of PFASs in Shandong are warranted.

Dietary exposure to per- and polyfluoroalkyl substances: Potential health impacts on human liver

Per- and polyfluoroalkyl substances (PFAS), dubbed "forever chemicals", are widely present in the environment. Environmental contamination and food contact substances are the main sources of PFAS in food, increasing the risk of human dietary exposure. Numerous epidemiological studies have established the link between dietary exposure to PFAS and liver disease. Correspondingly, PFAS induced-hepatotoxicity (e.g., hepatomegaly, cell viability, inflammation, oxidative stress, bile acid metabolism dysregulation and glycolipid metabolism disorder) observed from in vitro models and in vivo rodent studies have been extensively reported. In this review, the pertinent literature of the last 5 years from the Web of Science database was researched. This study summarized the source and fate of PFAS, and reviewed the occurrence of PFAS in food system (natural and processed food). Subsequently, the characteristics of human dietary exposure PFAS (population characteristics, distribution trend, absorption and distribution) were mentioned. Additionally, epidemiologic evidence linking PFAS exposure and liver disease was alluded, and the PFAS-induced hepatotoxicity observed from in vitro models and in vivo rodent studies was comprehensively reviewed. Lastly, we highlighted several critical knowledge gaps and proposed future research directions. This review aims to raise public awareness about food PFAS contamination and its potential risks to human liver health.

The sources and bioaccumulation of per- and polyfluoroalkyl substances in animal-derived foods and the potential risk of dietary intake

Per- and polyfluoroalkyl substances (PFAS) have attracted increasing attention due to their environmental persistence and potential toxicity. Diet is one of the main routes of human exposure to PFAS, particularly through the consumption of animal-derived foods (e.g., aquatic products, livestock and poultry, and products derived from them). This review summarizes the source, bioaccumulation, and distribution of PFAS in animal-derived foods and key influential factors. In most environmental media, perfluorooctanoic acid and perfluorooctane sulfonate are the dominant PFAS, with the levels of short-chain PFAS such as perfluorobutyric acid and perfluorohexane sulfonate surpassing them in some watersheds and coastal areas. The presence of PFAS in environmental media is mainly influenced by suspended particulate matter, microbial communities as well as temporal and spatial factors, such as season and location. Linear PFAS with long carbon chains (C ≥ 7) and sulfonic groups tend to accumulate in organisms and contribute significantly to the contamination of animal-derived foods. Furthermore, PFAS, due to their protein affinity, are prone to accumulate in the blood and protein-rich tissues such as the liver and kidney. Species differences in PFAS bioaccumulation are determined by diet, variances in protein content in the blood and tissues and species-specific activity of transport proteins. Carnivorous fish usually show higher PFAS accumulation than omnivorous fish. Poultry typically metabolize PFAS more rapidly than mammals. PFAS exposures in the processing of animal-derived foods are also attributable to the migration of PFAS from food contact materials, especially those in higher-fat content foods. The human health risk assessment of PFAS exposure from animal-derived foods suggests that frequent consumption of aquatic products potentially engender greater risks to women and minors than to adult males. The information and perspectives from this review would help to further identify the toxicity and migration mechanism of PFAS in animal-derived foods and provide information for food safety management.

Per- and polyfluoroalkyl substances (PFASs) in consumable species and food products

Per- and polyfluoroalkyl substances (PFASs) are a group of thousands of manmade chemicals widely used in consumer products and industrial processes. Toxicological studies have suggested that exposure to PFASs may lead to several adverse effects, including infertility and cancer development. In light of their widespread use, the contamination of food products has created health concerns in sites directly influenced by industrial and anthropogenic activity. In the present contribution, the current knowledge of PFAS contamination was systematically reviewed in order to provide with the knowledge gaps and main sources of contamination, as well as critically evaluate estimated dietary intake and relative risk values of the consulted studies. Legacy PFASs remain the most abundant despite their production restrictions. Edible species from freshwater bodies exhibit higher PFAS concentrations than marine species, probably due to low hydrodynamics and dilution in lentic ecosystems. Studies in food products from multiple sources, including aquatic, livestock, and agricultural, agree that the proximity to factories and fluorochemical industries rendered significantly higher and potentially hazardous PFAS contamination. Short-chain PFAS are suggested as chemicals of emerging concern to food security. However, the environmental and toxicological implications of short-chain congeners are not fully understood and, thus, much research is needed in this sense.

