The RIPPLE Study will examine how PFAS in the Stella area are getting into people’s bodies and whether PFAS exposure is associated with cholesterol and other blood lipids.

We will measure PFAS in blood of residents and in possible environmental sources, including private-well water. In selected households, we will also test locally grown or harvested foods, fish, deer meat, soil, air and household dust. We will ask participants to complete the study twice, two years apart. By studying participants twice we can examine how PFAS levels and blood lipids change over time.

PFAS, or per- and polyfluoroalkyl substances, are a large group of human-made chemicals. They have been used in products designed to resist water, grease, stains and heat.

Many PFAS break down very slowly. They can remain in the environment for years, and some can build up in the human body over time. People may be exposed through drinking water, food, household products, certain occupations and other environmental sources.

Some PFAS have been associated with health outcomes such as kidney and testicular cancer. However, these cancers are relatively uncommon and may develop many years after exposure. A study of approximately 400–450 people conducted over 4-5 years would not include enough cancer cases, or enough follow-up time, to reliably determine whether PFAS exposure increased cancer risk.

Cancer also has many contributing factors, including age, genetics, smoking, alcohol use, diet, physical activity and other environmental exposures. This makes it difficult to study in a single small community or determine what caused an individual person’s cancer.

RIPPLE will collect information about cancer and other health conditions, but its primary health focus is cholesterol and other blood lipids. These can be measured at both study visits, allowing us to examine whether differences or changes in PFAS exposure are related to differences or changes in lipids. This may help scientists better understand biological processes through which PFAS affect human health.

With participants’ permission, coded study data may also be combined with data from other PFAS-affected communities in the future. Larger populations and longer follow-up would provide better opportunities to study uncommon diseases such as cancer in the future.

Some private wells in the Stella area have high concentrations of PFAS. Stella provides an important opportunity to study how PFAS can move from environmental sources into people in a rural community. The results may help identify compounds and exposure pathways that should receive more attention in future monitoring, exposure-reduction and cleanup efforts.

The principal investigator in charge of the RIPPLE Study is Dr. Amy Schultz, an environmental epidemiologist and senior scientist at the University of Wisconsin–Madison. There are also other co-investigators at UW Madison (see our Team page) that are leading or advising on certain parts of the study.

In addition, we have community and governmental partners that will inform the study. They include Oneida County Health Department, Oneida County Clean Waters Action (OCCWA), the RIPPLE Community Advisory Board (CAB), and the RIPPLE Governmental Advisory Board (GAB) which includes representatives from the Wisconsin Department of Natural Resources (DNR) and the Wisconsin Department of Health Services (DHS).

The study is funded by the National Institute of Environmental Health Sciences (NIEHS). NIEHS is a branch of the National Institutes of Health (NIH) under the federal Department of Health and Human Services.

Initial eligibility will include people who are at least 6 years old, live within the study area, have lived in their current residence for more than one year and live there for at least six months of the year. All participants need to be willing to sign a consent form, provide blood and urine samples, have their height and weight measured, and answer a questionnaire.

The study will begin by mailing invitations to selected households in the Stella area. Anyone who receives an invitation and is interested will complete a short screening form. The screening form will confirm whether the person is currently eligible and provide information about how to schedule an appointment.

The recruitment area may expand later if additional participants are needed.

We are interested in enrolling at least 400 people aged six and older. We will ask them to complete the study two times, two years apart.

Participants will attend a study appointment at the Stella Town Hall. During the appointment, study staff will collect a blood and urine sample, and measure blood pressure, height and weight. Participants will also be asked to complete a questionnaire about their diet, drinking water, recreational activities, household characteristics and other possible sources of PFAS exposure.

The study team will also arrange to collect a drinking-water sample from the participant’s household. Some households may be invited to provide additional environmental or food samples.

Participants will be invited to complete a second appointment approximately two years later.

Yes! If you are invited, eligible, and interested in participating, please participate! It is very important people with low levels of PFAS contamination in their private well participate. We need people to participate that have different levels of exposure, even if they are very low. There are also other sources of PFAS exposure besides drinking water that we will be looking at.

Yes, we will be measuring PFAS compounds that have not yet been tested in your well water. There are thousands of PFAS compounds, but only a small number of them are routinely tested or monitored by the DNR and EPA. We will be looking at PFAS that are not regularly tested or monitored by the DNR or EPA.

At your study appointment you will receive your blood pressure, height, and weight measurements. You will receive your cholesterol and other clinical blood test results within a few weeks of your appointment. If any clinical tests are concerning, the study’s medical director will call you within a few days of your appointment to notify you.

Your individual blood PFAS results are expected approximately four to six months after the appointment. Results will be mailed directly to you. We may also arrange for results to be picked up at town hall in sealed envelope after showing an ID. Parents or guardians will receive results for participating children according to the study’s approved procedures. Households will receive drinking water and other environmental sample results, however the exact timing of those results has not been determined yet.

Yes, you will receive up to $70 for completing each study visit (up to $140 for completing both).

No, it is free to participate. However, you will need to arrange for your own transportation to and from the appointment at the Stella Town Hall.

Overall study findings will take longer to compile and analyze. We will share updates with the community through the RIPPLE website, community meetings at town hall, through a mailed newsletter and other public communications throughout the study.

A PFAS blood test can show how much of certain PFAS were present in your blood when the sample was collected. It cannot identify exactly where the PFAS came from or determine whether PFAS caused a particular health condition.

There is currently no single blood PFAS level that can predict whether someone will develop a health problem. Participants may choose to share their results with their health care provider, or whomever they want to, but the research team will not share individual participants results.

Your answers to the screening questions and larger questionnaire will be stored securely in authenticated password protected files. We will not make reference to individuals when we report the results of the study. Each participant will be assigned a unique ID number used on the questionnaire and all samples collected. Datasets will contain only that ID number, not your name or other identifying information. Names, addresses, and contact information will be stored separately from research data and specimens, and access will be limited to authorized study staff.

To further protect your privacy, we have obtained a Certificate of Confidentiality (CoC) from the National Institutes of Health. The researchers will use the CoC to resist any demands for information that would identify you except in the following circumstances:

1. The certificate cannot be used to resist a demand for information from personnel of the US federal agency sponsoring the project and that will be used for auditing on program evaluation of agency funded projects.
2. The certificate does not prevent you or a member of your family from voluntarily releasing information about yourself or your involvement in this research. If an insurer, medical care provider or other person obtains your written consent to receive information, then the researchers will not use the certificate to withhold that information.

Individual results will be provided only to the participant or, when applicable, the child’s parent or guardian. When study findings are reported publicly, results will be combined so that individual participants and households cannot be identified. The study will not provide individual results to employers, insurers, personal health care providers, family members or other third parties without the participant’s authorization and consent.

Community input has already helped shape the study. Residents asked that children be able to participate and raised questions about local foods as possible sources of exposure. These concerns helped inform the study’s inclusion of children and its plans to test selected locally produced and harvested foods.

The study will also have a paid Community Advisory Board made up of local residents. The board will help review recruitment materials, questionnaires, participant result reports and study communications. Community members will continue to advise the research team throughout the study.

No. The RIPPLE Study is an independent research study and is not being conducted for any party involved in litigation.

You will receive the results from your blood and water sample analyses. You can do whatever you choose with this information.