PFAS Exposure in Alessandria (Italy): Environmental Context, Population-Based Assessment, and Method Validation in the EU SCENARIOS Project

PFAS Exposure in Alessandria (Italy): Environmental Context, Population-Based Assessment, and Method Validation in the EU SCENARIOS Project Iacopo Megna , Marinella Bertolotti , Daniela Ferrante , Fabio Giacchero , Roberta Libener , Tatiana Bolgeo , Marta Betti , Masho Belay , Elisa Robotti , Antonio Maconi , Francesco Dondero 1 1 2 1 1 1 1 3 3 1 3 1 Research and Innovation Department (DAIRI), AOU AL 2 Unit of Medical Statistics, Department of Translational Medicine, UPO 3 Department of Science and Innovation Technology (DISIT), UPO OBJECTIVES The objectives of the study are to validate methods for the detection of PFAS in biological and environmental samples and to assess the exposure of residents living in selected areas of Alessandria, specifically through Case Study A and Case Study B INTRODUCTION Perand polyfluoroalkyl substances (PFAS) are highly persistent contaminants widely used in industrial applications for their chemical and thermal stability. Their resistance to degradation leads to bioaccumulation in living organisms and potential long-term health risks, including endocrine, immune, and metabolic effects. METHODS CONCLUSIONS Preliminary findings indicate a high prevalence of modifiable cardiovascular risk factors in children. The study highlights the central role of daily habits in shaping children's cardiometabolic health, underlining the importance of targeting family routines as part of effective prevention. The active involvement of Primary Care Pediatricians across the province has proven essential for implementing early, territory-wide preventive strategies. Ongoing data collection will further refine individual and population-level risk profiles. Two pilot studies were carried out in the Alessandria area. Case Study A compared residents of Montecastello, a municipality with documented PFAS detections in the local aqueduct, to residents of Frugarolo, chosen as a reference municipality without contamination. Case Study B included residents of Alessandria municipality, stratified according to their residential distance from a local chemical production site (0–3 km, 3–6 km, >6 km) Study Population and Setting 01 In Case Study A, 160 individuals were planned for enrollment, equally distributed by sex and across four age groups (<18 years, 18–49 years, 50–65 years >65 years). At the time of reporting, 76subjects had been recruited in Montecastello and 64 in Frugarolo. In Case Study B, 300 individuals were expected, with 201 enrolled to date Population and Enrollement 02 Blood, urine, and household water samples were collected from each participant. PFAS concentrations were determined, and blood analyses included lipid profile, glucose, glycated hemoglobin, creatinine, liver enzymes, thyroid hormones, uric acid, and vitamin D Sample collection and Analysis 03 A standardized questionnaire was administered by trained personnel, covering personal and environmental data, occupational exposure, diet, and water consumption. Residual biological material was stored at the Biological Materials Collection Centre of the University Hospital of Alessandria for long-term research purposes Questionnaires and Biobanking 04 RESULTS Case Study A Planned sample size 160 individuals: 80 residents from Montecastello (potentially exposed) 80 residents from Frugarolo (reference population, likely unexposed) Selection criteria Randomly identified, equally distributed according to gender and following age groups: <18 18 - 49 50 - 65 >65 Case Study B Planned sample size 300 individuals: 100 residents within a 3-km radius from the local Chemical Pole 100 residents between 3 km and 6 km from the local Chemical Pole; 100 residents from a 6-km radius from the local Chemical Pole Selection criteria Randomly identified, equally distributed according to gender and following age groups: <18 18 - 49 50 - 65 >65 Case Study A and B questionnaire Adequately trained personnel administer a on lifestyles and eating habits to participants The instrument used was developed based on the questionnaire used in 2015 as part of the ‘Biomonitoring of perfluoroalkyl substances (PFAS) in some areas of tVeneto Region territory’ (DGR n.565 of 21 April 2015) supplemented with subsequent scientific evidence The questionnaire is divided into 5 Sections, specifically: SECTION 1. Personal data SECTION 2. Environmental conditions SECTION 3. Work activity SECTION 4. Diet SECTION 5. Water FIG1 Spatial identification for the three sampling areas CASE STUDY B