Environmental Fate of Cl-PFPECAs: Accumulation of Novel and Legacy Perfluoroalkyl Compounds in Real-World Vegetation and Subsoils

Per- and polyfluoroalkyl substances (PFAS) are globally distributed and potentially toxic compounds. We report accumulation of chloroperfluoropolyethercarboxylates (Cl-PFPECAs) and perfluorocarboxylates (PFCAs) in vegetation and subsoils in New Jersey. Lower molecular weight Cl-PFPECAs, containing 7-10 fluorinated carbons, and PFCAs containing 3-6 fluorinated carbons were enriched in vegetation relative to surface soils. Subsoils were dominated by lower molecular weight Cl-PFPECAs, a divergence from surface soils. Contrastingly, PFCA homologue profiles in subsoils were similar to surface soils, likely reflecting temporal-use patterns. Accumulation factors (AFs) for vegetation and subsoils decreased with increasing CF2, 6-13 for vegetation and 8-13 in subsoils. In vegetation, for PFCAs having CF2 = 3-6, AFs diminished with increasing CF2 as a more sensitive function than for longer chains. Considering that PFAS manufacturing has transitioned from long-chain chemistry to short-chain, this elevated vegetative accumulation of short-chain PFAS suggests the potential for unanticipated PFAS exposure levels globally in human and/or wildlife populations. This inverse relationship between AFs and CF2-count in terrestrial vegetation is opposite the positive relationship reported in aquatic vegetation suggesting aquatic food webs may be preferentially enriched in long-chain PFAS. AFs normalized to soil-water concentrations increased with chain length for CF2 = 6-13 in vegetation but remained inversely related to chain length for CF2 = 3-6, reflecting a fundamental change in vegetation affinity for short chains compared to long.

Associations of per- and polyfluoroalkyl substances and their alternatives with bone mineral density levels and osteoporosis prevalence: A community-based population study in Guangzhou, Southern China

BACKGROUND

Evidence concerning associations of per- and polyfluoroalkyl substances (PFASs) exposure with bone mineral density (BMD) and osteoporosis is scarce. Additionally, no study has examined the effects of PFAS isomers and alternatives on bone health.

OBJECTIVES

To evaluate the associations of PFASs and PFAS alternatives with BMD levels and osteoporosis prevalence.

METHODS

A total of 1260 healthy adults from southern China were enrolled. Serum concentrations of 32 legacy PFASs, PFAS isomers, and alternatives were measured using modified liquid chromatography-tandem mass spectrometry. Logistic and linear regression models were applied to evaluate the associations of PFASs with osteoporosis prevalence and BMD levels, respectively, adjusting for confounding factors. We performed stratified analyses to assess potential effect modifications of age and sex. We further used sensitivity analyses to testify the robustness of the main findings.

RESULTS

There were 204 (16.2 %) participants diagnosed with osteoporosis. Eleven of the studied PFASs (i.e., PFHpA, PFOA, PFBS, PFHpS, total-PFHxS, n-PFHxS, br-PFHxS, br-PFOS, 1m-PFOS, Σ3 + 4 + 5m-PFOS, and 6:2 Cl-PFESA) showed significant and inverse associations with BMD levels (mean differences ranged from -6.47 to -26.07 per one ln-unit increase in the PFASs). Additionally, we observed that each one ln-unit increase in PFHpA was significantly associated a 23 % (OR = 1.23, 95 % CI = 1.04, 1.45) greater odds of osteoporosis. The above associations were consistent in several sensitivity analyses we performed. Stratified analyses showed stronger associations among women and younger compared to their counterparts.

CONCLUSIONS

Our findings suggested that greater PFAS exposure is associated with poorer bone health, especially in women and younger people.

EI/IOT of PFCs: Environmental impacts/interactions, occurrences, and toxicities of perfluorochemicals

Various studies have been conducted on the perfluorochemicals (PFCs) family over the years. These compounds have been sought in various industrial aspects involving the synthesis of everyday utilities due to their broad range of applications. As a result, PFCs have built up in the environment, causing concern. The presence of PFCs in various environmental media, such as terrestrial and marine settings, as well as the mechanisms of transport, bioaccumulation, and physio-chemical interactions of PFCs within plants, aquatic organisms, microplastics, and, ultimately, the human body, are discussed in this review, which draws on a variety of research publications. The interaction of PFCs with proteins, translocation, and adsorption by hydrophobic interactions were observed, and this had an impact on the natural functioning of biological processes, resulting in events such as phylogenic clustering, competitive inhibition, and many others, posing potential hazards to human health and other relevant organisms in the ecosystem. However, further research is needed to have a better knowledge of PFCs and their interactions so that low-cost treatments can be developed to eliminate them. It is therefore, future research should focus on the role of soil matrix as a defensive mechanism for PFCs, as well as the impact of PFC chain length rejection.

