Table of Contents

Component Description

Organic fluorochemicals are used in multiple commercial applications including surfactants, lubricants, paints, polishes, food packaging and fire-retarding foams. Several of these polyfluorochemicals (PFCs) are ubiquitous contaminants found both in humans and animals worldwide. Perfluorooctane sulfonate (PFOS) has been used in a wide variety of industrial and consumer products including protective coatings for carpets and apparel, paper coatings, insecticide formulations, and surfactants. In May 2000, the 3M Company, the sole manufacturer of PFOS in the United States and the principal manufacturer worldwide, announced that it was discontinuing the production of perfluorooctanyl fluoride-based chemistries, including PFOS. Perfluorooctanoic acid (PFOA) is used primarily to produce salts which are used in the production of fluoroelastomers and fluoropolymers, such as polytetrafluoroethylene (PTFE) and polyvinylidine fluoride (PVDF). PTFE has numerous uses in many industrial and consumer products, including coatings on textiles and carpet; uses in the automotive, mechanical, aerospace, chemical, electrical, medical, and building/construction industries; personal care products; and non-stick coatings on cookware. PVDF is used primarily in electrical/electronics, building/construction, and chemical processing industrial sectors.

Eligible Sample

Examined participants aged 12 years and older from a one-third sample.

Description of Laboratory Methodology

Solid phase extraction coupled to High Performance Liquid Chromatography-Turbo Ion Spray ionization-tandem Mass Spectrometry (online SPE-HPLC-TIS-MS/MS) is used for the quantitative detection of perfluorooctane sulfonamide (PFOSA), 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (Me-PFOSA-AcOH), 2-(N-ethyl-perfluorooctane sulfonamido) acetic acid (Et-PFOSA-AcOH), perfluorobutane sulfonate (PFBuS), perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluoroheptanoate (PFHpA), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorodecanoate (PFDeA), perfluoroundecanoate (PFUA), and perfluorododecanoate (PFDoA). Briefly, after dilution with formic acid, one aliquot of 100 μL of serum is injected into a commercial column switching system allowing for concentration and chromatographic separation of the analytes. Detection and quantification are done using tandem mass spectrometry (Kuklenyik Z, et al. 2005).

Refer to NHANES 2011-2012 Lab Methods for Polyfluoroalkyl Chemicals for detailed description of the laboratory method used.

Data Processing and Editing

The data were reviewed. Incomplete data or improbable values were sent to the performing laboratory for confirmation.

Laboratory Quality Assurance and Monitoring

Serum specimens are processed, stored, and shipped to the Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention for analysis.

Detailed instructions on specimen collection and processing are discussed in the NHANES Laboratory Procedures Manual (LPM). Vials are stored under appropriate frozen (–20°C) conditions until they are shipped to National Center for Environmental Health for testing.

Mobile Examination Centers (MECs)
Laboratory team performance is monitored using several techniques. NCHS and contract consultants use a structured quality assurance evaluation during unscheduled visits to evaluate both the quality of the laboratory work and the quality-control procedures. Each laboratory staff person is observed for equipment operation, specimen collection and preparation; testing procedures and constructive feedback are given to each staff. Formal retraining sessions are conducted annually to ensure that required skill levels were maintained.

The NHANES QA/QC protocols meet the 1988 Clinical Laboratory Improvement Amendments mandates. Detailed QA/QC instructions are discussed in the NHANES Laboratory Procedures Manual (LPM).

Analytical Laboratories
NHANES uses several methods to monitor the quality of the analyses performed by the contract laboratories. In the MEC, these methods include performing blind split samples collected on “dry run” sessions. In addition, contract laboratories randomly perform repeat testing on 2.0% of all specimens.

NCHS developed and distributed a quality control protocol for all the contract laboratories which outlined the Westgard rules (Westgard et al, 1981) used when running NHANES specimens. Progress reports containing any problems encountered during shipping or receipt of specimens, summary statistics for each control pool, QC graphs, instrument calibration, reagents, and any special considerations are submitted to NCHS quarterly. The reports are reviewed for trends or shifts in the data. The laboratories are required to explain any identified areas of concern.

All QC procedures recommended by the manufacturers were followed. Reported results for all assays meet the Division of Laboratory Science’s quality control and quality assurance performance criteria for accuracy and precision, similar to specifications outlined by Westgard (Westgard et al,1981; Caudill et al. 2008).

Analytic Notes

Refer to the 2011-2012 Laboratory Data Overview for general information on NHANES laboratory data.

The analysis of NHANES 2011-2012 laboratory data must be conducted using the appropriate survey design and demographic variables. The NHANES 2011-2012 Demographics File contains demographic data, health indicators, and other related information collected during household interviews as well as the sample weight variables. The Fasting Questionnaire File includes auxiliary information such as fasting status, the time of venipuncture, and the conditions precluding venipuncture. The demographics and fasting questionnaire files may be linked to the laboratory data file using the unique survey participant identifier (i.e., SEQN).

