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Chen Z, Wei W, Hu Y, Niu Q, Yan Y. Associations between co-exposure to per- and polyfluoroalkyl substances and metabolic diseases: The mediating roles of inflammation and oxidative stress. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 953:176187. [PMID: 39265689 DOI: 10.1016/j.scitotenv.2024.176187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 08/17/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) pose potential risks to human health. In real-world settings, humans are exposed to various PFAS through numerous pathways. OBJECTIVES This study evaluated the associations between co-exposure to PFAS and obesity and its comorbidities, along with the mediating roles of inflammation and oxidative stress. METHODS We analyzed 11,090 participants from National Health and Nutrition Examination Survey (NHANES), 2003-2018. Linear regression, logistic regression, and generalized additive models were used to assess the individual effects of PFAS exposure on obesity and its comorbidities. The environmental risk score (ERS) was calculated using the adaptive elastic-net model to assess the co-exposure effects. Linear and logistic regression models explored the associations between ERS and obesity and its comorbidities. Mediation analyses explored the roles of inflammatory (neutrophils, lymphocytes, and alkaline phosphatase) and oxidative stress (gamma-glutamyl transferase, total bilirubin, and uric acid) markers in the associations between ERS and obesity and its comorbidities. RESULTS For each unit increase in ERS, the odds of obesity and type 2 diabetes mellitus (T2DM) increased 3.60-fold (95 % CI: 2.03, 6.38) and 1.91-fold (95 % CI: 1.28, 2.86), respectively. For each unit increase in ERS, BMI increased by 2.36 (95 % CI: 1.24, 3.48) kg/m2, waist circumference increased by 6.47 (95 % CI: 3.56, 9.37) cm, and waist-to-height ratio increased by 0.04 (95 % CI: 0.02, 0.06). Lymphocytes, alkaline phosphatase, and total bilirubin were significantly associated with both ERS and obesity, with mediation proportions of 4.17 %, 3.62 %, and 7.37 %, respectively. Lymphocytes, alkaline phosphatase, total bilirubin, and uric acid were significantly associated with both ERS and T2DM, with the mediation proportions of 8.90 %, 8.74 %, 29.73 %, and 38.19 %, respectively. CONCLUSIONS Co-exposure to PFAS was associated with obesity and T2DM, and these associations may be mediated by inflammation and oxidative stress. Further mechanistic and prospective studies are required to verify these associations.
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Affiliation(s)
- Zuhai Chen
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Wanting Wei
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Yunhua Hu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Qiang Niu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Yizhong Yan
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
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Ozcagli E, Kubickova B, Jacobs MN. Addressing chemically-induced obesogenic metabolic disruption: selection of chemicals for in vitro human PPARα, PPARγ transactivation, and adipogenesis test methods. Front Endocrinol (Lausanne) 2024; 15:1401120. [PMID: 39040675 PMCID: PMC11260640 DOI: 10.3389/fendo.2024.1401120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/10/2024] [Indexed: 07/24/2024] Open
Abstract
Whilst western diet and sedentary lifestyles heavily contribute to the global obesity epidemic, it is likely that chemical exposure may also contribute. A substantial body of literature implicates a variety of suspected environmental chemicals in metabolic disruption and obesogenic mechanisms. Chemically induced obesogenic metabolic disruption is not yet considered in regulatory testing paradigms or regulations, but this is an internationally recognised human health regulatory development need. An early step in the development of relevant regulatory test methods is to derive appropriate minimum chemical selection lists for the target endpoint and its key mechanisms, such that the test method can be suitably optimised and validated. Independently collated and reviewed reference and proficiency chemicals relevant for the regulatory chemical universe that they are intended to serve, assist regulatory test method development and validation, particularly in relation to the OECD Test Guidelines Programme. To address obesogenic mechanisms and modes of action for chemical hazard assessment, key initiating mechanisms include molecular-level Peroxisome Proliferator-Activated Receptor (PPAR) α and γ agonism and the tissue/organ-level key event of perturbation of the adipogenesis process that may lead to excess white adipose tissue. Here we present a critical literature review, analysis and evaluation of chemicals suitable for the development, optimisation and validation of human PPARα and PPARγ agonism and human white adipose tissue adipogenesis test methods. The chemical lists have been derived with consideration of essential criteria needed for understanding the strengths and limitations of the test methods. With a weight of evidence approach, this has been combined with practical and applied aspects required for the integration and combination of relevant candidate test methods into test batteries, as part of an Integrated Approach to Testing and Assessment for metabolic disruption. The proposed proficiency and reference chemical list includes a long list of negatives and positives (20 chemicals for PPARα, 21 for PPARγ, and 11 for adipogenesis) from which a (pre-)validation proficiency chemicals list has been derived.
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Zachariah JP, Jone PN, Agbaje AO, Ryan HH, Trasande L, Perng W, Farzan SF. Environmental Exposures and Pediatric Cardiology: A Scientific Statement From the American Heart Association. Circulation 2024; 149:e1165-e1175. [PMID: 38618723 DOI: 10.1161/cir.0000000000001234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Environmental toxicants and pollutants are causes of adverse health consequences, including well-established associations between environmental exposures and cardiovascular diseases. Environmental degradation is widely prevalent and has a long latency period between exposure and health outcome, potentially placing a large number of individuals at risk of these health consequences. Emerging evidence suggests that environmental exposures in early life may be key risk factors for cardiovascular conditions across the life span. Children are a particularly sensitive population for the detrimental effects of environmental toxicants and pollutants given the long-term cumulative effects of early-life exposures on health outcomes, including congenital heart disease, acquired cardiac diseases, and accumulation of cardiovascular disease risk factors. This scientific statement highlights representative examples for each of these cardiovascular disease subtypes and their determinants, focusing specifically on the associations between climate change and congenital heart disease, airborne particulate matter and Kawasaki disease, blood lead levels and blood pressure, and endocrine-disrupting chemicals with cardiometabolic risk factors. Because children are particularly dependent on their caregivers to address their health concerns, this scientific statement highlights the need for clinicians, research scientists, and policymakers to focus more on the linkages of environmental exposures with cardiovascular conditions in children and adolescents.
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Zheng Q, Yan W, Gao S, Li X. The effect of PFAS exposure on glucolipid metabolism in children and adolescents: a meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1261008. [PMID: 38425754 PMCID: PMC10902913 DOI: 10.3389/fendo.2024.1261008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/19/2024] [Indexed: 03/02/2024] Open
Abstract
Background Previous studies showed that per- and polyfluoroalkyl substances (PFAS), which are widely found in the environment, can disrupt endocrine homeostasis when they enter the human body. This meta-analysis aimed to evaluate current human epidemiological evidence on the relationship between PFAS exposure and glucolipid metabolism in childhood and adolescence. Methods We searched PubMed, Web of Science, Embase, and Cochrane Library databases, and identified population-based epidemiological studies related to PFAS and glucolipid metabolism indexes that were published before 30 December 2022. The heterogeneity of the included literature was assessed using the I-square (I2) test and statistics Q. Random-effects and fixed-effects models were used to combine the effect size. Subgroup analysis based on age and sex of the study participants was performed. A sensitivity analysis was used to evaluate the robustness and reliability of the combined results. Egger's and Begg's tests were used to analyze publication bias. Results A total of 12 studies were included in this analysis. There was a positive association between PFAS and TC (β = 1.110, 95% CI: 0.601, 1.610) and LDL (β = 1.900, 95% CI: 1.030, 2.770), and a negative association between PFAS and HOMA-IR in children and adolescents (β = -0.130, 95% CI: -0. 200, -0.059). PFOS was significant positive associated with TC (β = 8.22, 95% CI: 3.93, 12.51), LDL (β = (12.04, 95% CI: 5.08, 18.99), and HOMA-IR (β = -0.165, 95% CI: -0.292, -0.038). Subgroup analysis showed that exposure to PFAS in the adolescent group was positively associated with TC and LDL levels, and the relationship was stronger in females. Conclusion PFAS exposure is associated with glucolipid metabolism in children and adolescents. Among them, PFOS may play an important role. Recognition of environmental PFAS exposure is critical for stabilizing the glycolipid metabolism relationship during the growth and development of children and adolescents.
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Affiliation(s)
- Qingqing Zheng
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Wu Yan
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Shenghu Gao
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaonan Li
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Institute of Pediatric Research, Nanjing Medical University, Nanjing, China
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Fleury ES, Kuiper JR, Buckley JP, Papandonatos GD, Cecil KM, Chen A, Eaton CB, Kalkwarf HJ, Lanphear BP, Yolton K, Braun JM. Evaluating the association between longitudinal exposure to a PFAS mixture and adolescent cardiometabolic risk in the HOME Study. Environ Epidemiol 2024; 8:e289. [PMID: 38343730 PMCID: PMC10852393 DOI: 10.1097/ee9.0000000000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/14/2023] [Indexed: 02/15/2024] Open
Abstract
Background Exposure to per- and polyfluoroalkyl substances (PFAS) throughout gestation and childhood may impact cardiometabolic risk. Methods In 179 HOME Study participants (Cincinnati, OH; recruited 2003-2006), we used latent profile analysis to identify two distinct patterns of PFAS exposure from serum concentrations of four PFAS measured at birth and ages 3, 8, and 12 years. We assessed the homeostatic model of insulin resistance, triglycerides-to-high-density lipoprotein cholesterol ratio, leptin-to-adiponectin ratio, systolic blood pressure, visceral fat, and hemoglobin A1c levels at age 12 years. We used multivariable linear regression to assess the association of membership in the longitudinal PFAS mixture exposure group with a summary measure of overall cardiometabolic risk and individual components. Results One PFAS exposure profile (n = 66, 39%) had higher geometric means of all PFAS across all visits than the other. Although adjusted associations were null in the full sample, child sex modified the association of longitudinal PFAS mixture exposure group with overall cardiometabolic risk, leptin-to-adiponectin ratio, systolic blood pressure, and visceral fat (interaction term P values: 0.02-0.08). Females in the higher exposure group had higher cardiometabolic risk scores (ß = 0.43; 95% CI = -0.08, 0.94), systolic blood pressures (ß = 0.6; 95% CI = 0.1, 1.1), and visceral fat (ß = 0.44; 95% CI = -0.13, 1.01); males had lower cardiometabolic risk scores (ß = -0.52; 95% CI = -1.06, -0.06), leptin-to-adiponectin ratios (ß = -0.7; 95% CI = -1.29, -0.1), systolic blood pressures (ß = -0.14; 95% CI = -0.7, 0.41), and visceral fat (ß = -0.52; 95% CI = -0.84, -0.19). Conclusions Exposure to this PFAS mixture throughout childhood may have sex-specific effects on adolescent cardiometabolic risk.
