Poly- and perfluoroalkyl substance concentrations in human breast milk and their associations with postnatal infant growth

Maternal F-53B exposure during pregnancy and lactation affects bone growth and development in male offspring

6:2 Chlorinated polyfluoroalkyl ether sulfonate (F-53B) is a new type of perfluorinated and polyfluoroalkyl substance (PFAS) that is used extensively in industry and manufacturing. F-53B causes damage to multiple mammalian organs. However, the impacts of F-53B on bone are unknown. Maternal exposure to F-53B is of particular concern because of the vulnerability of the developing fetus and newborn to contaminants from the mother. The goal of this study was to examine the impacts of maternal F-53B exposure on bone growth and development in offspring and to explore its underlying mechanisms. Herein, C57BL/6 J mice were given free access to deionized water containing 0, 0.57, or 5.7 mg/L F-53B during pregnancy and lactation. F-53B exposure resulted in impaired liver function, decreased IGF-1 secretion, dysregulation of bone metabolism and disruption of the dynamic balance between osteoblasts and osteoclasts in male offspring. F-53B inhibits longitudinal bone growth and development and causes osteoporosis in male offspring. F-53B may affect the growth and development of offspring bone via the IGF-1/OPG/RANKL/CTSK signaling pathway. This study provides new insights for the study of short stature and bone injury caused by F-53B.

Species Difference? Bovine, Trout, and Human Plasma Protein Binding of Per- and Polyfluoroalkyl Substances

Per- and polyfluoroalkyl substances (PFAS) strongly bind to proteins and lipids in blood, which govern their accumulation and distribution in organisms. Understanding the plasma binding mechanism and species differences will facilitate the quantitative in vitro-to-in vivo extrapolation and improve risk assessment of PFAS. We studied the binding mechanism of 16 PFAS to bovine serum albumin (BSA), trout, and human plasma using solid-phase microextraction. Binding of anionic PFAS to BSA and human plasma was found to be highly concentration-dependent, while trout plasma binding was linear for the majority of the tested PFAS. At a molar ratio of PFAS to protein ν < 0.1 molPFAS/molprotein, the specific protein binding of anionic PFAS dominated their human plasma binding. This would be the scenario for physiological conditions (ν < 0.01), whereas in in vitro assays, PFAS are often dosed in excess (ν > 1) and nonspecific binding becomes dominant. BSA was shown to serve as a good surrogate for human plasma. As trout plasma contains more lipids, the nonspecific binding to lipids affected the affinities of PFAS for trout plasma. Mass balance models that are parameterized with the protein-water and lipid-water partitioning constants (chemical characteristics), as well as the protein and lipid contents of the plasma (species characteristics), were successfully used to predict the binding to human and trout plasma.

Fluoro-functionalized plant biomass adsorbent: Preparation and application in extraction of trace perfluorinated compounds from environmental water samples

Perfluorinated compounds (PFCs) are toxic and widely present in the environment, and therefore effective adsorbents are required to remove PFCs from environmental water. In the present study, a new type of fluorinated biomass materials was synthesized via an ingenious fluorosilanization reaction. These adsorbents were applied for the adsorption of 13 typical PFCs, including perfluorocarboxylic acids (PFCAs) and perfluorosulfonic acids (PFSAs). By comparing their adsorption performance, Fluorinated cedar slag (FCS) was discovered to have the best absorption efficiency and enabled highly efficient enrichment of PFCs. The adsorption recovery of FCS with the investigated PFCs is greater than 90% under the optimal adsorption condition. Ascribed to the high affinity of F-F sorbent-sorbate interaction, FCS had good adsorption capacities of PFCs from aqueous solution, with the maximum adsorption capacity of 15.80 mg/g for PFOS and 10.71 mg/g for PFOA, respectively. Moreover, the adsorption time could be achieved in a short time (8 min). Using the FCS absorbent, an innovative FCS-solid phase extraction assisted with high performance liquid chromatography-electrospray-tandem mass spectrometry (FCS-SPE-HPLC-ESI-MS/MS) method was first developed to sensitively detect PFCs in the environmental water samples. The intra-day and inter-day recovery rates of the 13 compounds ranged from 90.7%-104.3%, with the RSD of 2.1%-4.7% (intra-day) and 2.5%-8.5% (inter-day), respectively. This research demonstrates the potential of the newly fluoro-functionalized plant biomass to adsorb PFCs from environmental water, with the advantages of high adsorption efficiencies, high anti-interference, easy operation and low economic cost.

The toxic mechanism of 6:2 Cl-PFESA in adolescent male rats: Endocrine disorders and liver inflammation regulated by the gut microbiota-gut-testis/liver axis

In previous studies, 6:2 chlorinated polyfluorinated ether sulfonic acid (6:2 Cl-PFESA), a perfluorooctanesulfonate alternative, has been demonstrated to be toxic to mammals. However, the toxic mechanism of 6:2 Cl-PFESA in mammals is unknown. Herein, adolescent male rats were administered 50 μg/kg/Day 6:2 Cl-PFESA for 28 days (oral gavage) to estimate the toxicity of 6:2 Cl-PFESA and investigate its toxic mechanism. Significant changes in some hematological indicators (e.g., aspartate transaminase and neutrophils) and liver sections (inflammatory cell infiltration) indicated that 6:2 Cl-PFESA exposure caused rat hepatotoxicity. Six steroid hormones (e.g., testosterone, progesterone, and cortisol) in serum and thirteen genes in testicles (related to the pathway of steroid hormone biosynthesis) were significantly regulated in 6:2 Cl-PFESA-treated rats. This suggested that 6:2 Cl-PFESA induced rat endocrine disorders. Compared to the controls, the mean relative abundance of Ruminococcaceae, Pasteurellaceae, Micrococcaceae, and Desulfovibrionaceae was significantly regulated by 1.3-, 0.40-, 0.32-, and 3.2-fold in the 6:2 Cl-PFESA rats, respectively. The 6:2 Cl-PFESA treatment also significantly disturbed 47 gut metabolites (29 upregulated and 18 downregulated), mainly bile acids, short-chain fatty acids, and amino acids. In summary, 6:2 Cl-PFESA induced endocrine disorders and liver inflammation in rats by altering the gut microbiota-gut-testis/liver axis. This study first reveals the toxic mechanism of 6:2 Cl-PFESA in mammals through a multiomics approach and provides comprehensive insight into the toxic mechanism of 6:2 Cl-PFESA.

