Longitudinal trends of per- and polyfluoroalkyl substances in children's serum

Evidence on the genotoxic and ecotoxic effects of PFOA, PFOS and their mixture on human lymphocytes and bacteria

Considering that the PFOA and PFOS are widely spread chemicals with harmful effects in human and environmental health as well as the increasing interest of the scientific community in the implications that might present especially when they co-exist, this study aims to assess their harmful impacts, both individually and as a mixture on human lymphocytes and aquatic microorganisms. The cytokinesis-block micronucleus (CBMN) assay was used to examine their potential for cytotoxicity and genotoxicity towards human cells, and Microtox assay using Aliivibrio fischeri assay was used to estimate the environmental risk. Regarding the human lymphocytes, the tested concentrations ranged between 250 and 1000 μg L-1, for all cases. PFOA increased slightly the frequency of micronuclei (MN) but without statistical significance. In the case of PFOS, our results showed a dose-dependent increase in the frequency of micronuclei which showed a statistically significant difference (p < 0.001) at 1000 μg L-1, which is the highest studied concentration. Regarding the CBPI index, statistically significant (p < 0.05, p < 0.01, and p < 0.001 respectively) differences were observed at all studied concentrations of PFOS, compared to the control. The mixture was found to be more cytotoxic and genotoxic than the individual tested compounds, causing a higher decrease at the CBPI index even in lower concentrations and increase at the MN frequencies. Aliivibrio fischeri was exposed to various concentrations in the range of 0.5 μg L-1- 20 mg L-1, for 5 and 15 min and significant increase in the inhibition percentage at the highest tested concentration of their mixture after 15 min was observed.

Estimating the dynamic early life exposure to PFOA and PFOS of the HELIX children: Emerging profiles via prenatal exposure, breastfeeding, and diet

In utero and children's exposure to per- and polyfluoroalkyl substances (PFAS) is a major concern in health risk assessment as early life exposures are suspected to induce adverse health effects. Our work aims to estimate children's exposure (from birth to 12 years old) to PFOA and PFOS, using a Physiologically-Based Pharmacokinetic (PBPK) modelling approach. A model for PFAS was updated to simulate the internal PFAS exposures during the in utero life and childhood, and including individual characteristics and exposure scenarios (e.g., duration of breastfeeding, weight at birth, etc.). Our approach was applied to the HELIX cohort, involving 1,239 mother-child pairs with measured PFOA and PFOS plasma concentrations at two sampling times: maternal and child plasma concentrations (6 to 12 y.o). Our model predicted an increase in plasma concentrations during fetal development and childhood until 2 y.o when the maximum concentrations were reached. Higher plasma concentrations of PFOA than PFOS were predicted until 2 y.o, and then PFOS concentrations gradually became higher than PFOA concentrations. From 2 to 8 y.o, mean concentrations decreased from 3.1 to 1.88 µg/L or ng/mL (PFOA) and from 4.77 to 3.56 µg/L (PFOS). The concentration-time profiles vary with the age and were mostly influenced by in utero exposure (on the first 4 months after birth), breastfeeding (from 5 months to 2 (PFOA) or 5 (PFOS) y.o of the children), and food intake (after 3 (PFOA) or 6 (PFOS) y.o of the children). Similar measured biomarker levels can correspond to large differences in the simulated internal exposures, highlighting the importance to investigate the children's exposure over the early life to improve exposure classification. Our approach demonstrates the possibility to simulate individual internal exposures using PBPK models when measured biomarkers are scarce, helping risk assessors in gaining insight into internal exposure during critical windows, such as early life.

Per- and Polyfluoroalkyl Substances (PFAS) in Serum of 2 to 5 year-Old Children: Temporal Trends, Determinants, and Correlations with Maternal PFAS Concentrations

Young children may experience higher per- and polyfluoroalkyl substances (PFAS) exposure than adults due to breastfeeding, higher dust ingestion rates, and frequent hand-to-mouth activities. We explored temporal trends and determinants of child serum PFAS concentrations and their correlations with paired maternal PFAS concentrations. From 2009 to 2017, we collected one blood sample from each of 541 children aged 2-5 years participating in the Childhood Autism Risks from Genetics and Environment (CHARGE) study and quantified 14 PFAS in serum. For nine frequently detected PFAS (>65% of samples), we performed multiple regression adjusting for potential determinants to estimate mean percent concentration changes. For a subset of 327 children, we also quantified nine PFAS in their mother's serum collected at the same visit and computed Spearman correlation coefficients (rsp) between maternal and child PFAS concentrations. During 2009-2017, child serum concentrations of all nine PFAS decreased by 6-25% annually. Several PFAS concentrations were higher among non-Hispanic white children and those with highly educated parents. Most maternal and child PFAS concentrations were moderately correlated (rsp = 0.13-0.39), with a strong correlation for N-methyl perfluorooctane sulfonamido acetic acid (rsp = 0.68). Breastfeeding duration appeared to contribute to higher child and lower maternal PFAS concentrations, resulting in relatively weak correlations between maternal and child PFAS concentrations for samples collected in early childhood. Considering that more than half of our study children had neurodevelopmental concerns, the generalizability of our findings might be limited.

Concentrations and association between exposure to mixed perfluoroalkyl and polyfluoroalkyl substances and glycometabolism among adolescents

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.

Prenatal and childhood exposure to per-/polyfluoroalkyl substances (PFASs) and its associations with childhood overweight and/or obesity: a systematic review with meta-analyses

BACKGROUND

Per-/polyfluoroalkyl substances (PFASs) are persistent organic pollutants and suspected endocrine disruptors.

OBJECTIVE

The aim of this work was to conduct a systematic review with meta-analysis to summarise the associations between prenatal or childhood exposure to PFASs and childhood overweight/obesity.

METHODS

The search was performed on the bibliographic databases PubMed and Embase with text strings containing terms related to prenatal, breastfeeding, childhood, overweight, obesity, and PFASs. Only papers describing a biomonitoring study in pregnant women or in children up to 18 years that assessed body mass index (BMI), waist circumference (WC), or fat mass in children were included. When the estimates of the association between a PFAS and an outcome were reported from at least 3 studies, a meta-analysis was conducted; moreover, to correctly compare the studies, we developed a method to convert the different effect estimates and made them comparable each other. Meta-analyses were performed also stratifying by sex and age, and sensitivity analyses were also performed.

