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Shi W, Zhang Z, Li M, Dong H, Li J. Reproductive toxicity of PFOA, PFOS and their substitutes: A review based on epidemiological and toxicological evidence. ENVIRONMENTAL RESEARCH 2024; 250:118485. [PMID: 38373549 DOI: 10.1016/j.envres.2024.118485] [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: 06/01/2023] [Revised: 01/27/2024] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
Per- and polyfluoroalkyl substances (PFAS) have already drawn a lot of attention for their accumulation and reproductive toxicity in organisms. Perfluorooctanoic acid (PFOA) and perfluorooctanoic sulfonate (PFOS), two representative PFAS, are toxic to humans and animals. Due to their widespread use in environmental media with multiple toxicities, PFOA and PFOS have been banned in numerous countries, and many substitutes have been produced to meet market requirements. Unfortunately, most alternatives to PFOA and PFOS have proven to be cumulative and highly toxic. Of the reported multiple organ toxicities, reproductive toxicity deserves special attention. It has been confirmed through epidemiological studies that PFOS and PFOA are not only associated with reduced testosterone levels in humans, but also with an association with damage to the integrity of the blood testicular barrier. In addition, for women, PFOA and PFOS are correlated with abnormal sex hormone levels, and increase the risk of infertility and abnormal menstrual cycle. Nevertheless, there is controversial evidence on the epidemiological relationship that exists between PFOA and PFOS as well as sperm quality and reproductive hormones, while the evidence from animal studies is relatively consistent. Based on the published papers, the potential toxicity mechanisms for PFOA, PFOS and their substitutes were reviewed. For males, PFOA and PFOS may produce reproductive toxicity in the following five ways: (1) Apoptosis and autophagy in spermatogenic cells; (2) Apoptosis and differentiation disorders of Leydig cells; (3) Oxidative stress in sperm and disturbance of Ca2+ channels in sperm membrane; (4) Degradation of delicate intercellular junctions between Sertoli cells; (5) Activation of brain nuclei and shift of hypothalamic metabolome. For females, PFOA and PFOS may produce reproductive toxicity in the following five ways: (1) Damage to oocytes through oxidative stress; (2) Inhibition of corpus luteum function; (3) Inhibition of steroid hormone synthesis; (4) Damage to follicles by affecting gap junction intercellular communication (GJIC); (5) Inhibition of placental function. Besides, PFAS substitutes show similar reproductive toxicity with PFOA and PFOS, and are even more toxic to the placenta. Finally, based on the existing knowledge, future developments and direction of efforts in this field are suggested.
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Affiliation(s)
- Wenshan Shi
- School of Public Health, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College, Soochow University, Suzhou, 215123, China
| | - Zengli Zhang
- School of Public Health, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College, Soochow University, Suzhou, 215123, China.
| | - Mei Li
- School of Civil Engineering, Suzhou University of Science and Technology, 215011, China
| | - Huiyu Dong
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Jiafu Li
- School of Public Health, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College, Soochow University, Suzhou, 215123, China.
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Ayodele A, Obeng-Gyasi E. Exploring the Potential Link between PFAS Exposure and Endometrial Cancer: A Review of Environmental and Sociodemographic Factors. Cancers (Basel) 2024; 16:983. [PMID: 38473344 DOI: 10.3390/cancers16050983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/01/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
This exploratory narrative review paper delves into the intricate interplay between per- and polyfluoroalkyl substances (PFAS) exposure, sociodemographic factors, and the influence of stressors in the context of endometrial cancer. PFAS, ubiquitous environmental contaminants notorious for their persistence in the ecosystem, have garnered attention for their potential to disrupt endocrine systems and provoke immune responses. We comprehensively examine the various sources of PFAS exposure, encompassing household items, water, air, and soil, thus shedding light on the multifaceted routes through which individuals encounter these compounds. Furthermore, we explore the influence of sociodemographic factors, such as income, education, occupation, ethnicity/race, and geographical location and their relationship to endometrial cancer risk. We also investigated the role of stress on PFAS exposure and endometrial cancer risk. The results revealed a significant impact of sociodemographic factors on both PFAS levels and endometrial cancer risk. Stress emerged as a notable contributing factor influencing PFAS exposure and the development of endometrial cancer, further emphasizing the importance of stress management practices for overall well-being. By synthesizing evidence from diverse fields, this review underscores the need for interdisciplinary research and targeted interventions to comprehensively address the complex relationship between PFAS, sociodemographic factors, stressors, and endometrial cancer.
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Affiliation(s)
- Aderonke Ayodele
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
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Pan J, Liu P, Yu X, Zhang Z, Liu J. The adverse role of endocrine disrupting chemicals in the reproductive system. Front Endocrinol (Lausanne) 2024; 14:1324993. [PMID: 38303976 PMCID: PMC10832042 DOI: 10.3389/fendo.2023.1324993] [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: 10/20/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024] Open
Abstract
Reproductive system diseases pose prominent threats to human physical and mental well-being. Besides being influenced by genetic material regulation and changes in lifestyle, the occurrence of these diseases is closely connected to exposure to harmful substances in the environment. Endocrine disrupting chemicals (EDCs), characterized by hormone-like effects, have a wide range of influences on the reproductive system. EDCs are ubiquitous in the natural environment and are present in a wide range of industrial and everyday products. Currently, thousands of chemicals have been reported to exhibit endocrine effects, and this number is likely to increase as the testing for potential EDCs has not been consistently required, and obtaining data has been limited, partly due to the long latency of many diseases. The ability to avoid exposure to EDCs, especially those of artificially synthesized origin, is increasingly challenging. While EDCs can be divided into persistent and non-persistent depending on their degree of degradation, due to the recent uptick in research studies in this area, we have chosen to focus on the research pertaining to the detrimental effects on reproductive health of exposure to several EDCs that are widely encountered in daily life over the past six years, specifically bisphenol A (BPA), phthalates (PAEs), polychlorinated biphenyls (PCBs), parabens, pesticides, heavy metals, and so on. By focusing on the impact of EDCs on the hypothalamic-pituitary-gonadal (HPG) axis, which leads to the occurrence and development of reproductive system diseases, this review aims to provide new insights into the molecular mechanisms of EDCs' damage to human health and to encourage further in-depth research to clarify the potentially harmful effects of EDC exposure through various other mechanisms. Ultimately, it offers a scientific basis to enhance EDCs risk management, an endeavor of significant scientific and societal importance for safeguarding reproductive health.
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Affiliation(s)
- Jing Pan
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Pengfei Liu
- Gynecology Department, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China
| | - Xiao Yu
- Gynecology Department, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China
| | - Zhongming Zhang
- Zhang Zhongjing College of Chinese Medicine, Nanyang Institute of Technology, Nanyang, Henan, China
| | - Jinxing Liu
- Gynecology Department, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China
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Ao J, Zhang R, Huo X, Zhu W, Zhang J. Environmental exposure to legacy and emerging per- and polyfluoroalkyl substances and endometriosis in women of childbearing age. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 907:167838. [PMID: 37839491 DOI: 10.1016/j.scitotenv.2023.167838] [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: 07/28/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are man-made chemicals known for their adverse effects on humans. Growing concern has risen regarding the reproductive toxicity of PFAS, but whether PFAS affect endometriosis remains to be explored. This hospital-based case-control study included 240 laparoscopic-confirmed endometriosis cases and 334 normal controls in China from 2014 to 2018. Concentrations of thirty-three legacy and emerging PFAS were measured in the plasma samples. Associations between single PFAS and endometriosis were estimated by binary logistic regression. The elastic net regression (ENR) model was used to identify dominant PFAS related to endometriosis. The joint effect of the PFAS mixture on endometriosis was assessed by principal component analysis (PCA), Bayesian kernel machine regression (BKMR), and quantile-based g-computation (q-gcomp). In the single-PFAS model, significant positive associations of PFOA [adjusted odds ratio (95 % CI): 1.22 (1.00, 1.51)], total PFOS [1.19 (1.05, 1.34)] and two branched PFOS isomers [1.16 (1.09, 1.22) for 1m-PFOS; 1.18 (1.04, 1.34) for 6m-PFOS] with increased endometriosis odds were observed. Mixture models showed that the joint effect of PFAS mixture on endometriosis was significant [1.24 (1.05, 1.48)], mainly driven by 1m-PFOS. The PFOS isomers profile suggested a PFOS precursor biotransformation source of 1m-PFOS in our population. Our study suggests that branched isomers of PFOS may be associated with endometriosis.