Subsample weights

Serum polyfluorinated chemicals were measured in a one third subsample of persons 12 years and over. Special sample weights are required to analyze these data properly. Specific sample weights for this subsample are included in this data file and should be used when analyzing these data.

Variance estimation

The analysis of NHANES laboratory data must be conducted with the key survey design and basic demographic variables. The NHANES Demographic Data File contains demographic and sample design variables. The recommended procedure for variance estimation requires use of stratum and PSU variables (SDMVSTRA and SDMVPSU, respectively) in the demographic data file.

Detection Limits

The detection limits were constant for all of the analytes in the data set. Two variables are provided for each of these analytes. The variable named LBD___LC indicates whether the result was below the limit of detection. There are two values: “0” and “1”. “0” means that the result was at or above the limit of detection. “1” indicates that the result was below the limit of detection. The other variable named LBX___ provides the analytic result for that analyte. For analytes with analytic results below the lower limit of detection (i.e., URD___LC=1), an imputed fill value was placed in the analyte results field. This value is the lower limit of detection divided by square root of 2 (LLOD/sqrt(2)).

The lower limit of detection (LLOD, in ng/mL) for each polyfluorochemical is:

Analyte Item Id LLOD
Perfluorooctanoic acid LBXPFOA 0.10
Perfluorooctane sulfonic acid LBXPFOS 0.20
Perfluorohexane sulfonic acid LBXPFHS 0.10
2-(N-Ethyl-perfluorooctane sulfonamido) acetic acid LBXEPAH 0.10
2-(N-Methyl-perfluorooctane sulfonamido) acetic acid LBXMPAH 0.09
Pefluorodecanoic acid LBXPFDE 0.10
Perfluorobutane sulfonic acid LBXPFBS 0.10
Perfluoroheptanoic acid LBXPFHP 0.10
Perfluorononanoic acid LBXPFNA 0.08
Perfluorooctane sulfonamide LBXPFSA 0.10
Perfluoroundecanoic acid LBXPFUA 0.10
Perflurododecanoic acid LBXPFDO 0.10

Please refer to the NHANES Analytic Guidelines and the on-line NHANES Tutorial for further details on the use of sample weights and other analytic issues.

References

Codebook and Frequencies

SEQN - Respondent sequence number

Variable Name:
SEQN
SAS Label:
Respondent sequence number
English Text:
Respondent sequence number.
Target:
Both males and females 12 YEARS - 150 YEARS

WTSA2YR - Subsample A weights

Variable Name:
WTSA2YR
SAS Label:
Subsample A weights
English Text:
Subsample A weights
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
12199.652219 to 643202.3505 Range of Values 2144 2144
. Missing 33 2177

LBXEPAH - 2-(N-ethyl-PFOSA) acetate

Variable Name:
LBXEPAH
SAS Label:
2-(N-ethyl-PFOSA) acetate
English Text:
2-(N-Ethyl-perfluorooctane sulfonamido) acetic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 0.72 Range of Values 1904 1904
. Missing 273 2177

LBDEPAHL - 2-(N-ethyl-PFOSA) acetate comment

Variable Name:
LBDEPAHL
SAS Label:
2-(N-ethyl-PFOSA) acetate comment
English Text:
2-(N-Ethyl-perfluorooctane sulfonamido) acetic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 97 97
1 Below lower detection limit 1807 1904
. Missing 273 2177

LBXPFDE - Perfluorodecanoic acid

Variable Name:
LBXPFDE
SAS Label:
Perfluorodecanoic acid
English Text:
Pefluorodecanoic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 17.8 Range of Values 1904 1904
. Missing 273 2177

LBDPFDEL - Perfluorodecanoic acid comment

Variable Name:
LBDPFDEL
SAS Label:
Perfluorodecanoic acid comment
English Text:
Pefluorodecanoic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 1620 1620
1 Below lower detection limit 284 1904
. Missing 273 2177

LBXPFOA - Perfluorooctanoic acid

Variable Name:
LBXPFOA
SAS Label:
Perfluorooctanoic acid
English Text:
Perfluorooctanoic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 43 Range of Values 1904 1904
. Missing 273 2177

LBDPFOAL - Perfluorooctanoic acid comment

Variable Name:
LBDPFOAL
SAS Label:
Perfluorooctanoic acid comment
English Text:
Perfluorooctanoic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 1895 1895
1 Below lower detection limit 9 1904
. Missing 273 2177

LBXPFOS - Perfluorooctane sulfonic acid

Variable Name:
LBXPFOS
SAS Label:
Perfluorooctane sulfonic acid
English Text:
Perfluorooctane sulfonic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.14 to 235 Range of Values 1904 1904
. Missing 273 2177