RESULTS

In total, 484 and 779 articles were retrieved from PubMed and Embase, respectively, resulting in a total of 826 articles after merging duplicates. The papers included in this systematic review were 49: 26 evaluating prenatal exposure to PFASs, 17 childhood exposure, and 6 both. Considering a qualitative evaluation, results were conflicting, with positive, negative, and null associations. 30 papers were included in meta-analyses (19 prenatal, 7 children, and 4 both). Positive associations were evidenced between prenatal PFNA and BMI, between PFOA and BMI in children who were more than 3 years, and between prenatal PFNA and WC. Negative associations were found between prenatal PFOS and BMI in children who were 3 or less years, and between PFHxS and risk of overweight. Relatively more consistent negative associations were evidenced between childhood exposure to three PFASs (PFOA, PFOS, and PFNA) and BMI, in particular PFOS in boys. However, heterogeneity among studies was high.

CONCLUSION

Even though heterogeneous across studies, the pooled evidence suggests possible associations, mostly positive, between prenatal exposure to some PFASs and childhood BMI/WC; and relatively stronger evidence for negative associations between childhood exposure to PFASs and childhood BMI.

Public health evaluation of PFAS exposures and breastfeeding: a systematic literature review

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.

Levels of per- and polyfluoroalkyl substances (PFAS) in Norwegian children stratified by age and sex - Data from the Bergen Growth Study 2

BACKGROUND AND AIM

Due to the persistence, bioaccumulation and potential adverse health effects, there have been restrictions and phase out in the production of certain per- and polyfluoroalkyl substances (PFAS) since the early 2000s. Published serum levels of PFAS during childhood are variable and may reflect the impact of age, sex, sampling year and exposure history. Surveying the concentrations of PFAS in children is vital to provide information regarding exposure during this critical time of development. The aim of the current study was therefore to evaluate serum concentrations of PFAS in Norwegian schoolchildren according to age and sex.

MATERIAL AND METHODS

Serum samples from 1094 children (645 girls and 449 boys) aged 6-16 years, attending schools in Bergen, Norway, were analyzed for 19 PFAS. The samples were collected in 2016 as part of the Bergen Growth Study 2. Statistical analyses included Student t-test, one-way ANOVA and Spearman's correlation analysis of log-transformed data.

RESULTS

Of the 19 PFAS examined, 11 were detected in the serum samples. Perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonic acid (PFHxS) and perfluorononaoic acid (PFNA) were present in all samples with geometric means of 2.67, 1.35, 0.47 and 0.68 ng/mL, respectively. In total, 203 children (19%) had PFAS levels above the safety limits set by the German Human Biomonitoring Commission. Significantly higher serum concentrations were found in boys compared to girls for PFOS, PFNA, PFHxS and perfluoroheptanesulfonic acid (PFHpS). Furthermore, serum concentrations of PFOS, PFOA, PFHxS and PFHpS were significantly higher in children under the age of 12 years than in older children.

CONCLUSIONS

PFAS exposure was widespread in the sample population of Norwegian children analyzed in this study. Approximately one out of five children had PFAS levels above safety limits, indicating a potential risk of negative health effects. The majority of the analyzed PFAS showed higher levels in boys than in girls and decreased serum concentrations with age, which may be explained by changes related to growth and maturation.

Exposure of children and adolescents from Northeastern Slovenia to per- and polyfluoroalkyl substances

Per- and polyfluoroalkyl substances (PFAS) are of high concern for the environment, wildlife, and human health due to their persistence and potential to cause adverse health effects. Despite political measures to restrict the production and distribution of PFAS and to limit the exposure of populations, PFAS can be measured at commonly high detection frequencies in human samples. Thus, this pilot study aimed to determine the serum concentrations of PFPA, PFHpA, PFOA, PFNA, PFDA, PFUnDA, PFHxS, PFHpS, PFOS, PFHxA, PFDoDA, and PFBS in 113 girls and 112 boys (age 7-10 and 12-15) from Northeastern Slovenia - a rural area characterized by agricultural activities - and to identify potential sources of exposure using questionnaire data. PFAS were analysed by liquid chromatography coupled to mass spectrometry after phospholipid removal. 9 out of 12 analytes were detected at detection frequencies above 30%, with the highest geometric means (GM) being observed for PFOS (GM 1.9 ng/mL) > PFOA (GM 1.0 ng/mL) > PFHxS (GM 0.3 ng/mL) = PFNA (GM 0.3 ng/mL). We identified the participants' socio-economic status, age, sex, sampling region, public water supply, and the consumption of fish and seafood, cereals, and locally produced fruits, vegetables, and mushrooms as the predominant determinants of exposure. Furthermore, we compared our results with the serum and plasma concentrations reported for similar age groups in other studies and concluded that PFAS exposure in this highly agricultural area in Slovenia is notably low. This is the first study systematic HBM study of PFAS exposure in Slovenia, although it was conducted on a limited number of participants representative of rural and agricultural areas, it represents a good basis for upgrading the approach to a nationwide HBM study.

Perfluoroalkyl substance exposure is associated with asthma and innate immune cell count in US adolescents stratified by sex

Exposure to perfluoroalkyl substances (PFAS) may be harmful to humans; however, previous studies have been inconsistent regarding the potential for PFAS-induced immunosuppresion. This study explored the relationship between PFAS exposure and risks of asthma, wheezing, and immunosuppression in 12-19 year-olds using the National Health and Nutrition Examination Survey (NHANES) data. Logistic regression models were used to reveal associations between serum PFAS levels and risks of asthma, wheezing, asthma attack, and emergency department visits. Pearson's correlation was used to determine the relationship between serum PFAS levels and leukocyte count. Data were also stratified by sex. We found that medium-low levels of serum perfluorooctane sulfonate (PFOS) (6.90-12.40 ng/mL) and serum perfluorooctanoic acid (PFOA) (2.43-3.60 ng/mL) were negatively related, respectively, to current asthma and wheezing in boys, and to wheezing in girls. Meanwhile, boys with medium-high levels (1.50-3.00 ng/mL) of serum perfluorohexanesulfonate (PFHxS) had a high risk of wheezing. Among asthmatic participants, both medium-high levels (3.75-5.07 ng/mL) of serum PFOA and high levels (> 3.92 ng/mL) of PFHxS correlated with asthma attacks in boys; likewise, medium-low levels (0.70-0.99 ng/mL) of serum PFNA correlated with asthma attacks in girls. Also, PFOA and PFNA levels were weakly positively correlated with basophil count, whereas PFOS levels were weakly negatively correlated with eosinophils in asthmatic boys, indicating that basophils may be important in the immune response to PFAS exposure among asthmatics.