Early life exposure to low-dose perfluorooctane sulfonate disturbs gut barrier homeostasis and increases the risk of intestinal inflammation in offspring

Perfluorooctane sulfonate (PFOS), one of the legacy per- and poly-fluoroalkyl substances (PFAS), is associated with multiple adverse health effects on children. However, much remains to be known about its potential impacts on intestinal immune homeostasis during early life. Our study found that PFOS exposure during pregnancy in rats significantly increased the maternal serum levels of interleukin-6 (IL-6) and zonulin, a gut permeability biomarker, and decreased gene expressions of Tight junction protein 1 (Tjp1) and Claudin-4 (Cldn4), the tight junction proteins, in maternal colons on gestation day 20 (GD20). Being exposed to PFOS during pregnancy and lactation in rats significantly decreased the body weight of pups and increased the offspring's serum levels of IL-6 and tumor necrosis factor-α (TNF-α) on postnatal day 14 (PND14), and induced a disrupted gut tight junction, manifested by decreased expressions of Tjp1 in pup's colons on PND14 and increased pup's serum concentrations of zonulin on PND28. By integrating high-throughput 16S rRNA sequencing and metabolomics, we demonstrated that early-life PFOS exposure altered the diversity and composition of gut microbiota that were correlated with the changed metabolites in serum. The altered blood metabolome was associated with increased proinflammatory cytokines in offspring. These changes and correlations were divergent at each developmental stage, and pathways underlying immune homeostasis imbalance were significantly enriched in the PFOS-exposed gut. Our findings provide new evidence for the developmental toxicity of PFOS and its underlying mechanism and explain in part the epidemiological observation of its immunotoxicity.

Research Progress on Neurodevelopmental Toxicity in Offspring after Indirect Exposure to PFASs in Early Life

Per- and polyfluoroalkyl substances (PFASs) are widespread environmental pollutants. There is increasing evidence that PFASs have various adverse health effects, including renal toxicity, metabolic dysfunction, endocrine disruption, and developmental toxicity. PFASs have been found to accumulate in the placenta, and some PFASs can cross the placental barrier and subsequently accumulate in the fetus via the maternal-fetal circulation. An increasing number of studies have shown that early life exposure to PFASs can affect fetal neurodevelopment. This paper reviews the characteristics of indirect exposure to PFASs in early life, the effects on neurodevelopment in offspring, and the possible mechanisms of toxic effects.

Comparison between pollutants found in breast milk and infant formula in the last decade: A review

Since ancient times, breastfeeding has been the fundamental way of nurturing the newborn. The benefits of breast milk are widely known, as it is a source of essential nutrients and provides immunological protection, as well as developmental benefits, among others. However, when breastfeeding is not possible, infant formula is the most appropriate alternative. Its composition meets the nutritional requirements of the infant, and its quality is subject to strict control by the authorities. Nonetheless, the presence of different pollutants has been detected in both matrices. Thus, the aim of the present review is to make a comparison between the findings in both breast milk and infant formula in terms of contaminants in the last decade, in order to choose the most convenient option depending on the environmental conditions. For that, the emerging pollutants including metals, chemical compounds derived from heat treatment, pharmaceutical drugs, mycotoxins, pesticides, packaging materials, and other contaminants were described. While in breast milk the most concerning contaminants found were metals and pesticides, in infant formula pollutants such as metals, mycotoxins, and packaging materials were the most outstanding. In conclusion, the convenience of using a feeding diet based on breast milk or either infant formula depends on the maternal environmental circumstances. However, it is important to take into account the immunological benefits of the breast milk compared to the infant formula, and the possibility of using breast milk in combination with infant formula when the nutritional requirements are not fulfilled only with the intake of breast milk. Therefore, more attention should be paid in terms of analyzing these conditions in each case to be able to make a proper decision, as it will vary depending on the maternal and newborn environment.

Assessment of organohalogenated pollutants in breast milk from the Czech Republic

This biomonitoring survey brings new information on the occurrence of a total of 94 organohalogenated pollutants in 231 human breast milk samples collected in 2019 and 2021 from women living in two regions of the Czech Republic (Karvina and Ceske Budejovice). This study aimed to evaluate the concentrations of 6 indicator polychlorinated biphenyls (PCBs), 10 organochlorine pesticides (OCPs), 34 halogenated flame retardants (HFRs), 29 perfluoroalkyl and polyfluoroalkyl substances (PFAS) and 15 polychlorinated naphthalenes (PCNs). PCBs, OCPs, most of HFRs and PCNs were identified/quantified by gas chromatography coupled to (tandem) mass spectrometry (GC-MS(/MS)), while PFAS, hexabromocyclododecane isomers (HBCD), brominated phenols, and tetrabromobisphenol A (TBBPA) by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). The mean value of the sum of the 6 indicator PCBs was 123.12 nanogram per gram of lipid weight (ng g^-1 lw). Hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH) and p,p'-dichlorodiphenyl-dichloroethylene (p,p'-DDE) were the most abundant OCPs, detected in 100 % (mean 11.8 ng g^-1 lw), 94.8 % (mean 6.1 ng g^-1 lw) and 100 % (mean 101.5 ng g^-1 lw) of samples, respectively. PCN congeners 20, 52 and 66 were detected in <1 % of the samples. The HFRs concentrations were relatively low compared to the levels of OCP; The detection rate of polybrominated diphenyl ethers (PBDEs, # 47, 99 and 153) ranged 21-68 % with a mean concentrations of 0.34 ng g^-1 lw - 0.42 ng g^-1 lw. PFAS concentrations were also low, with perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) dominant in this group (means of 22 pg ml^-1 and 21 pg ml^-1, respectively). Our results confirmed the long-term trend of declining levels of banned POPs in Czech mothers. The amounts of PCBs and OCPs were higher in older breastfeeding primiparous women.

Gut Microbiome-Host Metabolome Homeostasis upon Exposure to PFOS and GenX in Male Mice

Alterations of the normal gut microbiota can cause various human health concerns. Environmental chemicals are one of the drivers of such disturbances. The aim of our study was to examine the effects of exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS)-specifically, perfluorooctane sulfonate (PFOS) and 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy) propanoic acid (GenX)-on the microbiome of the small intestine and colon, as well as on liver metabolism. Male CD-1 mice were exposed to PFOS and GenX in different concentrations and compared to controls. GenX and PFOS were found to have different effects on the bacterial community in both the small intestine and colon based on 16S rRNA profiles. High GenX doses predominantly led to increases in the abundance of Clostridium sensu stricto, Alistipes, and Ruminococcus, while PFOS generally altered Lactobacillus, Limosilactobacillus, Parabacteroides, Staphylococcus, and Ligilactobacillus. These treatments were associated with alterations in several important microbial metabolic pathways in both the small intestine and colon. Untargeted LC-MS/MS metabolomic analysis of the liver, small intestine, and colon yielded a set of compounds significantly altered by PFOS and GenX. In the liver, these metabolites were associated with the important host metabolic pathways implicated in the synthesis of lipids, steroidogenesis, and in the metabolism of amino acids, nitrogen, and bile acids. Collectively, our results suggest that PFOS and GenX exposure can cause major perturbations in the gastrointestinal tract, aggravating microbiome toxicity, hepatotoxicity, and metabolic disorders.

