[Report] Ronneby PFAS Research Programme

By Eva Andersson, Axel Andersson, Magdalena Levandowski, Christian Lindh, YiYi Xu, Annelise Blomberg, Carina A Nilsson, Eva M Andersson, Christel Nielsen, Kristina Jakobsson, Tony Fletcher, Matilda Ebel, Erika Norén, Carmela Miniscalco, Charlotte Stübner, Huiqi Li, Sofia Hammarstrand, Ying Li, and Daniela Pineda
May 6, 2024

It has been ten years since it was discovered that the drinking water in one of the waterworks in Ronneby, which supplied approximately 1/3 of the households with drinking water, was very heavily contaminated with PFAS. Although the contaminated supply was immediately shut off and replaced with clean water, everyone who had been drinking the contaminated water for a long time still has elevated levels of PFAS in their bodies and will continue to do so for a long time to come. Women with elevated levels of PFAS in their bodies will pass some PFAS to their children during pregnancy and breastfeeding.

The situation in Ronneby is unique in several ways. First, the PFAS levels in the water were very high, especially for the substances PFOS and PFHxS, and second, there were clear differences within the municipality as only one of the waterworks had heavily contaminated water. This, together with the good opportunities for research in Sweden, has made it possible to study the health effects of PFASs over a very wide exposure range. For the substance PFOA, there are studies from the USA with very high exposure from drinking water (the so-called C8 studies). However, the majority of all epidemiological studies in general populations have been conducted at much lower exposures and studies at high exposures to PFOS and PFHxS outside Ronneby are completely lacking.

A broad research programme to investigate the health effects of PFAS exposure started within weeks of the contamination becoming known. In this report, we summarise the results of all the sub-studies carried out so far and describe the infrastructure for further research that has been built up.

In some cases, our results have confirmed previous findings, observed at background levels and/or in the C8 studies with high PFOA exposure. These include elevated cholesterol levels and increased risk of kidney cancer. Such consistency reinforces that there is a real causal relationship with PFAS exposure. However, it does not seem to be the case that a much higher exposure to PFAS has resulted in a much higher risk.

In other cases, neither our studies nor the C8 studies can confirm findings from different background exposure groups. This applies, for example, to impacts on thyroid hormones and childbirth weight. Another example where consistency is lacking is that previous research has shown that children's antibody responses after vaccinations are reduced by PFAS, while we could not see any such effect among adults with very high PFAS exposure. But we have also found elevated risks for several conditions for which there were previously only limited and conflicting results - such as increased risk of osteoporosis fractures, diabetes, the women's disease PCOS, and an increased incidence of language disorders in children. These are observations that need to be confirmed in more studies.


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