Per- and Polyfluoroalkyl Substances and Outcomes Related to Metabolic Syndrome: A Review of the Literature and Current Recommendations for Clinicians

Per- and polyfluoroalkyl substances (PFAS) are a class of toxic, ubiquitous, anthropogenic chemicals known to bioaccumulate in humans. Substantial concern exists regarding the human health effects of PFAS, particularly metabolic syndrome (MetS), a precursor to cardiovascular disease, the leading cause of mortality worldwide. This narrative review provides an overview of the PFAS literature on 4 specific components of MetS: insulin resistance/glucose dysregulation, central adiposity, dyslipidemia, and blood pressure. We focus on prospective cohort studies as these provide the best body of evidence compared to other study designs. Available evidence suggests potential associations between some PFAS and type-2 diabetes in adults, dyslipidemia in children and adults, and blood pressure in adults. Additionally, some studies found that sex and physical activity may modify these relationships. Future studies should consider modification by sex and lifestyle factors (e.g., diet and physical activity), as well quantifying the impact of PFAS mixtures on MetS features and related clinical disease. Finally, clinicians can follow recently developed clinical guidance to screen for PFAS exposure in patients, measure PFAS levels, conduct additional clinical care based on PFAS levels, and advise on PFAS exposure reduction.

The Threat Posed by Environmental Contaminants on Neurodevelopment: What Can We Learn from Neural Stem Cells?

Exposure to chemicals may pose a greater risk to vulnerable groups, including pregnant women, fetuses, and children, that may lead to diseases linked to the toxicants' target organs. Among chemical contaminants, methylmercury (MeHg), present in aquatic food, is one of the most harmful to the developing nervous system depending on time and level of exposure. Moreover, certain man-made PFAS, such as PFOS and PFOA, used in commercial and industrial products including liquid repellants for paper, packaging, textile, leather, and carpets, are developmental neurotoxicants. There is vast knowledge about the detrimental neurotoxic effects induced by high levels of exposure to these chemicals. Less is known about the consequences that low-level exposures may have on neurodevelopment, although an increasing number of studies link neurotoxic chemical exposures to neurodevelopmental disorders. Still, the mechanisms of toxicity are not identified. Here we review in vitro mechanistic studies using neural stem cells (NSCs) from rodents and humans to dissect the cellular and molecular processes changed by exposure to environmentally relevant levels of MeHg or PFOS/PFOA. All studies show that even low concentrations dysregulate critical neurodevelopmental steps supporting the idea that neurotoxic chemicals may play a role in the onset of neurodevelopmental disorders.

Bayesian Estimation of Human Population Toxicokinetics of PFOA, PFOS, PFHxS, and PFNA from Studies of Contaminated Drinking Water

BACKGROUND

Setting health-protective standards for poly- and perfluoroalkyl substances (PFAS) exposure requires estimates of their population toxicokinetics, but existing studies have reported widely varying PFAS half-lives (T_½) and volumes of distribution (V_d).

OBJECTIVES

We combined data from multiple studies to develop harmonized estimates of T_½ and V_d, along with their interindividual variability, for four PFAS commonly found in drinking water: perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS).

METHODS

We identified published data on PFAS concentrations in human serum with corresponding drinking water measurements, separated into training and testing data sets. We fit training data sets to a one-compartment model incorporating interindividual variability, time-dependent drinking water concentrations, and background exposures. Use of a hierarchical Bayesian approach allowed us to incorporate informative priors at the population level, as well as at the study level. We compared posterior predictions to testing data sets to evaluate model performance.

RESULTS

Posterior median (95% CI) estimates of T_½ (in years) for the population geometric mean were 3.14 (2.69, 3.73) for PFOA, 3.36 (2.52, 4.42) for PFOS, 2.35 (1.65, 3.16) for PFNA, and 8.30 (5.38, 13.5) for PFHxS, all of which were within the range of previously published values. The extensive individual-level data for PFOA allowed accurate estimation of population variability, with a population geometric standard deviation of 1.57 (95% CI: 1.42, 1.73); data from other PFAS were also consistent with this degree of population variability. V_d estimates ranged from 0.19 to 0.43L/kg across the four PFAS, which tended to be slightly higher than previously published estimates.

DISCUSSION

These results have direct application in both risk assessment (quantitative interspecies extrapolation and uncertainty factors for interindividual variability) and risk communication (interpretation of monitoring data). In addition, this study provides a rigorous methodology for further refinement with additional data, as well as application to other PFAS. https://doi.org/10.1289/EHP10103.

Childhood exposure to per- and polyfluoroalkyl substances and neurodevelopment in the CHARGE case-control study

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are shown to have neurotoxic effects on animals, but epidemiological evidence for associations between childhood PFAS exposure and neurodevelopment is inconclusive. We examined if childhood PFAS concentrations are associated with a diagnosis of autism spectrum disorder (ASD), developmental delay (DD), and other early concerns (OEC) in development.

METHODS

We included 551 children 2-5 years old from the CHildhood Autism Risks from Genetics and Environment (CHARGE) case-control study. Children were clinically diagnosed and classified as having ASD, DD, OEC, and typical development (TD). Fourteen PFAS were quantified in child serum samples collected when diagnostic assessments were performed. We used multinomial logistic regression models to investigate the cross-sectional associations of individual PFAS concentrations with neurodevelopmental outcomes and weighted quantile sum (WQS) regression models with repeated holdout validation to investigate the associations with PFAS mixtures.

RESULTS

Childhood perfluorooctanoic acid (PFOA) was associated with increased odds of ASD (odds ratio [OR] per ln ng/mL increase: 1.99, 95% confidence interval [CI]: 1.20, 3.29) and DD (OR: 2.16, 95% CI: 1.21, 3.84) versus TD. Perfluoroheptanoic acid (PFHpA) was associated with increased odds of ASD (OR: 1.61, 95% CI: 1.21, 2.13). However, perfluroundecanoic acid (PFUnDA) was associated with decreased odds of ASD (OR: 0.43, 95% CI: 0.26, 0.69). From mixture analyses, the WQS index was associated with increased odds of ASD (average OR: 1.57, 5th and 95th percentile: 1.16, 2.13). Child's sex and homeownership modified associations of perfluorodecanoic acid (PFDA) with DD and ASD, respectively.

CONCLUSIONS

In this case-control study, childhood PFOA, PFHpA, and a PFAS mixture was associated with increased odds of ASD, while PFUnDA was associated with decreased odds of ASD. Because we used concurrent measurements of PFAS, our results do not imply causal relationships and thus need to be interpreted with caution.

