Previous reports show that professional ski waxers have elevated blood levels of perfluorinated substances (PFAS) such as perfluorooctanoate (PFOA) and are exposed to very high concentrations of PFAS in air during ski waxing. Aerosol exposure increases the risk of cardiovascular disease, and PFOA is a potential hormonal disruptor and carcinogen, and can affect the fatty acid metabolism. Animal studies have shown that 8: 2 FTOH can undergo biotransformation to PFOA. For the first time, this study presents an occupational scenario of professional ski waxers who are exposed to extremely high dust levels as well as per-and polyfluorinated compounds. Personal and fixed measurements of total aerosol, inhalable and respirable fractions were performed during World Cup events 2007-2010. The occupational exposure limit (OEL) is exceeded in 37% of the personal measurements with concentrations up to 15 mu g m(-3) in air. There are differences between personal and area total aerosol concentrations with levels from personal measurements twice as high as those from the area measurements. The personal levels for FTOH ranged up to 996 mg m(-3) (mean = 114 mu g m(-3)) and for PFOA up to 4.89 mu g m(-3) (mean = 0.53 mu g m(-3)) in ENV+ sorbent samples as compared to the general exposure levels from air reaching only low ng m(-3) (<30 ng m(-3)) levels. FTOHs were not detected in aerosols but PFOA showed an average level of 12 mu g m(-3) (range = 1.2-47 mu g m(-3)). The ski waxers' exposure to paraffin fumes and PFAS is not in compliance with the occupational exposure standards and by far exceed the general populations' exposure. Preventive measures must be taken to minimize the exposure in this occupational group.