Per- and polyfluoroalkyl substances (PFAS) Exposure

Research assessing potential health effects from PFAS exposure in drinking water.

About

Per- and polyfluoroalkyl substances (PFAS) are man-made chemicals that have been around since the 1940’s. PFAS are made of carbon-fluorine bonds that are very difficult to break down in the environment and in the body. PFAS have water-resistant properties and are found in water-repellent clothing, stain-resistant carpets, fast-food wrappers, and some aqueous film-forming foams (AFFF) used for fire suppression, among others¹.

Between 2013 and 2016, PFAS concentrations exceeding the Environmental Protection Agency (EPA) health advisory levels were detected in public water systems serving the Fountain Valley communities of Fountain, Security, and Widefield, Colorado. Water from these Fountain Valley communities served approximately 80,000 people. The source of the PFAS water contamination was the use of AFFF at Peterson Air Force Base, located north of the affected communities²^,3.

In 2016 and 2017, affected water districts took measures to reduce PFAS in the drinking water to levels below the federal drinking water standards.

To date, there are three PFAS health research studies with the population from the Fountain Valley communities:

PFAS Assessment of Water and Resident Exposure (PFAS-AWARE) (2018, 2019)
Agency of Toxic Substances and Disease Registry’s (ATSDR) Exposure Assessment (2020)
Colorado Study on Community Outcomes from PFAS Exposure (CO SCOPE) (2021-2023)

John Adgate and Anne Starling have led the PFAS-AWARE and CO SCOPE health research studies. Please take a look at the information below to learn more about each study.

ABOUT

PFAS Assessment of Water and Resident Exposure (PFAS-AWARE) is a health research study on exposure and health effects from poly- and perfluoroalkyl substances (PFAS) in Colorado drinking water. In 2018, 212 adults participated in PFAS-AWARE, and about 50 adults were asked to return in 2019 for a follow-up visit. The purpose of PFAS-AWARE was to determine the levels of PFAS in the blood of community residents and to investigate how exposure to PFAS in drinking water affected health outcomes related to liver function, cholesterol, and immune response.

PUBLICATIONS

It takes many epidemiologic studies on an exposure to determine whether it affects a health outcome. The studies produced by PFAS-AWARE contributed to the evidence and understanding of PFAS exposure in the United States, as well as knowledge on the potential health effects of PFAS exposure in drinking water, particularly in relation to liver function, cholesterol, and immune response.

Sociodemographic and behavioral determinants of serum concentrations of per-and polyfluoroalkyl substances in a community highly exposed to aqueous film-forming foam contaminants in drinking water (Barton, 2020)
Unsaturated PFOS and other PFASs in human serum and drinking water from an AFFF-impacted community (McDonough, 2021)
Cross-sectional associations between serum PFASs and inflammatory biomarkers in a population exposed to AFFF-contaminated drinking water (Barton, 2022)
Source apportionment of serum PFASs in two highly exposed communities (Wallis, 2022)
Power and sample size analysis for longitudinal mixed models of health in populations exposed to environmental contaminants: a tutorial (Harrall, 2023)
Estimating historical exposure to perfluoroalkyl acids in Security, Fountain, and Widefield Colorado: use of water-infrastructure blending and toxicokinetic models (Meeks, 2023)

ABOUT

ATSDR’s Exposure Assessment (2020) randomly selected households from the Fountain Valley communities to participate in the study. Both individual samples and environmental samples were collected and used to estimate community-level exposure to PFAS. This fact sheet has information about the Exposure Assessment and how it compares to PFAS-AWARE and CO-SCOPE¹:

Fact Sheet

ABOUT

Colorado Study on Community Outcomes from PFAS Exposure (CO-SCOPE) is a health research study. Per- and polyfluoroalkyl substances (PFAS) were found in the drinking water in the Fountain Valley communities between 2006 and 2015 as a result of firefighting foam used at a nearby air force base. During 2021-2023, 925 adults and 141 children (as young as 4 years of age) who lived in one of the Fountain Valley communities during the time of PFAS water contamination participated in CO-SCOPE. CO-SCOPE is looking at various potential health effects from PFAS exposure in drinking water.

Multi-Site Study

CO-SCOPE is part of a national multi-site study (MSS) on the potential health effects from PFAS exposure in drinking water. The MSS is a collection of 5,826 adult and 710 child participants from sites in California, Colorado, New Hampshire, New Jersey, New York, Massachusetts, Michigan, and Pennsylvania¹.

Community Outreach

CO-SCOPE will host periodic online community meetings to share results on CO-SCOPE and MSS studies published in academic journals. Meeting information will be sent to CO-SCOPE participants via email and posted on this page once scheduled. The next community meeting is anticipated to be scheduled in early 2026.

Study Team

Investigators: John Adgate, PhD, Anne Starling, PhD, Chris Higgins, PhD, Greta Wilkening, PSYD,PhD, Amber Vaughn, DrPH, MPH
Research Assistants: Stephen Brindley, Shelby Kardel, Brent Windebank
Partners: Kristi Celico, Kelsey Schreiber, Kristy Richardson

Acknowledgements

Thank you to our Community Advisory Panel for your continual partnership, and to our research and student assistants for your strong work ethic and high-quality work you contributed to CO-SCOPE. Your insight, dedication, and skill have made CO-SCOPE a success.

PUBLICATIONS

It takes many epidemiologic studies on an exposure to determine whether it affects a health outcome. The studies produced by CO-SCOPE and other MSS sites will add to the existing knowledge and understanding of potential health outcomes from PFAS exposure in drinking water.

1. Multi-Site Study of PFAS-Contaminated Drinking Water: Methods, Demographics, and PFAS Concentrations (Pavuk, 2025).

This study details what was done for the PFAS Multi-Site Study (MSS), including which sites community members were recruited, how many adults and children participated, what participants completed as part of the study, a list of health-related outcomes collected from the questionnaire, and levels of PFAS measured in the blood of various groupings (i.e., age, site, etc.). The following summary sheets resulted from this paper:

2. Assessing the Success Rate and Costs of Common Recruitment Strategies for a Community-Based Environmental Health Study (Vaughn et al., 2026)

This study details the recruitment efforts for the CO-SCOPE study including response rate and estimated cost per participant.

Multi-Site Study: The most up-to-date information on research publications within the collection of sites participating in the MSS, virtual open house resources and fact sheets on how to prevent PFAS exposure and talking to your healthcare provider about PFAS exposure.

PFAS Study Comparison in El Paso County

Ways to Reduce PFAS Exposure

PFAS Definitions and Descriptions

Results Letter FAQ – PFAS in Blood

Results Letter Resource Guide for the Indoor Air Study

Community Meeting Materials

CAP Meeting Materials