Developmental Exposures to Perfluoroalkyl Substances (PFASs): An Update of Associated Health Outcomes

Liew, Zeyan; Goudarzi, Houman; Oulhote, Youssef

doi:10.1007/s40572-018-0173-4

Cited by 182 publications

(83 citation statements)

References 135 publications

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“…Other cohort studies that investigated the associations regarding prenatal PFASs exposures on fetal growth indicators were mostly small in size and they only assessed PFOS or PFOA exposures [ 37 , 38 ]. Among the larger cohorts (i.e., >500 births), two also reported that prenatal PFOA and PFNA exposures were associated with lower average birth weights [ 16 , 17 ], while several others reported non-statistically significant associations [ 29 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Prenatal Exposure to Perfluoroalkyl Substances and Birth Outcomes; An Updated Analysis from the Danish National Birth Cohort

Meng

Inoue

Ritz

et al. 2018

IJERPH

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105

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Perfluoroalkyl substances (PFASs) are widespread industrial pollutants that are extremely persistent in the environment. A previous study in the Danish National Birth Cohort (DNBC) found prenatal perfluorooctanoate (PFOA) exposure was associated with decreased birth weight, but had insufficient statistical power to evaluate adverse birth outcomes. Here, we conducted additional analyses in three samples originating from the DNBC for 3535 mothers and infant pairs to evaluate associations between prenatal PFASs exposures and low birth weight and preterm birth. Maternal plasma concentrations were measured for six types of PFASs in early pregnancy. Several PFASs were associated with a reduction in birth weight and gestational age. We estimated a nearly 2-fold increase in risks of preterm birth for the higher quartiles of PFOA and perflourooctanesulfonate (PFOS) exposure. In spline models, risk of preterm birth was increased for perfluorononanoic acid (PFNA), perfluoroheptane sulfonate (PFHpS) and perfluorodecanoic acid (PFDA) in higher exposure ranges. We also observed some elevated risks for low birth weight but these estimates were less precise. Our findings strengthen the evidence that in-utero PFASs exposures affect fetal growth. Future studies are needed to evaluate whether these associations persist with the decline of PFOA and PFOS in populations and should also investigate newer types of fluorinated compounds introduced more recently.

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Section: Discussionmentioning

confidence: 99%

Prenatal Exposure to Perfluoroalkyl Substances and Birth Outcomes; An Updated Analysis from the Danish National Birth Cohort

Meng

Inoue

Ritz

et al. 2018

IJERPH

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105

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“…We also excluded women reporting having hypertension, metabolic disorders, or chronic kidney diseases during pregnancy in the first telephone interview (n = 18 cases and 14 controls). We conducted stratified analyses for parity, maternal age, and socio-occupational status because these factors had previously been suggested to be associated with the risk for miscarriage in the DNBC (Feodor Nilsson et al 2014;Norsker et al 2012) and they could potentially modify the effect estimates of PFAS exposures (Chang et al 2016;Liew et al 2018a). Tests of heterogeneity were performed by assessing the p-value of the interaction term for each PFAS and potential modifying factors in the regression models.…”

Section: Discussionmentioning

confidence: 99%

“…In humans, considerable amounts of PFAS from the mothers can cross the placental barrier and accumulate in the fetus (Fei et al 2007;Manzano-Salgado et al 2015). Numerous epidemiological studies have suggested that prenatal PFAS exposure might affect fetal growth (Bjerregaard-Olesen et al 2019;Fei et al 2008;Liew et al 2018a) and increase risk for preterm birth (Meng et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Maternal Plasma Perfluoroalkyl Substances and Miscarriage: A Nested Case–Control Study in the Danish National Birth Cohort