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Affiliation(s)
| | - Jordan R. Kuiper
- Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, D.C
| | - Jessie P. Buckley
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | | | - Kim M. Cecil
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Charles B. Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI
| | - Heidi J. Kalkwarf
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, RI
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Yan W, Bai R, Zheng Q, Yang X, Shi Y, Yang R, Jiang C, Wang X, Li X. Concentrations and association between exposure to mixed perfluoroalkyl and polyfluoroalkyl substances and glycometabolism among adolescents. Ann Med 2023; 55:2227844. [PMID: 37354023 PMCID: PMC10291925 DOI: 10.1080/07853890.2023.2227844] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/07/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are widely used for industrial and commercial purposes and have received increasing attention due to their adverse effects on health. OBJECTIVE To examine the relationship of serum PFAS and glycometabolism among adolescents based on the US National Health and Nutrition Examination Survey. METHODS General linear regression models were applied to estimate the relationship between exposure to single PFAS and glycometabolism. Weighted quantile sum (WQS) regression models and Bayesian kernel machine regressions (BKMR) were used to assess the associations between multiple PFASs mixture exposure and glycometabolism. RESULTS A total of 757 adolescents were enrolled. Multivariable regression model showed that Me-PFOSA-AcOH exposure was negatively associated with fasting blood glucose. WQS index showed that there was marginal negative correlation between multiple PFASs joint exposure and the homeostasis model of assessment for insulin resistance index (HOMA-IR) (β = -0.26, p < .068), and PFHxS had the largest weight. BKMR models showed that PFASs mixture exposure were associated with decreased INS and HOMA-IR, and the exposure-response relationship had curvilinear shape. CONCLUSIONS The increase in serum PFASs were associated with a decrease in HOMA-IR among adolescents. Mixed exposure models could more accurately and effectively reveal true exposure.Key MessagesThe detection rates of different PFAS contents in adolescent serum remained diverse.Adolescent serum PFASs had negative curvilinear correlation with INS and HOMA-IR levels.PFHxS had the highest weight in the associations between multiple PFASs and adolescent glycometabolism.
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Affiliation(s)
- Wu Yan
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Ruhai Bai
- School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
| | - Qingqing Zheng
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaona Yang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yanan Shi
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Ruizhe Yang
- Department of Prevention and Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Chenjun Jiang
- Department of Physics, University of Auckland, Auckland, New Zealand
| | - Xu Wang
- Department of Endocrinology, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaonan Li
- Department of Children Health Care, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Institute of Pediatric Research, Nanjing Medical University, Nanjing, China
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Chang MC, Chung SM, Kwak SG. Exposure to perfluoroalkyl and polyfluoroalkyl substances and risk of stroke in adults: a meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2023-0021. [PMID: 37656598 DOI: 10.1515/reveh-2023-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/18/2023] [Indexed: 09/03/2023]
Abstract
INTRODUCTION Evidence of the adverse metabolic health effects of perfluoroalkyl and polyfluoroalkyl substances (PFAS) is increasing. However, the impact of PFAS on cardiovascular diseases remains controversial. This meta-analysis aimed to analyze the impact of PFAS on the stroke risk. CONTENT Databases were searched for studies published up to November 1, 2022, which report the association between stroke and exposure to at least one of four main PFAS (perfluorooctanoic acid [PFOA], perfluorooctanesulfonic acid [PFOS], perfluorononanoic acid [PFNA], and perfluorohexane sulfonic acid [PFHxS]). Data extraction and quality assessment were performed according to the Newcastle-Ottawa scale. SUMMARY AND OUTLOOK Four studies were included in this systematic review. Multivariate adjusted odds ratios (ORs) for incident stroke per 1-log unit increment in each serum PFAS were combined in the meta-analysis. The risk of development of stroke was not significantly associated with PFOA, PFOS, or PFNA exposure (PFOA: pooled odds ratio [OR]=1.001, 95 % confidence interval [CI]=0.975-1.028, p=0.934; PFOS: pooled OR=0.994, 95 % CI=0.972-1.017, p=0.601; PFNA: pooled OR=1.016, 95 % CI=0.920-1.123, p=0.752), whereas a moderately lower risk was associated with PFHxS exposure without statistical significance (pooled OR=0.953, 95 % CI=0.908-1.001, p=0.054). PFOA, PFOS, and PFNA exposure showed a neutral association, while PFHxS showed a possible inverse association with the risk of stroke. Therefore, this finding should be interpreted with caution. Further prospective observational studies with PFAS mixture analyses are warranted.
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Affiliation(s)
- Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Seung Min Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
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India-Aldana S, Yao M, Midya V, Colicino E, Chatzi L, Chu J, Gennings C, Jones DP, Loos RJF, Setiawan VW, Smith MR, Walker RW, Barupal D, Walker DI, Valvi D. PFAS Exposures and the Human Metabolome: A Systematic Review of Epidemiological Studies. CURRENT POLLUTION REPORTS 2023; 9:510-568. [PMID: 37753190 PMCID: PMC10520990 DOI: 10.1007/s40726-023-00269-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 09/28/2023]
Abstract
Purpose of Review There is a growing interest in understanding the health effects of exposure to per- and polyfluoroalkyl substances (PFAS) through the study of the human metabolome. In this systematic review, we aimed to identify consistent findings between PFAS and metabolomic signatures. We conducted a search matching specific keywords that was independently reviewed by two authors on two databases (EMBASE and PubMed) from their inception through July 19, 2022 following PRISMA guidelines. Recent Findings We identified a total of 28 eligible observational studies that evaluated the associations between 31 different PFAS exposures and metabolomics in humans. The most common exposure evaluated was legacy long-chain PFAS. Population sample sizes ranged from 40 to 1,105 participants at different stages across the lifespan. A total of 19 studies used a non-targeted metabolomics approach, 7 used targeted approaches, and 2 included both. The majority of studies were cross-sectional (n = 25), including four with prospective analyses of PFAS measured prior to metabolomics. Summary Most frequently reported associations across studies were observed between PFAS and amino acids, fatty acids, glycerophospholipids, glycerolipids, phosphosphingolipids, bile acids, ceramides, purines, and acylcarnitines. Corresponding metabolic pathways were also altered, including lipid, amino acid, carbohydrate, nucleotide, energy metabolism, glycan biosynthesis and metabolism, and metabolism of cofactors and vitamins. We found consistent evidence across studies indicating PFAS-induced alterations in lipid and amino acid metabolites, which may be involved in energy and cell membrane disruption.
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Affiliation(s)
- Sandra India-Aldana
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Meizhen Yao
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Vishal Midya
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Leda Chatzi
- Department of Population and Public Health Sciences, Keck
School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jaime Chu
- Department of Pediatrics, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Dean P. Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary,
Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Ruth J. F. Loos
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
- Charles Bronfman Institute for Personalized Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
- Faculty of Health and Medical Sciences, Novo Nordisk
Foundation Center for Basic Metabolic Research, University of Copenhagen,
Copenhagen, Denmark
| | - Veronica W. Setiawan
- Department of Population and Public Health Sciences, Keck
School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mathew Ryan Smith
- Clinical Biomarkers Laboratory, Division of Pulmonary,
Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
- Veterans Affairs Medical Center, Decatur, GA, USA
| | - Ryan W. Walker
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Dinesh Barupal
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Douglas I. Walker
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health,
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New
York, NY 10029, USA
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Hoadley L, Watters M, Rogers R, Werner LS, Markiewicz KV, Forrester T, McLanahan ED. Public health evaluation of PFAS exposures and breastfeeding: a systematic literature review. Toxicol Sci 2023; 194:121-137. [PMID: 37228093 PMCID: PMC10527886 DOI: 10.1093/toxsci/kfad053] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Per- and polyfluoroalkyl substances (PFAS) are a class of man-made chemicals that are persistent in the environment. They can be transferred across the placenta to fetuses and through human milk to infants. The American Academy of Pediatrics advises that the benefits of breastfeeding infants almost always outweigh the potential risks of harm from environmental chemicals. However, there are few chemical-specific summaries of the potential harms of exposure to PFAS during the neonatal period through breastfeeding. This systematic review explores whether exposure to PFAS through breastfeeding is associated with adverse health outcomes among infants and children using evidence from human and animal studies. Systematic searches identified 4297 unique records from 7 databases. The review included 37 total articles, including 9 animal studies and 1 human study measuring the direct contribution of exposure of the infant or pup through milk for any health outcome. Animal studies provided evidence of associations between exposure to PFOA through breastfeeding and reduced early life body weight gain, mammary gland development, and thyroid hormone levels. They also provided limited evidence of associations between PFOS exposure through breastfeeding with reduced early life body weight gain and cellular changes in the hippocampus. The direct relevance of any of these outcomes to human health is uncertain, and it is possible that many adverse health effects of exposure through breastfeeding have not yet been studied. This review documents the current state of science and highlights the need for future research to guide clinicians making recommendations on infant feeding.
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Affiliation(s)
- Lydia Hoadley
- Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia 30341, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee 37830, USA
| | - Michelle Watters
- Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia 30341, USA
| | - Rachel Rogers
- Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia 30341, USA
| | - Lora Siegmann Werner
- Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia 30341, USA
| | - Karl V. Markiewicz
- Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia 30341, USA
| | - Tina Forrester
- Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia 30341, USA
| | - Eva D. McLanahan
- Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, Georgia 30341, USA
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Ho SH, Soh SXH, Wang MX, Ong J, Seah A, Wong Y, Fang Z, Sim S, Lim JT. Perfluoroalkyl substances and lipid concentrations in the blood: A systematic review of epidemiological studies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 850:158036. [PMID: 35973530 DOI: 10.1016/j.scitotenv.2022.158036] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/19/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are widely used synthetic aliphatic compounds. This systematic review aims to assess PFAS associations with low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), total cholesterol (TC) and total triglyceride (TG) concentrations in human populations. METHOD We systematically searched four online databases, PubMed, Scopus, Embase, and Cochrane Library for relevant peer-reviewed English language articles published until July 2021. Additional relevant articles identified were also included in the search results. We categorised populations into adults (≥18 years old) and children. Primary findings were the associations between PFAS concentrations and LDL, HDL, TC, and TG concentrations in the serum, plasma, or whole blood; secondary findings were the associations between PFAS concentrations and the odds of lipid-related health outcomes. Quantitative synthesis was done by vote counting of the effect directions between concentrations of PFAS and lipids/health outcomes, repeated on articles with sample size >1000. Sign tests were performed to assess the statistical significance of the differences between positive and negative associations. Sensitivity analysis was performed by separating out articles with populations having high concentrations of perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS). Quality was assessed with the STROBE checklist and NHBLI Study Quality Assessment Tool. RESULTS A total of 58 articles were included for review. There was evidence that PFAS exposure is associated with higher concentrations of LDL, HDL, and TC, particularly for PFOA-LDL, PFOA-TC, PFOS-TC, and PFNA-LDL. Associations between PFAS and TG tended to be negative, especially for perfluoroundecanoic acid (PFUnDA). Associations between PFAS concentration and the odds of secondary outcomes generally supported a positive association between PFAS and cholesterol concentrations. CONCLUSION We found evidence of associations between the concentrations of some PFAS-lipid pairs in human populations. Future research should be conducted on the less well-studied PFAS to explore their effects on human health and in regions where such studies are currently lacking. (300 words).