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Affiliation(s)
- Junjie Ao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Rongrong Zhang
- Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Xiaona Huo
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Wenting Zhu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
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Zhang L, Yang X. Association between exposure to polycyclic aromatic hydrocarbons and endometriosis: data from the NHANES 2001-2006. Front Public Health 2024; 11:1267124. [PMID: 38259796 PMCID: PMC10801278 DOI: 10.3389/fpubh.2023.1267124] [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] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 01/24/2024] Open
Abstract
Aim To evaluate the association between urinary polycyclic aromatic hydrocarbon (PAH) metabolites and the risk of endometriosis. Methods This cross-sectional study obtained data on women aged 20-54 years from the National Health and Nutrition Examination Survey (NHANES) 2001-2006. The weighted multivariate logistic regression model was established to assess the association between the eight urinary PAH metabolites and the risk of endometriosis. In this multivariate analysis, the eight urinary PAH metabolites were adjusted with urinary creatinine, and were divided into three groups according to tertiles: Tertile 1, Tertile 2 and Tertile 3. To evaluate the overall association of mixed PAH metabolites with endometriosis, the Bayesian kernel machine regression (BKMR) model was applied. Results Totally 1,291 women were included, of which 90 (6.97%) had endometriosis and 1,201 (93.03%) did not have endometriosis. After adjusting for age, race, smoking, age at menarche, hysterectomy, ovary removed, female hormone use, and menopause, compared with the Tertile 1 group, the Tertile 2 and Tertile 3 groups of all PAH metabolites demonstrated no significant risk of endometriosis. A positive tendency was found between mixed PAH metabolites and endometriosis when all the metabolites were at their 60th percentile levels or above compared with their median levels. When all the other metabolites were fixed at their median levels, 1-hydroxynaphthalene was positively correlated with endometriosis. Potential interactions existed between 1-hydroxynaphthalene and 2-hydroxynaphthalene and between 2-hydroxyfluorene and 3-hydroxyfluorene. Conclusion No significant association was found between individual PAH metabolites and endometriosis. A positive association existed between mixed PAH metabolites and the risk of endometriosis.
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Affiliation(s)
| | - Xiaojun Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Rickard BP, Overchuk M, Tulino J, Tan X, Ligler FS, Bae-Jump VL, Fenton SE, Rizvi I. Exposure to select PFAS and PFAS mixtures alters response to platinum-based chemotherapy in endometrial cancer cell lines. Environ Health 2023; 22:87. [PMID: 38098045 PMCID: PMC10720226 DOI: 10.1186/s12940-023-01034-2] [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] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Exposure to per- and poly-fluoroalkyl substances (PFAS) has been associated with significant alterations in female reproductive health. These include changes in menstrual cyclicity, timing of menarche and menopause, and fertility outcomes, as well as increased risk of endometriosis, all of which may contribute to an increased risk of endometrial cancer. The effect of PFAS on endometrial cancer cells, specifically altered treatment response and biology, however, remains poorly studied. Like other gynecologic malignancies, a key contributor to lethality in endometrial cancer is resistance to chemotherapeutics, specifically to platinum-based agents that are used as the standard of care for patients with advanced-stage and/or recurrent disease. OBJECTIVES To explore the effect of environmental exposures, specifically PFAS, on platinum-based chemotherapy response and mitochondrial function in endometrial cancer. METHODS HEC-1 and Ishikawa endometrial cancer cells were exposed to sub-cytotoxic nanomolar and micromolar concentrations of PFAS/PFAS mixtures and were treated with platinum-based chemotherapy. Survival fraction was measured 48-h post-chemotherapy treatment. Mitochondrial membrane potential was evaluated in both cell lines following exposure to PFAS ± chemotherapy treatment. RESULTS HEC-1 and Ishikawa cells displayed differing outcomes after PFAS exposure and chemotherapy treatment. Cells exposed to PFAS appeared to be less sensitive to carboplatin, with instances of increased survival fraction, indicative of platinum resistance, observed in HEC-1 cells. In Ishikawa cells treated with cisplatin, PFAS mixture exposure significantly decreased survival fraction. In both cell lines, increases in mitochondrial membrane potential were observed post-PFAS exposure ± chemotherapy treatment. DISCUSSION Exposure of endometrial cancer cell lines to PFAS/PFAS mixtures had varying effects on response to platinum-based chemotherapies. Increased survival fraction post-PFAS + carboplatin treatment suggests platinum resistance, while decreased survival fraction post-PFAS mixture + cisplatin exposure suggests enhanced therapeutic efficacy. Regardless of chemotherapy sensitivity status, mitochondrial membrane potential findings suggest that PFAS exposure may affect endometrial cancer cell mitochondrial functioning and should be explored further.
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Affiliation(s)
- Brittany P Rickard
- Curriculum in Toxicology & Environmental Medicine, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC, 27599, USA
- Mechanistic Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, Durham, NC, 27709, USA
| | - Marta Overchuk
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC 27599, USA; Engineering Building III, North Carolina State University, Raleigh, NC, 27606, USA
| | - Justin Tulino
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC 27599, USA; Engineering Building III, North Carolina State University, Raleigh, NC, 27606, USA
| | - Xianming Tan
- Department of Biostatistics, University of North Carolina School of Public Health, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Frances S Ligler
- Department of Biomedical Engineering, Texas A&M University, 101 Bizzell Street, College Station, TX, 77843, USA
| | - Victoria L Bae-Jump
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, 450 West Drive, Chapel Hill, NC, 27599, USA
- Division of Gynecologic Oncology, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC, 27599, USA
| | - Suzanne E Fenton
- Curriculum in Toxicology & Environmental Medicine, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC, 27599, USA
- Mechanistic Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, Durham, NC, 27709, USA
| | - Imran Rizvi
- Curriculum in Toxicology & Environmental Medicine, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC, 27599, USA.
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC 27599, USA; Engineering Building III, North Carolina State University, Raleigh, NC, 27606, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, 450 West Drive, Chapel Hill, NC, 27599, USA.
- Center for Environmental Health and Susceptibility, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
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Li Y, Zheng N, Sun S, Wang S, Li X, Pan J, Li M, Lang L, Yue Z, Zhou B. Exposure estimates of parabens from personal care products compared with biomonitoring data in human hair from Northeast China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 267:115635. [PMID: 37897980 DOI: 10.1016/j.ecoenv.2023.115635] [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: 08/10/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 10/30/2023]
Abstract
Parabens (PBs), a class of endocrine-disrupting chemicals (EDCs), are extensively used as additives in personal care products (PCPs); however, distinguishing between endogenous and exogenous contamination from PCPs in hair remains a challenge. We conducted a comprehensive analysis of the levels, distribution patterns, impact factors, and sources of PBs in 119 human hair samples collected from Changchun, northeast China. The detection rates of methylparaben (MeP), propylparaben (PrP), and ethylparaben (EtP) in hair samples were found to be 100%. The concentration of PBs in hair followed the order of MeP (57.48 ng/g) > PrP (46.40 ng/g) > EtP (6.80 ng/g). The concentration of PrP in female hair was significantly higher (65.38 ng/g) than that observed in male hair (7.82 ng/g) (p < 0.05). The levels of excretion rates of MeP (ERMeP) and excretion rates of PrP (ERPrP) in the hair-dying samples (ERMeP: 17.89 ng/day; ERPrP: 14.15 ng/day) were found to be 2.52 and 2.40 times higher, respectively, compared to the non-hair-dying samples (ERMeP: 7.09 ng/day; ERPrP: 6.05 ng/day). However, the system exposure dosage (SED) results revealed that although hair dyes exhibited higher PBs, human exposure was found to be lower than certain PCPs. The results of the correlation analysis revealed that toner, face cream, body lotion, and hair conditioner were identified as the primary sources of PBs in male hair. Furthermore, the human exposure resulting from the utilization of female hair dye and serum exhibited a positive correlation with hair ERMeP and ERPrP levels, indicating in the screening of samples, excluding hair samples using hair dye and haircare essential oil can effectively avoid the interference caused by exogenous contamination from PCPs.
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Affiliation(s)
- Yunyang Li
- Key Laboratory of Groundwater Resources and Environment of the Ministry of Education, College of Environment and Resources, Jilin University, China; Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, Jilin, China; University of Chinese Academy of Sciences, Beijing, China
| | - Na Zheng
- Key Laboratory of Groundwater Resources and Environment of the Ministry of Education, College of Environment and Resources, Jilin University, China; Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, Jilin, China.
| | - Siyu Sun
- Key Laboratory of Groundwater Resources and Environment of the Ministry of Education, College of Environment and Resources, Jilin University, China
| | - Sujing Wang
- Key Laboratory of Groundwater Resources and Environment of the Ministry of Education, College of Environment and Resources, Jilin University, China
| | - Xiaoqian Li
- Key Laboratory of Groundwater Resources and Environment of the Ministry of Education, College of Environment and Resources, Jilin University, China
| | - Jiamin Pan
- Key Laboratory of Groundwater Resources and Environment of the Ministry of Education, College of Environment and Resources, Jilin University, China; Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, Jilin, China; University of Chinese Academy of Sciences, Beijing, China
| | - Muyang Li
- Jilin Province Product Quality Supervision and Inspection Institute, Changchun, China
| | - Le Lang
- Jilin Province Product Quality Supervision and Inspection Institute, Changchun, China
| | - Zelin Yue
- Jilin Province Product Quality Supervision and Inspection Institute, Changchun, China
| | - Binbin Zhou
- Changchun Sci-Tech University, Shuangyang District, Changchun, China
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Zhou Y, Lin X, Xing Y, Zhang X, Lee HK, Huang Z. Per- and Polyfluoroalkyl Substances in Personal Hygiene Products: The Implications for Human Exposure and Emission to the Environment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:8484-8495. [PMID: 37262408 DOI: 10.1021/acs.est.2c08912] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) have been related to reproductive toxicity in humans, but their occurrence in some specific personal hygiene products, i.e., sanitary pads, panty liners, tampons, paper diapers, menstrual cups, and bactericidal liquids, has not been extensively studied. This work investigated 31 representative PFAS in six categories of such personal hygiene products (n = 91). Perfluorinated carboxylic acids were the primary PFAS found in the samples, accounting for over 85% of the total concentrations of PFAS. Paper diapers contained the highest sum of PFAS concentrations (64.6 ng/g) followed by sanitary pads (52.3 ng/g) and menstrual cups (21.1 ng/g). The estimated exposure doses of perfluorooctanoic acid through dermal absorption from the use of menstrual cups and paper diapers for infants (adults) were 0.77 and 2.1 (1.2) ng/kg-bw/day, which contributed more than normal dust ingestion. The estimated emission of paper diapers and sanitary pads into the environment was 2.58 and 322 kg/year with an assumed leaching rate of 100%. The potential exposure of PFAS through the use of personal hygiene products observed in this work suggests a previously unreported exposure pathway of these chemicals to humans.