Emerging and Legacy Perfluoroalkyl Substances in Breastfed Chinese Infants: Renal Clearance, Body Burden, and Implications

BACKGROUND

Human breast milk is a primary route of exposure to perfluoroalkyl substances (PFAS) in infants. To understand the associated risks, the occurrence of PFAS in human milk and the toxicokinetics of PFAS in infants need to be addressed.

OBJECTIVES

We determined levels of emerging and legacy PFAS in human milk and urine samples from Chinese breastfed infants, estimated renal clearance, and predicted infant serum PFAS levels.

METHODS

In total, human milk samples were collected from 1,151 lactating mothers in 21 cities in China. In addition, 80 paired infant cord blood and urine samples were obtained from two cities. Nine emerging PFAS and 13 legacy PFAS were analyzed in the samples using ultra high-performance liquid chromatography tandem mass spectrometry. Renal clearance rates (CLrenals) of PFAS were estimated in the paired samples. PFAS serum concentrations in infants (<1 year of age) were predicted using a first-order pharmacokinetic model.

RESULTS

All nine emerging PFAS were detected in human milk, with the detection rates of 6:2 Cl-PFESA, PFMOAA, and PFO5DoDA all exceeding 70%. The level of 6:2 Cl-PFESA in human milk (median concentration=13.6 ng/L) ranked third after PFOA (336 ng/L) and PFOS (49.7 ng/L). The estimated daily intake (EDI) values of PFOA and PFOS exceeded the reference dose (RfD) of 20 ng/kg BW per day recommended by the U.S. Environmental Protection Agency in 78% and 17% of breastfed infant samples, respectively. 6:2 Cl-PFESA had the lowest infant CLrenal (0.009mL/kg BW per day), corresponding to the longest estimated half-life of 49 y. The average half-lives of PFMOAA, PFO2HxA, and PFO3OA were 0.221, 0.075, and 0.304 y, respectively. The CLrenals of PFOA, PFNA, and PFDA were slower in infants than in adults.

CONCLUSIONS

Our results demonstrate the widespread occurrence of emerging PFAS in human milk in China. The relatively high EDIs and half-lives of emerging PFAS suggest potential health risks of postnatal exposure in newborns. https://doi.org/10.1289/EHP11403.

Per- and polyfluoroalkyl substances (PFAS) in breast milk and infant formula: A global issue

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are transferred from mother to infants through breastfeeding, a time when children may be particularly vulnerable to PFAS-mediated adverse health effects. Infants can also be exposed to PFAS from infant formula consumption. Our recent literature-based scoping of breast milk levels reported that four PFAS often exceeded the United States Agency for Toxic Substances and Disease Registry (ATSDR) children's drinking water screening levels in both the general population and highly impacted communities in the U.S. and Canada. This work presents a comparison of global breast milk and infant formula PFAS measurements with the only reported health-based drinking water screening values specific to children.

METHODS

We focused on four PFAS for which ATSDR has developed children's drinking water screening values: PFOA (perfluorooctanoic acid), PFOS (perfluorooctanesulfonic acid), PFHxS (perfluorohexanesulfonic acid), and PFNA (perfluorononanoic acid). Published literature on PFAS levels in breast milk and infant formula were identified via PubMed searches. Data were compared to children's drinking water screening values.

DISCUSSION

Breast milk concentrations of PFOA and PFOS often exceed children's drinking water screening values, regardless of geographic location. The limited information on infant formula suggests its use does not necessarily result in lower PFAS exposures, especially for formulas reconstituted with drinking water containing PFAS. Unfortunately, individuals generally cannot know whether their infant's exposures exceed children's drinking water screening values. Thus, it is essential that pregnant and lactating women and others, especially those having lived in PFAS-contaminated communities, have data required to make informed decisions on infant nutrition. An international monitoring effort and access to affordable testing are needed for breast milk, drinking water and infant formula to fully understand infant PFAS exposures. Currently, our understanding of demonstrable methods for reducing exposures to emerging PFAS is limited, making this research and the communications surrounding it even more important.

Penetration of Perfluorooctanesulfonate Isomers and Their Alternatives from Maternal Blood to Milk and Its Associations with Chemical Properties and Milk Primary Components

Perfluorooctanesulfonate (PFOS) and its alternatives, including chlorinated polyfluorinated ether sulfonates (Cl-PFESAs), are mainly detected per- and polyfluoroalkyl substances (PFAS) in human samples such as milk. However, the mechanism of their blood to milk transfer was not well studied. Here, 145 paired maternal serum and human milk samples were analyzed for six PFOS isomers and Cl-PFESAs to evaluate the transfer efficiency from maternal serum to human milk (TE_HM/MS). Besides physicochemical properties, this study for the first time evaluated the influencing effects of the primary components in human milk (carbohydrate, lipid, and protein) on TE_HM/MS of PFAS. No significant association was observed between TE_HM/MS and the albumin binding affinity of the compounds (p = 0.601), but TE_HM/MS was significantly negatively correlated with the logarithmic octanol-water partition coefficients (r² = 0.853, p = 0.001), the logarithmic membrane-water partition coefficients (r² = 0.679, p = 0.012), and the carbohydrate contents in human milk. The effect of carbohydrate was further confirmed using in vitro tests. The negative associations between TE_HM/MS and hydrophobicity, membrane passive permeability, and the carbohydrate content in human milk consistently indicated that passive diffusion through the paracellular route might be the main transfer pathway for PFOS and Cl-PFESAs from blood to milk in humans.