Association between serum per- and polyfluoroalkyl substances concentrations and common cold among children and adolescents in the United States

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) exert immunosuppressive effects in experimental animals. Few epidemiologic studies investigated PFAS exposure and immune-related clinical outcomes such as common cold, especially during childhood when the immune system is developing.

METHODS

This study used data from the National Health and Nutrition Examination Survey and included 517 children 3-11 years (2013-2014 cycle) and 2732 adolescents 12-19 years (2003-2016 cycles). Serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA) and perfluorohexane sulfonic acid (PFHxS) were quantified. Common cold was self-reported by the participant or parent as having a head cold or chest cold in the last month. Multivariable logistic regression models were applied to examine the covariate-adjusted odds ratios (ORs) between individual PFAS concentrations and common cold incidence in the past month. The joint effect of PFAS mixtures was evaluated using Probit Bayesian Kernel Machine Regression (BKMR).

RESULTS

A doubling of serum PFHxS concentration was associated with a 31% higher odds (OR = 1.31, 95% CI: 1.06, 1.62) of common cold among children. Serum PFNA (OR = 1.36, 95% CI: 0.93, 1.98) and PFOA (OR = 1.32, 95% CI: 0.67, 2.62) concentrations were also related to common cold among children, as were serum PFOS concentrations among adolescents (OR = 1.13, 95% CI: 0.96, 1.32). ORs were higher in male than female children and adolescents. BKMR showed a clear increasing trend of common cold estimates across quantiles of the total PFAS mixture concentration among children, while no obvious pattern emerged in adolescents.

DISCUSSION

Among children in the United States, serum concentrations of PFAS mixtures, especially PFHxS and PFNA, were associated with higher odds of common cold. Among adolescents, PFOS was associated with increased common cold in the last month. This study contributes to the existing evidence supporting the immunotoxicity of PFAS in childhood and adolescence.

Human exposure pathways to poly- and perfluoroalkyl substances (PFAS) from indoor media: A systematic review

BACKGROUND

Human exposure to per- and polyfluoroalkyl substances (PFAS) has been primarily attributed to contaminated food and drinking water. There is information indicating other sources and pathways of exposure in residential environments, but few studies report relationships between these indoor media and human biomonitoring measurements.

METHODS

This study adapts existing systematic review tools and methodologies to synthesize evidence for PFAS exposure pathways from indoor environment media including consumer products, household articles, cleaning products, personal care products, and indoor air and dust. Studies were identified using innovative machine learning approaches and pathway-specific search strings to reduce time needed for literature search and screening. The included studies and systematic review were evaluated using tools modified specifically for exposure studies. The systematic review was conducted following a previously published protocol (DeLuca et al., 2021) that describes the systematic review methodology used in detail.

RESULTS

Only 7 studies were identified that measured the targeted subset of 8 PFAS chemicals in concordant household media (primarily house dust) and participant serum. Data extracted from the included studies were used to calculate exposure intake rates and estimate a percentage of occupant serum concentrations that could be attributed to the indoor exposure pathways. These calculations showed that exposure to PFOA, PFOS, PFNA, and PFHxS from contaminated house dust could account for 13%, 3%, 7%, and 25% of serum concentrations, respectively. Inhalation of PFAS in indoor air could account for less than 4% of serum PFOA concentrations and less than 2% of serum PFOS and PFNA concentrations. A risk of bias was identified due to participant profiles in most of the studies being skewed towards white, female, and higher socioeconomic status.

CONCLUSIONS

Along with synthesizing evidence for estimated contributions to serum PFAS levels from indoor exposure media, this systematic review also identifies a consistent risk of bias across exposure study populations that should be considered in future studies. It highlights a major research gap and need for studies that measure concordant data from both indoor exposure media and participant serum and the need for continued research on exposure modeling parameters for many PFAS chemicals.

Distribution of perfluoroalkyl acids in fish species from the Baltic Sea and freshwaters in Finland

Occurrence and distribution of perfluoroalkyl acids (PFAAs), a sub-category of per- and polyfluoroalkyl substances (PFASs), is widespread in the environment. Food, especially fish meat, is a major pathway via which humans are exposed to PFAAs. As fish is an integral part of Nordic diet, therefore, in this study, several fish species, caught in selected Baltic Sea basins and freshwater bodies of Finland, were analysed for PFAAs. Perfluorooctane sulfonate (PFOS) was detected in all Baltic Sea fish samples and in >80% fish samples from freshwaters. PFOS contributed between 46 and 100% to the total PFAA concentration in Baltic Sea fish samples and between 19 and 28% in fish samples from freshwaters. Geographically, concentration ratios of PFOS to other PFAAs differed between fish from the Baltic Sea and Finnish lakes suggesting that distribution of PFAAs differ in these environments. Results were compared with current safety thresholds - environmental quality standard for biota (EQS_biota) set by the European Commission and a group tolerable weekly intake (TWI) for the sum of four PFASs (∑PFAS-4) i.e. perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonate (PFHxS) and PFOS, recommended by the European Food Authority (EFSA). EQS_biota compliance was observed for PFOS in all species except smelt caught in the Baltic Sea and also in the River Aurajoki, where smelt had migrated from the Baltic Sea for spawning. Moderate consumption of most Baltic fishes (200 g week^-1) results in an exceedance of the new TWI (4.4 ng kg^-1 body weight week^-1) for ∑PFAS-4.

Longitudinal poly- and perfluoroalkyl substances (PFAS) levels in Dutch infants

BACKGROUND AND AIMS

Per- and polyfluoroalkyl substances (PFAS) are a potential hazard for public health. These man-made-chemicals are non-degradable with an elimination half-life of multiple years, causing accumulation in the environment and humans. Rodent studies demonstrated that PFAS are harmful, especially when present during the critical window in the first months of life. Because longitudinal data during infancy are limited, we investigated longitudinal plasma levels in infants aged 3 months and 2 years and its most important determinants.

METHODS

In 369 healthy term-born Dutch infants, we determined plasma PFOS, PFOA, PFHxS, PFNA and PFDA levels at age 3 months and 2 years, using liquid chromatography-electrospray-ionization-tandem-mass-spectrometry (LC-ESI-MS/MS). We studied the associations with maternal and child characteristics by multiple regression models.

