Exposure and Health (2026) 18:14

Overview

This source page is a mechanical bulk-ingest record for a PDF in the research-pulls corpus. It preserves source-level identity, routeable product/analyte scope, and exact extracted numeric lines for later human or fresh-context audit. It does not derive HMTc thresholds, percentiles, or brand-by-brand comparisons.

Key numbers

The worker extracted the full PDF text with layout preservation twice and compared extraction hashes before commit. The following lines are copied from numeric/table-bearing regions of the PDF and retain the source units and wording where legible:

Results PFOS, PFUnDA, PFDA, and PFNA increased 6–10% per five meals of any seafood over the past 30 days. Consum-
ing fish more than three times per week over the past 30 days was associated with higher PFOS (38%) and PFUnDA (42%)
more times per week over the past year was associated with 66–125% higher levels of PFOS, PFUnDA, PFDA, and PFNA,
compared to consumption less than once per month. Consumption of non-fillet fish parts was associated with 34–124%
PFASs, have estimated up to 50% of perfluorooctane sul- nizations. APA Family Support Services (APA), a long-
(n = 197) were sent paper reports detailing their individual week). We were not able to evaluate the frequency of caught
tube and evaporated to near dryness under a gentle nitrogen greater than 65% detection frequencies: PFDA, PFHxS,
volume of 0.15 mL. The sample extract was then transferred below the limit of detection (LOD) were substituted with
to HPLC vials containing 0.15 mL of Milli-Q water. The the LOD/√(2). All analyses utilized log-transformed serum
a C18 UPLC column (Acquity column, Waters Corporation) means (GMs) of the six serum PFAS concentrations were
batch of samples to verify method accuracy. Duplicates of sion models to calculate percent changes and 95% confi-
race, education, and nativity, and these factors also have over half were female (53%) and the mean age was around
been associated with differences in PFAS levels. Income 45 years (Table 1). Overall, participants reported ethnicities
than 20% of responses. 98). Participants reported birth countries largely within Asia
Female 104 (53%) 50 (52%) 54 (55%)
Male 91 (47%) 46 (48%) 45 (45%)
51%, USA: 11%). ACE 2 participants skewed more towards suming greater than or equal to three times per week. Con-
guages that were non-English compared with those in ACE ACE 1 (27%). An average of 3.6 ± 3.7 meals of bought
or more (60%) compared to ACE 2 participants (44%). Par- naire items were only introduced in the second phase of the
ticipants across both phases had median incomes below the ACE Project. The majority of ACE 2 participants (84%)
munity Survey and less representation of individuals with ined by specific fish part, fish head (64%) and skin (76%)
higher educational attainment than seen in the general popu- were consumed by more participants than fish organs (13%)
lation (Bureau 2016). In 2016, 71.4% of Chinese Califor- and fish eyes (34%).
nians and 57.0% of Vietnamese Californians had completed Statistically significant positive correlations were
the ACE phases, and to NHANES are presented in Table 2. 0.82 (between PFNA and PFDA) (p < 0.01) (Table 4). Cor-
compared with both national estimates. Blood mercury lev- 30 days are presented in Table 5. Consumption of seafood
compared to both national estimates. Among the other 26 10% higher PFOS (95% CI 4%, 15%), 10% higher PFUnDA
PFASs measured, 11 PFASs, including PFAS precursors, (95% CI 4%, 16%), 7% higher PFDA (95% CI 2%, 13%),
short chain PFASs, and other long chain PFCAs, were and 6% higher PFNA (95% CI 1%, 10%). Consumption of
frequencies ranging from 2 to 98% (Supplemental Table 1). associated with higher levels of four PFASs, ranging from 7
national estimates of all adults (19.2%) in the 2015–2016 in the past 30 days was associated with 39% higher PFOS
NHANES (Terry et al. 2018). Seafood consumption among (95% CI 13%, 63%), 29% higher PFUnDA (95% CI 10%,
non-Hispanic Asian adults from the 2013–2016 NHANES 51%), 37% higher PFDA (95% CI 10%, 51%), 32% higher
was also lower (41%) compared with that of ACE partici- PFNA (95% CI 17%, 49%), 16% higher PFHxS (95% CI
ipants, friends, or family (Table 3). Across all participants, measuring the total times fish was consumed in the past 30
reported consuming caught fish (32% of all participants), a bought shellfish among the pooled estimates. There was
Table 2 Serum PFAS and blood mercury levels (µg/L) among participants in the ACE project (n = 195)
p-value from the two-sided Student’s t-test for differences in geometric means by ACE 1 and ACE 2 groups
NHANES All Adults 2015–2016 geometric mean data. PFUnDA data not reported due to low detection frequency
NHANES Non-Hispanic Asian Adults 2015–2016 geometric mean data
Table 4 Pearson’s correlationa between serum PFAS levels and blood mercury among 195 ACE participants
higher PFUnDA (95% CI 11%, 82%), compared to those past 30 day consumption of shellfish, the highest frequency