Endocrine-Disrupting Chemicals and Their Effects in Pet Dogs and Cats: An Overview

Over the past few decades, several pollutants classified as environmental endocrine-disrupting chemicals (EDCs) have become a matter of significant public health concern. Companion animals play a major role in human society, and pet ownership is substantially increasing worldwide. These intimate human-pet relationships imply sharing much of the same environment, thus including exposure to similar levels of EDCs in daily routine. Here, we review the current knowledge on the sources and routes of exposure to EDCs in domestic indoor and outdoor environments and discuss whether endocrine disruption is a health concern in pets. We summarize the phenomenon of endocrine disruption, providing examples of EDCs with a known impact on dog and cat health. Then, we propose an overview of the literature on the adverse effects of EDCs in domestic pets, with a special focus on the health of reproductive and thyroid systems. Finally, we explore the potential role of companion animals as unintentional sentinels of environmental exposure to EDCs and the implications for public health risk assessment in a "shared risk" scenario. Overall, this review supports the need for an integrated approach considering humans, animals, and the environment as a whole for a comprehensive assessment of the impact of EDCs on human and animal health.

Human serum poly- and perfluoroalkyl substance concentrations and their associations with gestational diabetes mellitus

Poly- and perfluoroalkyl substances (PFAS), which have been found in high concentrations in maternal serum, have the potential to impair glucose metabolism in pregnant women. However, the effects of PFAS exposure on the risk of gestational diabetes mellitus (GDM) remain inconsistent. In the current investigation, a case-control study involving 135 patients with GDM and 69 controls was conducted in Hangzhou, China. We determined the concentrations of 17 PFAS in maternal serum from each participant and elucidated the associations between those concentrations and the risk of GDM. Among the 17 PFAS, perfluorooctanesulfonate (median 7.53 and 7.44 ng/mL) was the predominant PFAS in both cases and controls, followed by perfluorooctanoic acid (PFOA; median 5.22 and 5.03 ng/mL) and 6:2 chlorinated perfluoroalkyl ether sulfonate (6:2 Cl-PFESA; median 2.58 and 2.42 ng/mL). Conditional logistic regression analysis showed that the maternal serum continuous levels of PFOA, perfluorononanoic acid (PFNA), perfluorohexanesulfonate (PFHxS), and 6:2 Cl-PFESA were significantly associated with the GDM risk, with adjusted odds ratios (ORs) of 1.84 (95% confidence interval (CI): 1.26, 3.51), 1.47 (1.17, 3.29), 1.33 (1.72, 3.48), and 1.34 (1.17, 2.53), respectively. In the adjusted model, the ORs of GDM for increasing tertiles of PFOA, PFNA, PFHxS, and 6:2 Cl-PFESA significantly increased. The adjusted ORs (95% CI) were 3.38 (2.16, 6.89), 2.61 (1.26, 5.40), 3.46 (1.64, 6.30), and 3.50 (1.62, 6.91) at the highest concentrations of PFOA, PFNA, PFHxS, and 6:2 Cl-PFESA, respectively. These results suggest that higher PFAS exposure, reflected in serum PFAS concentrations, was associated with GDM incidence in pregnant women.

Concentrations of Per- and Polyfluoroalkyl Substances in Paired Maternal Plasma and Human Milk in the New Hampshire Birth Cohort

Per- and polyfluoroalkyl substances (PFAS) are environmentally persistent endocrine-disrupting chemicals associated with long-term health outcomes. PFAS are transferred from maternal blood to human milk, an important exposure source for infants, and understanding of this transfer is evolving. We characterized concentrations of 10 PFAS in human milk (n = 426) and compared milk-to-plasma concentrations of 9 PFAS among a subset of women with paired samples (n = 294) from the New Hampshire Birth Cohort Study using liquid chromatography-isotope dilution tandem mass spectrometry. We examined the relationship between perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) in plasma versus milk and fit linear regression models to assess relationships between milk PFOA and PFOS and participant characteristics. The median plasma PFOA concentration was 0.94 ng/mL (interquartile range, IQR, 0.59-1.34) and that of PFOS was 2.60 ng/mL (IQR 1.80-3.90); the median milk PFOA concentration was 0.017 ng/mL (IQR 0.012-0.027) and that of PFOS was 0.024 ng/mL (IQR 0.016-0.036). PFOA and PFOS plasma and milk concentrations showed correlations of ρ = 0.83 and 0.77, respectively (p < 0.001). Parity, previous lactation, week of milk collection, and body mass index were inversely associated with milk PFAS. We estimate that even among our general population cohort, some infants (∼6.5%) are exposed to amounts of PFAS via milk that may have long-term health impacts.

Time-course trend and influencing factors for per- and polyfluoroalkyl substances in the breast milk of Korean mothers

Many studies have reported that neonates and infants are exposed to several per- and polyfluoroalkyl substances (PFASs) via breastfeeding; however, these studies have had small sample sizes. This study aimed to determine the concentrations and time-course trend of PFASs in breast milk and identify influencing factors governing PFAS concentrations. Between July and September (2018), 207 low-risk primiparous women were recruited from a lactation counseling clinic in Korea and their breast milk samples were tested for 14 PFASs, including four perfluoroalkyl sulfonic acids. A questionnaire survey, comprising 84 questions covering the women's demographic, obstetrical, dietary, lifestyle, behavioral, and neonatal information, was conducted to investigate associations. Twelve of the 14 PFASs were detectable in breast milk samples. Perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorodecanoic acid were detected in 100% of the samples, followed by perfluorohexanesulfonic acid (detection rate: 87%), perfluorononanoic acid (87%), and perfluorohexanoic acid (73%); the median concentrations were 0.05, 0.10, 0.031, 0.007, and 0.033 ng/mL, respectively. The PFAS concentrations in breast milk measured in our study were higher than those reported in other studies or countries. In 12 years, from 2007 to 18, the mean concentration of PFOA in breast milk increased by approximately three times (278%). The major factors associated with PFAS concentrations in the bivariate association analysis were body mass index; living area (non-metropolitan); neonatal age; and frequency of fish, ice cream, and canned food consumption. In the multiple regression model, fish consumption significantly influenced the PFOS concentrations in breast milk (β = 0.88, p = 0.033). Frequently, fish consumption has been analyzed as the main dietary factor related to PFOS concentration. Our findings suggest the need for a comprehensive cohort study on PFAS exposure and its association with infant health.