RESULTS

At age 3 months, median plasma levels of PFOS, PFOA, PFHxS, PFNA and PFDA were 1.48, 2.40, 0.43, 0.23 and 0.07 ng/mL, resp. Levels decreased slightly until age 2 years to 1.30, 1.81, 0.40, 0.21 and 0.08 ng/mL, resp. Maternal age, first born, Caucasian ethnicity and exclusive breastfeeding were associated with higher infant's plasma levels at age 3 months. Levels at 3 months were the most important predictor for PFAS levels at age 2 years. Infants with exclusive breastfeeding during the first 3 months of life (EBF) had 2-3 fold higher levels throughout infancy compared to infants with exclusive formula feeding (EFF), with PFOA levels at 3 months 3.72 ng/mL versus 1.26 ng/mL and at 2 years 3.15 ng/mL versus 1.22 ng/mL, respectively.

CONCLUSION

Plasma PFAS levels decreased only slightly during infancy. Higher levels at age 3 months were found in Caucasian, first-born infants from older mothers and throughout infancy in EBF-infants. Our findings indicate that trans-placental transmission and breastfeeding are the most important determinants of PFAS exposure in early life.

Differential susceptibility of rat primary neurons and neural stem cells to PFOS and PFOA toxicity

Per and polifluorinated substances (PFAS) are ubiquitous and persistent contaminants. Studies have indicated that fetuses and infants can be exposed to these chemicals in utero and through breastfeeding. Despite this, limited data about their effects on brain development are available. Here, we compared the effects of perfluoroctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) exposure in rat primary neurons and neural stem cells (NSC). Treatment with 1-250 μM of either of these compounds caused no effects on cell viability or proliferation in primary neurons, while PFOS exposure increased the NSC proliferation already at the lowest concentration tested (1-100 μM). Further analysis showed that both PFOS and PFOA caused morphological alterations of NSC-derived neurons. The neurons derived from NSC treated with either of the PFAS demonstrated a decrease in cell body area. Exposure to 1 and 10 μM PFOA also affected the neurite network and caused an increase in the number of processes and branches per cell. None of the PFAS caused morphological alterations in primary neurons. These data suggest that NSC, mimicking the immature brain, is clearly more susceptible to PFOS and PFOA exposure than the primary neurons. The PFAS-induced alterations in NSC may be related to neurobehavioral alterations observed in rodents developmentally exposed to these compounds, and show the importance to consider the effects of these compounds on human brain development and disease.

Childhood exposure to per- and polyfluoroalkyl substances (PFAS) and neurobehavioral domains in children at age 8 years

BACKGROUND

Toxicological studies have raised concerns regarding the neurotoxic effects of per- and polyfluoroalkyl substances (PFAS). However, observational evidence from human studies investigating the association between childhood PFAS and neurobehavior is limited and remains unclear.

OBJECTIVES

To examine whether childhood PFAS concentrations are associated with neurobehavior in children at age 8 years and whether child sex modifies this relationship.

METHODS

We used data from 208 mother-child dyads in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort (Cincinnati, OH, USA). We quantified PFAS in child serum at 3 and 8 years. We assessed neurobehavioral domains using the Behavior Assessment System for Children-2 at 8 years. We used multiple informant models to estimate score changes per ln-increase in repeated PFAS concentrations.

RESULTS

Childhood PFAS were not associated with Externalizing or Internalizing Problems at 8 years. However, we noted effect measure modification by sex, with higher scores in Externalizing Problems among males per ln-unit increase in perfluorononanoate (PFNA) at 3 years (β = 4.3 points, 95% CI: 1.0, 7.7) while females had lower scores (β = -2.8 points, 95% CI: -4.7, -1.0). More Internalizing Problems were observed among males per ln-unit increase in concurrent PFNA concentrations (β = 3.7 points, 95% CI: 0.7, 6.8), but not in females (β = -1.7 points, 95% CI: -4.6, 1.2). Childhood PFNA concentrations were associated with lower scores for attention problems and activity of daily living.

CONCLUSION

While findings do not consistently support an association between childhood PFAS serum concentrations and neurobehavior, child sex may play a role in this relationship.

Per- and polyfluoroalkyl substances (PFASs) in Swedish household dust and exposure of pet cats

Per- and polyfluoroalkyl substances (PFASs) are used in a wide range of products and have been found ubiquitously in our indoor environment, and there is evidence that exposure to PFAS can lead to adverse endocrine effects, such as thyroid hormone disruption. Pet cats have a high dust intake due to their grooming behavior and have been shown to be a suitable sentinel species for assessment of toddler's exposure. Here we used paired household dust (n=46) and cat serum (n=27) samples to establish whether dust is a relevant exposure pathway to PFASs. An analytical method for PFAS analysis was optimized using a low volume of cat serum samples, combining solid-phase extraction and online sample cleanup. Dust was extracted with methanol by sonication and cleaned up by addition of active carbon. In total, 27 PFASs were analyzed by liquid chromatography/mass spectrometry analysis. The correlation between PFAS levels in dust and serum, serum lipids and thyroid hormone levels, and PFAS levels in dust between different rooms were statistically evaluated. PFOS and PFDA could be quantified in all cat serum samples (median 2300 pg/mL and 430 pg/mL, respectively), followed by PFOA (median 1100 pg/mL), quantified in 96% of the samples. The levels of 6:2 and 8:2 diPAPs were determined in 65% and 92% of the serum samples, respectively, and were an order of magnitude lower (1.4-160 pg/mL). Household dust on the other hand was dominated by 6:2 and 8:2 diPAPs, with a median of 65 ng/g dust and 49 ng/g dust, respectively. PFOS (median 13 ng/g dust) and PFOA (median 9 ng/g dust) were quantified in 93% of the dust samples. Only eight PFASs were detected (>LOD) in at least 50% of the samples of both matrices and could be paired. Significant correlations between cat serum and dust were found for PFOA (r_S=0.32, p<0.049) and PFUnDA (r_S=0.55, p<0.001). Significant positive correlations were found between serum total thyroxine (r_S=0.11, p<0.05) and PFNA and between serum cholesterol and PFHpA (r_S=0.46, p<0.01), PFUnDA (r_S=0.40, p<0.05), PFDoDA (r_S=0.44, p<0.01), and sum PFAS (r_S=0.48, p<0.01). In conclusion, this study confirmed that dust is a relevant exposure pathway for the ingestion of some PFASs for cats, and the serum levels of PFASs could be of relevance for the cat's health.

