Per- and polyfluoroalkyl substances and blood lipid levels in pre-diabetic adults—longitudinal analysis of the diabetes prevention program outcomes study

Lin, Pi‐I D.; Cárdenas, Andrés; Hauser, Russ; Gold, Diane R.; Kleinman, Ken; Hivert, Marie‐France; Fleisch, Abby F.; Calafat, Antònia M.; Webster, Thomas F.; Horton, Edward S.; Oken, Emily

doi:10.1016/j.envint.2019.05.027

Cited by 99 publications

(59 citation statements)

References 66 publications

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“…At baseline, they found a positive cross-sectional association between PFOA serum levels and SBP and a signi cantly increased prevalence of hypertension with higher serum PFOA among males. In the prospective analyses, however, the associations with both blood pressure trajectories and the risk of developing hypertension were null, except for an inverse association between PFOS and SBP in the intervention arm [22].…”

Section: Discussionmentioning

confidence: 81%

“…To our knowledge, only two studies assessed the association between PFAS exposure and blood pressure or hypertension with a longitudinal design [21,22]. In the C8 Health Project, a large study involving a highly exposed community of the Mid-Ohio Valley, USA, there was no clear evidence of an association between PFOA exposure and self-reported incident hypertension, although small statistically signi cant associations emerged in certain subgroups (females aged 20-39 years and males aged 40-59 years) [21].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies in the general population [9][10][11][12][13][14], and just one on 500 highly exposed individuals in China [9] found positive associations between serum PFAS concentrations and hypertension. However, these ndings were not demonstrated in other cross sectional studies [15][16][17][18][19][20], nor in two longitudinal studies on hypertension [21] and one on blood pressure trajectory [22]. The association of serum PFAS with blood pressure as a continuous outcome was evaluated in few cross-sectional studies, but with con icting ndings [9,11,12,14].…”

Section: Introductionmentioning

confidence: 93%

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Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

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Jeddi

Barbieri

et al. 2020

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BackgroundResidents in a large area of North-Eastern Italy were exposed to perfluoroalkyl substances (PFAS) via drinking water. Studies on the association between PFAS and blood pressure levels are limited, and results are inconsistent. Using cross-sectional data from the Regional health surveillance program, we aimed to quantify the associations between PFAS serum concentrations and blood pressure and hypertension prevalence.MethodsThe study comprised 16,224 individuals aged 20-39 years. Pregnant women (n=327), or individuals with missing information on the selected covariates (n=111) were excluded, leaving 15,786 subjects for the analyses. Hypertension was defined as any self-reported diagnosis, use of antihypertensive drugs, or elevated systolic blood pressure (SBP≥140 mmHg)/diastolic blood pressure (DBP≥90 mmHg). Generalized additive models were used to investigate the relation between perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)) natural log (ln) transformed and by decile, and SBP, DBP, hypertension, adjusted for potential confounders.ResultsBoth SBP and DBP increased significantly with an increase in the ln-transformed serum PFAS concentrations in a monotonic way. The predicted increase in SBP and DBP were 1.54 mmHg (95%CI 0.61-2.47), 1.60 mmHg (95%CI 0.92-2.27) from lowest to highest decile of PFOA. The associations were stronger for SBP in men and for DBP in women. One unit increase in each In-transformed PFAS was positively associated with an increased odd of hypertension in men: PFOA OR=1.06 (1.01-1.11), PFOS OR=1.13 (1.03-1.23), PFHxS OR=1.08 (1.02-1.15), PFNA OR=1.20 (1.02-1.40).ConclusionsOur findings suggest that serum PFAS concentrations were associated with increased systolic and diastolic blood pressure in a large highly exposed young adult population. Although the magnitude of the observed effect was relatively small, if confirmed it would be of public health relevance since even small increases in blood pressure levels at the population level may be associated to a raised risk of adverse outcomes such as cardiovascular disease and target organ damage.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

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Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

Pitter

Jeddi

Barbieri

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…At baseline, they found a positive cross-sectional association between PFOA serum levels and systolic blood pressure and a signi cantly increased prevalence of hypertension with higher serum PFOA among males. In the prospective analyses, however, the associations with both blood pressure trajectories and the risk of developing hypertension were null, except for an inverse association between PFOS and SBP in the intervention arm [21].…”

Section: Discussionmentioning

confidence: 81%

“…To our knowledge, only two studies assessed the association between PFAS exposure and blood pressure or hypertension with a longitudinal design [20,21]. In the C8 Health Project, a large study involving a highly exposed community of the Mid-Ohio Valley, USA, there was no clear evidence of an association between PFOA exposure and self-reported incident hypertension, although small statistically signi cant associations emerged in certain subgroups (females aged 20-39 years and males aged 40-59 years) [20].…”

Section: Discussionmentioning

confidence: 99%

Perfluoroalkyl Substances Are Associated With Elevated Blood Pressure and Hypertension in Highly Exposed Young Adults