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Affiliation(s)
- Yan Zhou
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, P.R. China
| | - Xia Lin
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, P.R. China
| | - Yudong Xing
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, P.R. China
| | - Xin Zhang
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, P.R. China
| | - Hian Kee Lee
- Department of Chemistry, National University of Singapore, 3 Science Drive 3, Singapore 117543, Singapore
| | - Zhenzhen Huang
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, P.R. China
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Thacharodi A, Hassan S, Hegde TA, Thacharodi DD, Brindhadevi K, Pugazhendhi A. Water a major source of endocrine-disrupting chemicals: An overview on the occurrence, implications on human health and bioremediation strategies. ENVIRONMENTAL RESEARCH 2023; 231:116097. [PMID: 37182827 DOI: 10.1016/j.envres.2023.116097] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/24/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
Endocrine disrupting chemicals (EDCs) are toxic compounds that occur naturally or are the output of anthropogenic activities that negatively impact both humans and wildlife. A number of diseases are associated with these disruptors, including reproductive disorders, cardiovascular disorders, kidney disease, neurological disorders, autoimmune disorders, and cancer. Due to their integral role in pharmaceuticals and cosmetics, packaging companies, agro-industries, pesticides, and plasticizers, the scientific awareness on natural and artificial EDCs are increasing. As these xenobiotic compounds tend to bioaccumulate in body tissues and may also persist longer in the environment, the concentrations of these organic compounds may increase far from their original point of concentrations. Water remains as the major sources of how humans and animals are exposed to EDCs. However, these toxic compounds cannot be completely biodegraded nor bioremediated from the aqueous medium with conventional treatment strategies thereby requiring much more efficient strategies to combat EDC contamination. Recently, genetically engineered microorganism, genome editing, and the knowledge of protein and metabolic engineering has revolutionized the field of bioremediation thereby helping to breakdown EDCs effectively. This review shed lights on understanding the importance of aquatic mediums as a source of EDCs exposure. Furthermore, the review sheds light on the consequences of these EDCs on human health as well as highlights the importance of different remediation and bioremediation approaches. Particular attention is paid to the recent trends and perspectives in order to attain sustainable approaches to the bioremediation of EDCs. Additionally, rigorous restrictions to preclude the discharge of estrogenic chemicals into the environment should be followed in efforts to combat EDC pollution.
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Affiliation(s)
- Aswin Thacharodi
- Department of Biochemistry, University of Otago, Dunedin, 9054, New Zealand; Thacharodi's Laboratories, Department of Research and Development, Puducherry, 605005, India
| | - Saqib Hassan
- Future Leaders Mentoring Fellow, American Society for Microbiology, Washington, 20036, USA; Department of Microbiology, School of Life Sciences, Pondicherry University, Puducherry, 605014, India
| | - Thanushree A Hegde
- Civil Engineering Department, NMAM Institute of Technology, Nitte, Karnataka, 574110, India
| | - Dhanya Dilip Thacharodi
- Thacharodi's Laboratories, Department of Research and Development, Puducherry, 605005, India
| | - Kathirvel Brindhadevi
- Emerging Materials for Energy and Environmental Applications Research Group, School of Engineering and Technology, Van Lang University, Ho Chi Minh City, Viet Nam
| | - Arivalagan Pugazhendhi
- Emerging Materials for Energy and Environmental Applications Research Group, School of Engineering and Technology, Van Lang University, Ho Chi Minh City, Viet Nam.
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10
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Rickard BP, Tan X, Fenton SE, Rizvi I. Photodynamic Priming Overcomes Per- and Polyfluoroalkyl Substance (PFAS)-Induced Platinum Resistance in Ovarian Cancer †. Photochem Photobiol 2023; 99:793-813. [PMID: 36148678 PMCID: PMC10033467 DOI: 10.1111/php.13728] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/18/2022] [Indexed: 12/01/2022]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are widespread environmental contaminants linked to adverse outcomes, including for female reproductive biology and related cancers. We recently reported, for the first time, that PFAS induce platinum resistance in ovarian cancer, potentially through altered mitochondrial function. Platinum resistance is a major barrier in the management of ovarian cancer, necessitating complementary therapeutic approaches. Photodynamic therapy (PDT) is a light-based treatment modality that reverses platinum resistance and synergizes with platinum-based chemotherapy. The present study is the first to demonstrate the ability of photodynamic priming (PDP), a low-dose, sub-cytotoxic variant of PDT, to overcome PFAS-induced platinum resistance. Comparative studies of PDP efficacy using either benzoporphyrin derivative (BPD) or 5-aminolevulinic acid-induced protoporphyrin IX (PpIX) were conducted in two human ovarian cancer cell lines (NIH:OVCAR-3 and Caov-3). BPD and PpIX are clinically approved photosensitizers that preferentially localize to, or are partly synthesized in, mitochondria. PDP overcomes carboplatin resistance in PFAS-exposed ovarian cancer cells, demonstrating the feasibility of this approach to target the deleterious effects of environmental contaminants. Decreased survival fraction in PDP + carboplatin treated cells was accompanied by decreased mitochondrial membrane potential, suggesting that PDP modulates the mitochondrial membrane, reducing membrane potential and re-sensitizing ovarian cancer cells to carboplatin.
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Affiliation(s)
- Brittany P. Rickard
- Curriculum in Toxicology & Environmental Medicine, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xianming Tan
- Department of Biostatistics, University of North Carolina School of Public Health, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Suzanne E. Fenton
- Curriculum in Toxicology & Environmental Medicine, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA
| | - Imran Rizvi
- Curriculum in Toxicology & Environmental Medicine, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
- Center for Environmental Health and Susceptibility, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; North Carolina State University, Raleigh, NC 27606, USA
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11
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Szczęsna D, Wieczorek K, Jurewicz J. An exposure to endocrine active persistent pollutants and endometriosis - a review of current epidemiological studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:13974-13993. [PMID: 36564686 PMCID: PMC9908711 DOI: 10.1007/s11356-022-24785-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Widespread exposure to persistent pollutants can disrupt the bodies' natural endocrine functions and contribute to reproductive diseases like endometriosis. In this review, we focus at the relationship between endocrine-disrupting chemicals (EDCs), including metals and trace elements, organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated biphenyls (PBBs), poly-brominated diphenyl ethers (PBDEs), polychlorinated dibenzodioxin (PCDDs), polychlorinated dibenzofurans (PCDFs), and per- and polyfluoroalkyl substances (PFAS) exposure and risk of endometriosis. Relevant studies from the last 10 years by November 2022 were identified by searching Pubmed, Web of Science, and Scopus. The cohort and case-control studies that reported effect size with 95% confidence intervals (CIs) of EDC exposure and endometriosis were selected. Twenty three articles examining the relationship between endometriosis and exposure to persistent EDCs were considered. Most of the studies indicated association with exposure to persistent chemicals and development of endometriosis. The consistent results were found in case of lead, PCB-28, PCB-138, PCB-153, PCB-180, PCB-201, 1,2,3,7,8 - PeCDD, 2,3,4,7,8 - PeCDF and all described OCPs, showing the increased risk of endometriosis. These results support that exposure to certain EDCs, including OCPs, PCBs, PBBs, PBDEs, PFAS, and lead increase the risk of endometriosis.
