Per- and polyfluoroalkyl substances and hand osteoarthritis: data from the Osteoarthritis Initiative

Authors

Jeffrey B. Driban, Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA.
Lisa B. Rokoff, Center for Interdisciplinary and Population Health Research, MaineHealth Institute for Research, Westbrook, ME, USA.
Bing Lu, Department of Public Health Sciences, UConn Health, Farmington, CT, USA.
Timothy E. McAlindon, Division of Rheumatology, Department of Medicine, UMass Chan Medical School, Worcester, MA, USA.
Charles B. Eaton, Center for Primary Care and Prevention, Kent Hospital, Pawtucket, RI, USA.
Mary B. Roberts, Center for Primary Care and Prevention, Kent Hospital, Pawtucket, RI, USA.
Diana Mathes, Environmental and Chemical Laboratory Services, Public Health & Environmental Laboratories, New Jersey Department of Health, Ewing, NJ, USA.

Document Type

Article

Publication Date

12-22-2025

Institution/Department

Center for Interdisciplinary and Population Health Research; Pediatrics

Journal Title

Arthritis & rheumatology (Hoboken, N.J.)

Abstract

OBJECTIVE: To explore whether biological levels of specific per- and polyfluoroalkyl substances (PFAS) and a mixture of PFAS - reflecting the overall effect and accounting for correlations among each PFAS - relate to incident hand osteoarthritis (HOA) and progression. METHODS: Among a case-cohort sample from the Osteoarthritis Initiative (n=1,878), we examined associations of 8 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. RESULTS: Participants were primarily female (58%) and on average 62 years of age and overweight (mean BMI=28.6 kg/m). Participants with higher perfluorodecanoic acid (PFDA) and perfluorononanoic acid (PFNA; continuous variables) had greater odds of incident symptomatic HOA [OR (95%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 sulfonoic acid (PFHxS) had lower odds of incident HOA [e.g., OR (95%CI): 0.94 (0.88-1.00) per interquartile-range increment]. We observed no other consistent associations between PFAS and either outcome. CONCLUSION: 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.

Recommended Citation

Driban, Jeffrey B.; Rokoff, Lisa B.; Lu, Bing; McAlindon, Timothy E.; Eaton, Charles B.; Roberts, Mary B.; and Mathes, Diana, "Per- and polyfluoroalkyl substances and hand osteoarthritis: data from the Osteoarthritis Initiative" (2025). MaineHealth Maine Medical Center. 4249.
https://knowledgeconnection.mainehealth.org/mmc/4249