Pitter

Jeddi

Barbieri

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Residents in a large area of North-Eastern Italy were exposed to perfluoroalkyl substances (PFAS) via drinking water. Studies on the association between PFAS and blood pressure levels are limited and results inconsistent. Using cross-sectional data from the Regional health surveillance program, we aimed to quantify the associations between PFAS serum concentrations and blood pressure and hypertension prevalence. Methods The study included 16,224 individuals aged 20-39 years. Pregnant women (n=327), or individuals with missing information on the selected covariates (n=111) were excluded, leaving 15,786 subjects. Hypertension was defined as any self-reported diagnosis, use of antihypertensive drugs, or elevated systolic blood pressure (SBP)/diastolic blood pressure (DBP). Generalized additive models were used to investigate the relation between each PFAS (perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)) ln transformed and by decile, and SBP, DBP, hypertension, adjusted for potential confounders. Results Both SBP and DBP increased significantly with an increase in the ln-transformed serum PFAS concentrations in a monotonic way. The predicted increase in SBP and DBP were 1.54 mmHg (95%CI 0.61-2.47), 1.60 mmHg (95%CI 0.92-2.27) from lowest to highest decile of PFOA. The associations were stronger for SBP in men and DBP in women. One unit increase in each natural log transformed PFAS was positively associated with an increased odd of hypertension in men: PFOA OR=1.06 (1.01-1.11), PFOS OR=1.13 (1.03-1.23), PFHxS OR=1.08 (1.02-1.15), PFNA OR=1.20 (1.02-1.40). Conclusions Our findings suggest that serum PFAS concentrations were associated with moderately increased systolic and diastolic blood pressure in a large highly exposed young adult population. Although the magnitude of the observed effect was relatively small, if confirmed it would be of clinical significance since even small increases in blood pressure levels at population level may be associated to a raised risk of adverse outcomes such as cardiovascular disease and target organ damage.

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Effect of Plasma and Blood Donations on Levels of Perfluoroalkyl and Polyfluoroalkyl Substances in Firefighters in Australia

et al. 2022

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IMPORTANCEElevated levels of blood perfluoroalkyl and polyfluoroalkyl substances (PFASs) have been associated with a range of adverse health outcomes. Firefighters have been exposed to PFASs in firefighting foams and have previously been shown to have higher PFAS levels in blood samples than the general population. No interventions have been shown to reduce PFAS levels. OBJECTIVE To examine the effect of blood or plasma donations on PFAS levels in firefighters in Australia. DESIGN, SETTING, AND PARTICIPANTS This 52-week, open-label, randomized clinical trial enrolled participants from May 23 to August 23, 2019. Participants were 285 Fire Rescue Victoria staff orcontractors with serum levels of perfluorooctane sulfonate (PFOS) of 5 ng/mL or more who were eligible to donate blood, had not donated blood in the 3 months prior to randomization, and were able to provide written informed consent. Analysis was performed on an intention-to-treat basis from May to July 2021. INTERVENTIONSFirefighters with baseline PFOS levels of 5 ng/mL or more were randomly assigned to donate plasma every 6 weeks for 12 months, donate blood every 12 weeks for 12 months, or be observed only. MAIN OUTCOMES AND MEASURESThe primary end points were changes in the serum PFOS and perfluorohexane sulfonic acid (PFHxS) levels after 12 months of plasma or blood donations or after observation only. Secondary end points included changes in serum PFAS levels from week 52 to week 64, changes in other PFASs, and changes in complete blood count, biochemistry, thyroid function, and lipid profile from screening to week 52. RESULTSA total of 285 firefighters (279 men [97.9%]; mean [SD] age, 53.0 [8.4] years) were enrolled; 95 were randomly assigned to donate plasma, 95 were randomly assigned to donate blood, and 95 were randomly assigned to be observed. The mean level of PFOS at 12 months was significantly reduced by plasma donation (-2.9 ng/mL; 95% CI, -3.6 to -2.3 ng/mL; P < .001) and blood donation (-1.1 ng/mL; 95% CI, -1.5 to -0.7 ng/mL; P < .001) but was unchanged in the observation group. The mean level of PFHxS was significantly reduced by plasma donation (-1.1 ng/mL; 95% CI, -1.6 to -0.7 ng/mL; P < .001), but no significant change was observed in the blood donation or observation groups. Analysis between groups indicated that plasma donation had a larger treatment effect than blood donation, but both were significantly more efficacious than observation in reducing PFAS levels. (continued) Key Points Question Can levels of perfluoroalkyl and polyfluoroalkyl substances (PFASs) in the blood be reduced by blood or plasma donations? Findings In this randomized clinical trial of 285 firefighters, both blood and plasma donations resulted in significantly lower PFAS levels than observation alone. Plasma donation was the most effective intervention, reducing mean serum perfluorooctane sulfonate levels by 2.9 ng/mL compared with a 1.1-ng/mL reduction with blood donation, a significant difference; similar changes were seen with other PFASs. Meaning Blood or pl...

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Per- and polyfluoroalkyl substances and blood lipid levels in pre-diabetic adults—longitudinal analysis of the diabetes prevention program outcomes study

Cited by 99 publications

References 66 publications

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

Perfluoroalkyl Substances Are Associated With Elevated Blood Pressure and Hypertension in Highly Exposed Young Adults

Effect of Plasma and Blood Donations on Levels of Perfluoroalkyl and Polyfluoroalkyl Substances in Firefighters in Australia

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