Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 2, 2024
Date Accepted: Feb 25, 2025
Interventions to reduce serum per- and poly-fluoroalkyl substances (PFAS) levels, improve cardiovascular risk profiles, and improve epigenetic age acceleration in U.S. firefighters: protocol for a randomized controlled trial
ABSTRACT
Background:
Occupational cancer and acute cardiac events are the leading causes of death among firefighters. Increased exposure to toxicants on the fireground, such as polycyclic aromatic hydrocarbons, benzene, and per- and poly-fluoroalkyl substances (PFAS), has been linked to certain cancers, cardiovascular disease, accelerated epigenetic aging, and other adverse health effects. PFAS are a major concern because they are persistent, can bioaccumulate, and are present in several firefighting tools. Compared to the general population, firefighters have elevated levels of serum PFAS. A randomized clinical trial in Australian firefighters found that routine blood and plasma donation for one year led to decreased serum PFAS levels, although health outcomes were not directly measured in that study.
Objective:
In collaboration with fire service leadership in Arizona, the Firefighter Collaborative Research Project (FCRP) was established to evaluate the effectiveness of three interventions in a randomized control trial design to reduce serum PFAS levels, reduce cancer and cardiovascular risk and improve overall health and wellness in United States firefighters.
Methods:
Active firefighters are recruited and randomized into a study arm based on their eligibility, including serum PFOS levels, for the specific arms. The trial arms include 1) blood and plasma donation, 2) zone 2 physical activity, and 3) intermittent fasting. FCRP outcomes include serum PFAS reduction (arm 1), epigenetic age acceleration (all arms), cardiovascular conditioning (arm 2) and cognitive outcomes (all arms), mental health (all arms), and overall disease risk (all arms). Each study arm includes an intervention and a control group. At enrollment and end of study, participants provide blood and urine samples and complete a comprehensive questionnaire on their occupational and health history, exposures, and lifestyle behaviors. At the end of study, participants also participate in a cognitive evaluation. Depending on the study arm, participants may additionally complete a Cardiopulmonary Exercise Test (CPET) at baseline and follow-up, a mid-study survey, and/or mid-study blood and urine collection.
Results:
NA
Conclusions:
This study aims to recruit and enroll up to 1,500 active firefighters between August 2023 and October 2024. Clinical Trial: ClinicalTrials.gov ID: NCT05869747 Registration Date: 04/24/2023 First submitted that met QC criteria: 2023-05-17
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