Occupation and serum concentrations of per- and polyfluoroalkyl substances: Data from the 2013 to 2014 National Health and Nutrition Examination Survey
By Abimbola Ojo, Karyn Heavner, Dhimiter Bello, Wenjun Li, and Anila Bello
Ann Work Expo Health
July 6, 2026
DOI: 10.1093/annweh/wxag052
Background
Occupational exposure to per- and polyfluoroalkyl substances (PFASs) is a growing concern, as workers may experience higher exposures compared to the general population. However, the contribution of occupational exposure to PFAS on overall body burden remains understudied.
Objective
This study aims to identify occupational groups with high PFAS body burden based on the data from 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) and assess potential health risks using the National Academy of Sciences, Engineering, and Medicine (NASEM) guidelines for clinicians.
Methods
Serum concentration of 12 PFAS compounds among U.S. residents aged ≥16 yr was obtained from the 2013 to 2014 NHANES (N = 2099), which provides the most recent cycle with detailed information on current and longest jobs. Occupational history was obtained from 2010 U.S. Bureau of the Census Industrial & Occupational Classification coding system reported in the NHANES dataset. Occupations and industries associated with the highest PFAS body burden were determined and categorized into 3 risk groups per NASEM thresholds (<2, 2 to 20, and >20 ng/mL) for the sum of 7 PFAS. Survey-weighted linear regressions were conducted to compare PFAS levels across 23 occupational/industry groups, stratified by gender and age.
Results
Higher total PFAS concentrations (sum of all detectable PFAS) were observed for both current and longest jobs (GMs: 12.4 to 14.4 ng/mL) in construction/extraction, installation/maintenance/repair, and arts/design/entertainment/sports/media occupations. PFOA, PFOS, PFHxS, and PFNA accounted for >70% of total PFAS body burden. Over 20% of participants exceeded the NASEM high-risk threshold (≥20 ng/mL) in installation/maintenance/repair, construction, manufacturing, durable goods, and transportation/warehousing, with GMs ranging from 28.6 to 37.6 ng/mL. Elevated PFAS levels were observed in construction and installation/maintenance/repair groups in adjusted models, relative to their respective reference groups. Significantly elevated associations were most pronounced among adults aged 30 to 64 and among females in installation/maintenance/repair compared with sales.
Conclusions
The observed differences in PFAS serum levels, including elevated body burdens among workers in construction/extraction, arts/design/entertainment/sports/media, and installation/maintenance/repair, underscore the need for targeted biomonitoring and exposure intervention among these occupational groups.
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