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Affiliation(s)
- Dorota Szczęsna
- Department of Chemical Safety, Nofer Institute of Occupational Medicine, St. Teresa Street 8, 91-348, Lodz, Poland.
| | - Katarzyna Wieczorek
- Department of Chemical Safety, Nofer Institute of Occupational Medicine, St. Teresa Street 8, 91-348, Lodz, Poland
| | - Joanna Jurewicz
- Department of Toxicology, Medical University of Lodz, Muszyńskiego 1A Street, 90-151, Lodz, Poland
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12
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Shen H, Gao M, Li Q, Sun H, Jiang Y, Liu L, Wu J, Yu X, Jia T, Xin Y, Han S, Wang Y, Zhang X. Effect of PFOA exposure on diminished ovarian reserve and its metabolism. Reprod Biol Endocrinol 2023; 21:16. [PMID: 36726108 PMCID: PMC9890749 DOI: 10.1186/s12958-023-01056-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/05/2023] [Indexed: 02/03/2023] Open
Abstract
Owing to its difficulty in degrading and ease of accumulation in the body, perfluorooctanoic acid (PFOA) has a detrimental effect on reproduction. This study aimed to examine the effect of PFOA concentration in follicular fluid during ovulation stimulation on embryo quality and the impact of PFOA exposure on the metabolic components of follicular fluid. This was a single-center prospective study that included 25 patients with diminished ovarian reserve (DOR), 25 with normal ovarian reserve (NOR), and 25 with polycystic ovary syndrome (PCOS). Follicular fluid samples were analyzed using ultra-high performance liquid chromatography-tandem mass spectrometry. We demonstrated that the PFOA levels of follicular fluid in the DOR group were higher than those in the NOR group and PCOS group (P < 0.05). PFOA concentration in the PCOS group was negatively correlated with high-quality embryos (P < 0.05). To gain more insight into the impact of PFOA on the metabolic composition of follicular fluid, we classified the DOR group based on the PFOA concentration, for which metabolomic analysis was performed. In the high-concentration PFOA group, there was an increase and a decrease in three and nine metabolites, respectively, compared to that in the low-concentration group. These results suggest that PFOA may alter the metabolic composition of follicular fluid, thus, affecting ovarian reserve function.
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Affiliation(s)
- Haofei Shen
- Lanzhou University, Lanzhou, 730000, Gansu, China
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China
- Gansu International Scientific and Technological Cooperation Base of Reproductive Medicine Transformation Application, Lanzhou, 730030, Gansu, China
| | - Min Gao
- Lanzhou University, Lanzhou, 730000, Gansu, China
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China
| | - Qiuyuan Li
- Lanzhou University, Lanzhou, 730000, Gansu, China
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China
| | - Huipeng Sun
- Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Yingdi Jiang
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China
| | - Lihong Liu
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China
| | - Jingyuan Wu
- Lanzhou University, Lanzhou, 730000, Gansu, China
- Gansu International Scientific and Technological Cooperation Base of Reproductive Medicine Transformation Application, Lanzhou, 730030, Gansu, China
| | - Xiao Yu
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China
| | - Tianyu Jia
- Lanzhou University, Lanzhou, 730000, Gansu, China
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China
| | - Yongan Xin
- Linxia Hui Autonomous Prefecture Maternity and Childcare Hospital, Linxia, China
| | - Shiqiang Han
- Linxia Hui Autonomous Prefecture Maternity and Childcare Hospital, Linxia, China.
| | - Yiqing Wang
- Lanzhou University, Lanzhou, 730000, Gansu, China.
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China.
- Gansu International Scientific and Technological Cooperation Base of Reproductive Medicine Transformation Application, Lanzhou, 730030, Gansu, China.
| | - Xuehong Zhang
- Lanzhou University, Lanzhou, 730000, Gansu, China.
- Lanzhou University First Affiliated Hospital, Lanzhou, 730030, Gansu, China.
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13
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Tan Y, Zeng Z, Liang H, Weng X, Yao H, Fu Y, Li Y, Chen J, Wei X, Jing C. Association between Perfluoroalkyl and Polyfluoroalkyl Substances and Women's Infertility, NHANES 2013-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15348. [PMID: 36430067 PMCID: PMC9692248 DOI: 10.3390/ijerph192215348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are widely used in consumer products. However, the role of PFAS in infertility is still poorly understood. A total of 788 women from the 2013-2016 nationally representative NHANES were included to explore the association between PFAS exposure and self-reported infertility. Six PFAS, including PFDE, PFNA, PFHxS, n-PFOA, n-PFOS, and Sm-PFOS, were detected by online SPE-HPLC-TIS-MS/MS. We used the generalized linear regression model (GLM), generalized additive models (GAM), and Bayesian kernel machine regression (BKMR) to assess the single effects, non-linear relationships, and mixed effects on women's infertility, respectively. The prevalence of self-reported infertility was 15.54% in this study. In GLM, n-PFOA showed a negative association with self-reported infertility in women for the Q3 (OR: 0.396, 95% CI: 0.119, 0.788) and Q4 (OR: 0.380, 95% CI: 0.172-0.842) compared with Q1 (p for trend = 0.013). A negative trend was also observed in n-PFOS and ∑PFOS (p for trend < 0.05). In GAM, a non-linear relationship was revealed in Sm-PFOS, which exhibits a U-shaped relationship. The BKMR model indicated that there might be a joint effect between PFAS and women's infertility, to which PFNA contributed the highest effect (PIP = 0.435). Moreover, age stratification analysis showed a different dose-response curve in under and above 35 years old. Women under the age of 35 have a more noticeable U-shaped relationship with infertility. Therefore, the relatively low level of mixed PFAS exposure was negatively associated with self-reported infertility in women in general, and the impact of PFAS on infertility may vary among women of different age groups. Further studies are needed to determine the etiological relationship.
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Affiliation(s)
- Yuxuan Tan
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
| | - Zurui Zeng
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
- Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510632, China
| | - Huanzhu Liang
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
| | - Xueqiong Weng
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Huojie Yao
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
| | - Yingyin Fu
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
| | - Yexin Li
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
| | - Jingmin Chen
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
| | - Xiangcai Wei
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
- Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510632, China
| | - Chunxia Jing
- Department of Preventive Medicine and Public Health, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou 510632, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou 510632, China
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14
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Marlatt VL, Bayen S, Castaneda-Cortès D, Delbès G, Grigorova P, Langlois VS, Martyniuk CJ, Metcalfe CD, Parent L, Rwigemera A, Thomson P, Van Der Kraak G. Impacts of endocrine disrupting chemicals on reproduction in wildlife and humans. ENVIRONMENTAL RESEARCH 2022; 208:112584. [PMID: 34951986 DOI: 10.1016/j.envres.2021.112584] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
Endocrine disrupting chemicals (EDCs) are ubiquitous in aquatic and terrestrial environments. The main objective of this review was to summarize the current knowledge of the impacts of EDCs on reproductive success in wildlife and humans. The examples selected often include a retrospective assessment of the knowledge of reproductive impacts over time to discern how the effects of EDCs have changed over the last several decades. Collectively, the evidence summarized here within reinforce the concept that reproduction in wildlife and humans is negatively impacted by anthropogenic chemicals, with several altering endocrine system function. These observations of chemicals interfering with different aspects of the reproductive endocrine axis are particularly pronounced for aquatic species and are often corroborated by laboratory-based experiments (i.e. fish, amphibians, birds). Noteworthy, many of these same indicators are also observed in epidemiological studies in mammalian wildlife and humans. Given the vast array of reproductive strategies used by animals, it is perhaps not surprising that no single disrupted target is predictive of reproductive effects. Nevertheless, there are some general features of the endocrine control of reproduction, and in particular, the critical role that steroid hormones play in these processes that confer a high degree of susceptibility to environmental chemicals. New research is needed on the implications of chemical exposures during development and the potential for long-term reproductive effects. Future emphasis on field-based observations that can form the basis of more deliberate, extensive, and long-term population level studies to monitor contaminant effects, including adverse effects on the endocrine system, are key to addressing these knowledge gaps.
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Affiliation(s)
- V L Marlatt
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
| | - S Bayen
- Department of Food Science and Agricultural Chemistry, McGill University, Montreal, QC, Canada
| | - D Castaneda-Cortès
- Centre Eau Terre Environnement, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - G Delbès
- Centre Armand Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - P Grigorova
- Département Science et Technologie, Université TELUQ, Montréal, QC, Canada
| | - V S Langlois
- Centre Eau Terre Environnement, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - C J Martyniuk
- Center for Environmental and Human Toxicology, Department of Physiological Sciences, University of Florida, Gainesville, FL, United States
| | - C D Metcalfe
- School of Environment, Trent University, Trent, Canada
| | - L Parent
- Département Science et Technologie, Université TELUQ, Montréal, QC, Canada
| | - A Rwigemera
- Centre Armand Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - P Thomson
- Centre Eau Terre Environnement, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - G Van Der Kraak
- Department of Integrative Biology, University of Guelph, Guelph, ON, Canada
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15
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Rickard BP, Rizvi I, Fenton SE. Per- and poly-fluoroalkyl substances (PFAS) and female reproductive outcomes: PFAS elimination, endocrine-mediated effects, and disease. Toxicology 2022; 465:153031. [PMID: 34774661 PMCID: PMC8743032 DOI: 10.1016/j.tox.2021.153031] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/29/2021] [Accepted: 11/08/2021] [Indexed: 01/17/2023]
Abstract
Per- and poly-fluoroalkyl substances (PFAS) are widespread environmental contaminants frequently detected in drinking water supplies worldwide that have been linked to a variety of adverse reproductive health outcomes in women. Compared to men, reproductive health effects in women are generally understudied while global trends in female reproduction rates are declining. Many factors may contribute to the observed decline in female reproduction, one of which is environmental contaminant exposure. PFAS have been used in home, food storage, personal care and industrial products for decades. Despite the phase-out of some legacy PFAS due to their environmental persistence and adverse health effects, alternative, short-chain and legacy PFAS mixtures will continue to pollute water and air and adversely influence women's health. Studies have shown that both long- and short-chain PFAS disrupt normal reproductive function in women through altering hormone secretion, menstrual cyclicity, and fertility. Here, we summarize the role of a variety of PFAS and PFAS mixtures in female reproductive tract dysfunction and disease. Since these chemicals may affect reproductive tissues directly or indirectly through endocrine disruption, the role of PFAS in breast, thyroid, and hypothalamic-pituitary-gonadal axis function are also discussed as the interplay between these tissues may be critical in understanding the long-term reproductive health effects of PFAS in women. A major research gap is the need for mechanism of action data - the targets for PFAS in the female reproductive and endocrine systems are not evident, but the effects are many. Given the global decline in female fecundity and the ability of PFAS to negatively impact female reproductive health, further studies are needed to examine effects on endocrine target tissues involved in the onset of reproductive disorders of women.