Liew

Luo

Nøhr

et al. 2020

Environ Health Perspect

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BACKGROUND: Per-and polyfluoroalkyl substances (PFAS) are widespread persistent organic pollutants and endocrine disruptors. High doses of perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) exposure can cause pregnancy loss and infant deaths in animals, but the associations between PFAS exposures and risk of miscarriage in humans are not well studied. METHODS: Using a case-control study nested within the Danish National Birth Cohort (DNBC, 1996-2002), we compared 220 pregnancies ending in miscarriage during weeks 12-22 of gestation, with 218 pregnancies resulting in live births. Levels of seven types of PFAS [PFOS, PFOA, perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctanesulfonic acid (PFOSA)] were measured in maternal plasma collected in early gestation (mean gestational week 8). We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for miscarriage and each PFAS as a continuous variable or in quartiles, controlling for maternal age, parity, socio-occupational status, smoking and alcohol intake, gestational week of blood sampling, and maternal history of miscarriage. Stratification by parity and PFAS mixture analyses using weighted quantile sum (WQS) regression were also conducted. RESULTS: We observed a monotonic increase in odds for miscarriage associated with increasing PFOA and PFHpS levels. The ORs comparing the highest PFOA or PFHpS quartile to the lowest were 2.2 (95% CI: 1.2, 3.9) and 1.8 (95% CI: 1.0, 3.2). The ORs were also elevated for the second or third quartile of PFHxS or PFOS, but no consistent exposure-outcome pattern emerged. An interquartile range (IQR) increment in the WQS index of seven PFAS was associated with 64% higher odds for miscarriage (95% CI: 1.15, 2.34). The associations were stronger in parous women, while findings were inconsistent among nulliparous women. CONCLUSION: Maternal exposures to higher levels of PFOA, PFHpS, and PFAS mixtures were associated with the risk of miscarriage and particularly among parous women. Larger replication studies among nulliparous women are needed to allay concerns about confounding by reproductive history.

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“…PFAS exposure also affected birth outcomes controlled by thyroid hormone [161] and increased thyroid disease at general population exposure levels [162]. A recent systematic review identified evidence of a positive association between maternal levels of PFHxS, PFOS, and PFNA and maternal thyroid stimulating hormone (TSH) and a potential negative association with T4 [163].…”

Section: Modulates Receptor-mediated Effectsmentioning

confidence: 99%

Application of the Key Characteristics of Carcinogens to Per and Polyfluoroalkyl Substances

Temkin

Hocevar

Andrews

et al. 2020

IJERPH

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Per- and polyfluoroalkyl substances (PFAS) constitute a large class of environmentally persistent chemicals used in industrial and consumer products. Human exposure to PFAS is extensive, and PFAS contamination has been reported in drinking water and food supplies as well as in the serum of nearly all people. The most well-studied member of the PFAS class, perfluorooctanoic acid (PFOA), induces tumors in animal bioassays and has been associated with elevated risk of cancer in human populations. GenX, one of the PFOA replacement chemicals, induces tumors in animal bioassays as well. Using the Key Characteristics of Carcinogens framework for cancer hazard identification, we considered the existing epidemiological, toxicological and mechanistic data for 26 different PFAS. We found strong evidence that multiple PFAS induce oxidative stress, are immunosuppressive, and modulate receptor-mediated effects. We also found suggestive evidence indicating that some PFAS can induce epigenetic alterations and influence cell proliferation. Experimental data indicate that PFAS are not genotoxic and generally do not undergo metabolic activation. Data are currently insufficient to assess whether any PFAS promote chronic inflammation, cellular immortalization or alter DNA repair. While more research is needed to address data gaps, evidence exists that several PFAS exhibit one or more of the key characteristics of carcinogens.

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Developmental Exposures to Perfluoroalkyl Substances (PFASs): An Update of Associated Health Outcomes

Cited by 182 publications

References 135 publications

Prenatal Exposure to Perfluoroalkyl Substances and Birth Outcomes; An Updated Analysis from the Danish National Birth Cohort

Prenatal Exposure to Perfluoroalkyl Substances and Birth Outcomes; An Updated Analysis from the Danish National Birth Cohort

Maternal Plasma Perfluoroalkyl Substances and Miscarriage: A Nested Case–Control Study in the Danish National Birth Cohort

Application of the Key Characteristics of Carcinogens to Per and Polyfluoroalkyl Substances

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