Multi-Site Study

At a glance

The PFAS Multi-site Study (MSS) provides information to communities about the health effects of exposure to PFAS. Expanding on the work of the Pease Study, the MSS has identified various locations throughout the United States where potential PFAS exposures have been recorded.

Multi-Site Study icon

About the study

The per- and polyfluoroalkyl substances (PFAS) Multi-site Study (MSS) was authorized by the National Defense Authorization Acts of 2018 and 2019. The study provides information to communities about the health effects of exposure to PFAS. Information learned from the MSS will help all communities in the United States who have been exposed to PFAS through drinking water. Even communities that were not directly involved in this study. More information about the MSS can be found in the Journal of Environmental Health publication: Direct from ATSDR: PFAS MSS.

In 2019, CDC and ATSDR announced partnerships with seven study teams to carry out the MSS in communities across the nation.

MSS efforts expand on the work that began with the Pease Study, which was started in 2019 and located in Portsmouth, NH. The Pease Study used data collection and evaluation methods that are now being used at the seven MSS locations. Data collected at each MSS location will be combined with data from the Pease Study. The combined dataset will allow researchers to better explore health outcomes from PFAS exposure.

Image showing the Multi-site Study Process.
The Multi-site Study Process

Fact sheets and additional resources

To learn more about PFAS and your health, use the following fact sheets and resources.

Additional information is available on the ATSDR PFAS Resources page.

MSS Locations

MSS site location U.S. map
Map of ATSDR-funded Multi-site Study Ssites

Detailed study area maps by state are shown below. Click on the maps for a full-size image with accompanying legend and landmarks. For more information on ATSDR regional offices, please refer to the following link: https://www.atsdr.cdc.gov/dro/index.html

California

Orange County, CA

Image shows a map of Orange County, CA. The map includes a key and the estimated sample population size is 1,445,000
Map of the MSS area of interest in Orange County, CA

University of California – Irvine is looking at exposures in communities near the UC Irvine Medical Center, CA.

Colorado

El Paso County, CO

Image shows a map of El Paso County, CO. The map includes a key and the estimated sample population size is 75,000.
Map of the MSS area of interest in El Paso County, CO

Colorado School of Public Health, University of Colorado Anschutz Medical Campus is looking at exposures in El Paso County, CO.

Massachusetts

Ayer, MA

Image shows a map of Ayer, MA. The map includes a key and the Estimated Sample Population Size is 400.
Map of the MSS area of interest in Ayer, MA

Hyannis, MA

Image shows a map of Hyannis, MA. The map includes a key and the Estimated Sample Population Size is 900.
Map of the MSS area of interest in Hyannis, MA

Silent Spring Institute is looking at exposures in Ayer, MA, and Hyannis, MA.

Michigan

Belmont/Rockford area, MI

Image shows a map of Belmont/Rockford Area, MI. The map includes a key and the Estimated Sample Population Size is 4,000.
Map of the MSS area of interest in the Belmont/Rockford area of Michigan.

Parchment/Cooper Township, MI

Image shows a map of Parchment/Cooper Township, MI. The map includes a key and the Estimated Sample Population Size is 4,300.
Map of the MSS area of interest in Parchment/Cooper Township, MI

Michigan State Department of Health and Human Services is looking at exposures in the Belmont/Rockford and Parchment/ Cooper Township areas in Michigan.

New Jersey

Gloucester County, NJ

Image shows a map of Gloucester County, NJ. The map includes a key and the Estimated Sample Population Size is 6,500.
Map of the MSS area of interest in Gloucester County, NJ

Rutgers Biomedical and Health Sciences – School of Public Health is looking at exposures in Gloucester County, NJ.

Pennsylvania

Montgomery and Bucks Counties, PA

Image shows a map of Montgomery & Bucks Counties, PA. The map includes a key and the Estimated Sample Population Size is 266,586.
Map of the MSS area of interest in Montgomery and Bucks Counties, PA

RTI International and the Pennsylvania Department of Health are looking at exposures in Montgomery and Bucks Counties, PA.

New York

Hoosick Falls, NY

Image shows a map of Hoosick Falls, NY. The map includes a key and the Estimated Sample Population Size is 8,200.
Map of the MSS area of interest in Hoosick Falls, NY

Newburgh, NY

Image shows a map of Newburgh, NY. The map includes a key and the Estimated Sample Population Size is 28,800.
Map of the MSS area of interest in Newburgh, NY

University at Albany, SUNY and  New York State Department of Health are looking at exposures in Hoosick Falls, NY, and Newburgh, NY.

Expected outcomes of the MSS

The MSS aims to provide a better scientific understanding about the relationships between PFAS exposure via drinking water and certain health outcomes among differing populations. The study also aims to help people understand their risk for health effects. Information gathered from the MSS can be applied to help protect communities across the nation.

MSS teams will collect information about things like immune response, lipid metabolism, kidney function, thyroid disease, liver disease, glycemic parameters, and diabetes. The MSS seeks to enroll at least 2,100 children and 7,000 adults from communities who were exposed to PFAS-contaminated drinking water.

Existing research involving humans suggests that high levels of certain PFAS may lead to the following:

  • Increased cholesterol levels
  • Changes in liver enzymes
  • Decreased vaccine response in children
  • Increased risk of high blood pressure or pre-eclampsia in pregnant women
  • Small decreases in infant birth weights
  • Increased risk of kidney or testicular cancer

Understanding the relationship between PFAS exposure and health outcomes will allow communities and governmental agencies to make better decisions about how to protect public health.

Child enrollment in the MSS‎

Some MSS teams are actively recruiting participants, ages 4-17 years, who meet study criteria. Data collected from child participants will help ATSDR and MSS teams identify any health risks that children may face from exposure to PFAS through their drinking water. If you would like to know if your child is eligible to enroll, please contact your local MSS team.

Community engagement in the MSS

ATSDR is committed to supporting the MSS teams' efforts to engage communities in the study. As an agency, ATSDR recognizes that partnering and working with communities is critical to the success of many public health endeavors, including the MSS.

MSS teams will work closely with local and state health agencies, local community organizations, and local media to share information about the study and encourage participation. In addition, study teams may establish a community assistance panel (CAP) to involve the community in decisions related to the study. CAPs may provide input on outreach about the study, participant recruitment strategies, study logistics, and dissemination of study findings within the community. More information on site-specific community engagement activities may be found on study team websites. Team websites are linked in the MSS Locations section.

Technical workgroups

The MSS teams are:

  • Using historical reconstruction (HR) methods to research past concentrations of PFAS in the drinking water of study areas.
  • Using a type of statistical modeling called pharmacokinetic (PK)/physiologically based pharmacokinetic (PBPK) modeling to research the historical concentrations of PFAS in blood serum levels of affected populations.

ATSDR has established two technical workgroups, the MSS HR Workgroup and the MSS PK Workgroup, to oversee the technical evaluation and the quality assurance of all methods and models used. MSS team representatives serve on these workgroups and facilitate information sharing throughout the study teams.

Information for healthcare providers

PFAS resources for clinicians and environmental health professionals, including health assessors, are available at PFAS Information for Clinicians and Environmental Health Professionals.

PFAS research notice of funding opportunity (NOFO)

The final protocol for the MSS was OMB approved in November 2020. All recipients must follow the final protocol to conduct the research at their sites.