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Affiliation(s)
- Brittany P Rickard
- Curriculum in Toxicology & Environmental Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, North Carolina State University, Raleigh, NC 27599, USA
| | - Imran Rizvi
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, North Carolina State University, Raleigh, NC 27599, USA; Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Suzanne E Fenton
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, 111 TW Alexander Dr., Rm E121A, Research Triangle Park, NC 27709, USA.
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16
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Hammarstrand S, Jakobsson K, Andersson E, Xu Y, Li Y, Olovsson M, Andersson EM. Perfluoroalkyl substances (PFAS) in drinking water and risk for polycystic ovarian syndrome, uterine leiomyoma, and endometriosis: A Swedish cohort study. ENVIRONMENT INTERNATIONAL 2021; 157:106819. [PMID: 34391986 DOI: 10.1016/j.envint.2021.106819] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/14/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Perfluorinated substances (PFAS) are chemicals with endocrine disruptive properties that may interfere with the female reproductive system. However, few studies have explored the association between benign gynecological diseases and high PFAS exposure. OBJECTIVES The aim of this study was to investigate the possible associations between PFAS exposure and subsequent diagnosis of polycystic ovarian syndrome (PCOS), uterine leiomyoma (fibroids), and endometriosis in a cohort exposed to PFAS through drinking water. MATERIAL AND METHODS In 2013, high levels (with sum of PFAS above 10,000 ng/L), dominated by perfluorooctanesulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS), were found in the drinking water from one of the two waterworks in Ronneby, Sweden. The contamination came from firefighting foams used at a nearby airfield. Females of all ages (n = 29,106) who had ever resided in the municipality between 1985 and 2013 formed a cohort. Individual exposure was assessed based on municipality waterworks distribution data linked to annual residential address data; 27% of the females had ever lived at an address with PFAS-contaminated water. Gynecological health outcomes were retrieved from the Swedish National Patient Register. The Cox proportional hazards model was used to estimate the association between exposure and each diagnosis. RESULTS There were in all 161 cases of PCOS, 1,122 cases of uterine leiomyoma, and 373 cases of endometriosis. In women aged 20-50 years (n = 18,503), those with the highest estimated PFAS exposure had increased hazard ratios (HR) for PCOS (HR = 2.18; 95% confidence interval (CI) 1.43, 3.34) and uterine leiomyoma (HR = 1.28; 95% CI 0.95, 1.74). No increased HR for endometriosis was found (HR = 0.74; 95% CI 0.42, 1.29). CONCLUSIONS Exposure to high levels of PFAS in drinking water was associated with increased risk of PCOS and possibly uterine leiomyoma, but not endometriosis. The findings for PCOS are consistent with prior studies reporting positive associations between PCOS and PFAS exposure at background levels.
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Affiliation(s)
- Sofia Hammarstrand
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Kristina Jakobsson
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Andersson
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Yiyi Xu
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ying Li
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Eva M Andersson
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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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: 604] [Impact Index Per Article: 201.3] [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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18
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Hölzer J, Lilienthal H, Schümann M. Human Biomonitoring (HBM)-I values for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) - Description, derivation and discussion. Regul Toxicol Pharmacol 2021; 121:104862. [PMID: 33444659 DOI: 10.1016/j.yrtph.2021.104862] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/27/2020] [Accepted: 01/05/2021] [Indexed: 01/09/2023]
Abstract
In 2016, the German Human Biomonitoring Commission (HBM-C) published a statement on its decision to develop HBM-I values for Perfluorooctanoic acid (PFOA) and Perfluorooctanesulfonic acid (PFOS) (Bundesgesundheitsbl 2016, 59:1364 DOI 10.1007/s00103-016-2437-1). The HBM-I value corresponds to the concentration of a substance in a human biological material below which no adverse health effects are expected, according to current knowledge and assessment by the HBM-C, and, consequently, there is no need for action. Evidence for associations between PFOA- and PFOS-body burden and health outcomes was found for fertility and pregnancy, weights of newborns at birth, lipid metabolism, immunity, sex hormones and age at puberty/menarche, thyroid hormones, onset of menopause as well as uric acid metabolism. Significant contrasts were reported for human blood plasma concentrations between 1 and 10 ng PFOA/mL, and 1-15 ng PFOS/mL, respectively. Within the reported ranges, the HBM-C has decided to set the HBM-I-values at 2 ng PFOA/mL and 5 ng PFOS/mL blood plasma. The underlying pathomechanisms do not appear to be sufficiently clarified to provide an unambiguous explanation of the effects observed. Consistency of toxicological and epidemiological data has been considered. The available data do not indicate an unequivocal proof of a genotoxicity of PFOA and PFOS.
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Affiliation(s)
- Jürgen Hölzer
- Department for Hygiene, Social and Environmental Medicine, MA 1/31, Ruhr-University Bochum, Universitätsstrasse 150, 44801, Bochum, Germany.
| | - Hellmuth Lilienthal
- Department for Hygiene, Social and Environmental Medicine, MA 1/31, Ruhr-University Bochum, Universitätsstrasse 150, 44801, Bochum, Germany
| | - Michael Schümann
- Department for Hygiene, Social and Environmental Medicine, MA 1/31, Ruhr-University Bochum, Universitätsstrasse 150, 44801, Bochum, Germany
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19
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Caporossi L, Capanna S, Viganò P, Alteri A, Papaleo B. From Environmental to Possible Occupational Exposure to Risk Factors: What Role Do They Play in the Etiology of Endometriosis? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020532. [PMID: 33440623 PMCID: PMC7826798 DOI: 10.3390/ijerph18020532] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 01/25/2023]
Abstract
Endometriosis is a gynecological disorder characterized by the presence of endometrial stroma and glands outside the uterine cavity. A systematic review of the literature was conducted to clarify, starting from environmental exposure data, whether possible occupational risk factors may correlate with the onset of the disease. The guidelines for reporting systematic reviews of the “PRISMA” statement were followed and two databases, Scopus and PubMed, were used. Of the 422 studies selected with specific keywords, 32 publications were eligible, 28 of which referred to chemical agents and 4 related to night work. Conflicting data emerged among these studies. Although some compounds seemed to be more involved than others in the onset of endometriosis. Association with exposure to organochlorine compounds is the most supported by the epidemiological data, while other pesticide exposure did not show any clear correlation. Likewise, the hypothesis of a correlation with perfluoroalkyls exposure is not currently supported by data. The involvement of metals as risk factors has not been confirmed, while the role of night work, in the case of long service, seems to play an etiological role. In order to clarify the potential occupational risk of endometriosis development, well-designed studies are needed to evaluate the potential association between chemical compounds and disease etiology.
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Affiliation(s)
- Lidia Caporossi
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (S.C.); (B.P.)
- Correspondence:
| | - Silvia Capanna
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (S.C.); (B.P.)
| | - Paola Viganò
- IRCCS San Raffele Scientific Institute, Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, via Olgettina 60, 20132 Milan, Italy;
| | - Alessandra Alteri
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynecology Unit, via Olgettina 60, 20132 Milan, Italy;
| | - Bruno Papaleo
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Italy; (S.C.); (B.P.)
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Laws MJ, Neff AM, Brehm E, Warner GR, Flaws JA. Endocrine disrupting chemicals and reproductive disorders in women, men, and animal models. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 92:151-190. [PMID: 34452686 PMCID: PMC9743013 DOI: 10.1016/bs.apha.2021.03.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This chapter covers the known effects of endocrine disrupting chemicals (EDCs) on reproductive disorders. The EDCs represented are highly studied, including plasticizers (bisphenols and phthalates), chemicals in personal care products (parabens), persistent environmental contaminants (polychlorinated biphenyls), and chemicals in pesticides or herbicides. Both female and male reproductive disorders are reviewed in the chapter. Female disorders include infertility/subfertility, irregular reproductive cycles, early menopause, premature ovarian insufficiency, polycystic ovarian syndrome, endometriosis, and uterine fibroids. Male disorders include infertility/subfertility, cryptorchidism, and hypospadias. Findings from both human and animal studies are represented.
