The largest documented episode of human contamination by PFOA in the world (approximately 150,000 actual residents on 1 January 2020) has occurred in Italy’s Veneto Region. In this large, mostly flat plain area, a cluster of testicular cancers has also been observed. Preliminary data are reported, and the most relevant and recent recommendations regarding the health surveillance of exposed individuals are emphasized.

Since March 2019, a non-communicable diseases program has been established at hospital level, with enrollment and clinical reassessment every 6 months. Since July 2023, monthly enrollment and visits have also been conducted at health center level. This study aimed at assessing the adherence to scheduled follow-up visits following the decentralization of the integrated NCDs program from Hospital to Health Center level and investigate factors influencing follow-up adherence. The study was performed in a rural district in Iringa Region, Tanzania. Adherence was measured at both levels. Multivariate regression analysis was conducted to describe socio-demographic and clinical factors influencing attendance at the 6-month hospital-level visit. Among 2198 patients enrolled at the hospital level, weighted adherence over 42 months was 40.8% (95% CI 39.0–42.6%) at the 6-month visit. Multivariate analysis revealed that as the distance from the hospital increased, the probability of attendance decreased (OR 0.17; 95% CI: 0.08–0.39). Among 571 patients enrolled at the residence level, adherence over the first 10 months of program implementation was 91.6% (90.4–92.8%). The findings showed that distance was by far the most important barrier to follow-up adherence and suggested that decentralizing the program from the hospital to peripheral health centers may ensure high follow-up rates.

This research letter reviews the recorded serum values obtained following the detection of perfluorooctanoic acid (PFOA) water contamination in Veneto, which are underestimations of the true extent of the internal contamination experienced by the exposed populations. The most likely peak serum concentrations were in a range with a median of 136.0 and an intequartile( IQR )of 64.8–258.3 ng/mL for young males and a median of 74.5 and an IQR of 22.6–167.4 ng/mL for young females, compared to the median serum PFOA contamination that was finally detected (64.1 for males and 30.2 ng/mL for females, respectively) when blood samples were drawn. This was 27 months after the implementation of the single granular activated carbon drinking water filtration and 30 months after the disclosure of the heavy drinking water contamination.