Extractable Organofluorine Analysis in Pooled Human Serum and Placental Tissue Samples from an Austrian Subpopulation-A Mass Balance Analysis Approach

Embryos and fetuses are of major concern due to their high vulnerability. Previous studies demonstrated that human exposure to per- and polyfluoroalkyl substances (PFAS) may be underestimated because only a limited number of known PFAS can be measured. This investigation studied the total PFAS exposure by measuring the extractable organofluorine (EOF) in pooled maternal serum, placental tissue, and cord serum samples (total number of pooled samples: n = 45). The EOF was analyzed using combustion ion chromatography, and the concentrations of known PFAS were determined using ultraperformance liquid chromatography coupled with a tandem mass spectrometer. Using a mass balance analysis approach, the amount of unknown PFAS was estimated between the levels of known PFAS and EOF. The EOF levels ranged from 2.85 to 7.17 ng F/mL (21 PFAS were quantified) in the maternal serum, from 1.02 to 1.85 ng F/g (23 PFAS were quantified) in the placental tissue, and from 1.2 to 2.10 ng F/mL (18 PFAS were quantified) in the cord serum. An average of 24, 51, and 9% of EOF is unidentified in the maternal serum, placental tissue, and cord serum, respectively. The results show that the levels of unidentified EOF are higher in the placental tissue, suggesting accumulation or potential transformation of precursors in the placenta.

Per and polyfluoroalkyl substances scientific literature review: water exposure, impact on human health, and implications for regulatory reform

Among other emerging contaminants in water, per and polyfluoroalkyl substances (PFASs) have garnered international attention from the scientific community on a global scale. Some countries, such as the United States, have found that PFASs are present in humans on a wide scale. Although two PFASs have been widely studied-Perfluorooctanoic acid and Perfluorooctanesulfonic acid-many more PFASs are being created by industry and are either not known, not studied, or both. The objective of this literature review on PFASs is to give an overview of the information available about PFASs related to human exposure. The information from this literature review on the exposure of humans to PFASs through drinking water and the lack of many conventional drinking water treatment systems' ability to remove PFASs (particularly short-chain PFASs) suggests that current regulatory limits are insufficient to adequately protect humans. This is especially true for particularly vulnerable populations such as infants, young children, and developing children (pubescent). The gaps in the current knowledge and in current regulatory approaches could have long-term effects on human health.

Impact of "healthier" materials interventions on dust concentrations of per- and polyfluoroalkyl substances, polybrominated diphenyl ethers, and organophosphate esters

Per- and polyfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDEs), and organophosphate esters (OPEs) are found in building materials and associated with thyroid disease, infertility, and impaired development. This study's objectives were to (1) compare levels of PFAS, PBDEs, and OPEs in dust from spaces with conventional versus "healthier" furniture and carpet, and (2) identify other product sources of flame retardants in situ. We measured 15 PFAS, 8 PBDEs, and 19 OPEs in dust from offices, common areas, and classrooms having undergone either no intervention (conventional rooms in older buildings meeting strict fire codes; n = 12), full "healthier" materials interventions (rooms with "healthier" materials in buildings constructed more recently or gut-renovated; n = 7), or partial interventions (other rooms with at least "healthier" foam furniture but more potential building contamination; n = 28). We also scanned all materials for bromine and phosphorus as surrogates of PBDEs and OPEs respectively, using x-ray fluorescence. In multilevel regression models, rooms with full "healthier" materials interventions had 78% lower dust levels of PFAS than rooms with no intervention (p < 0.01). Rooms with full "healthier" interventions also had 65% lower OPE levels in dust than rooms with no intervention (p < 0.01) and 45% lower PBDEs than rooms with only partial interventions (p < 0.10), adjusted for covariates related to insulation, electronics, and furniture. Bromine loadings from electronics in rooms were associated with PBDE concentrations in dust (p < 0.05), and the presence of exposed insulation was associated with OPE dust concentrations (p < 0.001). Full "healthier" materials renovations successfully reduced chemical classes in dust. Future interventions should address electronics, insulation, and building cross-contamination.

Per- and Polyfluoroalkyl Substance Toxicity and Human Health Review: Current State of Knowledge and Strategies for Informing Future Research

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.

Developing interim water quality criteria for emerging chemicals of concern for protecting marine life in the Greater Bay Area of South China

This study aimed to establish marine water quality criteria (MWQC) for emerging chemicals of concern (ECCs) for protecting aquatic life in the Greater Bay Area (GBA) of South China. Despite the frequent occurrence and elevated concentrations of these ECCs in the GBA, there is a lack of regional MWQC for these contaminants. We screened 21 common ECCs that were classified into the following six groups: (1) new persistent organic contaminants; (2) brominated flame retardants; (3) perfluoroalkyl and polyfluoroalkyl substances; (4) pharmaceutically active compounds (PhACs); (5) plasticizers; and (6) personal care products. Globally, MWQC for PhACs remain largely unavailable despite their increasing occurrence in marine environments. Using an integrative scientific approach, we derived interim MWQC for the GBA with specific protection goals. The approach described herein can be applied for the derivation of MWQC for ECCs and the establishment of guidelines for ecological risk assessment in the GBA and other regions.

The Relationship Between Perfluoroalkyl Substances Concentrations and Thyroid Function in Early Childhood: A Prospective Cohort Study

Background: Exposure to perfluoroalkyl substances (PFAS) has been suggested to affect thyroid function; however, data on early-life exposure and thyroid function in early childhood are scarce. We investigated the cross-sectional and longitudinal relationships of early-life exposure to PFAS with thyroid function at 2, 4, and 6 years of age. Methods: This study used data on PFAS exposure and thyroid function from the Environment and Development of Children (EDC) cohort study. A total of 660 children who visited at least once at 2, 4, or 6 years of age (381 children aged 2 years, 569 children aged 4 years, and 511 children aged 6 years) were included in this study. Serum thyrotropin (TSH) levels were measured at 2, 4, and 6 years of age. The relationship of serum PFAS (sPFAS) concentrations with TSH levels at the three time points was assessed by repeated-measure analysis using linear mixed models. The serum levels of free thyroxine (fT4) and triiodothyronine (T3) were measured once (at 6 years of age). The relationship of sPFAS with fT4 and T3 levels at 6 years of age was investigated by linear regression analyses. Results: None complained of hyper- or hypothyroid symptoms with normal fT4 and T3 levels. Repeated-measure analysis showed that TSH levels at 2, 4, and 6 years of age were inversely associated with serum perfluorononanoic acid (sPFNA), after adjusting for age, sex, and/or dietary iodine intake (p < 0.05). When stratified by sex, TSH levels were inversely associated with serum perfluorooctanoic acid (sPFOA) in boys and sPFNA in girls (p < 0.05 for both). fT4 levels at 6 years of age were positively related to sPFNA and serum perfluorohexane sulfonic acid at 2 years of age and sPFOA at 6 years of age, and T3 levels at 6 years of age showed positive relationships with serum perfluorodecanoic acid and serum perfluorooctane sulfonic acid at 6 years of age (p < 0.05 for all). When stratified by sex, similar positive relationships for sPFAS with fT4 and T3 levels were significant among boys only. Conclusions: A significant relationship was found between early-life exposure to PFAS and thyroid function. Early-life exposure to PFAS was associated with decreased TSH and increased fT4 or T3 levels among preschool-age children.

