# Per- and Polyfluoroalkyl substances (PFAS) Exposures and COVID-19 in Firefighters

> **NIH NIH R21** · UNIVERSITY OF ARIZONA · 2020 · $254,748

## Abstract

PROJECT SUMMARY/ABSTRACT
The spread of SARS-CoV-2 infection and its associated disease state, COVID-19, has led to a global pandemic.
Exposure to per- or polyfluoroalkyl substances (PFAS) is associated with reduced immune response, but its
effect on COVID-19 is not known. We have a time-sensitive opportunity to determine the effect of serum PFAS
on COVID-19, building on a unique statewide firefighter testing program for SARS-CoV-2 antibodies. Our long-
term goal is to identify health risks of PFAS mixtures. Our objective in this application is to evaluate the effects
of PFAS exposure levels in firefighters in regards to the severity of and immune response to COVID-19 infection.
Our hypotheses are that increased PFAS serum concentrations will increase the severity of COVID-19 infection
and reduce post-recovery serologic titers, which could thereby increase risk of later re-infection. We will test
these hypotheses through two specific aims: 1) Determine the association of serum PFAS concentrations with
infection severity; and 2) Determine the association of serum PFAS with SARS-CoV-2 antibody titers. For aim
1, recruiting from our state registry, we will enroll 100 Tucson and Phoenix firefighters with positive SARS-CoV-
2 IgM and/or IgG antibodies, and collect and analyze their serum for PFAS. Using an online survey instrument
completed at the time of biological sample collection, we will obtain information on whether the subjects had
COVID-19 infection(s) confirmed by diagnostic testing, extent of symptoms (if any) consistent with COVID-19
infection, and whether they were hospitalized. We will evaluate the association between serum PFAS and: 1)
severity of symptoms; 2) symptomatic vs. asymptomatic COVID-19 infection; and 3) hospitalization. For aim 2,
we will repeat SARS-CoV-2 IgG testing after five months and ten months in all firefighters enrolled in the study
to measure changes in immune response and to test the association of PFAS levels and longitudinal changes
in IgG using generalized linear regression models that account for repeated measures. At study completion, we
will have documented the effects of PFAS exposure on the likelihood of a symptomatic COVID-19 infection and
symptom severity in a highly exposed population, as well as effects of PFAS exposure on the subsequent
immune response persistence. The proposed research is significant given the potential for PFAS exposure to
increase the risk of already severe health consequences of COVID-19 and to reduce long-term immune
response. The proposed research is innovative as it is the first to our knowledge to determine the association
between serum PFAS levels and COVID-19.

## Key facts

- **NIH application ID:** 10151777
- **Project number:** 1R21ES032680-01
- **Recipient organization:** UNIVERSITY OF ARIZONA
- **Principal Investigator:** Jefferey L. Burgess
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $254,748
- **Award type:** 1
- **Project period:** 2020-09-08 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10151777

## Citation

> US National Institutes of Health, RePORTER application 10151777, Per- and Polyfluoroalkyl substances (PFAS) Exposures and COVID-19 in Firefighters (1R21ES032680-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10151777. Licensed CC0.

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