Perfluoroalkyl and polyfluoroalkyl substances and indicators of immune function in children aged 12–19 y: National Health and Nutrition Examination Survey

Stein, Cheryl R.; McGovern, Kathleen; Pajak, Ashley; Maglione, Paul J.; Wolff, Mary S.

doi:10.1038/pr.2015.213

Cited by 153 publications

(161 citation statements)

References 32 publications

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“…A Taiwanese case-control study reported that increased PFAS exposures were associated with concurrent asthma among 10–15-year-olds (Dong et al 2013), while a cross-sectional study using the U.S. National Health and Nutrition Examination Survey (NHANES) data (1999–2000, 2003–2004, 2005–2006, 2007–2008) of 12–19 year-olds found that serum-PFOA was associated with increased odds of asthma while PFOS showed a negative association (Humblet et al 2014), and finally a recent study using NHANES data (2005–2006) of 12–19 year-olds did not find any association between PFAS and asthma but found that higher serum-PFOS concentrations were associated with reduced odds of sensitization to any allergen, while increased PFOA and PFNA were associated with increased serum IgE (Stein et al 2016). Neither of these studies examined MMR vaccinations or other factors that might contribute to the different findings.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, higher serum-PFAS concentrations in childhood have been associ-ated with increased odds of concurrent asthma (Dong et al 2013), perhaps due to a shift towards a T-helper type 2 cell (T H 2) immune response (Dong et al 2011) as seen in allergic asthma and allergic diseases. However, other studies could not replicate this association (Humblet et al 2014; Stein et al 2016). Reported associations between pre-natal PFAS exposure and asthma, wheezing, and other allergic diseases in children also have not been consistent (Wang et al 2011; Okada et al 2012, 2014; Granum et al.…”

Section: Introductionmentioning

confidence: 90%

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Association between perfluoroalkyl substance exposure and asthma and allergic disease in children as modified by MMR vaccination

Timmermann

Budtz‐Jørgensen

Jensen

et al. 2017

Journal of Immunotoxicology

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Perfluoroalkyl substances (PFAS) are highly persistent chemicals that might be associated with asthma and allergy, but the associations remain unclear. Therefore, this study examined whether pre- and post-natal PFAS exposure was associated with childhood asthma and allergy. Measles, mumps and rubella (MMR) vaccination in early life may have a protective effect against asthma and allergy and is therefore taken into account when evaluating these associations. In a cohort of Faroese children whose mothers were recruited during pregnancy, serum concentrations of five PFAS were measured: Perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) at three timepoints (maternal serum in pregnancy week 34–36 and child serum at ages 5 and 13 years) and determined their association with immunoglobulin E (IgE) (cord blood and at age 7 years) and asthma/allergic diseases (questionnaires at ages 5 and 13 years and skin prick test at age 13 years). A total of 559 children were included in the analyses. Interactions with MMR vaccination were evaluated. Among 22 MMR-unvaccinated children, higher levels of the five PFAS at age 5 years were associated with increased odds of asthma at ages 5 and 13. The associations were reversed among MMR-vaccinated children. Pre-natal PFAS exposure was not associated with childhood asthma or allergic diseases regardless of MMR vaccination status. In conclusion, PFAS exposure at age 5 was associated with increased risk of asthma among a small subgroup of MMR-unvaccinated children but not among MMR-vaccinated children. While PFAS exposure may impact immune system functions, this study suggests that MMR vaccination might be a potential effect-modifier.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Association between perfluoroalkyl substance exposure and asthma and allergic disease in children as modified by MMR vaccination

Timmermann

Budtz‐Jørgensen

Jensen

et al. 2017

Journal of Immunotoxicology

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“…The second study of vaccine response in relation to PFAS exposure among adults observed decreased antibody response after a diphtheria and tetanus booster vaccination, but included only 12 subjects (Kielsen et al, 2015). Three other investigations of selected PFAS exposure and response to vaccination studied children (Grandjean et al, 2012; Granum et al, 2013; Stein et al, 2016), who may be more susceptible to immunotoxicants.…”

Section: Discussionmentioning

confidence: 99%

“…A Taiwanese case-control study (n=456) reported positive associations between higher PFOS and PFOA exposure and serum IgE among 10 – 15 year old asthmatics; non-asthmatic controls were not tested (Dong et al, 2013). In a cross-sectional NHANES study (n=1,191) of 12 – 19 year olds, there was no adverse association between PFAS exposure and current allergic conditions; children with higher PFOS concentration were less likely to have IgE sensitization to a range of allergens (Stein et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

“…A Faroe Islands birth cohort (n=587) reported inverse associations between prenatal PFOS serum concentration and tetanus and diphtheria toxoids at ages 5 and 7 years (Grandjean et al, 2012). In the NHANES study, higher PFOS, PFOA, and PFHxS serum concentrations were associated with lower levels of mumps and rubella antibody concentrations among children aged 12 – 19 years (Stein et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

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Perfluoroalkyl substance serum concentrations and immune response to FluMist vaccination among healthy adults

Stein

Wolff

et al. 2016

Environmental Research

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Perfluoroalkyl substances (PFAS) were shown to be immunotoxic in laboratory animals. There is some epidemiological evidence that PFAS exposure is inversely associated with vaccine-induced antibody concentration. We examined immune response to vaccination with FluMist intranasal live attenuated influenza vaccine in relation to four PFAS (perfluorooctanoate, perfluorononanoate, perfluorooctane sulfonate, perfluorohexane sulfonate) serum concentrations among 78 healthy adults vaccinated during the 2010 – 2011 influenza season. We measured anti-A H1N1 antibody response and cytokine and chemokine concentrations in serum pre-vaccination, 3 days post-vaccination, and 30 days post-vaccination. We measured cytokine, chemokine, and mucosal IgA concentration in nasal secretions 3 days post-vaccination and 30 days post-vaccination. Adults with higher PFAS concentrations were more likely to seroconvert after FluMist vaccination as compared to adults with lower PFAS concentrations. The associations, however, were imprecise and few participants seroconverted as measured either by hemagglutination inhibition (9%) or immunohistochemical staining (25%). We observed no readily discernable or consistent pattern between PFAS concentration and baseline cytokine, chemokine, or mucosal IgA concentration, or between PFAS concentration and change in these immune markers between baseline and FluMist-response states. The resuts of this study do not support a reduced immune response to FluMist vaccination among healthy adults in relation to serum PFAS concentration. Given the study’s many limitations, however, it does not rule out impaired vaccine response to other vaccines or vaccine components in either children or adults.

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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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Perfluoroalkyl and polyfluoroalkyl substances and indicators of immune function in children aged 12–19 y: National Health and Nutrition Examination Survey

Cited by 153 publications

References 32 publications

Association between perfluoroalkyl substance exposure and asthma and allergic disease in children as modified by MMR vaccination

Association between perfluoroalkyl substance exposure and asthma and allergic disease in children as modified by MMR vaccination

Perfluoroalkyl substance serum concentrations and immune response to FluMist vaccination among healthy adults

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

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