Per- and polyfluoroalkyl substances and male reproductive health: a systematic review of the epidemiological evidence

Exposure to environmental pollutants may produce impairment of male reproductive health. The epidemiological literature evaluating potential consequences of human exposure to per- and polyfluoroalkyl substances (PFAS) has grown in recent years with concerns for both pre- and postnatal influences. The aim of this systematic review was to assess available evidence on associations between PFAS exposures in different stages of life and semen quality, reproductive hormones, cryptorchidism, hypospadias, and testicular cancer. A systematic search of literature published prior to March 9th, 2020, was performed in the databases PubMed and Embase®. Predefined criteria for eligibility were applied by two authors screening study records independently. Among the 242 study records retrieved in the literature search, 26 studies were eligible for qualitative assessment. While several investigations suggested weak associations for single compounds and specific outcomes, a lack of consistency across studies limited conclusions of overall evidence. The current gap in knowledge is particularly obvious regarding exposures prior to adulthood, exposure to combinations of both PFAS and other types of environmental chemicals, and outcomes such as cryptorchidism, hypospadias, and testicular cancer. Continued efforts to clarify associations between PFAS exposure and male reproductive health through high-quality epidemiological studies are needed.

Per- and polyfluoroalkyl substances in blood plasma - Results of the German Environmental Survey for children and adolescents 2014-2017 (GerES V)

The 5th cycle of the German Environmental Survey (GerES V) investigated the internal human exposure of children and adolescents aged 3-17 years in Germany to per- and polyfluoroalkyl substances (PFAS). The fieldwork of the population-representative GerES V was performed from 2014 to 2017. In total, 1109 blood plasma samples were analysed for 12 PFAS including perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid (PFHxS). PFOS was quantified in all and PFOA in almost all samples, demonstrating ubiquitous exposure. The highest geometric mean concentrations measured were 2.49 ng/mL for PFOS, followed by PFOA (1.12 ng/mL) and PFHxS (0.36 ng/mL), while concentrations of other PFAS were found in much lower concentrations. The 95th percentile levels of PFOS and PFOA were 6.00 and 3.24 ng/mL, respectively. The results document a still considerable exposure of the young generation to the phased out chemicals PFOS and PFOA. The observed exposure levels vary substantially between individuals and might be due to different multiple sources. The relative contribution of various exposure parameters such as diet or the specific use of consumer products need to be further explored. Although additional investigations on the time trend of human exposure are warranted, GerES V underlines the need for an effective and sustainable regulation of PFAS as a whole.

Evaluation of Developmental Toxicity, Developmental Neurotoxicity, and Tissue Dose in Zebrafish Exposed to GenX and Other PFAS

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are a diverse class of industrial chemicals with widespread environmental occurrence. Exposure to long-chain PFAS is associated with developmental toxicity, prompting their replacement with short-chain and fluoroether compounds. There is growing public concern over the safety of replacement PFAS.

OBJECTIVE

We aimed to group PFAS based on shared toxicity phenotypes.

METHODS

Zebrafish were developmentally exposed to 4,8-dioxa-3H-perfluorononanoate (ADONA), perfluoro-2-propoxypropanoic acid (GenX Free Acid), perfluoro-3,6-dioxa-4-methyl-7-octene-1-sulfonic acid (PFESA1), perfluorohexanesulfonic acid (PFHxS), perfluorohexanoic acid (PFHxA), perfluoro-n-octanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), or 0.4% dimethyl sulfoxide (DMSO) daily from 0-5 d post fertilization (dpf). At 6 dpf, developmental toxicity and developmental neurotoxicity assays were performed, and targeted analytical chemistry was used to measure media and tissue doses. To test whether aliphatic sulfonic acid PFAS cause the same toxicity phenotypes, perfluorobutanesulfonic acid (PFBS; 4-carbon), perfluoropentanesulfonic acid (PFPeS; 5-carbon), PFHxS (6-carbon), perfluoroheptanesulfonic acid (PFHpS; 7-carbon), and PFOS (8-carbon) were evaluated.

RESULTS

PFHxS or PFOS exposure caused failed swim bladder inflation, abnormal ventroflexion of the tail, and hyperactivity at nonteratogenic concentrations. Exposure to PFHxA resulted in a unique hyperactivity signature. ADONA, PFESA1, or PFOA exposure resulted in detectable levels of parent compound in larval tissue but yielded negative toxicity results. GenX was unstable in DMSO, but stable and negative for toxicity when diluted in deionized water. Exposure to PFPeS, PFHxS, PFHpS, or PFOS resulted in a shared toxicity phenotype characterized by body axis and swim bladder defects and hyperactivity.

CONCLUSIONS

All emerging fluoroether PFAS tested were negative for evaluated outcomes. Two unique toxicity signatures were identified arising from structurally dissimilar PFAS. Among sulfonic acid aliphatic PFAS, chemical potencies were correlated with increasing carbon chain length for developmental neurotoxicity, but not developmental toxicity. This study identified relationships between chemical structures and in vivo phenotypes that may arise from shared mechanisms of PFAS toxicity. These data suggest that developmental neurotoxicity is an important end point to consider for this class of widely occurring environmental chemicals. https://doi.org/10.1289/EHP5843.

