Military veterans under 40 have higher levels of the "forever chemicals" known as PFAS in their blood than civilians their age, according to a new peer-reviewed study led by Brown and Harvard researchers. They recommended that younger veterans consider getting tested.
Three researchers at Brown University conducted the study, including lead author Christian Hoover, who is affiliated with the Harvard T.H. Chan School of Public Health. It was published Sept. 14 in the peer-reviewed journal Environmental Health Perspectives. Researchers analyzed nationally representative federal health data to compare PFAS levels in veterans and non-veterans.
Among veterans ages 20 to 39, concentrations of individual per/polyfluoroalkyl substances (PFAS) compounds ran 13% to 24% higher than in non-veterans the same age, the study found. The findings drew on federal health survey data collected from 2003 to 2018, representing an estimated 22.8 million veterans.
PFAS are a large class of synthetic chemicals used for their resistance to heat, water and grease in products including firefighting foam, nonstick cookware and stain-resistant materials. Routinely called "forever chemicals," they can persist for years in the environment and the human body.
Levels of perfluorooctanoic acid (PFOA) were 13% higher, perfluorooctane sulfonate (PFOS) were 19% higher, and perfluorohexanesulfonic acid (PFHxS) were 24% higher. A combined measure of seven PFAS was 17% higher.
Younger veterans were also 18% more likely to have PFAS levels above 20 nanograms per milliliter. This is the point at which the National Academies of Sciences, Engineering and Medicine recommend monitoring by a health care professional.
Findings Behind the Research
Elevated levels were concentrated in just one group. After adjusting for other factors, the study found that veterans overall had lower PFAS concentrations than non-veterans—not higher.
Among the youngest veterans, levels were higher than those of their civilian peers.
The pattern also varied by race and sex. Non-Hispanic white veterans had lower concentrations of PFOA, PFOS and PFHxS, as well as the combined seven-PFAS measure.
For the question of how many veterans had elevated levels, female veterans had a 37% lower prevalence of readings above the threshold. Male veterans showed no significant difference.
Why Younger Veterans are More Susceptible
The researchers offered a likely explanation for the age gap.
Younger veterans are more likely to have had recent exposure to PFAS through their work and training, said study co-author Joseph Braun, a professor of epidemiology at Brown.
Since the chemicals leave the body slowly, older veterans have had more time to clear them.
"The common PFAS chemical PFOA, for example, has a half-life of about one and a half to two years," Braun said, adding that it can take years for the body to excrete a single exposure.
As veterans age and move away from active service, he said, they encounter less of it and clear what they have.
The researchers said they do not know the source of the excess exposure. Possible contributors include firefighting foams, munitions and groundwater contamination. Their analysis was cross-sectional, meaning it identified an association rather than establishing that military service caused the higher levels.
Asked whether the department covers PFAS testing for veterans, Department of Veterans Affairs spokesperson Quinn Slaven said VA physicians can order the testing through commercial lab partners when it is deemed medically necessary.
Slaven pointed to the department's public health page on PFAS exposure for more information.
He did not address whether the study changes the VA's assessment of the evidence, or whether any PFAS-related conditions are under review for the presumptive list.
Military Bases and How Veterans Can Respond
PFAS contamination at military installations has long been recognized as an issue.
The Defense Department reviewed hundreds of installations for known or suspected PFAS releases, with many requiring cleanup.
PFAS has been associated with a range of health effects, including kidney and testicular cancers, liver and cardiovascular disease, and thyroid dysfunction, according to the study.
The study came with a recommendation.
"If you're a male veteran between the ages of 20 and 39, it would be advisable to speak to a physician about getting tested for PFAS levels," lead author Hoover, a pre-doctoral fellow in epidemiology at Brown's School of Public Health, wrote.
He said older veterans may still want to raise the subject with their doctors, and that the findings may inform Veterans Health Administration policies on PFAS testing coverage.
For veterans weighing that advice, the benefits landscape is mixed. PFAS-related conditions are not currently on the VA's presumptive list under the PACT Act, which would automatically connect them to service.
However, the PACT Act extended VA health care eligibility to veterans exposed to toxic substances—including PFAS—and the department offers a toxic exposure screening to enrolled veterans.
Claims for PFAS-related conditions are currently handled through the standard process, not the presumptive one.