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Affiliation(s)
- Soon Hoe Ho
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore.
| | - Stacy Xin Hui Soh
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Min Xian Wang
- Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Annabel Seah
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Yvonne Wong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Zhanxiong Fang
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Shuzhen Sim
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Jue Tao Lim
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore; Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, #10-01, Singapore 117549, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University Novena Campus, 11 Mandalay Road, Singapore 308232, Singapore
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11
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Florsheim RL, Zhang Q, Durmus N, Zhang Y, Pehlivan S, Arslan AA, Shao Y, Reibman J. Characteristics of Cancers in Community Members Exposed to the World Trade Center Disaster at a Young Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15163. [PMID: 36429881 PMCID: PMC9690329 DOI: 10.3390/ijerph192215163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
The destruction of the World Trade Center (WTC) towers on 11 September 2001 (9/11) released tons of dust and smoke into the atmosphere, exposing hundreds of thousands of community members (survivors) and responders to carcinogens. The WTC Environmental Health Center (WTC EHC) is a federally designated surveillance and treatment program for community members who were present in the New York City disaster area on 9/11 or during the months that followed. WTC EHC enrollment requires exposure to the WTC dust and fumes and a federally certifiable medical condition, which includes most solid and blood cancers. Several studies have described the prevalence and characteristics of cancers in responders and survivors exposed to the WTC dust and fumes as adults. Cancers in those exposed at a young age warrant specific investigation since environmental toxin exposure at a younger age may change cancer risk. We describe the characteristics of 269 cancer patients with 278 cancer diagnoses among WTC EHC enrollees who were young in age (aged 0 to 30) on 9/11. These include 215 patients with a solid tumor (79.9%) and 54 with a lymphoid and/or hematopoietic cancer (20.1%). Among them, 9 patients had a known second primary cancer. A total of 23 different types of cancer were identified, including cancer types rare for this age group. Many were diagnosed in individuals lacking traditional cancer-specific risk factors such as tobacco use. The current study is the first to report specifically on cancer characteristics of younger enrollees in the WTC EHC program.
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Affiliation(s)
- Rebecca Lynn Florsheim
- Department of Medicine, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Qiao Zhang
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Nedim Durmus
- Department of Medicine, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Yian Zhang
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Sultan Pehlivan
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Alan A. Arslan
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Yongzhao Shao
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Joan Reibman
- Department of Medicine, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
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12
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Brackbill RM, Butturini E, Cone JE, Ahmadi A, Daniels RD, Farfel MR, Kubale T. Scientific Value of the Sub-Cohort of Children in the World Trade Center Health Registry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12461. [PMID: 36231761 PMCID: PMC9564973 DOI: 10.3390/ijerph191912461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
The World Trade Center Health Registry (WTCHR) was established in 2002 as a public health resource to monitor the health effects from the World Trade Center (WTC) disaster. We evaluated the representativeness of the WTC youth population (<18 years on 11 September 2001) by comparing the distributions of age, gender, race/ethnic groups, and income to 2000 census data for the matched geographic area, including distance from disaster. There were 2379 WTCHR enrolled children living in Lower Manhattan south of Canal Street on 11 September 2001, along with 752 enrolled students who attended school in Lower Manhattan but were not area residents. The WTCHR sub-group of children who were residents was similar to the geographically corresponding census population on age and sex. Black and Hispanic children are moderately overrepresented at 0.9% and 2.4% in the WTCHR compared to 0.8% and 1.7% in census population, respectively, while lower-income households are slightly under-represented, 28.8% in the WTCHR and 30.8% for the corresponding census information. Asian children appear underrepresented at 3.0% participation compared to 6.3% in the census. While the demographics of WTCHR youth are somewhat skewed, the gaps are within expected patterns of under-representation observed in other longitudinal cohorts and can be effectively addressed analytically or through targeted study design.
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Affiliation(s)
- Robert M. Brackbill
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Emma Butturini
- World Trade Center Health Program Division, National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - James E. Cone
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Ayda Ahmadi
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Robert D. Daniels
- World Trade Center Health Program Division, National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Mark R. Farfel
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Travis Kubale
- World Trade Center Health Program Division, National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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13
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Kaiser AM, Zare Jeddi M, Uhl M, Jornod F, Fernandez MF, Audouze K. Characterization of Potential Adverse Outcome Pathways Related to Metabolic Outcomes and Exposure to Per- and Polyfluoroalkyl Substances Using Artificial Intelligence. TOXICS 2022; 10:toxics10080449. [PMID: 36006128 PMCID: PMC9412358 DOI: 10.3390/toxics10080449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 01/09/2023]
Abstract
Human exposure to per- and polyfluoroalkyl substances (PFAS) has been associated with numerous adverse health effects, depending on various factors such as the conditions of exposure (dose/concentration, duration, route of exposure, etc.) and characteristics associated with the exposed target (e.g., age, sex, ethnicity, health status, and genetic predisposition). The biological mechanisms by which PFAS might affect systems are largely unknown. To support the risk assessment process, AOP-helpFinder, a new artificial intelligence tool, was used to rapidly and systematically explore all available published information in the PubMed database. The aim was to identify existing associations between PFAS and metabolic health outcomes that may be relevant to support building adverse outcome pathways (AOPs). The collected information was manually organized to investigate linkages between PFAS exposures and metabolic health outcomes, including dyslipidemia, hypertension, insulin resistance, and obesity. Links between PFAS exposure and events from the existing metabolic-related AOPs were also retrieved. In conclusion, by analyzing dispersed information from the literature, we could identify some associations between PFAS exposure and components of existing AOPs. Additionally, we identified some linkages between PFAS exposure and metabolic outcomes for which only sparse information is available or which are not yet present in the AOP-wiki database that could be addressed in future research.
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Affiliation(s)
| | - Maryam Zare Jeddi
- National Institute for Public Health and Environment (RIVM), 3721 MA Bilthoven, The Netherlands
- Correspondence:
| | - Maria Uhl
- Environment Agency Austria, 1090 Vienna, Austria
| | - Florence Jornod
- Université Paris Cité, T3S, Inserm UMRS 1124, F-75006 Paris, France
| | - Mariana F. Fernandez
- Centre for Biomedical Research, E-18016 Granada, Spain
- Department of Radiology and Physical Medicine, School of Medicine, University of Granada, E-18071 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Instituto de Salud Carlos III, E-28029 Madrid, Spain
| | - Karine Audouze
- Université Paris Cité, T3S, Inserm UMRS 1124, F-75006 Paris, France
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14
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Dunder L, Lind PM, Salihovic S, Stubleski J, Kärrman A, Lind L. Changes in plasma levels of per- and polyfluoroalkyl substances (PFAS) are associated with changes in plasma lipids - A longitudinal study over 10 years. ENVIRONMENTAL RESEARCH 2022; 211:112903. [PMID: 35231461 DOI: 10.1016/j.envres.2022.112903] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Associations between per- and polyfluoroalkyl substances (PFAS), mainly PFOS and PFOA, and increased blood lipids have been reported primarily from cross-sectional studies. The aim of the present study was to investigate associations between multiple PFAS and blood lipids in a longitudinal fashion. METHODS A total of 864 men and women aged 70 years and free from lipid medication were included from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study from Uppsala Sweden, 614 and 404 of those were reinvestigated at age 75 and 80. At all three occasions, eight PFAS were measured in plasma using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were also measured in plasma at all three occasions. Mixed-effects linear regression models were used to examine the relationship between the changes in PFAS levels and changes in lipid levels. RESULTS Changes in plasma levels of six out of the eight investigated PFAS were positively associated with changes in plasma lipids after adjustment for sex, change in body mass index (BMI), smoking, physical activity, statin use (age was the same in all subjects), and correction for multiple testing. For example, changes in perfluorodecanoic acid (PFDA) were positively associated with the changes in total cholesterol (β: 0.23, 95% confidence interval (CI): 0.14 to 0.32), triglycerides (β: 0.08, 95% CI: 0.04-0.12) and HDL-cholesterol (β: 0.08, 95% CI: 0.04-0.11). CONCLUSION In this longitudinal study with three measurements over 10 years of both plasma PFAS and lipids, changes in six out of the eight investigated PFAS were positively associated with changes in plasma lipids, giving further support for a role of PFAS exposure in human lipid metabolism.
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Affiliation(s)
- Linda Dunder
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - P Monica Lind
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - Samira Salihovic
- Inflammatory Response and Infection Susceptibility Centre, School of Medical Sciences, Örebro University, Örebro, Sweden.
| | - Jordan Stubleski
- MTM, School of Science and Technology, Örebro University, Örebro, Sweden. Wellington Laboratories Inc, Guelph, ON, Canada.
| | - Anna Kärrman
- MTM, School of Science and Technology, Örebro University, Örebro, Sweden.
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
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15
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Zhang Y, Rosen R, Reibman J, Shao Y. Posttraumatic Stress Disorder Mediates the Association between Traumatic World Trade Center Dust Cloud Exposure and Ongoing Systemic Inflammation in Community Members. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148622. [PMID: 35886474 PMCID: PMC9322679 DOI: 10.3390/ijerph19148622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022]
Abstract
Exposure to World Trade Center (WTC) dust/fumes and traumas on 11 September 2001 has been reported as a risk factor for post-traumatic stress disorder (PTSD) and other mental/physical health symptoms in WTC-affected populations. Increased systemic inflammation and oxidative stress from the exposure and subsequent illnesses have been proposed as contributors to the underlying biological processes. Many blood-based biomarkers of systemic inflammation, including C-reactive protein (CRP), are useful for non-invasive diagnostic and monitoring of disease process, and also potential targets for therapeutic interventions. Twenty years after 9/11, however, the relationships between WTC exposure, chronic PTSD, and systemic inflammation are only beginning to be systematically investigated in the WTC-affected civilian population despite the fact that symptoms of PTSD and systemic inflammation are still common and persistent. This paper aims to address this knowledge gap, using enrollees of the WTC Environmental Health Center (EHC), a federally designated treatment and surveillance program for community members (WTC Survivors) exposed to the 9/11 terrorist attack. We conducted a mediation analysis to investigate the association between acute WTC dust cloud traumatic exposure (WDCTE) on 9/11, chronic PTSD symptoms, and levels of systemic inflammation. The data indicate that the chronic PTSD symptoms and some specific symptom clusters of PTSD significantly mediate the WDCTE on systemic inflammation, as reflected by the CRP levels. As both chronic PTSD and systemic inflammation are long-term risk factors for neurodegeneration and cognitive decline, further research on the implications of this finding is warranted.
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Affiliation(s)
- Yian Zhang
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA;
- HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA;
- NYU Alzheimer Disease Research Center, 145 E 32 Street, New York, NY 10016, USA
| | - Rebecca Rosen
- HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA;
- Department of Psychiatry, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Joan Reibman
- HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA;
- Department of Medicine, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
- Correspondence: (J.R.); (Y.S.)
| | - Yongzhao Shao
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA;
- HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA;
- NYU Alzheimer Disease Research Center, 145 E 32 Street, New York, NY 10016, USA
- Correspondence: (J.R.); (Y.S.)