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21
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Kim YR, White N, Bräunig J, Vijayasarathy S, Mueller JF, Knox CL, Harden FA, Pacella R, Toms LML. Per- and poly-fluoroalkyl substances (PFASs) in follicular fluid from women experiencing infertility in Australia. ENVIRONMENTAL RESEARCH 2020; 190:109963. [PMID: 32745751 DOI: 10.1016/j.envres.2020.109963] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
UNLABELLED Per- and poly-fluoroalkyl substances (PFASs) have been widely used and detected in human matrices. Evidence that PFAS exposure may be associated with adverse human reproductive health effects exists, however, data is limited. The use of a human matrix such as follicular fluid to determine chemical exposure, along with reproductive data will be used to investigate if there is a relationship between PFAS exposure and human fertility. OBJECTIVE This study aims to: (1) assess if associations exist between PFAS concentrations and/or age and fertilisation rate (as determined in follicular fluid of women in Australia who received assisted reproductive treatment (ART)); and (2) assess if associations exist between PFAS concentrations and infertility aetiology. METHODS Follicular fluids were originally collected from participants who underwent fully stimulated ART treatment cycles at an in vitro fertilisation (IVF) clinic in the period 2006-2009 and 2010-11 in Queensland, Australia. The samples were available for analysis of 32 PFASs including perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) using high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS). 97 samples were matched with limited demographic data (age and fertilisation rate) and five infertility factors (three known female factors): 1) endometriosis, 2) polycystic ovarian syndrome (PCOS), and 3) genital tract infections - tubal/pelvic inflammation disease; as well as 4) male factor, and 5) idiopathic or unknown from either males or females. SPSS was used for linear regression analysis. RESULTS PFASs were detected in all follicular fluid samples with the mean concentrations of PFOS and PFOA, 4.9, and 2.4 ng/ml, respectively. A lower fertilisation rate was observed at higher age when age was added as a covariate, but there was no relationship between PFAS concentrations and fertilisation rate. There were few statistically significant associations between PFAS concentrations in follicular fluid and infertility factors. Log-transformed PFHxS concentrations were lower in females with endometriosis (factor 1) than in women who had reported 'male factors' as a reason of infertility, while PFHpA was higher in women who had infertile due to female factors (factor 1-3) compared to those who had infertile due to male factor. CONCLUSION PFASs were detected in follicular fluid of Australian women who had been treated at an IVF clinic. PFAS exposure found in follicular fluids is linked to increased risk of some infertility factors, and increased age was associated with decreased fertilisation rate in our data. But there was no relationship between PFAS and ferlitisation rate. Further large-scale investigations of PFAS and health effects including infertility are warranted.
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Affiliation(s)
- Young Ran Kim
- School of Public Health and Social Work, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia.
| | - Nicole White
- School of Public Health and Social Work, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia
| | - Jennifer Bräunig
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, QLD, Australia
| | - Soumini Vijayasarathy
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, QLD, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, QLD, Australia
| | - Christine L Knox
- School of Biomedical Science, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia
| | | | - Rosana Pacella
- Institute for Lifecourse Development, Faculty of Education, Health and Human Sciences, University of Greenwich, UK
| | - Leisa-Maree L Toms
- School of Public Health and Social Work, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia
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Ding N, Harlow SD, Randolph JF, Calafat AM, Mukherjee B, Batterman S, Gold EB, Park SK. Associations of Perfluoroalkyl Substances with Incident Natural Menopause: The Study of Women's Health Across the Nation. J Clin Endocrinol Metab 2020; 105:dgaa303. [PMID: 32491182 PMCID: PMC7418447 DOI: 10.1210/clinem/dgaa303] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/20/2020] [Indexed: 01/09/2023]
Abstract
CONTEXT Previous epidemiologic studies of per- and polyfluoroalkyl substances (PFASs) and menopausal timing conducted in cross-sectional settings were limited by reverse causation because PFAS serum concentrations increase after menopause. OBJECTIVES To investigate associations between perfluoroalkyl substances and incident natural menopause. DESIGN AND SETTING A prospective cohort of midlife women, the Study of Women's Health Across the Nation, 1999-2017. PARTICIPANTS 1120 multiracial/ethnic premenopausal women aged 45-56 years. METHODS Serum concentrations of perfluoroalkyls were quantified by high-performance liquid chromatography isotope dilution tandem mass spectrometry. Natural menopause was defined as the bleeding episode prior to at least 12 months of amenorrhea not due to surgery or hormone use. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Participants contributed 5466 person-years of follow-up, and 578 had incident natural menopause. Compared with the lowest tertile, women at the highest tertile of baseline serum concentrations had adjusted HR for natural menopause of 1.26 (95% CI: 1.02-1.57) for n-perfluorooctane sulfonic acid (n-PFOS) (Ptrend = .03), 1.27 (95% CI: 1.01-1.59) for branched-PFOS (Ptrend = .03), and 1.31 (95% CI: 1.04-1.65) for n-perfluorooctanoic acid (Ptrend = .01). Women were classified into four clusters based on their overall PFAS concentrations as mixtures: low, low-medium, medium-high, and high. Compared with the low cluster, the high cluster had a HR of 1.63 (95% CI: 1.08-2.45), which is equivalent to 2.0 years earlier median time to natural menopause. CONCLUSION This study suggests that select PFAS serum concentrations are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.
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Affiliation(s)
- Ning Ding
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - John F Randolph
- Department of Obstetrics and Gynecology, School of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Civil and Environmental Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan
| | - Ellen B Gold
- Department of Public Health Sciences, University of California, Davis, School of Medicine, Davis, California
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Upson K. Environmental risk factors for endometriosis: A critical evaluation of studies and recommendations from the epidemiologic perspective. CURR EPIDEMIOL REP 2020; 7:149-170. [PMID: 33042729 DOI: 10.1007/s40471-020-00236-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose of review Recent studies of environmental chemicals and endometriosis were critically evaluated from the epidemiologic perspective to identify aspects of study design and analyses that may contribute to discrepant results across studies. Recent findings Of the 29 studies reviewed, 12 studies used new approaches to population-based sampling. The remaining studies were conducted primarily among patients undergoing pelvic surgery; controls may not represent the exposure experience of the underlying study base, resulting in biased estimates of associations. Most studies used biologic specimens collected near diagnosis and varied in analytic approaches to minimize bias. Few studies investigated ovarian, deep-infiltrating, and peritoneal endometriosis presentations separately. Summary Recommendations to move the field forward include: (1) control selection from a defined study base, (2) exposure characterization during the etiologically-relevant window, (3) employment of best practices to minimize bias in analyses, and (4) separate consideration of endometriosis presentations that may be etiologically-distinct entities.
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Affiliation(s)
- Kristen Upson
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
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24
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Kahn LG, Philippat C, Nakayama SF, Slama R, Trasande L. Endocrine-disrupting chemicals: implications for human health. Lancet Diabetes Endocrinol 2020; 8:703-718. [PMID: 32707118 PMCID: PMC7437820 DOI: 10.1016/s2213-8587(20)30129-7] [Citation(s) in RCA: 315] [Impact Index Per Article: 78.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/03/2020] [Accepted: 04/02/2020] [Indexed: 12/27/2022]
Abstract
Since reports published in 2015 and 2016 identified 15 probable exposure-outcome associations, there has been an increase in studies in humans of exposure to endocrine-disrupting chemicals (EDCs) and a deepened understanding of their effects on human health. In this Series paper, we have reviewed subsequent additions to the literature and identified new exposure-outcome associations with substantial human evidence. Evidence is particularly strong for relations between perfluoroalkyl substances and child and adult obesity, impaired glucose tolerance, gestational diabetes, reduced birthweight, reduced semen quality, polycystic ovarian syndrome, endometriosis, and breast cancer. Evidence also exists for relations between bisphenols and adult diabetes, reduced semen quality, and polycystic ovarian syndrome; phthalates and prematurity, reduced anogenital distance in boys, childhood obesity, and impaired glucose tolerance; organophosphate pesticides and reduced semen quality; and occupational exposure to pesticides and prostate cancer. Greater evidence has accumulated than was previously identified for cognitive deficits and attention-deficit disorder in children following prenatal exposure to bisphenol A, organophosphate pesticides, and polybrominated flame retardants. Although systematic evaluation is needed of the probability and strength of these exposure-outcome relations, the growing evidence supports urgent action to reduce exposure to EDCs.
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Affiliation(s)
- Linda G Kahn
- Department of Pediatrics, New York University, New York, NY, USA
| | - Claire Philippat
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Shoji F Nakayama
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Rémy Slama
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Leonardo Trasande
- Department of Pediatrics, New York University, New York, NY, USA; Department of Environmental Medicine, and Department of Population Health, New York University Grossman School of Medicine and New York University School of Global Public Health, New York University, New York, NY, USA.