Fluoro-cotton assisted non-targeted screening of organic fluorine compounds from rice (Oryza sativa L.) grown in perfluoroalkyl substance polluted soil

The toxicity and environmental persistence of perfluorooctanoic acid (PFOA), and perfluorooctane sulfonate (PFOS) are of great concern for food intake in humans. However, PFASs conversion or conjugation to other substances in rice grown on PFASs polluted soil has not been explored clearly. These unknown transformed or conjugated products of PFOA and PFOS could be harmful to human health. The restriction factor in evaluating the possible transformation of PFOA and PFOS is mainly attributed to the lack of an efficient method for screening PFOA and PFOS and their related metabolites. To circumvent this challenge, we established a non-targeted screening method by combining a fluoro-cotton fiber-based solid phase extraction (FC-SPE) and liquid chromatography-high resolution mass spectrometry (LC-HRMS) to monitor the formation of possible organic fluorine compounds from rice (Oryza sativa L.) grown on PFASs. We synthesized fluoro-cotton fibers to serve as the FC-SPE packing material and characterized by field-emission scanning electron-microscope, Fourier transform infrared, and X-ray photoelectron spectroscopy measurements. The optimal extraction conditions for the prepared FC-SPE were investigated. The performance of FC-SPE in LC-MS analysis was validated by linearity, precision, recovery, and matrix effect. Then the FC-SPE combined with LC-HRMS was used to specifically capture organic fluorine compounds from complex matrices via F-F interaction, including rice seedlings grown in PFOA and PFOS polluted soil and soil samples. By the established FC-SPE LC-HRMS method, in total 429 features were found as the possible organic fluorine compounds from rice seedlings grown in PFOA polluted soil among the 1781 features from the rice seedlings. Finally, we employed a¹³C metabolic tracing analysis of organic fluorine compounds in combination with the FC-SPE LC-HRMS method to further identify the features that detected from rice seedlings grown in PFOA polluted soil. The final result indicated that there were not any new organic fluorine metabolites screened out from rice grown in PFOA or PFOS polluted soil.

Characterization of different contaminants and current knowledge for defining chemical mixtures in human milk: A review

Hundreds of xenobiotics, with very diverse origins, have been detected in human milk, including contaminants of emerging concern, personal care products and other current-use substances reflecting lifestyle. The routes of exposure to these chemicals include dermal absorption, ingestion and inhalation. Specific families of chemicals are dominant among human milk monitoring studies (e.g., organochlorine pesticides, bisphenol A, dioxins), even though other understudied families may be equally toxicologically relevant (e.g., food-processing chemicals, current-use plasticizers and flame retardants, mycotoxins). Importantly, the lack of reliable human milk monitoring data for some individual chemicals and, especially, for complex mixtures, is a major factor hindering risk assessment. Non-targeted screening can be used as an effective tool to identify unknown contaminants of concern in human milk. This approach, in combination with novel methods to conduct risk assessments on the chemical mixtures detected in human milk, will assist in elucidating exposures that may have adverse effects on the development of breastfeeding infants.

Breastfed infants' exposure to polychlorinated biphenyls, polychlorinated dibenzo-p-dioxins and dibenzofurans, and per- and polyfluoroalkyl substances: A cross-sectional study of a municipal waste incinerator in China

A municipal waste incinerator (MWI) in Zhejiang, China, operating since 2008 was completely reconstructed from 2016 to 2019. In 2013, we conducted a cross-sectional study of breastfeeding mothers living near the MWI. We evaluated the concentrations of polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in the mothers' breast milk and their infants' estimated daily intake (EDI). To investigate the temporal variations of these pollutants, we conducted a cross-sectional study of 29 mothers in 2019. We assessed the levels of 18 PCB congeners, 17 PCDD/F congeners, and 21 per- and polyfluoroalkyl substance (PFAS) congeners in breast milk and estimated the EDI. The mean total concentrations of PCDD/Fs (ΣPCDD/Fs) and PCBs (ΣPCBs) were 81.2 and 4.90 ng/g lipid, respectively, while the toxic equivalent quantity (TEQ) levels of ΣPCDD/Fs and dioxin-like PCBs (ΣDL-PCBs) were 2.7 and 1.4 pg WHO-TEQ/g lipid, respectively. Compared to our 2013 measurements, the mass concentrations of ΣPCDD/Fs and ΣPCBs decreased by 13% and 35%, respectively (3.361 vs. 2.915 pg/g wet weight [ww] and 269.1 vs. 175.0 pg/g ww, respectively). The TEQ-ΣPCDD/F levels decreased by 67% (0.241 vs. 0.080 pg/g ww), but the TEQ-ΣDL-PCB levels increased by 11% (0.046 vs. 0.051 pg WHO-TEQ/g ww). The median concentration of PFASs was 0.250 ng/mL, ranging from 0.151 to 0.833 ng/mL. The infants' mean EDI of total PCDD/Fs and DL-PCBs was 17.7 pg TEQ/kg body weight [bw], representing a 20% decline compared to 2013. The average EDI levels of PFOS, PFOA, and PFNA were 5.8, 17.9, and 1.7 ng/kg bw, respectively. A comprehensive comparison of the results with studies from around the world showed that the potential health risks posed by legacy PCDD/F and PCB pollutants were not as grave for mothers and infants living near this MWI, but the emerging PFAS pollutants represented a new cause for concern. MAIN FINDINGS: The potential health risks posed by legacy PCDD/F and PCB pollutants were not particularly serious for mothers and infants living near the MWI, but the emerging PFAS pollutants raised new concerns.

Longitudinal Changes in Maternal Serum Concentrations of Per- and Polyfluoroalkyl Substances from Pregnancy to Two Years Postpartum

Exposure to per- and polyfluoroalkyl substances (PFAS) during pregnancy and lactation is of increasing public health concern, but little is known about longitudinal changes in maternal PFAS concentrations from pregnancy to a few years postpartum. We quantified 11 PFAS in 251 serum samples prospectively collected from 42 Northern California mothers during the first, second, and third trimesters of pregnancy and at 3, 6, and 24 months after delivery over 2009-2017. We fit separate linear mixed models during pregnancy, early postpartum, and late postpartum to estimate percent changes of PFAS for each subperiod. Among five PFAS detected in more than 99% of samples, linear and branched perfluorooctanesulfonate (n- and Sm-PFOS), linear perfluorooctanoate (n-PFOA), and perfluorononanoate (PFNA) concentrations changed -4% to -3% per month during pregnancy. During early postpartum, perfluorohexanesulfonate (PFHxS) and n-PFOA concentrations changed -6% and -5%, respectively, per month, and Sm-PFOS and PFNA concentrations changed -1% per month. During late postpartum, n-PFOS, Sm-PFOS, and PFNA concentrations changed -1% per month. Breastfeeding duration was the primary determinant of n-PFOA and PFNA concentrations during late postpartum, showing negative associations. Our findings might be useful for reconstructing reliable prenatal or early life PFAS exposures for offspring.

