Global Exposure to Per- and Polyfluoroalkyl Substances and Associated Burden of Low Birthweight

Abstract

Low birthweight (LBW) is a worldwide public health concern, while the global burden of LBW attributable to endocrine-disrupting chemicals, such as per- and polyfluoroalkyl substances (PFAS), has not yet been evaluated. Here, we established a large dataset for the biomonitoring of seven representative congeners of PFAS by examining data from 2325 publications. Global exposure to perfluorooctanesulfonic acid (PFOS) was the highest, followed by perfluorohexanesulfonic acid (PFHxS) and perfluorooctanoic acid (PFOA). Spatiotemporal exposure to PFAS varied considerably, with daily intake estimated in the range of 0.01–1.7 ng/kg/day. Moreover, decreasing trends in PFOS, PFHxS, and PFOA exposure were noted in most regions of the world over the past two decades, but such trends were not observed for other PFAS with long carbon chains, especially in East Asia. Furthermore, we estimated that human exposure to PFOA contributed to approximately 461,635 (95% confidence interval: 57,418 to 854,645) cases per year of LBW during the past two decades, predominantly from Asian regions. Although our estimation may be constrained by uncertainties from the dose–response curve and data availability, this study has unveiled that PFAS might be a contributor to global LBW prevalence during 2000–2019, supporting continuous actions to mitigate PFAS contamination.

Emerging and Legacy Perfluoroalkyl Substances in Breastfed Chinese Infants: Renal Clearance, Body Burden, and Implications

“…Given that the one-compartment model has been previously adopted to estimate time-dependent serum concentrations and PFAS compounds are not highly lipophilic, 59 , 65 a first-order model based on the one-compartment model was employed to address temporal trends in PFAS in infants in days after birth ( ) via breast milk intake 66 : where k is the elimination rate calculated using the half-life with the following equation: …”

Correspondence on “Global Exposure to Per- and Polyfluoroalkyl Substances and Associated Burden of Low Birthweight”

“…We found 4922 hits in Web of Science and 1556 hits in PubMed. The number of articles we found significantly differed from the authors’ results (2013 hits in Web of Science and 1811 hits in PubMed) . We further included 18 additional search terms such as “perfluorooctanesulfonic acid*”, “perfluorooctanesulfonate*”, “perfluorooctanesulfonic acid*”, and “perfluorooctanesulfonate*”.…”

“…We read the article by Fan et al . about the global exposure to per- and polyfluoroalkyl substances (PFASs) and their contributions on low birthweight based on a systematic literature review.…”

“…The incomprehensive literature search strategy causes the absence of relevant studies. For example, the temporal trend in exposure to PFOS and PFOA in Japan was shown in the limited range of results between 1985 and 2007 (Figure 2 of the original article) . However, there are available studies published after 2007, such as those by Harada et al, , Okada et al, , Goudarzi et al, and Yamaguchi et al…”

Determinants of maternal and neonatal PFAS concentrations: a review

“…There is evidence of numerous health effects associated with PFAS exposure in adults, including dyslipidemia [ 14 – 16 ], changes in liver enzymes [ 17 , 18 ], elevated blood pressure and hypertension [ 19 , 20 ], and kidney and testicular cancer [ 21 ]. In neonates and children, there is evidence of decreases in birthweight [ 22 , 23 ], neurobehavioral problems [ 24 – 27 ], immunosuppression [ 28 , 29 ], and increased adiposity [ 30 – 32 ].…”