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16
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Grunig G, Durmus N, Zhang Y, Lu Y, Pehlivan S, Wang Y, Doo K, Cotrina-Vidal ML, Goldring R, Berger KI, Liu M, Shao Y, Reibman J. Molecular Clustering Analysis of Blood Biomarkers in World Trade Center Exposed Community Members with Persistent Lower Respiratory Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8102. [PMID: 35805759 PMCID: PMC9266229 DOI: 10.3390/ijerph19138102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Abstract
The destruction of the World Trade Center (WTC) on September 11, 2001 (9/11) released large amounts of toxic dusts and fumes into the air that exposed many community members who lived and/or worked in the local area. Many community members, defined as WTC survivors by the federal government, developed lower respiratory symptoms (LRS). We previously reported the persistence of these symptoms in patients with normal spirometry despite treatment with inhaled corticosteroids and/or long-acting bronchodilators. This report expands upon our study of this group with the goal to identify molecular markers associated with exposure and heterogeneity in WTC survivors with LRS using a selected plasma biomarker approach. Samples from WTC survivors with LRS (n = 73, WTCS) and samples from healthy control participants of the NYU Bellevue Asthma Registry (NYUBAR, n = 55) were compared. WTCS provided information regarding WTC dust exposure intensity. Hierarchical clustering of the linear biomarker data identified two clusters within WTCS and two clusters within NYUBAR controls. Comparison of the WTCS clusters showed that one cluster had significantly increased levels of circulating matrix metalloproteinases (MMP1, 2, 3, 8, 12, 13), soluble inflammatory receptors (receptor for advanced glycation end-products-RAGE, Interleukin-1 receptor antagonist (IL-1RA), suppression of tumorigenicity (ST)2, triggering receptor expressed on myeloid cells (TREM)1, IL-6Ra, tumor necrosis factor (TNF)RI, TNFRII), and chemokines (IL-8, CC chemokine ligand- CCL17). Furthermore, this WTCS cluster was associated with WTC exposure variables, ash at work, and the participant category workers; but not with the exposure variable WTC dust cloud at 9/11. A comparison of WTC exposure categorial variables identified that chemokines (CCL17, CCL11), circulating receptors (RAGE, TREM1), MMPs (MMP3, MMP12), and vascular markers (Angiogenin, vascular cell adhesion molecule-VCAM1) significantly increased in the more exposed groups. Circulating biomarkers of remodeling and inflammation identified clusters within WTCS and were associated with WTC exposure.
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Affiliation(s)
- Gabriele Grunig
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Nedim Durmus
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
| | - Yian Zhang
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Yuting Lu
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Sultan Pehlivan
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Yuyan Wang
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Kathleen Doo
- Pulmonary, Kaiser Permanente East Bay, Oakland, CA 94611, USA;
| | - Maria L. Cotrina-Vidal
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Roberta Goldring
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Kenneth I. Berger
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Mengling Liu
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Yongzhao Shao
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Joan Reibman
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
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17
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Mears MJ, Aslaner DM, Barson CT, Cohen MD, Gorr MW, Wold LE. Health effects following exposure to dust from the World Trade Center disaster: An update. Life Sci 2022; 289:120147. [PMID: 34785191 PMCID: PMC8791014 DOI: 10.1016/j.lfs.2021.120147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/22/2021] [Accepted: 11/08/2021] [Indexed: 01/17/2023]
Abstract
Exposure to dust, smoke, and fumes containing volatile chemicals and particulate matter (PM) from the World Trade Center (WTC) towers' collapse impacted thousands of citizens and first responders (FR; firefighters, medicals staff, police officers) of New York City. Surviving FR and recovery workers are increasingly prone to age-related diseases that their prior WTC dust exposures might expedite or make worse. This review provides an overview of published WTC studies concerning FR/recovery workers' exposure and causal mechanisms of age-related disease susceptibility, specifically those involving the cardiopulmonary and neurological systems. This review also highlights the recent findings of the major health effects of cardiovascular, pulmonary, and neurological health sequelae from WTC dust exposure. To better treat those that risked their lives during and after the disaster of September 11, 2001, the deleterious mechanisms that WTC dust exposure exerted and continue to exert on the heart, lungs, and brain of FR must be better understood.
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Affiliation(s)
- Matthew J Mears
- College of Nursing, The Ohio State University, Columbus, OH, United States of America
| | - David M Aslaner
- College of Nursing, The Ohio State University, Columbus, OH, United States of America
| | - Chad T Barson
- College of Nursing, The Ohio State University, Columbus, OH, United States of America
| | - Mitchell D Cohen
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, United States of America
| | - Matthew W Gorr
- College of Nursing, The Ohio State University, Columbus, OH, United States of America; Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States of America.
| | - Loren E Wold
- College of Nursing, The Ohio State University, Columbus, OH, United States of America; Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine, The Ohio State University, Columbus, OH, United States of America.
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18
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Chang CJ, Barr DB, Ryan PB, Panuwet P, Smarr MM, Liu K, Kannan K, Yakimavets V, Tan Y, Ly V, Marsit CJ, Jones DP, Corwin EJ, Dunlop AL, Liang D. Per- and polyfluoroalkyl substance (PFAS) exposure, maternal metabolomic perturbation, and fetal growth in African American women: A meet-in-the-middle approach. ENVIRONMENT INTERNATIONAL 2022; 158:106964. [PMID: 34735953 PMCID: PMC8688254 DOI: 10.1016/j.envint.2021.106964] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Prenatal exposures to per- and polyfluoroalkyl substances (PFAS) have been linked to reduced fetal growth. However, the detailed molecular mechanisms remain largely unknown. This study aims to investigate biological pathways and intermediate biomarkers underlying the association between serum PFAS and fetal growth using high-resolution metabolomics in a cohort of pregnant African American women in the Atlanta area, Georgia. METHODS Serum perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) measurements and untargeted serum metabolomics profiling were conducted in 313 pregnant African American women at 8-14 weeks gestation. Multiple linear regression models were applied to assess the associations of PFAS with birth weight and small-for-gestational age (SGA) birth. A high-resolution metabolomics workflow including metabolome-wide association study, pathway enrichment analysis, and chemical annotation and confirmation with a meet-in-the-middle approach was performed to characterize the biological pathways and intermediate biomarkers of the PFAS-fetal growth relationship. RESULTS Each log2-unit increase in serum PFNA concentration was significantly associated with higher odds of SGA birth (OR = 1.32, 95% CI 1.07, 1.63); similar but borderline significant associations were found in PFOA (OR = 1.20, 95% CI 0.94, 1.49) with SGA. Among 25,516 metabolic features extracted from the serum samples, we successfully annotated and confirmed 10 overlapping metabolites associated with both PFAS and fetal growth endpoints, including glycine, taurine, uric acid, ferulic acid, 2-hexyl-3-phenyl-2-propenal, unsaturated fatty acid C18:1, androgenic hormone conjugate, parent bile acid, and bile acid-glycine conjugate. Also, we identified 21 overlapping metabolic pathways from pathway enrichment analyses. These overlapping metabolites and pathways were closely related to amino acid, lipid and fatty acid, bile acid, and androgenic hormone metabolism perturbations. CONCLUSION In this cohort of pregnant African American women, higher serum concentrations of PFOA and PFNA were associated with reduced fetal growth. Perturbations of biological pathways involved in amino acid, lipid and fatty acid, bile acid, and androgenic hormone metabolism were associated with PFAS exposures and reduced fetal growth, and uric acid was shown to be a potential intermediate biomarker. Our results provide opportunities for future studies to develop early detection and intervention for PFAS-induced fetal growth restriction.
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Affiliation(s)
- Che-Jung Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - P Barry Ryan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Parinya Panuwet
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Melissa M Smarr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ken Liu
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Volha Yakimavets
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Youran Tan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - ViLinh Ly
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dean P Jones
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | | | - Anne L Dunlop
- Woodruff Health Sciences Center, School of Medicine and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Canova C, Di Nisio A, Barbieri G, Russo F, Fletcher T, Batzella E, Dalla Zuanna T, Pitter G. PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412881. [PMID: 34948492 PMCID: PMC8701234 DOI: 10.3390/ijerph182412881] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 02/07/2023]
Abstract
Background: Residents of a large area of north-eastern Italy were exposed for decades to high concentrations of perfluoroalkyl and polyfluoroalkyl substances (PFAS) via drinking water. Despite the large amount of evidence in adults of a positive association between serum PFAS and metabolic outcomes, studies focusing on children and adolescents are limited. We evaluated the associations between serum PFAS concentrations that were quantifiable in at least 40% of samples and lipid profile, blood pressure (BP) and body mass index (BMI) in highly exposed adolescents and children. Methods: A cross-sectional analysis was conducted in 6669 adolescents (14–19 years) and 2693 children (8–11 years) enrolled in the health surveillance program of the Veneto Region. Non-fasting blood samples were obtained and analyzed for perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglycerides. Low-density lipoprotein cholesterol (LDL-C) was calculated. Systolic and diastolic BP were measured, and BMI z-score accounting for age and sex was estimated. The associations between ln-transformed PFAS (and categorized into quartiles) and continuous outcomes were assessed using generalized additive models. The weighted quantile sum regression approach was used to assess PFAS-mixture effects for each outcome. Analyses were stratified by gender and adjusted for potential confounders. Results: Among adolescents, significant associations were detected between all investigated PFAS and TC, LDL-C, and to a lesser extent HDL-C. Among children, PFOS and PFNA had significant associations with TC, LDL-C and HDL-C, while PFOA and PFHxS had significant associations with HDL-C only. Higher serum concentrations of PFAS, particularly PFOS, were associated with lower BMI z-score. No statistically significant associations were observed between PFAS concentrations and BP. These results were confirmed by the multi-pollutant analysis. Conclusions: Our study supports a consistent association between PFAS concentration and serum lipids, stronger for PFOS and PFNA and with a greater magnitude among children compared to adolescents, and a negative association of PFAS with BMI.
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Affiliation(s)
- Cristina Canova
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy; (G.B.); (E.B.); (T.D.Z.)
- Correspondence:
| | - Andrea Di Nisio
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35131 Padova, Italy;
| | - Giulia Barbieri
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy; (G.B.); (E.B.); (T.D.Z.)
- Eurac Research, Institute for Biomedicine, 39100 Bolzano, Italy
| | - Francesca Russo
- Directorate of Prevention, Food Safety, and Veterinary Public Health-Veneto Region, 30123 Venice, Italy;
| | - Tony Fletcher
- Public Health, Environments and Society Department, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK;
| | - Erich Batzella
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy; (G.B.); (E.B.); (T.D.Z.)
| | - Teresa Dalla Zuanna
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy; (G.B.); (E.B.); (T.D.Z.)
| | - Gisella Pitter
- Screening and Health Impact Assessment Unit, Azienda Zero-Veneto Region, 35131 Padua, Italy;
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Margolis R, Sant KE. Associations between Exposures to Perfluoroalkyl Substances and Diabetes, Hyperglycemia, or Insulin Resistance: A Scoping Review. J Xenobiot 2021; 11:115-129. [PMID: 34564296 PMCID: PMC8482218 DOI: 10.3390/jox11030008] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 01/09/2023] Open
Abstract
Per- and polyfluoroalkyl substances (PFASs) are persistent environmental pollutants that are commonly found in the human body due to exposures via drinking water, surfactants used in consumer materials, and aqueous film-forming foams (AFFFs). PFAS exposure has been linked to adverse health effects such as low infant birth weights, cancer, and endocrine disruption, though increasingly studies have demonstrated that they may perturb metabolic processes and contribute to dysfunction. This scoping review summarizes the chemistry of PFAS exposure and the epidemiologic evidence for associations between exposure to per- and polyfluoroalkyl substances and the development of diabetes, hyperglycemia, and/or insulin resistance. We identified 11 studies on gestational diabetes mellitus, 3 studies on type 1 diabetes, 7 studies on type 2 diabetes, 6 studies on prediabetes or unspecified diabetes, and 15 studies on insulin resistance or glucose tolerance using the SCOPUS and PubMed databases. Approximately 24 reported positive associations, 9 negative associations, 2 non-linear associations, and 2 inverse associations, and 8 reported no associations found between PFAS and all diabetes search terms. Cumulatively, these data indicate the need for further studies to better assess these associations between PFAS exposure and diabetes.