LBDPFOSL - Perfluorooctane sulfonic acid comment

Variable Name:
LBDPFOSL
SAS Label:
Perfluorooctane sulfonic acid comment
English Text:
Perfluorooctane sulfonic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 1897 1897
1 Below lower detection limit 7 1904
. Missing 273 2177

LBXPFHS - Perfluorohexane sulfonic acid

Variable Name:
LBXPFHS
SAS Label:
Perfluorohexane sulfonic acid
English Text:
Perfluorohexane sulfonic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 47.8 Range of Values 1904 1904
. Missing 273 2177

LBDPFHSL - Perfluorohexane sulfonic acid comment

Variable Name:
LBDPFHSL
SAS Label:
Perfluorohexane sulfonic acid comment
English Text:
Perfluorohexane sulfonic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 1874 1874
1 Below lower detection limit 30 1904
. Missing 273 2177

LBXMPAH - 2-(N-methyl-PFOSA) acetate

Variable Name:
LBXMPAH
SAS Label:
2-(N-methyl-PFOSA) acetate
English Text:
2-(N-Methyl-perfluorooctane sulfonamido) acetic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.06 to 4.25 Range of Values 1904 1904
. Missing 273 2177

LBDMPAHL - 2-(N-methyl-PFOSA) acetate comment

Variable Name:
LBDMPAHL
SAS Label:
2-(N-methyl-PFOSA) acetate comment
English Text:
2-(N-Methyl-perfluorooctane sulfonamido) acetic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 1027 1027
1 Below lower detection limit 877 1904
. Missing 273 2177

LBXPFBS - Perfluorobutane sulfonic acid

Variable Name:
LBXPFBS
SAS Label:
Perfluorobutane sulfonic acid
English Text:
Perfluorobutane sulfonic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 0.8 Range of Values 1904 1904
. Missing 273 2177

LBDPFBSL - Perfluorobutane sulfonic acid comment

Variable Name:
LBDPFBSL
SAS Label:
Perfluorobutane sulfonic acid comment
English Text:
Perfluorobutane sulfonic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 23 23
1 Below lower detection limit 1881 1904
. Missing 273 2177

LBXPFHP - Perfluoroheptanoic acid

Variable Name:
LBXPFHP
SAS Label:
Perfluoroheptanoic acid
English Text:
Perfluoroheptanoic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 1.55 Range of Values 1904 1904
. Missing 273 2177

LBDPFHPL - Perfluoroheptanoic acid comment

Variable Name:
LBDPFHPL
SAS Label:
Perfluoroheptanoic acid comment
English Text:
Perfluoroheptanoic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 383 383
1 Below lower detection limit 1521 1904
. Missing 273 2177

LBXPFNA - Perfluorononanoic acid

Variable Name:
LBXPFNA
SAS Label:
Perfluorononanoic acid
English Text:
Perfluorononanoic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.06 to 80.77 Range of Values 1904 1904
. Missing 273 2177

LBDPFNAL - Perfluorononanoic acid comment

Variable Name:
LBDPFNAL
SAS Label:
Perfluorononanoic acid comment
English Text:
Perfluorononanoic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 1890 1890
1 Below lower detection limit 14 1904
. Missing 273 2177

LBXPFSA - Perfluorooctane sulfonamide

Variable Name:
LBXPFSA
SAS Label:
Perfluorooctane sulfonamide
English Text:
Perfluorooctane sulfonamide
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 0.62 Range of Values 1904 1904
. Missing 273 2177

LBDPFSAL - Perfluorooctane sulfonamide comment

Variable Name:
LBDPFSAL
SAS Label:
Perfluorooctane sulfonamide comment
English Text:
Perfluorooctane sulfonamide comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 15 15
1 Below lower detection limit 1889 1904
. Missing 273 2177

LBXPFUA - Perfluoroundecanoic acid

Variable Name:
LBXPFUA
SAS Label:
Perfluoroundecanoic acid
English Text:
Perfluoroundecanoic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 6.96 Range of Values 1904 1904
. Missing 273 2177

LBDPFUAL - Perfluoroundecanoic acid comment

Variable Name:
LBDPFUAL
SAS Label:
Perfluoroundecanoic acid comment
English Text:
Perfluoroundecanoic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 1188 1188
1 Below lower detection limit 716 1904
. Missing 273 2177

LBXPFDO - Perfluorododecanoic acid

Variable Name:
LBXPFDO
SAS Label:
Perfluorododecanoic acid
English Text:
Perflurododecanoic acid
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.07 to 1.35 Range of Values 1904 1904
. Missing 273 2177

LBDPFDOL - Perfluorododecanoic acid comment

Variable Name:
LBDPFDOL
SAS Label:
Perfluorododecanoic acid comment
English Text:
Perflurododecanoic acid comment code
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 At or above the detection limit 179 179
1 Below lower detection limit 1725 1904
. Missing 273 2177