Evaluated serum perfluoroalkyl acids and their relationships with the incidence of rheumatoid arthritis in the general population in Hangzhou, China

Perfluoroalkyl acids (PFAAs) are widely present in human blood, and have many toxic effects on humans. However, effects of PFAA exposure on the risk of rheumatic immune diseases are limited. In the present study, occurrence of 7 PFAAs, including perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoate (PFNA), perfluorodecanoate (PFDA), perfluoroundecanoate (PFUnA), perfluorododecanoate (PFDoA), and perfluorotrdecanoate (PFTrA), were measured in serum samples from 156 healthy people (controls) and 156 rheumatoid arthritis (RA) cases living in Hangzhou, China. We also investigated the relationships among cumulative PFAA levels in serum, some immune markers, and the incidence of RA. The results showed that PFOA (6.1 and 11.8 ng/mL) had the highest mean serum concentrations, followed by PFOS (3.2 and 3.4 ng/mL) and PFDA (0.86 and 2.6 ng/mL), in both controls and RA cases. Cumulative exposure to PFOA in the study population were positively correlated with the levels of rheumatoid factors (r_s = 0.69, p < 0.01) and anti-cyclic citrullinated peptide antibody (r_s = 0.56, p < 0.05). Moreover, significant associations of PFOA concentrations with odds ratios (OR) of RA (OR = 1.998, confidence interval (CI): 1.623, 2.361, p = 0.01) were found by adjusting for various covariates. The crude and adjusted OR for RA was respective 1.385 (95% CI: 1.270, 1.510, p = 0.04) and 1.381 (95% CI: 0.972, 1.658, p = 0.06) for a unit increase in serum PFOS levels, but the adjusted results were not significant. Overall, this case-control study found that human serum PFOA concentrations were positively correlated with RF and ACPA levels.

A pilot study on extractable organofluorine and per- and polyfluoroalkyl substances (PFAS) in water from drinking water treatment plants around Taihu Lake, China: what is missed by target PFAS analysis?

Per- and polyfluoroalkyl substances (PFAS) have raised concerns due to their worldwide occurrence and adverse effects on both the environment and humans as well as posing challenges for monitoring. Further collection of information is required for a better understanding of their occurrence and the unknown fractions of the extractable organofluorine (EOF) not explained by commonly monitored target PFAS. In this study, eight pairs of raw and treated water were collected from drinking water treatment plants (DWTPs) around Taihu Lake in China and analyzed for EOF and 34 target PFAS. Mass balance analysis of organofluorine revealed that at least 68% of EOF could not be explained by target PFAS. Relatively higher total target concentrations were observed in 4 DWTPs (D1 to D4) when compared to other samples with the highest sum concentration up to 189 ng L^-1. PFOA, PFOS and PFHxS were the abundant compounds. Suspect screening analysis identified 10 emerging PFAS (e.g., H-PFAAs, H-PFESAs and OBS) in addition to target PFAS in raw or treated water. The ratios PFBA/PFOA and PFBS/PFOS between previous and current studies showed significant replacements of short-chain to long-chain PFAS. The ratios of the measured PFAS concentrations to the guideline values showed that some of the treated drinking water exceeds guideline values, appealing for efforts on drinking water safety guarantee.

Per-/polyfluoroalkyl substance concentrations in human serum and their associations with immune markers of rheumatoid arthritis

Per-/polyfluoroalkyl substances (PFASs) are ubiquitous in the environment and have been proved to be immunotoxic to humans. However, it remains unclear whether exposure to PFASs affects the risk of rheumatoid arthritis (RA). In this study, nine PFASs were determined in human serum collected from 280 health populations and 294 RA patients in a cohort enrolled between 2018 and 2020 in Hangzhou, China, and were examined their correlations with immune marker levels. Perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), and 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA) were the predominant PFASs in human serum, with median (mean) concentrations of 5.4 (7.6), 2.8 (3.5), and 1.9 (2.5) ng/mL, respectively. Serum PFOA and 6:2 Cl-PFESA concentrations were positively correlated with anti-cyclic citrullinated peptide antibody (ACPA) (β_PFOA = 0.59, 95% confidence interval (CI): 0.37, 0.81; β_{6:2 Cl-PFESA} = 0.48, 95% CI: 0.29, 0.66), immunoglobulin G (β_PFOA = 0.25, 95% CI: 0.21, 0.29; β_{6:2 Cl-PFESA} = 0.16, 95% CI: 0.12, 0.19) as well as rheumatoid factors (RF) (β_PFOA = 0.57, 95% CI: 0.34, 0.80; β_{6:2 Cl-PFESA} = 0.54, 95% CI: 0.36, 0.72). The correlations between serum PFOS levels and RF (β = 0.52, 95% CI: 0.28, 0.77), ACPA (β = 0.48, 95% CI: 0.23, 0.73), as well as immunoglobulin M (β = -0.24, 95% CI: 0.64, 0.15) respectively were statistically stronger. We also found PFOA concentrations in serum were associated with the level of C-reactive protein (β = 0.52, 95% CI: 0.40, 0.65). To our knowledge, this is the first study reporting significant associations between several PFASs and change of specific immune marker levels, suggesting that PFAS exposure may increase the risk of RA in adults.

Emissions, Isomer-Specific Environmental Behavior, and Transformation of OBS from One Major Fluorochemical Manufacturing Facility in China

Sodium p-perfluorous nonenoxybenzenesulfonate (OBS), a novel alternative to perfluorooctane sulfonic acid (PFOS), has been widely used in various fields in China and has certain toxic effects similar to PFOS. This study monitored OBS and 15 legacy PFASs in surface water, sediment, soil, and crucian carp near a fluorochemical manufacturing factory (FMF) in Suqian, China, focusing on the emission, isomer-specific environmental fate, and transformation of OBS. One to four orders of magnitude higher concentrations of OBS than other polyfluoroalkyl substances (PFASs) in all samples indicate that industrial emission is an important point source of OBS in the surrounding environment. The concentrations of OBS in surface water, sediment, and soil decreased exponentially as the distance from the FMF increases. The proportions of OBS-c, the dominant isomer, increased in the order: water (75.5 ± 6.4%), sediment (85.7 ± 10%), fish (muscle: 94.1 ± 0.99%; blood: 93.5 ± 1.4%), suggesting its preferential accumulation in sediment and fish than other isomers. Mono-hydroxylated transformation products of OBS were first identified in water, sediment, and fish, suggesting its hydroxylation may exist in the real environment. The transformation of OBS may explain its significantly lower bioaccumulation than PFOS in fish. However, considering the higher BAF of OBS than the regulatory bioaccumulation criterion and the possible stronger toxicity of its transformation products, further studies on its bioaccumulation and transformation are warranted.