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Affiliation(s)
| | - Karilyn E. Sant
- School of Public Health, San Diego State University, San Diego, CA 92182, USA;
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21
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Blomberg AJ, Shih YH, Messerlian C, Jørgensen LH, Weihe P, Grandjean P. Early-life associations between per- and polyfluoroalkyl substances and serum lipids in a longitudinal birth cohort. ENVIRONMENTAL RESEARCH 2021; 200:111400. [PMID: 34081971 PMCID: PMC8403652 DOI: 10.1016/j.envres.2021.111400] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/30/2021] [Accepted: 05/23/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Exposures to per- and polyfluoroalkyl substances (PFASs) may affect metabolic outcomes, including lipid concentrations in the blood. However, few studies have evaluated potential associations between PFASs and lipids longitudinally. OBJECTIVES We estimated associations between PFAS and lipid concentrations at birth and at several points in childhood. METHODS We measured concentrations of five major PFASs in cord serum and in serum collected at 18 months, five years and nine years in 490 children from a prospective cohort in the Faroe Islands. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations were measured at birth, 18 months and nine years. We estimated associations between PFAS and lipid concentrations and evaluated possible effect modification by sex. We also tested whether PFAS associations with age-nine lipids varied by exposure period. RESULTS Serum PFAS concentrations at ages five and nine were positively associated with lipid concentrations at age nine. Cross-sectional associations between PFASs and lipids at age nine were the strongest, with increases in serum concentrations of perfluorodecanoic acid (PFDA), perfluorononanoic acid (PFNA) and perfluorooctanesulfonic acid (PFOS) associated with increases in TC, HDL-C and LDL-C. We found statistically significant differences in estimated PFAS effects by sex, where girls had stronger positive associations between PFASs and TC and LDL-C and boys had stronger positive associations with HDL-C. In repeated measure models, exposure period was a significant modifier of PFAS effects. CONCLUSIONS Our findings suggest that childhood PFAS exposures may be associated with elevated serum lipid concentrations. This is a public health concern, as a detrimental lipid profile in childhood is a risk factor for later development of hyperlipidemia and cardiovascular disease.
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Affiliation(s)
- Annelise J Blomberg
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
| | - Yu-Hsuan Shih
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Carmen Messerlian
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Louise Helskov Jørgensen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital and Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands; Center of Health Science, University of the Faroe Islands, Torshavn, Faroe Islands
| | - Philippe Grandjean
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
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Abdullah Soheimi SS, Abdul Rahman A, Abd Latip N, Ibrahim E, Sheikh Abdul Kadir SH. Understanding the Impact of Perfluorinated Compounds on Cardiovascular Diseases and Their Risk Factors: A Meta-Analysis Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168345. [PMID: 34444092 PMCID: PMC8391474 DOI: 10.3390/ijerph18168345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/16/2021] [Accepted: 07/31/2021] [Indexed: 01/23/2023]
Abstract
Perfluorinated compounds (PFCs) are non-biodegradable synthetic chemical compounds that are widely used in manufacturing many household products. Many studies have reported the association between PFCs exposure with the risk of developing cardiovascular diseases (CVDs). However, those reports are still debatable, due to their findings. Thus, this review paper aimed to analyse the association of PFCs compound with CVDs and their risk factors in humans by systematic review and meta-analysis. Google Scholar, PubMed and ScienceDirect were searched for PFCs studies on CVDs and their risk from 2009 until present. The association of PFCs exposure with the prevalence of CVDs and their risk factors were assessed by calculating the quality criteria, odds ratios (ORs), and 95% confidence intervals (CIs). CVDs risk factors were divided into serum lipid profile (main risk factor) and other known risk factors. The meta-analysis was then used to derive a combined OR test for heterogeneity in findings between studies. Twenty-nine articles were included. Our meta-analysis indicated that PFCs exposure could be associated with CVDs (Test for overall effect: z = 2.2, p = 0.02; Test for heterogeneity: I2 = 91.6%, CI = 0.92–1.58, p < 0.0001) and their risk factors (Test for overall effect: z = 4.03, p < 0.0001; Test for heterogeneity: I2 = 85.8%, CI = 1.00–1.14, p < 0.0001). In serum lipids, total cholesterol levels are frequently reported associated with the exposure of PFCs. Among PFCs, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) exposure increased the risk of CVDs than other types of PFCs. Although the risk of PFOA and PFOS were positively associated with CVDs and their risk factors, more observational studies shall be carried out to identify the long-term effects of these contaminants in premature CVDs development in patients.
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Affiliation(s)
- Siti Suhana Abdullah Soheimi
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia;
- Institute of Medical Molecular Biotechnology (IMMB), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia;
| | - Amirah Abdul Rahman
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia;
| | - Normala Abd Latip
- Atta-ur-Rahman Institute for Natural Products Discovery (AuRINS), Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam 42300, Selangor, Malaysia;
| | - Effendi Ibrahim
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia;
| | - Siti Hamimah Sheikh Abdul Kadir
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia;
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia;
- Correspondence:
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23
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Gargano LM, Locke SH, Alper HE, Brite J. Hospitalizations among World Trade Center Health Registry Enrollees Who Were under 18 Years of Age on 9/11, 2001-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7527. [PMID: 34299982 PMCID: PMC8303493 DOI: 10.3390/ijerph18147527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 01/02/2023]
Abstract
Much of the literature on hospitalizations post-September 11, 2001 (9/11) focuses on adults but little is known about post-9/11 hospitalizations among children. Data for World Trade Center Health Registry enrollees who were under 18-years old on 9/11 were linked to New York State hospitalization data to identify hospitalizations from enrollment (2003-2004) to December 31, 2016. Logistic regression was used to analyze factors associated with hospitalization. Of the 3151 enrollees under age 18 on 9/11, 243 (7.7%) had at least one 9/11-related physical health hospitalization and 279 (8.9%) had at least one 9/11-related mental health hospitalization. Individuals of non-White race, those living in New York City Housing Authority housing, those exposed to the dust cloud on 9/11, and those with probable 9/11-related PTSD symptoms were more likely to be hospitalized for a 9/11-related physical health condition. Older age and having probable 9/11-related PTSD symptoms at baseline were associated with being hospitalized for a 9/11-related mental health condition. Dust cloud exposure on 9/11 and PTSD symptoms were associated with hospitalizations among those exposed to 9/11 as children. Racial minorities and children living in public housing were at greater risk of hospitalization. Continued monitoring of this population and understanding the interplay of socioeconomic factors and disaster exposure will be important to understanding the long-term effects of 9/11.
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Affiliation(s)
| | - Sean H. Locke
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, USA; (L.M.G.); (H.E.A.); (J.B.)
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24
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Osorio-Yáñez C, Sanchez-Guerra M, Cardenas A, Lin PID, Hauser R, Gold DR, Kleinman KP, Hivert MF, Fleisch AF, Calafat AM, Webster TF, Horton ES, Oken E. Per- and polyfluoroalkyl substances and calcifications of the coronary and aortic arteries in adults with prediabetes: Results from the diabetes prevention program outcomes study. ENVIRONMENT INTERNATIONAL 2021; 151:106446. [PMID: 33631604 PMCID: PMC8721596 DOI: 10.1016/j.envint.2021.106446] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are endocrine disrupting chemicals that have been associated with cardiovascular risk factors including elevated body weight and hypercholesterolemia. Therefore, PFAS may contribute to the development of atherosclerosis and cardiovascular disease (CVD). However, no previous study has evaluated associations between PFAS exposure and arterial calcification. METHODS AND RESULTS This study used data from 666 prediabetic adults enrolled in the Diabetes Prevention Program trial who had six PFAS quantified in plasma at baseline and two years after randomization, as well as measurements of coronary artery calcium (CAC) and ascending (AsAC) and descending (DAC) thoracic aortic calcification 13-14 years after baseline. We performed multinomial regression to test associations between PFAS and CAC categorized according to Agatston score [low (<10), moderate (11-400) and severe (>400)]. We used logistic regression to assess associations between PFAS and presence of AsAC and DAC. We adjusted models for baseline sex, age, BMI, race/ethnicity, cigarette smoking, education, treatment assignment (placebo or lifestyle intervention), and statin use. PFAS concentrations were similar to national means; 53.9% of participants had CAC > 11, 7.7% had AsAC, and 42.6% had DAC. Each doubling of the mean sum of plasma concentrations of linear and branched isomers of perfluorooctane sulfonic acid (PFOS) was associated with 1.49-fold greater odds (95% CI: 1.01, 2.21) of severe versus low CAC. This association was driven mainly by the linear (n-PFOS) isomer [1.54 (95% CI: 1.05, 2.25) greater odds of severe versus low CAC]. Each doubling of mean plasma N-ethyl-perfluorooctane sulfonamido acetic acid concentration was associated with greater odds of CAC in a dose-dependent manner [OR = 1.26 (95% CI:1.08, 1.47) for moderate CAC and OR = 1.37 (95% CI:1.07, 1.74) for severe CAC, compared to low CAC)]. Mean plasma PFOS and n-PFOS were also associated with greater odds of AsAC [OR = 1.67 (95% CI:1.10, 2.54) and OR = 1.70 (95% CI:1.13, 2.56), respectively], but not DAC. Other PFAS were not associated with outcomes. CONCLUSIONS Prediabetic adults with higher plasma concentrations of select PFAS had higher risk of coronary and thoracic aorta calcification. PFAS exposure may be a risk factor for adverse cardiovascular health among high-risk populations.
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Affiliation(s)
- Citlalli Osorio-Yáñez
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico.
| | - Marco Sanchez-Guerra
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico.
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Pi-I D Lin
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ken P Kleinman
- Department of Biostatistics, School of Public Health and Human Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Abby F Fleisch
- Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, USA; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas F Webster
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Edward S Horton
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Averina M, Brox J, Huber S, Furberg AS. Exposure to perfluoroalkyl substances (PFAS) and dyslipidemia, hypertension and obesity in adolescents. The Fit Futures study. ENVIRONMENTAL RESEARCH 2021; 195:110740. [PMID: 33460636 DOI: 10.1016/j.envres.2021.110740] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/16/2020] [Accepted: 01/07/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Prevalence of obesity, hypertension and dyslipidemia has been increasing in children and adolescents worldwide. Exposure to environmental pollutants may contribute to this development. Our aim was to study associations between perfluoroalkyl substances (PFAS) and dyslipidemia, hypertension and obesity in a population-based sample of adolescents. METHODS Serum PFAS concentrations were measured in 940 adolescents, mean age 16.4 (SD 1.3) years, from the cross-sectional Fit Futures study by the UHPLC-MS/MS method. The following endpoints were used: hypertension (systolic blood pressure over 130 mmHg and/or diastolic blood pressure over 80 mmHg); obesity (body mass index over 2 z-score, WHO charts for adolescents); dyslipidemia (total cholesterol ≥ 5.17 mmol/L, and/or LDL-cholesterol ≥ 3.36 mmol/l, and/or apolipoprotein B ≥ 1.10 g/L). RESULTS Perfluorooctane sulfonate (PFOS), perfluorononanoate (PFNA), perfluorodecanoate (PFDA) and perfluoroundecanoate (PFUnDA) serum concentrations were positively associated with apolipoprotein B, total- and LDL cholesterol. The highest vs. lowest quartiles of total PFAS (∑PFAS), PFNA and PFDA concentrations were positively associated with the risk of dyslipidemia: OR 2.24 (95% CI 1.10-4.54), OR 2.30 (95% CI 1.16-4.57) and 2.36 (95% CI 1.08-5.16), respectively. The highest vs. lowest quartiles of ∑PFAS, perfluorohexane sulfonate (PFHxS), PFOS, perfluorooctanoate (PFOA) concentrations were positively associated with the risk of hypertension: OR 1.91 (95% CI 1.12-3.26), OR 2.06 (95% CI 1.16-3.65), 1.86 (95% CI 1.08-3.19) and 2.08 (95% CI 1.17-3.69) respectively. PFHxS and perfluoroheptane sulfonate (PFHpS) concentrations were positively associated with obesity. CONCLUSIONS This cross-sectional study showed a possible link between several PFAS and dyslipidemia, hypertension and obesity in Norwegian adolescents.