Methods (brief)

Participants completed an exposure questionnaire and provided blood samples for analysis of PFASs and mercury. We
levels (Papadopoulou et al. 2019; Christensen et al. 2017; ment, and sample collection. Additional support was pro-
lived in the area for at least 1 year prior to sample collection, a longer period of time included: consumption of fish parts
tionnaire and provided blood samples for biomonitoring. (yes/no); sauces or flavorings containing shrimp or crab
While sample collection and questionnaire administration (yes/no) in the past year, and consumption of caught fish in
Data Collection For PFAS analyses, phlebotomists collected blood in
Participants enrolled in the study from June 21, 2016 to ing Teflon-coated materials. Samples were inverted several
to June 10, 2017 for ACE 2. Trained study staff adminis- in a rack to allow blood samples to clot at room temperature
tered the questionnaire in the language of the participant’s between 30 min to 2 h. Clotted blood samples were then cen-
reported age, race/ethnicity, birth country, years lived in the serum samples were frozen in labeled polypropylene (PP) or
ucts over the past 30 days and past year), and smoking his- (ECL) in Berkeley, California where samples were stored
tory. For analysis, we combined primary languages reported at −20 °C until analysis. Samples were stored for 34 weeks
sample collection: within the past year and prior 30 days. isotopic-labeled standards. Samples were allowed to equili-
ENVI-CARB to the extract, mixing the samples on a rotary Statistical Analyses
volume of 0.15 mL. The sample extract was then transferred below the limit of detection (LOD) were substituted with
to HPLC vials containing 0.15 mL of Milli-Q water. The the LOD/√(2). All analyses utilized log-transformed serum
tandem mass spectrometry (Shimadzu Nexera X2 UPLC ferences in the distribution of potential covariates by ACE
Duplicate samples of NIST SRM 1958 (Organic Contami- To assess the association of seafood consumption with

Implications

This page makes the source discoverable for category-level evidence routing. Values remain source-native and should be used only with the stated matrix, species, basis, geography, and censoring context from the paper. The page does not convert total mercury to methylmercury or use total arsenic as inorganic arsenic.

Wiki pages this source may touch

Verification notes

Identity check: DOI, raw handle, candidate cite-key, and SHA-256 were compared against existing wiki/sources/ pages before creation.
Full-PDF read: pdftotext -layout was run on the full PDF twice; extracted text hashes matched before the page was written.
Numeric verification: numeric/table-bearing lines were selected mechanically from the verified extraction and preserved without unit conversion or rounding.
Brand firewall: the worker skips PDFs when extracted numeric lines appear brand/manufacturer-sensitive; this page contains category-level or species-level evidence only.
HMTc firewall: no threshold, percentile, pass/fail, clean/dirty, or certification math is stated.

Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.

Commit	Date	Change	Description
b01ec52c	2026-08-04	major	2 sections added
d49e450f	2026-08-03	major	5 sections added; narrative text revised