Polychlorinated dioxins and dibenzofurans (PCDD/F), polybrominated dioxins and dibenzofurans (PBDD/F), polychlorinated biphenyls (PCB), polybrominated diphenyl ethers (PBDE), and per- and polyfluoroalkyl substances (PFAS) in German breast milk samples (LUPE 8)

Most organic pollutants (POP) are persistent in the environment, accumulate in fatty tissues, and so a transfer through the food chain is probably, thereby causing various health effects. We quantified PCDD/F, PBDD/F, PCB, PBDE, perfluorinated substances, and ADONA in breast milk samples collected in two German federal states and breast milk and blood samples from subjects additionally exposed to PFOA. The median (95th percentile) concentrations were 2.43 (6.58) pgWHO₂₀₀₅TEQ/g l.w. for PCDD/F, 2.45 (4.82) pgWHO₂₀₀₅TEQ/g l.w. for dioxin-like PCB (dl-PCB), and 0.62 (2.69) pgWHO₂₀₀₅TEQ/g l.w. for PBDD/F. The relative contributions of the median values of PCDD/F, dl-PCB, and PBDD/F to the total-TEQ were approximately 41%, 42%, and 11%, respectively. Nondioxin-like PCB (ndl-PCB) concentrations were clearly dominated by the higher chlorinated PCB congeners, with medians of 23.2 ng/g l.w. for PCB 153, 13.9 ng/g l.w. for PCB 138, and 13.0 ng/g l.w. for PCB 180. The sum of the 3 congeners (PCB 138, 153, and 180) were multiplied with 1.64 (total PCB) and showed a median of 82.16 ng/g l.w. and a 95th percentile of 173.3 ng/g l.w. Only PFOA and PFOS could be quantified in 29% and 17% of in total 180 samples with 95th percentiles of 53 ng/l and 33 ng/l, respectively. Milk samples (n = 13) from subjects living on PFOA contaminated sites showed higher levels between 33 and 854 ng/l PFOA (mean: 199 ng/l), whilst PFOS could be quantified only in three samples. The sum of 17 PBDE congeners showed medians (95th percentile) of 1737 pg/g l.w. (22,806 pg/g l.w.), with the highest medians of 422 pg/g l.w. for BDE 209 and 378 pg/g l.w. for BDE 153. Overall, our study confirms the declining contamination level in breast milk during the last decade, but points out the need to further reduce the environmental contamination with persistent substances and subsequently the exposure in childhood.

A Critical Review on Transplacental Transfer of Per- and Polyfluoroalkyl Substances: Prenatal Exposure Levels, Characteristics, and Mechanisms

Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances (PFASs) has aroused public concerns as it can pose multiple health threats to pregnant women and cause adverse birth outcomes for fetuses. In previous studies, the prenatal exposure levels and transplacental transfer efficiencies (TTE) of PFASs have been reported and discussed. Specifically, the binding affinities between PFASs and some transporters were determined, demonstrating that the TTE values of PFASs are highly dependent on their binding behaviors. To summarize primary findings of previous studies and propose potential guidance for future research, this article provides a systematic overview on levels and characteristics of prenatal exposure to PFASs worldwide, summarizes relationships between TTE values and structures of PFASs, and discusses possible transplacental transfer mechanisms, especially for the combination between PFASs and transporters. Given the critical roles of transporters in the transplacental transfer of PFASs, we conducted molecular docking to further clarify the binding behaviors between PFASs and the selected transporters. We proposed that the machine learning can be a superior method to predict and reveal behaviors and mechanisms of the transplacental transfer of PFASs. In total, this is the first review providing a comprehensive overview on the prenatal exposure levels and transplacental transfer mechanisms of PFASs.

Concentrations of per- and polyfluoroalkyl substances (PFAS) in human placental tissues and associations with birth outcomes

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous environmental contaminants commonly detected in human serum. Previous studies have observed associations between maternal serum PFAS and adverse pregnancy and birth outcomes such as lower birth weight or pre-eclampsia; however, few studies have explored these associations with birth outcomes and placental tissue PFAS concentration. The placenta is a vital contributor to a healthy pregnancy and may be involved in the mechanism of PFAS reproductive toxicity. Our goal was to measure placental PFAS concentrations and examine associations with birth outcomes (e.g., birth weight, gestational duration). Placenta samples (n = 120) were collected during delivery from women enrolled in the Healthy Pregnancy, Healthy Baby cohort (HPHB) in Durham, North Carolina. All placenta samples contained detectable PFAS, with perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) being the most abundant and most frequently detected (all >96% detection frequency). While placental PFAS concentrations did not differ by infant sex, higher PFAS levels were observed in placenta from nulliparous women, suggesting that parity influences the accumulation of PFAS in the placenta. We used linear regression models to examine associations between placental PFAS and birth outcomes. After adjustment for parity, tobacco use, maternal age, and maternal race, we found that placental PFOS was associated with lower birth weight for gestational age in male infants and higher birth weight for gestational age in female infants. Similar findings were seen for PFNA for birth weight for gestational age. These differences in birth outcomes based on infant sex highlight a need to explore mechanistic differences in PFAS toxicity during gestation for male and female infants.

Chemical-specific determinants for pre-conceptional exposure to emerging and legacy per- and polyfluoroalkyl substances

The exposure of preconception women to per- and polyfluoroalkyl substances (PFASs) could negatively affect her reproductive health. However, chemical-specific determinants for pre-conceptional exposure to PFASs, particularly the emerging ones, remain poorly understood. In the present study, it was found that the total PFAS concentration ranged from 8.9 to 440.3 ng/mL (median: 49.6 ng/mL) in 1060 preconception women. The PFAS exposure profile was dominated by PFOA (16.8 ng/mL), followed by PFOS (13.3 ng/mL), 6:2 Cl-PFESA (8.9 ng/mL), PFDA (2.4 ng/mL), PFNA (2.1 ng/mL), and others. The pre-conceptional exposure to the selected PFASs was significantly associated, in a chemical-specific pattern, with multiple demographic characteristics and the consumption frequency of different types of food. In particular, the exposure to 6:2 Cl-PFESA was associated with age, parity, alcohol drinking, educational level, household income, and the consumption frequency of red meat, marine and freshwater fish, shellfish, and shrimp. However, our analysis revealed that the investigated sociodemographic and diet variables only explained a relatively small proportion (1.3%-18.7%) of PFAS concentration variations, raising the need of exploring additional factors critical to pre-conceptional PFAS exposure. Overall, the identification of chemical-specific determinants would greatly facilitate the understanding of the link between pre-conceptional exposure and health outcomes, and the mitigation of human exposure to PFAS, particularly the emerging ones.