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Affiliation(s)
- Maria Averina
- Department of Laboratory Medicine, University Hospital of North Norway, 9038, Tromsø, Norway; Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
| | - Jan Brox
- Department of Laboratory Medicine, University Hospital of North Norway, 9038, Tromsø, Norway
| | - Sandra Huber
- Department of Laboratory Medicine, University Hospital of North Norway, 9038, Tromsø, Norway
| | - Anne-Sofie Furberg
- Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway; Faculty of Health and Social Sciences, Molde University College, Molde, Norway
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Durmus N, Pehlivan S, Zhang Y, Shao Y, Arslan AA, Corona R, Henderson I, Sterman DH, Reibman J. Lung Cancer Characteristics in the World Trade Center Environmental Health Center. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2689. [PMID: 33800009 PMCID: PMC7967411 DOI: 10.3390/ijerph18052689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 12/16/2022]
Abstract
The destruction of the World Trade Center (WTC) towers on 11 September 2001 resulted in acute and chronic dust and fume exposures to community members, including local workers and residents, with well-described aerodigestive adverse health effects. This study aimed to characterize lung cancer in the WTC Environmental Health Center (WTC EHC) focusing on gender and smoking history. WTC EHC patients undergo an initial evaluation that includes WTC exposure information, demographics, and tobacco use. Detailed cancer characteristics are recorded from pathology reports. As of 31 December 2019, 248 WTC EHC patients had a diagnosis of lung cancer. More patients with lung cancer were women (57%) compared to men (43%). Many cases (47% women, 51% men) reported acute dust cloud exposure. Thirty-seven percent of lung cancer cases with available smoking history were never-smokers (≤1 pack-years) and 42% had a ≤5 pack-year history. The median age of cancer diagnosis in never-smoking women was 61 years compared to 66 years in men. Adenocarcinoma was more common in never-smokers compared to ever-smokers (72% vs. 65%) and in women compared to men (70% vs. 65%). We provide an initial description of lung cancers in local community members with documented exposure to the WTC dust and fumes.
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Affiliation(s)
- Nedim Durmus
- Department of Medicine, Division of Pulmonary Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA; (N.D.); (S.P.); (I.H.); (D.H.S.)
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (Y.Z.); (Y.S.); (A.A.A.); (R.C.)
| | - Sultan Pehlivan
- Department of Medicine, Division of Pulmonary Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA; (N.D.); (S.P.); (I.H.); (D.H.S.)
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (Y.Z.); (Y.S.); (A.A.A.); (R.C.)
| | - Yian Zhang
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (Y.Z.); (Y.S.); (A.A.A.); (R.C.)
- Department of Population Health, Division of Biostatistics, School of Medicine (SOM), New York University, New York, NY 10016, USA
| | - Yongzhao Shao
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (Y.Z.); (Y.S.); (A.A.A.); (R.C.)
- Department of Population Health, Division of Biostatistics, School of Medicine (SOM), New York University, New York, NY 10016, USA
- Department of Environmental Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
| | - Alan A. Arslan
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (Y.Z.); (Y.S.); (A.A.A.); (R.C.)
- Department of Population Health, Division of Biostatistics, School of Medicine (SOM), New York University, New York, NY 10016, USA
- Department of Environmental Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
- Department of Obstetrics and Gynecology, School of Medicine (SOM), New York University, New York, NY 10016, USA
| | - Rachel Corona
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (Y.Z.); (Y.S.); (A.A.A.); (R.C.)
| | - Ian Henderson
- Department of Medicine, Division of Pulmonary Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA; (N.D.); (S.P.); (I.H.); (D.H.S.)
| | - Daniel H. Sterman
- Department of Medicine, Division of Pulmonary Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA; (N.D.); (S.P.); (I.H.); (D.H.S.)
| | - Joan Reibman
- Department of Medicine, Division of Pulmonary Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA; (N.D.); (S.P.); (I.H.); (D.H.S.)
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (Y.Z.); (Y.S.); (A.A.A.); (R.C.)
- Department of Environmental Medicine, School of Medicine (SOM), New York University, New York, NY 10016, USA
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Fenton SE, Ducatman A, Boobis A, DeWitt JC, Lau C, Ng C, Smith JS, Roberts SM. Per- and Polyfluoroalkyl Substance Toxicity and Human Health Review: Current State of Knowledge and Strategies for Informing Future Research. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2021; 40:606-630. [PMID: 33017053 PMCID: PMC7906952 DOI: 10.1002/etc.4890] [Citation(s) in RCA: 694] [Impact Index Per Article: 231.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/29/2020] [Accepted: 09/20/2020] [Indexed: 01/09/2023]
Abstract
Reports of environmental and human health impacts of per- and polyfluoroalkyl substances (PFAS) have greatly increased in the peer-reviewed literature. The goals of the present review are to assess the state of the science regarding toxicological effects of PFAS and to develop strategies for advancing knowledge on the health effects of this large family of chemicals. Currently, much of the toxicity data available for PFAS are for a handful of chemicals, primarily legacy PFAS such as perfluorooctanoic acid and perfluorooctane sulfonate. Epidemiological studies have revealed associations between exposure to specific PFAS and a variety of health effects, including altered immune and thyroid function, liver disease, lipid and insulin dysregulation, kidney disease, adverse reproductive and developmental outcomes, and cancer. Concordance with experimental animal data exists for many of these effects. However, information on modes of action and adverse outcome pathways must be expanded, and profound differences in PFAS toxicokinetic properties must be considered in understanding differences in responses between the sexes and among species and life stages. With many health effects noted for a relatively few example compounds and hundreds of other PFAS in commerce lacking toxicity data, more contemporary and high-throughput approaches such as read-across, molecular dynamics, and protein modeling are proposed to accelerate the development of toxicity information on emerging and legacy PFAS, individually and as mixtures. In addition, an appropriate degree of precaution, given what is already known from the PFAS examples noted, may be needed to protect human health. Environ Toxicol Chem 2021;40:606-630. © 2020 SETAC.
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Affiliation(s)
- Suzanne E. Fenton
- National Toxicology Program Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Alan Ducatman
- West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - Alan Boobis
- Imperial College London, London, United Kingdom
| | - Jamie C. DeWitt
- Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Christopher Lau
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Carla Ng
- Departments of Civil and Environmental Engineering and Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James S. Smith
- Navy and Marine Corps Public Health Center, Portsmouth, Virginia, USA
| | - Stephen M. Roberts
- Center for Environmental & Human Toxicology, University of Florida, Gainesville, Florida, USA
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Shao Y, Durmus N, Zhang Y, Pehlivan S, Fernandez-Beros ME, Umana L, Corona R, Addessi A, Abbott SA, Smyth-Giambanco S, Arslan AA, Reibman J. The Development of a WTC Environmental Health Center Pan-Cancer Database. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041646. [PMID: 33572220 PMCID: PMC7916067 DOI: 10.3390/ijerph18041646] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/23/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022]
Abstract
(1) Background: Recent studies have reported elevated risks of multiple cancers in the World Trade Center (WTC) affected community members (also called WTC “Survivors”). The large variety of WTC-cancers created a need to develop a comprehensive cancer database. This paper describes the development of a pan-cancer database at the WTC Environmental Health Center (EHC) Data Center. (2) Methods: A new REDCap-based pan-cancer database was created using the pathology reports and available biomarker data of confirmed cancer cases after review by a cancer epidemiologist, a pathologist, physicians and biostatisticians. (3) Results: The WTC EHC pan-cancer database contains cancer characteristics and emerging biomarker information for cancers of individuals enrolled in the WTC EHC and diagnosed after 11 September 2001 and up to 31 December 2019 obtained from WTC EHC clinical records, pathological reports and state cancer registries. As of 31 December 2019, the database included 3440 cancer cases with cancer characteristics and biomarker information. (4) Conclusions: This evolving database represents an important resource for the scientific community facilitating future research about the etiology, heterogeneity, characteristics and outcomes of cancers and comorbid mental health conditions, cancer economics and gene–environment interaction in the unique population of WTC survivors.
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Affiliation(s)
- Yongzhao Shao
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine (NYUGSOM), New York University, New York, NY 10016, USA; (Y.Z.); (A.A.A.)
- Department of Environmental Medicine, NYUG-SOM, New York University, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
- Correspondence: (Y.S.); (J.R.)
| | - Nedim Durmus
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Yian Zhang
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine (NYUGSOM), New York University, New York, NY 10016, USA; (Y.Z.); (A.A.A.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Sultan Pehlivan
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Maria-Elena Fernandez-Beros
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Lisette Umana
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Rachel Corona
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Adrienne Addessi
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Sharon A. Abbott
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Sheila Smyth-Giambanco
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Alan A. Arslan
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine (NYUGSOM), New York University, New York, NY 10016, USA; (Y.Z.); (A.A.A.)
- Department of Environmental Medicine, NYUG-SOM, New York University, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
- Department of Obstetrics and Gynecology, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Joan Reibman
- Department of Environmental Medicine, NYUG-SOM, New York University, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
- Correspondence: (Y.S.); (J.R.)
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Meneguzzi A, Fava C, Castelli M, Minuz P. Exposure to Perfluoroalkyl Chemicals and Cardiovascular Disease: Experimental and Epidemiological Evidence. Front Endocrinol (Lausanne) 2021; 12:706352. [PMID: 34305819 PMCID: PMC8298860 DOI: 10.3389/fendo.2021.706352] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/28/2021] [Indexed: 01/06/2023] Open
Abstract
Polyfluoro- and perfluoro-alkyl substances (PFAS) are organic chemicals extensively used worldwide for industry and consumer products. Due to their chemical stability, PFAS represent a major cause of environmental pollution. PFAS accumulate in animal and human blood and tissues exerting their toxicity. We performed a review of the epidemiological studies exploring the relationship between exposure to PFAS and thromboembolic cardiovascular disease. An increase in cardiovascular disease or death related to PFAS exposure has been reported from cross-sectional and longitudinal observational studies with evidence concerning the relation with early vascular lesions and atherosclerosis. Several studies indicate an alteration in lipid and glucose metabolism disorders and increased blood pressure as a possible link with cardiovascular thromboembolic events. We also examined the recent evidence indicating that legacy and new PFAS can be incorporated in platelet cell membranes giving a solid rationale to the observed increase risk of cardiovascular events in the populations exposed to PFAS by directly promoting thrombus formation. Exposure to PFAS has been related to altered plasma membrane fluidity and associated with altered calcium signal and increased platelet response to agonists, both in vitro and ex vivo in subjects exposed to PFAS. All the functional responses are increased in platelets by incorporation of PFAS: adhesion, aggregation, microvesicles release and experimental thrombus formation. These findings offer mechanistic support the hypothesis that platelet-centred mechanisms may be implicated in the increase in cardiovascular events observed in populations chronically exposed to PFAS.
