Exposure to ‘Forever Chemicals’ May Weaken Bones as People Age

AMHERST — A UMass Amherst epidemiology researcher will examine whether and how exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS), sometimes called ‘forever chemicals,’ increases the risk of brittle bones and bone fractures as people age.

“There is evidence from laboratory studies and also animal studies showing that PFAS exposure can impact bone health,” said Katherine Reeves, associate dean of Graduate and Professional Studies and professor of Epidemiology in the School of Public Health and Health Sciences.

PFAS have been used in consumer products with non-stick, water- and stain-resistant coatings, and these chemicals remain stable in the environment rather than breaking down. “They also accumulate within human tissues,” Reeves said. “And, unfortunately, about 98% of the U.S. population is exposed, most notably through drinking-water contamination.”

Reeves has received a five-year, $4.9 million grant from the National Institutes of Health to use biological samples and data from the two largest prospective osteoporosis studies to investigate the link between PFAS accumulation in the body and bone loss and fractures.

“Our overarching hypothesis is that PFAS concentrations are associated with increased bone loss and fracture risk,” said Reeves, who also is studying PFAS exposure and breast-cancer risk.

About 2 million bone fractures occur each year in the U.S. due to weakened or osteoporotic bones, incurring an estimated healthcare cost of $17 billion. “As our population ages, low bone-mineral density has a huge impact on population health,” Reeves said. “Once individuals have a fracture as they age, it often unfortunately leads to other subsequent negative health outcomes.”

Bone is continually remodeling; it gets broken down, and then it rebuilds. “So there is a lot of opportunity for chemicals to interfere with that very delicate balancing act of breaking down and rebuilding bone,” Reeves said.

In addition, bone-mineral density naturally declines with age, she added. “But there have been some human studies suggesting that people with higher exposure to certain PFAS chemicals actually experience a more rapid decline in their bone-mineral density than those with lower exposure.”

She points to a study in Sweden that found a higher-than-anticipated risk of fracture among people living in an area with known PFAS contamination. She hopes to “close a gap in the literature in terms of high-quality, prospective studies that could look at the whole spectrum of bone health.”

The research team will measure the levels of up to 25 different PFAS chemicals in blood-serum samples and perform an in-depth study of bone loss and fractures, using data and biospecimens from the Osteoporotic Fractures in Men Study and the Study of Osteoporotic Fractures.

“We’re going to be able to look at fracture risk, and we’ll also look at the rate of bone-mineral density change, as well as some biomarkers that are known to be related to bone formation and also bone resorption, or breaking down,” Reeves said.

Finally, she will validate her team’s findings using data from a third aging cohort that has better racial diversity — in fact, an equal number of Caucasian and African-American participants. This robust, multi-layer investigation is expected to provide the clearest picture to date of the impact of PFAS on bone health.

“It’s a really important health condition that we should be paying attention to,” Reeves said, “and we’re hoping that this study will inform efforts to regulate these chemicals and also help us to understand ways that we could potentially intervene in populations that are known to have high exposure to these chemicals.”