Optimization and validation of a fast supercritical fluid chromatography tandem mass spectrometry method for the quantitative determination of a large set of PFASs in food matrices and human milk

An Ultra-High Performance Supercritical Fluid Chromatography coupled with tandem Mass Spectrometry analytical method (UHPSFC-MS/MS) was developed for the determination of 34 perfluoroalkylated substances (PFASs) in food-related matrices. Two parameters (i.e. stationary phase and co-solvent) were selected and optimized using a step-by-step method, while a design of experiment (DoE) method using a central composite design (CCD) was implemented to optimize column temperature, mobile phase flow rate, co-solvent concentration and automated back pressure regulator (ABPR). The Torus 2-PIC column was selected along with ammonium acetate AcoNH₄ as additive in the co-solvent. DoE optimization of both peak width and resolution enabled validating an optimized model (desirability 0.613) and setting column temperature at 38.7 °C, AcoNH₄ concentration at 8 mM, mobile phase flow rate of 1.9 mL/min and ABPR at 1654 psi. The validated resulting method enabled reaching limits of quantification below 0.2 ng/g (w.w.) for 97 % PFASs in accordance with current EU requirements. The strategy was successfully applied to the characterization of a range (n > 30) of food-related matrices (red meat, poultry meat, eggs, fish and breast milk) collected in Algeria in 2019. PFOA and PFBA were observed as the most frequently detected PFASs, i.e. in 96.96 % and 90.9 % of the samples respectively. The highest concentrations were determined in fishery products up to 4.42 ng/g (w.w.) for PFTeDA and 0.75 ng/g (w.w.) for PFOS.

Spatiotemporal distribution of perfluoroalkyl acid in Chinese eggs

To study the contamination levels of perfluoroalkyl acids (PFAAs) in Chinese eggs and the effects of persistent organic pollutant (POP) amendments to the Stockholm Convention blacklist, 3200 eggs from 10 major producing areas were collected from June 2013 to May 2017. Seventeen PFAAs in eggs were analysed. Perfluorooctane sulphonic acid (PFOS), perfluoropentanoic acid (PFPeA) and perfluorooctanoic acid (PFOA) were the main PFAAs in eggs. Perfluoroalkyl carboxylic acids (PFCAs) and short-chain PFAAs levels in eggs decreased after the amendment was implemented in China (p < .05), but no significant difference was observed in PFOS. The average ΣPFAAs of eggs from 10 major producing areas was 0.23 ng/g (<LOD-5.4 ng/g), with samples from Hunan, Hubei and Henan being above this threshold, indicates the need for more stringent evaluation and regulation on pollutant management practices. The detection rate of eggs with PFOS risk was very low and no consumption-related health risk was identified.

The toxicity of perfluorodecanoic acid is mainly manifested as a deflected immune function

BACKGROUND

Perfluorodecanoic acid (PFDA) is a type of perfluoroalkyl acid (PFAA). PFDA has toxicity similar to dioxin; its effect on the body is not through a single target or a single pathway. However, the mechanism at the global level is still unclear.

METHODS AND RESULTS

We treated mice with PFDA and characterized the global changes in gene expression in the liver using microarray analyses. The enriched KEGG pathways and GO analyses revealed that PFDA greatly affected the immune response, which was different from the response of gastric cells previously studied. As a proof of principle, the expressions of IL-1β and IL-18 were both decreased after PFDA treatment, and qRT-PCR and ELISAs verified the reduction of IL-1β and IL-18 in liver tissues. Mechanistic investigations indicated that PFDA inhibited caspase-1 activation, and decreased the mRNA levels of NLRP1, NLRP3, and NLRC4; thus, suggesting that inflammasome assemblies were suppressed. Further microarray data revealed that cIAP2 and its binding proteins, which are critical for regulating inflammasome assembly, were also repressed by PFDA. In addition, flow cytometry results revealed a significant inhibition of Th1 cell differentiation in the livers of PFDA-treated mice.

CONCLUSIONS

The results of this study suggested that one of the main toxic effects of PFDA on livers was the inhibition of immune response.

PFASs intake from fish, eggs and drinking water in Greece in relation to the safety limits for weekly intake proposed in the EFSA scientific opinion of 2020

Food consumption has been recognized as the most significant contributor to human exposure to polyfluoroalkyl and perfluoroalkyl substances (PFASs) for the general population. In 2020, EFSA introduced for the first time safety limit of 4.4 ng/kg body weight (bw) for weekly intake for the sum of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA) and perfluorohexane sulfonic acid (PFHxS) which are all perfluoralkyl acids (PFAAs) that belong to PFASs group. Fish and eggs have been found to contribute significantly, almost 50 % to PFOS and PFOA dietary intake of the Greek population. In the present study, estimation of human intake of these four PFASs from fish, eggs and drinking water consumption is attempted. Data from EFSA food consumption database for fish and eggs are used for assessment. Mean weekly intake estimated is above the tolerable weekly intake (TWI) recently proposed, mainly due to fish consumption. Exceedance of the proposed TWI emphasizes the need for continuous monitoring of levels of PFASs in food in parallel with efforts to lower these levels.