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Björvang RD, Damdimopoulou P. Persistent environmental endocrine-disrupting chemicals in ovarian follicular fluid and in vitro fertilization treatment outcome in women. Ups J Med Sci 2020; 125:85-94. [PMID: 32093529 PMCID: PMC7721012 DOI: 10.1080/03009734.2020.1727073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 02/07/2023] Open
Abstract
Several international organizations have recently highlighted endocrine-disrupting chemicals (EDCs) as factors of concern in human reproduction. Since successful reproduction is dependent on timely and appropriate action of hormones, disruption of the endocrine system could lead to difficulties in conceiving or carrying a pregnancy to term. EDCs are chemicals that disrupt the endocrine system by activating or inhibiting receptors of the endocrine system, and/or altering hormone receptor expression; signal transduction; epigenetic marks; hormone synthesis, transport, distribution, and metabolism; and the fate of hormone-producing cells. Due to the increasing production of industrial chemicals over the past century and their lenient control, EDCs are now common contaminants in the environment. Consequently, everyone faces a life-long exposure to mixtures of chemicals, some of which have been identified as EDCs. As birth rates in humans are declining and the use of assisted reproductive technologies increasing, it is timely to consider possible effects of EDCs on human reproduction and fertility. In this review, we focus on persistent EDCs, their occurrence in ovarian follicular fluid, and associations to treatment outcomes in assisted reproduction. Our summary shows that despite being banned decades ago, mixtures of persistent EDCs are still detected in the ovarian follicular fluid, demonstrating direct exposure of oocytes to these chemicals. In addition, there are several reported associations between exposure and worse outcome in in vitro fertilization. Further research is therefore warranted to prove causality, which will lead towards better regulation and exposure reduction.
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Affiliation(s)
- Richelle D. Björvang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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26
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Endocrine Disruptors in Water and Their Effects on the Reproductive System. Int J Mol Sci 2020; 21:ijms21061929. [PMID: 32178293 PMCID: PMC7139484 DOI: 10.3390/ijms21061929] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022] Open
Abstract
Anthropogenic contaminants in water can impose risks to reproductive health. Most of these compounds are known to be endocrine disrupting chemicals (EDCs). EDCs can impact the endocrine system and subsequently impair the development and fertility of non-human animals and humans. The source of chemical contamination in water is diverse, originating from byproducts formed during water disinfection processes, release from industry and livestock activity, or therapeutic drugs released into sewage. This review discusses the occurrence of EDCs in water such as disinfection byproducts, fluorinated compounds, bisphenol A, phthalates, pesticides, and estrogens, and it outlines their adverse reproductive effects in non-human animals and humans.
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Li AJ, Chen Z, Lin TC, Buck Louis GM, Kannan K. Association of urinary metabolites of organophosphate and pyrethroid insecticides, and phenoxy herbicides with endometriosis. ENVIRONMENT INTERNATIONAL 2020; 136:105456. [PMID: 31924582 PMCID: PMC7023990 DOI: 10.1016/j.envint.2019.105456] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/13/2019] [Accepted: 12/27/2019] [Indexed: 05/14/2023]
Abstract
Endometriosis is a hormone-responsive gynecologic disease, signifying its connotations across a woman's life span. Previous studies suggested that endocrine disrupting chemicals were risk factors for endometriosis. Nevertheless, little is known on exposure to organophosphate, pyrethroid and phenoxy acid pesticides on endometriosis diagnosis. In this study, we determined the concentrations of 11 pesticides, metabolites of organophosphate and pyrethroid insecticides, and phenoxy herbicides, in urine collected from 619 reproductive-age women in Utah and California, using liquid chromatography-tandem mass spectrometry. The association of urinary concentrations of pesticides with an increase in the odds of endometriosis diagnosis was examined in 594 women who underwent laparoscopy/laparotomy (operative cohort: n = 471) or pelvic magnetic resonance imaging (population cohort: n = 123), during 2007-2009. 2-Isopropyl-4-methyl-6-hydroxypyrimidine (IMPY), malathion dicarboxylic acid (MDA), para-nitrophenol (PNP), 3,5,6-trichloro-2-pyridinol (TCPY), 3-phenoxybenzoic acid (3-PBA), and 2,4-dichlorophenoxyacetic acid (2,4-D) were detected in ≥95% of the urine samples analyzed. Urinary concentrations of IMPY, MDA, PNP, 3-PBA and 2,4-D tended to be higher in younger, non-Hispanic black, nulliparous and less affluent women. IMPY was the most dominant compound in urine followed by PNP and TCPY. When women in the 4th quartile of IMPY and the 2nd quartile of TCPY concentrations (μg/g creatinine) were compared with women in the 1st quartile, the odds ratios (ORs) for diagnosis of endometriosis increased significantly in unadjusted models (IMPY OR = 1.89, 95% confidence interval (Cl) = 1.12-3.20; TCPY OR = 1.65, 95% Cl = 1.02-2.69) for the operative (n = 471) and entire data set (n = 594), respectively. Our results suggest that exposure to elevated concentrations of diazinon (the parent compound of IMPY) and chlorpyrifos and chlorpyrifos-methyl (parent compounds of TCPY) may be associated with endometriosis.
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Affiliation(s)
- Adela Jing Li
- Wadsworth Center, New York State Department of Health, and Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Empire State Plaza, P.O. Box 509, Albany, NY 12201-0509, United States
| | - Zhen Chen
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, United States
| | - Tzu-Chun Lin
- Glotech Inc. 1801 Research Blvd. Suite 605, Rockville, MD, United States
| | - Germaine M Buck Louis
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, United States; Dean's Office, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, and Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Empire State Plaza, P.O. Box 509, Albany, NY 12201-0509, United States; Biochemistry Department, Faculty of Science and Experimental Biochemistry Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
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Bougie O, Yap MI, Sikora L, Flaxman T, Singh S. Influence of race/ethnicity on prevalence and presentation of endometriosis: a systematic review and meta-analysis. BJOG 2019; 126:1104-1115. [PMID: 30908874 DOI: 10.1111/1471-0528.15692] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Understanding the impact of race/ethnicity on the prevalence and presentation of endometriosis may help improve patient care. OBJECTIVE To review systematically the evidence for the influence of race/ethnicity on the prevalence of endometriosis. SEARCH STRATEGY CENTRAL, MEDLINE, PubMed, Embase, LILACS, SCIELO, and CINAHL databases, as well as the grey literature, were searched from date of inception until September 2017. SELECTION CRITERIA Randomised control trials and observational studies reporting on prevalence and/or clinical presentation of endometriosis. DATA COLLECTION AND ANALYSIS Twenty studies were included in the review and 18 studies were used to calculate odds ratio (OR) with 95% confidence interval (CI) through a random effects model. Methodological quality was assessed using the Newcastle-Ottawa risk of bias scale (NOS). MAIN RESULTS Compared with White women, Black woman were less likely to be diagnosed with endometriosis (OR 0.49, 95% CI 0.29-0.83), whereas Asian women were more likely to have this diagnosis (OR 1.63, 95% CI 1.03-2.58). Compared with White women, there was a statistically significant difference in likelihood of endometriosis diagnosis in Hispanic women (OR 0.46, 95% CI 0.14-1.50). Significant heterogeneity (I2 > 50%) was present in the analysis for all racial/ethnic groups but was partially reduced in subgroup analysis by clinical presentation, particularly when endometriosis was diagnosed as self-reported, CONCLUSIONS: Prevalence of endometriosis appears to be influenced by race/ethnicity. Most notably, Black women appear less likely to be diagnosed with endometriosis compared with White women. There is scarce literature exploring the influence of race/ethnicity on symptomatology, as well as treatment access, preference, and response. TWEETABLE ABSTRACT Prevalence of endometriosis may be influenced by race/ethnicity, but there is limited quality literature exploring this topic.
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Affiliation(s)
- O Bougie
- Department of Obstetrics and Gynaecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Ma I Yap
- Department of Obstetrics and Gynecology, St. Luke's Medical Center, Quezon City, Philippines
| | - L Sikora
- Health Sciences Library, University of Ottawa, Ottawa, ON, Canada
| | - T Flaxman
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - S Singh
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada
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Knutsen HK, Alexander J, Barregård L, Bignami M, Brüschweiler B, Ceccatelli S, Cottrill B, Dinovi M, Edler L, Grasl-Kraupp B, Hogstrand C, Hoogenboom LR, Nebbia CS, Oswald IP, Petersen A, Rose M, Roudot AC, Vleminckx C, Vollmer G, Wallace H, Bodin L, Cravedi JP, Halldorsson TI, Haug LS, Johansson N, van Loveren H, Gergelova P, Mackay K, Levorato S, van Manen M, Schwerdtle T. Risk to human health related to the presence of perfluorooctane sulfonic acid and perfluorooctanoic acid in food. EFSA J 2018; 16:e05194. [PMID: 32625773 PMCID: PMC7009575 DOI: 10.2903/j.efsa.2018.5194] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The European Commission asked EFSA for a scientific evaluation on the risks to human health related to the presence of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in food. Regarding PFOS and PFOA occurrence, the final data set available for dietary exposure assessment contained a total of 20,019 analytical results (PFOS n = 10,191 and PFOA n = 9,828). There were large differences between upper and lower bound exposure due to analytical methods with insufficient sensitivity. The CONTAM Panel considered the lower bound estimates to be closer to true exposure levels. Important contributors to the lower bound mean chronic exposure were 'Fish and other seafood', 'Meat and meat products' and 'Eggs and egg products', for PFOS, and 'Milk and dairy products', 'Drinking water' and 'Fish and other seafood' for PFOA. PFOS and PFOA are readily absorbed in the gastrointestinal tract, excreted in urine and faeces, and do not undergo metabolism. Estimated human half-lives for PFOS and PFOA are about 5 years and 2-4 years, respectively. The derivation of a health-based guidance value was based on human epidemiological studies. For PFOS, the increase in serum total cholesterol in adults, and the decrease in antibody response at vaccination in children were identified as the critical effects. For PFOA, the increase in serum total cholesterol was the critical effect. Also reduced birth weight (for both compounds) and increased prevalence of high serum levels of the liver enzyme alanine aminotransferase (ALT) (for PFOA) were considered. After benchmark modelling of serum levels of PFOS and PFOA, and estimating the corresponding daily intakes, the CONTAM Panel established a tolerable weekly intake (TWI) of 13 ng/kg body weight (bw) per week for PFOS and 6 ng/kg bw per week for PFOA. For both compounds, exposure of a considerable proportion of the population exceeds the proposed TWIs.