Children's exposure to perfluoroalkyl acids - a modelling approach

Adults are mainly exposed to per- and polyfluoroalkyl substances (PFASs) via ingestion of food, inhalation of air and ingestion of dust, whereas for children the exposure to PFASs is largely unknown. This study aimed to reconstruct the serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS) in children after infancy up to 10.5 years of age and to test if dietary intake is the major exposure pathway for children to PFOA, PFOS and PFHxS after infancy. For this work, a dataset from a Finnish child cohort study was available, which comprised serum concentrations of the studied perfluoroalkyl acids (PFAAs) and PFAS concentration measurements in dust and air samples from the children's bedrooms. The calculated PFAA intakes were used in a pharmacokinetic model to reconstruct the PFAA serum concentrations from 1 to 10.5 years of age. The calculated PFOA and PFOS intakes were close to current regulatory intake thresholds and diet was the major exposure medium for the 10.5 year-olds. The one-compartment PK model reconstructed median PFOA and PFOS serum concentrations well compared to corresponding measured median serum concentrations, while the modelled PFHxS serum concentrations showed a constant underestimation. The results imply that children's exposure to PFOA and PFOS after breastfeeding and with increasing age resembles the exposure of adults. Further, the children in the Finnish cohort experienced a rather constant exposure to PFOA and PFOS between 1 and 10.5 years of age. The PFHxS exposure sources and respective pharmacokinetic parameter estimations need further investigation.

Perfluorinated compounds in poultry products from the Yangtze River Delta and Pearl River Delta regions in China

Chicken, duck, egg, and duck egg samples from the Yangtze River Delta and Pearl River Delta regions in China were analyzed for 17 perfluorinated compounds (PFCs). The concentrations of PFCs in chicken and duck livers ranged from <LOD to 35.53 μg/kg and 40.41 μg/kg, respectively, which is higher than in other tissues. PFDA was the predominant PFC in live with mean concentrations of 2.09 μg/kg and 1.73 μg/kg in chicken and duck livers, respectively. The mean ∑PFCs concentrations were 1.87 μg/kg and 1.88 μg/kg in chicken and duck eggs, respectively. The mean PFC concentrations were also similar in the subcutaneous fat of both chicken and duck. The total PFC concentrations in chicken and ducks ranged from <LOD to 54.63 μg/kg and 10.21 μg/kg. The current concentration levels of PFCs would not cause health risks to adults even with the frequent consumption of poultry products. However, the higher concentrations of PFCs in chicken and chicken eggs might cause health risks in children.

Assessing exposure to legacy and emerging per- and polyfluoroalkyl substances via hair - The first nationwide survey in India

In recent years, environmental issues emerging from per- and polyfluoroalkyl substances (PFAS) have raised high concern worldwide. Levels of human exposure to PFAS remain unknown in India. Biomonitoring data obtained from hair analysis have been evidenced to provide insight into retrospective human exposure to PFAS. In this study, 25 PFAS, including perfluoroalkyl acids and their precursors, were measured in 39 human hair samples collected from 14 cities in India. The inuflence of gender on the PFAS levels was also examined. To our knowledge, this is the first attempt to provide preliminary indicative data (due to the limited sample size and variability in hair-length sampling) on the levels of PFAS in Indian hair. The concentrations of total PFAS in hair varied from below matrix-specific limit of quantification (<0.02 ng/g) to 3.78 ng/g. Among 9 PFAS quantified, perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), and perfluorooctanoic acid (PFOA) were the predominant compounds. Categorized into 4 regions, PFAS contamination exhibited certain regional difference where South India may show higher levels than the other regions. Highly significant positive correlation was observed between PFHxS and PFOS (p ≪ 0.001; r = 0.644), suggesting similar pathways of exposure to the two compounds. Higher PFAS occurrence was generally observed in the hair of females. Our results highlighted the urgent need to investigate the deposition mechanism of PFAS in hair.

Per- and polyfluoroalkyl substances (PFAS) in Australia: Current levels and estimated population reference values for selected compounds

BACKGROUND

Increased public awareness of PFAS contamination in Australia has resulted in serum biomonitoring efforts in individuals in potentially affected communities. However, population-based reference values for assessing whether individual results exceed the typical range in the Australian general population are not currently available.

OBJECTIVE

Estimate population upper bound reference values based on updated serum PFAS concentrations in pooled samples from southeast Queensland, Australia and population variation observed in the US National Health and Nutrition Examination Survey (NHANES) datasets.

METHODS

We calculated ratios of 95th percentile to arithmetic mean (P95:AM ratios) using data from the NHANES 2013-14 and 2015-16 cycle samples for frequently detected PFASs: PFOA, linear and branched PFOS, perfluorononanoate (PFNA), perfluorodecanoate (PFDA), and perfluorohexanesulfonate (PFHxS). We estimated Australian age-specific means for PFAS using pooled serum samples collected in 2014-15 and 2016-17. We used the P95:AM ratios to estimate 95th percentile concentrations in the Australian population based on the results of the 2016-17 pooled samples.

RESULTS AND CONCLUSIONS

P95:AM ratios for each PFAS were similar across NHANES cycle and age group, so overall compound-specific ratios were estimated for PFOA (2.1), PFNA (2.4), PFDA (2.7), PFHxS (2.7), and linear (2.4) and summed PFOS (2.3). Australian mean PFAS concentrations continued previously reported declining trends. The estimated P95 values can be used as preliminary substitutes for more rigorous population reference values to identify samples with clearly elevated serum PFAS concentrations in Australian biomonitoring efforts. Given uncertainties and variability inherent in this evaluation, the estimated P95 values should be interpreted with caution. Mean and estimated P95 serum PFAS concentrations in Australia should continue to be monitored to document declining trends in population serum concentrations.

Dried blood spots for reliable biomonitoring of poly- and perfluoroalkyl substances (PFASs)

Dried blood spot (DBS) sampling has gained attention in several scientific areas because of the low sampling burden. The study aimed to develop a method for the determination of poly- and perfluoroalkyl substances (PFASs) in DBS using a standardized blood volume. The DBS method using a simple methanol extraction followed by online solid phase extraction-ultra high performance liquid chromatography-tandem mass spectrometry quantification was validated. Only 30 μL of blood is required. Based on the measurements of DBS dispersed areas from known blood volumes (20-70 μL), the blood volume on a 3 mm diameter DBS subsample was calculated to be 3.3 μL (median, n = 708 measurements, 59 adults). Strong correlations of PFAS concentrations between finger prick DBSs and venous whole blood samples (n = 57) were found (rho 0.72-0.97, p < 0.0001). Also, Passing-Bablok regressions and Bland-Altman plots demonstrated good agreements of PFAS concentrations in finger prick DBSs and venous whole blood samples. This finding indicates that the DBS method was satisfactory, and allows straightforward analysis of PFASs in DBS without hematocrit correction. This DBS method is reliable for accurate determination of PFASs and has a high potential for use of self-collected DBS in large-scale biomonitoring studies as well as for archived DBS samples.