Estimating the dietary exposure and risk of persistent organic pollutants in China: A national analysis

Substantial heterogeneities have been found in previous estimations of the risk from dietary exposures to persistent organic pollutants (POPs) in China, mainly due to spatiotemporal variations. To comprehensively evaluate the dietary risks of POPs listed in the Stockholm Convention, more than 27,580 data records from 753 reports published over the last three decades were examined. Respectively, for various food categories, the results obtained for the range of mean concentrations of POPs are as follows: total dichlorodiphenyltrichloroethanes (DDTs: 1.4-27.1 μg/kg), hexachlorocyclohexanes (HCHs: 1.8-29.3 μg/kg), polybrominated diphenyl ethers (PBDEs: 0.046-2.82 μg/kg), polychorinated biphenyls (PCBs: 0.05-7.57 μg/kg), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD&Fs: 2.9-210 pg toxic equivalent (TEQ)/kg), perfluorooctanoic acid (PFOA: 0.02-0.97 μg/kg), perfluoroctane sulfonate (PFOS: 0.00082-2.76 μg/kg) and short-chain chlorinated paraffins (SCCPs: 64-348.92 μg/kg). Temporal decreasing trends were observed for DDTs, HCHs, PBDEs, PCDD&Fs, and PFOA, with no significant change for other POPs. Meanwhile, the estimated daily intake for adults were 75.2 ± 43.6 ng/kg/day for DDTs, 123 ± 87 ng/kg/day for HCHs, 0.37 ± 0.17 pg TEQ/kg/day for PCDD&Fs, 17.8 ± 9.5 ng/kg/day for PCBs, 3.3 ± 1.8 ng/kg/day for PBDEs, 3.6 ± 1.9 ng/kg/day for PFOA, 3.3 ± 2.0 ng/kg/day for PFOS, and 2.5 ± 1.6 μg/kg/day for SCCPs. Furthermore, non-carcinogenic risks were the highest for PCBs (0.89) and PCDD&Fs (0.53), followed by PFOA (0.18), PFOS (0.17), HCHs (0.062), SCCPs (0.025), DDTs (0.0075), and PBDEs (0.00047). These findings illustrated that exposure to POPs declined due to the control policies implemented in China, while the cumulative risk of POPs was still higher than 1, indicating continuous efforts are required to mitigate associated contamination.

Impact of kidney hyperfiltration on concentrations of selected perfluoroalkyl acids among US adults for various disease groups

Data from the National Health and Nutrition Examination Survey (N = 6141) for the years 2003-2016 for US adults were analyzed to evaluate the impact of glomerular hyperfiltration on the observed concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorodecanoic acid, perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) for several disease groups. Hyperfiltrators were defined as having an estimated glomerular filtration rate (eGFR) ≥ 110 mL/min/1.73 m², and normal filtrators were defined as those having an eGFR between 90 and 110 mL/min/1.73 m². The seven disease groups for which the data were analyzed were as follows: those (i) without any diseases; (ii) with hypertension only; (iii) with albuminuria only; (iv) with anemia only; (v) with diabetes only; (vi) with hypertension and one or more of diabetes, anemia, and albuminuria; and (vii) with two or more of diabetes, anemia, and albuminuria without hypertension. For almost every PFAA, for all seven disease groups except the albuminuria only group, hyperfiltrators had lower adjusted geometric means (AGM) than normal filtrators. For example, for the disease group with hypertension only, for PFOS, the AGMs for hyperfiltrators and normal filtrators were 8.3 and 10.6 ng/mL, respectively, for the total population. For the group with albuminuria only, normal filtrators were found to have higher AGMs than hyperfiltrators for the total population and males. For example, for PFHxS, the AGMs for normal and hyperfiltrators were 0.98 and 1.05 ng/mL, respectively, for the total population. For females, these AGMs for normal and hyperfiltrators were 0.96 and 0.86 ng/mL respectively. Males usually had higher AGMs than females, but the reverse was also true occasionally. Usually, male-female differences were substantially narrower for normal filtrators than hyperfiltrators. Irrespective of the filtration status, the disease group with hypertension only had the highest AGMs for every PFAA. AGMs for the anemia only group were the lowest for every PFAA as compared with other disease groups among hyperfiltrators.