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Knutsen HK, Alexander J, Barregård L, Bignami M, Brüschweiler B, Ceccatelli S, Cottrill B, Dinovi M, Edler L, Grasl-Kraupp B, Hogstrand C, Hoogenboom LR, Nebbia CS, Oswald IP, Petersen A, Rose M, Roudot AC, Vleminckx C, Vollmer G, Wallace H, Bodin L, Cravedi JP, Halldorsson TI, Haug LS, Johansson N, van Loveren H, Gergelova P, Mackay K, Levorato S, van Manen M, Schwerdtle T. Risk to human health related to the presence of perfluorooctane sulfonic acid and perfluorooctanoic acid in food. EFSA J 2018. [PMID: 32625773 DOI: 10.2903/j.efsa.2018.5194">10.2903/j.efsa.2018.5194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [10.2903/j.efsa.2018.5194','32625773', '10.1016/j.reprotox.2016.08.009')">Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
10.2903/j.efsa.2018.5194" />
Abstract
The European Commission asked EFSA for a scientific evaluation on the risks to human health related to the presence of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in food. Regarding PFOS and PFOA occurrence, the final data set available for dietary exposure assessment contained a total of 20,019 analytical results (PFOS n = 10,191 and PFOA n = 9,828). There were large differences between upper and lower bound exposure due to analytical methods with insufficient sensitivity. The CONTAM Panel considered the lower bound estimates to be closer to true exposure levels. Important contributors to the lower bound mean chronic exposure were 'Fish and other seafood', 'Meat and meat products' and 'Eggs and egg products', for PFOS, and 'Milk and dairy products', 'Drinking water' and 'Fish and other seafood' for PFOA. PFOS and PFOA are readily absorbed in the gastrointestinal tract, excreted in urine and faeces, and do not undergo metabolism. Estimated human half-lives for PFOS and PFOA are about 5 years and 2-4 years, respectively. The derivation of a health-based guidance value was based on human epidemiological studies. For PFOS, the increase in serum total cholesterol in adults, and the decrease in antibody response at vaccination in children were identified as the critical effects. For PFOA, the increase in serum total cholesterol was the critical effect. Also reduced birth weight (for both compounds) and increased prevalence of high serum levels of the liver enzyme alanine aminotransferase (ALT) (for PFOA) were considered. After benchmark modelling of serum levels of PFOS and PFOA, and estimating the corresponding daily intakes, the CONTAM Panel established a tolerable weekly intake (TWI) of 13 ng/kg body weight (bw) per week for PFOS and 6 ng/kg bw per week for PFOA. For both compounds, exposure of a considerable proportion of the population exceeds the proposed TWIs.
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Ableitung von HBM-I-Werten für Perfluoroktansäure (PFOA) und Perfluoroktansulfonsäure (PFOS) – Stellungnahme der Kommission „Humanbiomonitoring“ des Umweltbundesamts. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:474-487. [DOI: 10.1007/s00103-018-2709-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Rush EL, Singer AB, Longnecker MP, Haug LS, Sabaredzovic A, Symanski E, Whitworth KW. Oral contraceptive use as a determinant of plasma concentrations of perfluoroalkyl substances among women in the Norwegian Mother and Child Cohort (MoBa) study. ENVIRONMENT INTERNATIONAL 2018; 112:156-164. [PMID: 29274593 PMCID: PMC5899038 DOI: 10.1016/j.envint.2017.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/08/2017] [Accepted: 12/11/2017] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Because oral contraceptives (OC) tends to lessen menstrual fluid loss - a route of excretion for perfluoroalkyl substances (PFASs) - we hypothesized that such use would be positively associated with PFAS concentrations. METHODS This analysis was based on the Norwegian Mother and Child Cohort (MoBa) study. We included 1090 women from two previous substudies of women enrolled from 2003 to 2007. Characteristics of OC use were obtained at baseline: use in the past 12months, duration and recency of use, age at first use. We examined log-transformed plasma concentrations of seven PFASs (perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS), and perfluorooctane sulfonate (PFOS)). Linear regression analyses, adjusted for maternal age, menstrual cycle length, parity, and education, were used to examine whether OC use characteristics were determinants of PFAS concentrations. RESULTS Except for PFDA and PFUnDA, women who used OCs in the 12months preceding the baseline interview had 12.9-35.7% higher PFAS concentrations than never OC users. To a lesser extent, past OC use was positively associated with PFASs (estimates ranged from 7.2-32.1%). Compared with never users, using OCs for 10 or more years was associated with increased PFAS concentrations, except for PFDA and PFUnDA (estimates for other PFASs ranged from 18.9-46.2%). We observed little effect of age at first OC use. CONCLUSIONS This analysis shows that characteristics of OC use, and duration of use in particular, may be important considerations when investigating relationships between women's reproductive outcomes and PFASs.
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Affiliation(s)
- Elise L Rush
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health in San Antonio, San Antonio, TX, USA
| | - Alison B Singer
- The Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Matthew P Longnecker
- National Institute for Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, NC, USA
| | - Line S Haug
- Department of Exposure Assessment and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Azemira Sabaredzovic
- Department of Exposure Assessment and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Elaine Symanski
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA; Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Kristina W Whitworth
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health in San Antonio, San Antonio, TX, USA; Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA.
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Wang B, Zhang R, Jin F, Lou H, Mao Y, Zhu W, Zhou W, Zhang P, Zhang J. Perfluoroalkyl substances and endometriosis-related infertility in Chinese women. ENVIRONMENT INTERNATIONAL 2017; 102:207-212. [PMID: 28283302 DOI: 10.1016/j.envint.2017.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/23/2017] [Accepted: 03/01/2017] [Indexed: 06/06/2023]
Abstract
Endometriosis is one of the main causes for female infertility. Previous studies suggested that perfluoroalkyl substances (PFASs), a group of ubiquitous environmental chemicals with properties of endocrine disruption and reproductive toxicity, were risk factors for endometriosis but there lacks direct evidence on the possible role of PFASs in endometriosis-related infertility. To fill this gap, we examined the association between PFASs and endometriosis-related infertility among Chinese reproductive-age women in a case-control study, which comprised 157 surgically confirmed endometriosis cases and 178 controls seeking infertility treatment because of male reproductive dysfunction in 2014 and 2015. Blood specimens were collected at the enrollment and analyzed for ten PFASs. Logistic regression was utilized to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) for individual PFAS compound. Plasma concentrations of perfluorobutane sulfonic acid (PFBS) were associated with an increased risk of endometriosis-related infertility (second vs. lowest tertile: OR=3.74, 95% CI: 2.04, 6.84; highest vs. lowest tertile: OR=3.04, 95% CI: 1.65, 5.57). This association remained consistent when we restricted to subjects with no previous pregnancy (second vs. lowest tertile: OR=2.91, 95% CI: 1.28, 6.61; highest vs. lowest tertile: OR=3.41, 95% CI: 1.52, 7.65) or to subjects without other gynecologic pathology (second vs. lowest tertile: OR=4.65, 95% CI: 2.21, 9.82; highest vs. lowest tertile: OR=3.36, 95% CI: 1.58, 7.15). Plasma concentrations of perfluoroheptanoic acid (PFHpA), perfluorohexane sulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) were inversely associated with endometriosis-related infertility, but the associations were attenuated in the sensitivity analyses. Our preliminary evidence suggests that exposure to PFBS may increase the risk of female infertility due to endometriosis. Future prospective studies are necessary to confirm these findings.
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Affiliation(s)
- Bin Wang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Rongrong Zhang
- Department of Gynecology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Fan Jin
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Hangying Lou
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yuchan Mao
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Wenting Zhu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China; Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Wei Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Ping Zhang
- Department of Gynecology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.
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Stewart J. The relevance of experimental reproductive studies in safety assessment. CURRENT OPINION IN TOXICOLOGY 2017. [DOI: 10.1016/j.cotox.2017.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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