Biomonitoring of per- and polyfluoroalkyl substances (PFAS) in sportfish consumers in the Great Lakes – Milwaukee, Wisconsin

Abstract

Background: The Milwaukee Angler Study was initiated in 2017 as part of the Biomonitoring of Great Lakes Populations Program (BGLP-III) to examine two adult populations at high risk of per- and polyfluoroalkyl substances (PFAS) exposure from consumption of PFAS-contaminated sportfish: licensed anglers near the Milwaukee Estuary Area of Concern (AOC) and Burmese refugees for whom fish is a dietary staple. Objective: This study seeks to provide a comprehensive examination of serum PFAS concentrations in these groups and investigate associations with locally caught fish consumption. Methods: Licensed urban anglers and Burmese refugees were independently recruited using population-specific sampling strategies. Participants completed questionnaires on demographics and fish consumption and provided biological specimens. Median and 95th percentile concentrations of seven PFAS were compared to 2017–2018 National Health and Nutrition Examination Survey (NHANES) data. Multivariable regression assessed associations between serum PFAS concentrations and self-reported local fish consumption from the Milwaukee AOC. Results: Among the 396 licensed angler participants, serum concentrations of three of the seven PFAS (PFOS, PFHxS, PFNA) were elevated compared to the U.S. population; PFOS, PFDA, PFHxS, PFNA, and total PFAS were significantly associated with increased local fish consumption when controlling for other demographic factors. Among the 103 Burmese refugee participants, four of the seven measured PFAS (PFOS, PFDA, PFUnDA, PFNA) were elevated compared to the U.S. population; PFOA, PFOS, PFDA, and total PFAS were associated with increased local fish consumption when controlling for other demographic factors. Significance: The results from this study support an association of local fish consumption with PFAS exposure among high-risk populations with varied demographic and local fish consumption practices in the Milwaukee Estuary AOC. Given that adherence to and awareness of state fish advisories can vary widely, our biomonitoring results underscore the importance of ongoing, tailored efforts to deliver culturally relevant public health interventions to the diverse populations surrounding the Great Lakes basin. Impact Statement: Building on the Biomonitoring of Great Lakes Populations program, this study adds PFAS-focused data from Milwaukee’s urban anglers and Burmese refugees, two understudied, high-exposure groups in the Milwaukee Estuary Area of Concern. By integrating detailed fish-consumption histories with serum PFAS and NHANES comparisons, the work directly informs Great Lakes Restoration Initiative goals and targeted fish-advisory interventions. These findings offer actionable evidence for exposure scientists, environmental epidemiologists, and public health practitioners.