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World Trade Center Health Program: First Decade of Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197290. [PMID: 33036199 PMCID: PMC7579473 DOI: 10.3390/ijerph17197290] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022]
Abstract
The terrorist attacks on 11 September 2001 placed nearly a half million people at increased risk of adverse health. Health effects research began shortly after and continues today, now mostly as a coordinated effort under the federally mandated World Trade Center (WTC) Health Program (WTCHP). Established in 2011, the WTCHP provides medical monitoring and treatment of covered health conditions for responders and survivors and maintains a research program aimed to improve the care and well-being of the affected population. By 2020, funds in excess of USD 127 M had been awarded for health effects research. This review describes research findings and provides an overview of the WTCHP and its future directions. The literature was systematically searched for relevant articles published from 11 September 2001 through 30 June 2020. Synthesis was limited to broad categories of mental health, cancer, respiratory disease, vulnerable populations, and emerging conditions. In total, 944 WTC articles were published, including peer-reviewed articles funded by the WTCHP (n = 291) and other sources. Research has focused on characterizing the burden and etiology of WTC-related health conditions. As the program moves forward, translational research that directly enhances the care of individuals with chronic mental and physical health conditions is needed.
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Qi W, Clark JM, Timme-Laragy AR, Park Y. Per- and Polyfluoroalkyl Substances and Obesity, Type 2 Diabetes and Non-alcoholic Fatty Liver Disease: A Review of Epidemiologic Findings. TOXICOLOGICAL AND ENVIRONMENTAL CHEMISTRY 2020; 102:1-36. [PMID: 33304027 PMCID: PMC7723340 DOI: 10.1080/02772248.2020.1763997] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/27/2020] [Indexed: 05/17/2023]
Abstract
Per- and polyfluoroalkyl substances, a group of fluoro-surfactants widely detected in the environment, wildlife and humans, have been linked to adverse health effects. A growing body of literature has addressed their effects on obesity, diabetes and non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis. This review summarizes the brief historical use and chemistry of per- and polyfluoroalkyl substances, routes of human exposure, as well as the epidemiologic evidence for associations between exposure to per- and polyfluoroalkyl substances and the development of obesity, diabetes and non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis. We identified 22 studies on obesity and 32 studies on diabetes, while only 1 study was found for non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis by searching PubMed for human studies. Approximately 2/3 of studies reported positive associations between per- and polyfluoroalkyl substances exposure and the prevalence of obesity and/or type 2 diabetes. Causal links between per- and polyfluoroalkyl substances and obesity, diabetes and non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis, however, require further large-scale prospective cohort studies combined with mechanistic laboratory studies to better assess these associations.
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Affiliation(s)
- Weipeng Qi
- Department of Food Science, University of Massachusetts, Amherst, MA, 01003, United States
| | - John M. Clark
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, MA, 01003, United States
| | - Alicia R. Timme-Laragy
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA, 01003, United States
| | - Yeonhwa Park
- Department of Food Science, University of Massachusetts, Amherst, MA, 01003, United States
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Spratlen MJ, Perera FP, Lederman SA, Robinson M, Kannan K, Herbstman J, Trasande L. The Association Between Perfluoroalkyl Substances and Lipids in Cord Blood. J Clin Endocrinol Metab 2020; 105:5571855. [PMID: 31536623 PMCID: PMC6936966 DOI: 10.1210/clinem/dgz024] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/26/2019] [Accepted: 09/17/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Perfluoroalkyl substances (PFAS) were among various persistent organic pollutants suspected to have been released during the collapse of the World Trade Center (WTC) on 9/11/2001. Evidence suggests that PFAS may have cardiometabolic effects, including alterations in lipid profiles. This study evaluated the association between cord blood PFAS and lipids in a population prenatally exposed to the WTC disaster. STUDY POPULATION 222 pregnant women in the Columbia University WTC birth cohort enrolled between December 13, 2001 and June 26, 2002 at hospitals located near the WTC site: Beth Israel, St. Vincent's, and New York University Downtown. METHODS We evaluated the association between 5 cord blood PFAS-perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorodecane sulfonate (PFDS)-and cord blood lipids (total lipids, total cholesterol, triglycerides). RESULTS Median (interquartile range [IQR]) concentrations of PFAS were 6.32 (4.58-8.57), 2.46 (1.77-3.24), 0.38 (0.25-0.74), 0.66 (0.48-0.95) and 0.11 (0.09-0.16) ng/mL for PFOS, PFOA, PFNA, PFHxS, and PFDS, respectively. Median (IQR) for lipids were 59.0 (51.5-68.5) mg/dL for total cholesterol, 196.5 (170.5-221.2) mg/dL for total lipids and 33.1 (24.2-43.9) mg/dL for triglycerides. In fully adjusted models, several PFAS were associated with higher lipid levels, including evidence of a strong linear trend between triglycerides and both PFOA and PFHxS. CONCLUSIONS Findings support previous evidence of an association between PFAS exposure and altered lipid profiles and add novel information on this relationship in cord blood, as well as for an understudied PFAS, PFDS (J Clin Endocrinol Metab XX: 0-0, 2019).
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Affiliation(s)
- Miranda J Spratlen
- Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
- Correspondence: Miranda J. Spratlen, Department of Environmental Health Sciences, Columbia University, 122 W 168th, Room 1105, New York, NY 10032. E-mail:
| | - Frederica P Perera
- Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Sally Ann Lederman
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York
| | - Morgan Robinson
- Wadsworth Center, New York State Department of Health, Albany, New York
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, Albany, New York
- Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York
| | - Julie Herbstman
- Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York, New York
- Department of Environmental Medicine, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
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Duan Y, Sun H, Yao Y, Meng Y, Li Y. Distribution of novel and legacy per-/polyfluoroalkyl substances in serum and its associations with two glycemic biomarkers among Chinese adult men and women with normal blood glucose levels. ENVIRONMENT INTERNATIONAL 2020; 134:105295. [PMID: 31726357 DOI: 10.1016/j.envint.2019.105295] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/06/2019] [Accepted: 10/28/2019] [Indexed: 05/23/2023]
Abstract
In recent years, the occurrence of novel per-/polyfluoroalkyl substances (PFASs) such as polyfluoroalkyl ether sulfonates (PFAESs) in human samples have aroused attention due to the change in PFASs production profile, however, the data are still lacking. Furthermore, epidemiological studies have examined the associations of PFAS exposure with glucose homeostasis, but with inconsistent results. Therefore, in this study, fasting serum samples from 252 participants with an age range from 19 to 87 years old were collected in Tianjin, China. A total of 21 target PFASs were determined to analyze the levels and distribution of novel and legacy PFASs in serum and to further evaluate the cross-sectional associations of serum PFAS concentrations with two glycemic biomarkers (i.e., fasting glucose and glycated hemoglobin (HbA1c)). 6:2 chlorinated PFAES (6:2 Cl-PFAES) and trifluoroacetic acid (TFA) were widely detected novel PFASs (greater than90%) with relatively high median concentrations (8.64 ng/mL and 8.46 ng/mL, respectively), which were second only to the two dominant legacy PFASs, i.e., perfluorooctanoic acid (PFOA, 14.83 ng/mL) and perfluorooctane sulfonic acid (14.24 ng/mL). The percentage contributions to the total known PFASs were separately 17.6% and 17.2% for 6:2 Cl-PFAES and TFA. The levels of 6:2 Cl-PFAES were significantly correlated with age and BMI, and the concentrations of TFA were also significantly correlated with age. Furthermore, 1% increase in serum PFOA and perfluorononanoic acid (PFNA) was separately significantly associated with 0.018% [95% confidence interval (CI): 0.004%, 0.033%] and 0.022% (95% CI: 0.007%, 0.037%) increment in fasting glucose levels. Similarly, 1% increase in serum perfluorohexanoic acid, PFNA, and perfluorohexane sulfonic acid was significantly associated with 0.030% (95% CI: 0.010%, 0.051%), 0.018% (95% CI: 0.003%, 0.033%), 0.007% (95% CI: 0.003%, 0.011%) increment in HbA1c levels, respectively. These findings suggested that 6:2 Cl-PFAES and TFA showed greater contributions to PFASs in serum and supported an association of exposure to PFASs with fasting glucose and HbA1c.
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Affiliation(s)
- Yishuang Duan
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China; Institute of Environment and Health, Jianghan University, Wuhan, China
| | - Hongwen Sun
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China.
| | - Yiming Yao
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Yue Meng
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
| | - Yongcheng Li
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, China
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Anderko L, Pennea E, Chalupka S. Per- and Polyfluoroalkyl Substances: An Emerging Contaminant of Concern. ANNUAL REVIEW OF NURSING RESEARCH 2019; 38:159-182. [PMID: 32102961 DOI: 10.1891/0739-6686.38.159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Concerns about the health impacts from per- and polyfluoroalkyl substances (PFAS) continue to grow as the science continues to emerge associating this chemical family with a wide range of health impacts. PFAS exposure may affect growth, learning, and behavior of infants and older children, and also impact reproductive health, cardiovascular health, and the immune system. PFAS exposure is widespread, with communities surrounding military bases at potentially greater risk of exposure from the use of fire fighting foam that may have entered the drinking water. As trusted health professionals, nurses have been in the frontlines communicating risks regarding PFAS to impacted communities. This chapter describes a large number of PFAS studies in blood and harmful health effects in people. The chapter discusses primary sources of exposure and risk reduction. It explains health advisory levels, minimal risk levels. The chapter provides medical testing and medical management.
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Fassler CS, Pinney SE, Xie C, Biro FM, Pinney SM. Complex relationships between perfluorooctanoate, body mass index, insulin resistance and serum lipids in young girls. ENVIRONMENTAL RESEARCH 2019; 176:108558. [PMID: 31271921 PMCID: PMC6739842 DOI: 10.1016/j.envres.2019.108558] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/17/2019] [Accepted: 06/24/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Perfluorooctanoate (PFOA) has been used extensively in the manufacture of both commercial and household products. PFOA serum concentrations have been associated with adverse health effects, including lower body mass in children and infants. OBJECTIVE To determine if there is an association between serum PFOA concentration and body mass, serum insulin and lipid profile in exposed young girls. METHODS We conducted a cross-sectional study of PFAS environmental biomarkers and insulin resistance in 6 to 8 year-old girls from Greater Cincinnati (n=353). In 2004-2006, blood samples were obtained to measure polyfluoroalkyl substances (PFAS), fasting insulin, glucose and lipids. Clinical exams included anthropometric measurements and pubertal maturation staging. Linear regression and mediation analyses, specifically structural equation modeling (SEM), were used to determine the strength and direction of the relationships between PFAS, pubertal maturation status, body mass index (BMI), cholesterol and insulin resistance. RESULTS The median PFOA (7.7ng/ml) was twice the National Health and Nutrition Examination Survey (2005-2006). Only PFOA, a PFAS sub-species, showed statistically significant relationships with the outcomes. In regression models, PFOA was associated with decreased BMI and waist-to-height ratio (p=0.0008; p=0.0343), HDL-cholesterol (p=0.0046) and had a borderline inverse association with the HOMA Index of insulin resistance (p=0.0864). In SEM, PFOA retained an inverse relationship with BMI (p<0.0001) but the relationships with HOMA and HDL-cholesterol were no longer statistically significant. Pubertal initiation (Tanner breast or pubic stage 2 or greater) and BMI were associated with increased HOMA Index (p<0.0001). CONCLUSIONS These findings suggest PFOA exposure in young girls affects both BMI and ultimately insulin resistance. In mediation analysis with puberty in the model, the direct effects of PFOA on insulin resistance and were reduced.
