Abstract

Background
Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants commonly found in seafood; however, evidence of dietary ingestion among adolescents remains limited. We aimed to evaluate the association between seafood consumption and serum PFAS concentrations among Korean adolescents.
Methods
This cross-sectional study used data from the fifth Korean National Environmental Health Survey (KoNEHS, 2021–2023). We included 827 adolescents aged 12–18 years. Serum concentrations of five PFAS compounds (perfluorooctanoic acid [PFOA], perfluorooctane sulfonic acid [PFOS], perfluorohexane sulfonic acid, perfluorononanoic acid [PFNA], and perfluorodecanoic acid [PFDeA]) were measured. Seafood consumption was assessed using a questionnaire and categorized as rarely consumed, monthly consumption, or weekly consumption. Complex sample general linear models were performed using log-transformed PFAS concentrations.
Results
Compared with rarely consumed, weekly fish consumption was significantly associated with higher serum concentrations of PFOA (B = 1.15; 95% confidence interval [CI]: 0.46–1.83; p = 0.001), PFOS (B = 2.14; 95% CI: 1.23–3.05; p < 0.001), PFNA (B = 0.28; 95% CI: 0.14–0.42; p < 0.001), and PFDeA (B=0.14; 95% CI: 0.05–0.23; p = 0.004), whereas monthly fish consumption was associated with higher PFOS and PFNA. Crustacean consumption showed positive associations with PFOA (B = 1.10; 95% CI: 0.57–1.63; p < 0.001), PFOS (B = 0.93; 95% CI: 0.24–1.61; p = 0.009), PFNA (B = 0.18; 95% CI: 0.08–0.28; p < 0.001), and PFDeA (B = 0.11; 95% CI: 0.05–0.16; p < 0.001) in the monthly group, whereas associations were attenuated in the weekly group. No significant associations were observed for large fish and tuna, seaweed, shellfish, or other seafood.
Conclusions
Fish and crustacean consumption were associated with serum PFAS concentrations among Korean adolescents, whereas other seafood types showed no significant associations. Future prospective studies with more detailed dietary assessments are warranted to clarify causal relationships.

• Keywords: PFAS; Seafood consumption; Korean adolescents; Dietary exposure