Per- and Polyfluoroalkyl Substances and Hand Osteoarthritis: Data From the Osteoarthritis Initiative

To explore whether biologic levels of specific per- and polyfluoroalkyl substances (PFAS) and a mixture of PFAS-reflecting the overall effect and accounting for correlations among PFAS-relate to incident hand osteoarthritis (HOA) and progression.

Among a case-cohort sample from the Osteoarthritis Initiative (n = 1,878), we examined associations of eight PFAS in serum with odds of developing over the subsequent 4 years (1) symptomatic HOA and (2) an increased number of joints with radiographic osteoarthritis (Kellgren-Lawrence ≥2; yes/no). We used weighted logistic regression to assess single PFAS (continuous and quartiles) and quantile g-computation to assess the PFAS mixture in relation to our primary outcomes.

Participants were primarily female (58%) and on average aged 62 years and overweight (mean body mass index = 28.6 kg/m²). Participants with higher perfluorodecanoic acid (PFDA) and perfluorononanoic acid (PFNA; continuous variables) had greater odds of incident symptomatic HOA (odds ratio [OR] [95% confidence interval (CI)] per interquartile range increment: PFDA 1.12 [1.05-1.20]; PFNA 1.07 [1.00-1.13]), but associations were not monotonic when these PFAS were represented in quartiles. Participants with higher perfluorohexane sulfonic acid had lower odds of incident HOA (eg, OR 0.94 [95% CI 0.88-1.00] per interquartile range increment). We observed no other consistent associations between PFAS and either outcome.

We observed possible associations of PFDA and PFNA serum concentrations with symptomatic HOA incidence, but we otherwise found no consistent evidence that greater PFAS concentrations relate to a greater chance of developing HOA incidence or progression.