Abstract
The plateau region is conventionally regarded as a "clean land" with minimal environmental pollution, leading to scarce research on the distribution of emerging pollutants such as per- and polyfluoroalkyl substances (PFAS) and their effects on the health of plateau inhabitants. To understand that, we studied participants from two representative towns in Gannan Tibetan Autonomous Prefecture, Gansu Province, China. Lung function parameters (FVC%, FEV1%, and FEV1/FVC) were measured, while PFAS concentrations in urine and indoor dust were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). We measured the levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), 8-epi-prostaglandin F2α (8-epi-PGF2α), and malondialdehyde (MDA) in urine. The results demonstrated a preponderance of short-chain PFAS in urine, with PFBS, PFPeA, and PFBA showing the highest detection rates. PFBA had the highest median concentration at 0.47 ng/mL. Similarly, in indoor dust, PFBA was the most frequently detected, followed by PFOA, with median concentrations of 0.56 and 0.44 ng/g, respectively. Multiple PFAS compounds showed significant inverse correlations with FVC% and FEV1%. PFAS exposure was associated with elevated oxidative stress biomarker levels (8-OHdG, 8-epi-PGF2α, and MDA), and their synergistic interaction aggravated the decline in lung function. This research provides valuable evidence of PFAS exposure patterns in the plateau population, highlighting the dominance of short-chain PFAS compounds and the concerning link between PFAS exposure and impaired lung function.