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Affiliation(s)
- Cecily S Fassler
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH, USA.
| | - Sara E Pinney
- Children's Hospital of Philadelphia, Philadelphia, PA, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Changchun Xie
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH, USA.
| | - Frank M Biro
- Cincinnati Children's Hospital Medical Center, Division of Adolescent Medicine, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Department of Pediatrics, USA.
| | - Susan M Pinney
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH, USA.
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Gaylord A, Berger KI, Naidu M, Attina TM, Gilbert J, Koshy TT, Han X, Marmor M, Shao Y, Giusti R, Goldring RM, Kannan K, Trasande L. Serum perfluoroalkyl substances and lung function in adolescents exposed to the World Trade Center disaster. ENVIRONMENTAL RESEARCH 2019; 172:266-272. [PMID: 30822559 PMCID: PMC8336627 DOI: 10.1016/j.envres.2019.02.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/12/2019] [Accepted: 02/15/2019] [Indexed: 05/04/2023]
Abstract
The effects of childhood exposure to perfluoroalkyl substances (PFASs) on lung function remain mostly unknown. Previous research indicates that children living or going to school near the World Trade Center (WTC) disaster were exposed to high levels of PFASs, among other toxic chemicals. To explore the effects of PFAS exposure on lung function, we measured serum PFASs in a cohort of children from the WTC Health Registry and a matched control group. Perfluorooctanesulfonate had the highest median concentrations in both groups (WTCHR = 3.72 ng/mL, Comparison = 2.75 ng/mL), while the lowest median concentrations were seen for perfluoroundecanoic acid (WTCHR = 0.12 ng/mL, Comparison = 0.01 ng/mL). Lung function outcomes were measured by spirometry, plethysmography, and oscillometry. Asthma diagnosis and serum eosinophil count were also recorded. We examined the relationships of each PFAS with lung function parameters and eosinophil count using linear regressions. Odds ratios for asthma were obtained for each PFAS using logistic regression. The effect of total PFASs on these outcomes was also assessed. All regression models were adjusted for sex, race/ethnicity, age, body mass index (BMI) and tobacco smoke exposure. We found that serum PFASs were not statistically associated with the measured lung function parameters, asthma diagnosis, or eosinophil count in this cohort (p < 0.05). These findings highlight the need for more longitudinal studies to explore the long-term effects of childhood PFAS exposure on lung function past adolescence and early adulthood.
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Affiliation(s)
- Abigail Gaylord
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Kenneth I Berger
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Mrudula Naidu
- Departments of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Teresa M Attina
- Departments of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Joseph Gilbert
- Departments of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Tony T Koshy
- Departments of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Xiaoxia Han
- Public Health Sciences Department, Henry Ford Health System, Detroit, MI, USA
| | - Michael Marmor
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Yongzhao Shao
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Robert Giusti
- Departments of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Roberta M Goldring
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | | | - Leonardo Trasande
- Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Medicine, New York University School of Medicine, New York, NY, USA; Departments of Pediatrics, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; NYU College of Global Public Health, New York, NY, USA.
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Sunderland EM, Hu XC, Dassuncao C, Tokranov AK, Wagner CC, Allen JG. A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:131-147. [PMID: 30470793 PMCID: PMC6380916 DOI: 10.1038/s41370-018-0094-1] [Citation(s) in RCA: 1098] [Impact Index Per Article: 219.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/15/2018] [Accepted: 10/19/2018] [Indexed: 05/18/2023]
Abstract
Here, we review present understanding of sources and trends in human exposure to poly- and perfluoroalkyl substances (PFASs) and epidemiologic evidence for impacts on cancer, immune function, metabolic outcomes, and neurodevelopment. More than 4000 PFASs have been manufactured by humans and hundreds have been detected in environmental samples. Direct exposures due to use in products can be quickly phased out by shifts in chemical production but exposures driven by PFAS accumulation in the ocean and marine food chains and contamination of groundwater persist over long timescales. Serum concentrations of legacy PFASs in humans are declining globally but total exposures to newer PFASs and precursor compounds have not been well characterized. Human exposures to legacy PFASs from seafood and drinking water are stable or increasing in many regions, suggesting observed declines reflect phase-outs in legacy PFAS use in consumer products. Many regions globally are continuing to discover PFAS contaminated sites from aqueous film forming foam (AFFF) use, particularly next to airports and military bases. Exposures from food packaging and indoor environments are uncertain due to a rapidly changing chemical landscape where legacy PFASs have been replaced by diverse precursors and custom molecules that are difficult to detect. Multiple studies find significant associations between PFAS exposure and adverse immune outcomes in children. Dyslipidemia is the strongest metabolic outcome associated with PFAS exposure. Evidence for cancer is limited to manufacturing locations with extremely high exposures and insufficient data are available to characterize impacts of PFAS exposures on neurodevelopment. Preliminary evidence suggests significant health effects associated with exposures to emerging PFASs. Lessons learned from legacy PFASs indicate that limited data should not be used as a justification to delay risk mitigation actions for replacement PFASs.
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Affiliation(s)
- Elsie M Sunderland
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.
| | - Xindi C Hu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
| | - Clifton Dassuncao
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
| | - Andrea K Tokranov
- Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
| | - Charlotte C Wagner
- Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA
| | - Joseph G Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Jain RB. Synergistic impact of co-exposures to toxic metals cadmium, lead, and mercury along with perfluoroalkyl substances on the healthy kidney function. ENVIRONMENTAL RESEARCH 2019; 169:342-347. [PMID: 30504076 DOI: 10.1016/j.envres.2018.11.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 06/09/2023]
Abstract
Impact of co-exposures to toxic metals cadmium, lead, and mercury along with perfluoroalkyl substances on the healthy kidney function was evaluated among US adults aged > = 20 years by analyzing data (N = 7857) from National Health and Nutrition Examination Survey for 2003-2014. Perfluoroalkyl substances selected for analysis were: perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). High levels of exposures to Cd, Pb, total Hg, and PFAS were said to occur if their observed levels in blood/serum were greater than 75th percentiles. A healthy kidney function was defined if estimated glomerular filtration rate was found to be > = 60 mL/min/1.73 m2 and urine albumin creatinine ratio was ≤ 30 mg/g creatinine. Adjusted odds of a healthy kidney function due to co-exposures to high levels of Cd along with high levels of PFOA, PFOS, and PFNA were found to be 0.713, 0.576, and 0.640 respectively. Adjusted odds of a healthy kidney function due to co-exposures to high levels of Pb along with high levels of PFOA, and PFNA were found to be 0.657, and 0.671 respectively. Co-exposures to high levels of Hg as measured by the total mercury in blood was not found to affect the odds of a healthy kidney function.
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Affiliation(s)
- Ram B Jain
- 2959 Estate View Ct, Dacula, GA 30019, USA
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Jain RB. Time trends over 2003-2014 in the concentrations of selected perfluoroalkyl substances among US adults aged ≥20 years: Interpretational issues. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 645:946-957. [PMID: 30248883 DOI: 10.1016/j.scitotenv.2018.07.198] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/13/2018] [Accepted: 07/15/2018] [Indexed: 05/28/2023]
Abstract
Data (N = 9650) for US adults aged ≥20 years downloaded from National Health and Nutrition Examination Survey for 2003-2014 were analyzed to study trends in adjusted and unadjusted concentrations of selected perfluoroalkyl substances (PFAS), namely, perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorodecanoic acid (PFDA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). Over 2003-2014, unadjusted concentrations of PFOA decreased by 50%, by 75% for PFOS, by 32% for PFDA, by 27% for PFHxS, and by 30% for PFNA. Females not only had substantially lower concentrations of every PFAS than males but rate of decrease was also higher for females than males, for example, 36.7% for females and 30.6% for males every two years for PFOS. For each survey period of two years, percent decrease in adjusted concentrations was 17% for PFOA, 33.5% for PFOS, 11.5% for PFDA, 6.3% for PFHxS, and 7.6% for PFNA. However, these trend data must be examined within the context of design changes in NHANES over 2003-2014 resulting in oversampling of Hispanics other than Mexican Americans starting 2007-2008 survey cycle and oversampling of non-Hispanic Asians starting 2011-2012 survey cycle. In order to examine how design changes may have affected computations of adjusted and unadjusted concentrations, the data were analyzed using the racial/ethnic categories prior to and after oversampling of Hispanics other than Mexican Americans and non-Hispanic Asians was put into place.
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Affiliation(s)
- Ram B Jain
- 2959 Estate View Court, Dacula, GA 30019, USA.
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Roles of gender and obesity in defining correlations between perfluoroalkyl substances and lipid/lipoproteins. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 653:74-81. [PMID: 30408670 DOI: 10.1016/j.scitotenv.2018.10.362] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/06/2018] [Accepted: 10/27/2018] [Indexed: 01/09/2023]
Abstract
Data from National Health and Nutrition Examination Survey (NHANES) for 2005-2014 for those aged ≥20 years fasting for ≥8 h (N = 3629) were analyzed to evaluate the role that gender and obesity play in defining correlations between selected perfluoroalkyl substances (PFAS) and total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), and triglycerides. PFAS considered for analyses were: perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorodecanoic acid (PFDA), perfluorononanoic acid (PFNA), perfluorohexane sulfonate (PFHxS), perfluoroundecanoic acid (PFUnDA), and 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (Me-FOSAA). Gender and obesity stratified regression models were fitted to estimate associations between PFAS and lipid/lipoproteins with adjustments made for confounders. For obese males, but not for nonobese males, positive associations were found between TC and LDL with PFOA (β = 0.0519, p = 0.01 for TC and β = 0.0822, p = 0.03 for LDL), and PFNA (β = 0.0328, p = 0.03 for TC and β = 0.0679, p = 0.04 for LDL). For obese females, adjusted concentrations of TC increased with increase in the concentrations of PFDA (β = 0.0247, p = 0.048), PFNA (β = 0.0286, p = 0.04), and Me-PFOSAA (β = 0.0274, p = 0.02), and there was a positive association of LDL with PFOS (β = 0.0375, p = 0.04), PFDA (β = 0.0397, p = 0.047), and PFNA (β = 0.0593, p = 0.02). The findings, concerning the relationship of longer chain PFAS to serum lipids, suggest greater susceptibility to elevated TC and LDL cholesterol in the obese participants, with some differences between men and women. The key contributing modifiable risk for nonalcoholic steatosis is obesity, and, the development of nonalcoholic steatosis is recognized to be sexually dimorphic. The epidemiologic observation of a susceptible obese subgroup in our data is consistent with toxicology literature findings of disrupted cholesterol metabolism via induced steatosis following PFAS exposure. Gender differences affect serum concentration of PFAS during the reproductive years, and our data add a secondary question concerning whether they also affect the interaction between PFAS exposure and lipid handling in males and females.
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