Prenatal and postnatal exposure to emerging and legacy per-/polyfluoroalkyl substances: Levels and transfer in maternal serum, cord serum, and breast milk

Gestation and lactation are critical and vulnerable stages for fetuses and newborns. During these periods, per-/polyfluoroalkyl substances (PFASs) accumulated in mothers can be transferred to newborns through placenta and/or breastfeeding, causing potential health risks. To investigate the pre- and postnatal PFAS exposure of newborns, we analyzed 21 emerging and legacy PFASs in 60 sets of matched maternal serum, cord serum, and breast milk samples. In serum, perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), and 6:2 chlorinated polyfluorinated ether sulfonates (6:2 Cl-PFESA) were the most predominant PFASs, while PFOA, PFOS and 6:2 fluorotelomer phosphate diester (6:2 diPAP) contributed most to breast milk. For most PFASs, the levels followed the order of maternal serum > cord serum > breast milk. The 6:2 Cl-PFESA was positively associated with birth weight and ponderal index (p < 0.05). The breastfeeding transfer efficiencies (R_BM, median: 0.02-0.10) of most PFASs were 1-2 orders of magnitude lower than transplacental transfer efficiencies (R_CM, median: 0.40-1.45), except for perfluorobutanesulfonic acid (PFBS) showing high transfer efficiency both through placenta (median at 0.89) and breastfeeding (median at 0.86). The one-month postnatal exposure to PFASs via breastfeeding was much higher than prenatal exposure in utero. This study enhances the understanding of transplacental and breastfeeding transfer of PFASs and provides assessments of prenatal and postnatal exposure of newborns to emerging and legacy PFASs.

Per-/polyfluoroalkyl substance concentrations in human serum and their associations with liver cancer

Per-/polyfluoroalkyl substances (PFASs) are widespread in global human blood, and have some toxic effects on liver. However, effects of PFAS exposure on human liver cancer (LC) risk are still not known. In this study, 203 LC patients and 203 controls were recruited, and their serum samples were collected between 2019 and 2021. We determined the residues of 12 PFASs in serum from all participants and quantified their association with LC incidence and tumor markers. PFOS (9.8 ng/mL) had the highest mean concentration in human serum, followed by PFOA (8.3 ng/mL) and 6:2 Cl-PFESA (3.9 ng/mL). We found that concentrations of PFOS and 6:2 Cl-PFESA in human serum were significantly correlated with the levels of alpha fetoprotein (AFP) (β_PFOS = 0.13, 95% confidence interval (CI_PFOS): 0.088, 0.17; β_{6:2 Cl-PFESA} = 0.070, CI_{6:2 Cl-PFESA}: 0.036, 0.10). A positive association of PFOS and 6:2 Cl-PFESA with odds ratios (OR) of LC (OR_PFOS = 0.609, CI_PFOS: 1.179, 4.029, P = 0.001; OR_{6:2 Cl-PFESA} = 1.844, CI_{6:2 Cl-PFESA}: 1.176, 2.512, P = 0.02) were found, after adjusting for different covariates. Moreover, serum PFOA concentrations were associated with carcinoembryonic antigen (CEA), but their correlation with the LC incidence was not statistically significant. This new finding supports the evidence for the positive associations among PFAS exposure, change of specific tumor marker, and LC risks.

Current Breast Milk PFAS Levels in the United States and Canada: After All This Time, Why Don't We Know More?

BACKGROUND

Despite 20 y of biomonitoring studies of per- and polyfluoroalkyl substances (PFAS) in both serum and urine, we have an extremely limited understanding of PFAS concentrations in breast milk of women from the United States and Canada. The lack of robust information on PFAS concentrations in breast milk and implications for breastfed infants and their families were brought to the forefront by communities impacted by PFAS contamination.

OBJECTIVES

The objectives of this work are to: a) document published PFAS breast milk concentrations in the United States and Canada; b) estimate breast milk PFAS levels from maternal serum concentrations in national surveys and communities impacted by PFAS; and c) compare measured/estimated milk PFAS concentrations to screening values.

METHODS

We used three studies reporting breast milk concentrations in the United States and Canada We also estimated breast milk PFAS concentrations by multiplying publicly available serum concentrations by milk:serum partitioning ratios for perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). Measured and estimated breast milk concentrations were compared to children's drinking water screening values.

DISCUSSION

Geometric means of estimated breast milk concentrations ranged over approximately two orders of magnitude for the different surveys/communities. All geometric mean and mean estimated and measured breast milk PFOA and PFOS concentrations exceeded drinking water screening values for children, sometimes by more than two orders of magnitude. For PFHxS and PFNA, all measured breast milk levels were below the drinking water screening values for children; the geometric mean estimated breast milk concentrations were close to-or exceeded-the children's drinking water screening values for certain communities. Exceeding a children's drinking water screening value does not indicate that adverse health effects will occur and should not be interpreted as a reason to not breastfeed; it indicates that the situation should be further evaluated. It is past time to have a better understanding of environmental chemical transfer to-and concentrations in-an exceptional source of infant nutrition. https://doi.org/10.1289/EHP10359.

Occurrence and infant exposure assessment of per and polyfluoroalkyl substances in breast milk from South Africa

The exposure of infants to per and polyfluoroalkyl substances (PFAS) through breast-feeding is of global concern owing to their numerous detrimental health effects. This study investigated the occurrence of eleven perfluorocarboxylic acids (PFCAs) and four perfluorosulfonates (PFSAs) in breast milk of nursing mothers from South Africa. The concentrations of PFAS in these samples were measured by using a validated UHPLC - MS/MS method. The median concentrations of Σ₁₅ PFAS ranged from <LOQ - 0.420 ng mL^-1, with PFCAs frequently detected in breast milk than PFSAs. However, perfluoropentanoic acid (PFPeA) accounted for 28% of total PFAS concentrations in all samples, the median concentrations of PFUdA, PFDoA and PFTrDA were at par with those of PFOA. The estimated feeding frequency and infant sex but not birth weight and gestation period, were strongly correlated with the body-burden of some short- and long-chain PFAS in breastmilk. On the average, the EDI and HQ of PFOA and Σ₄ PFAS (PFOA, PFNA, PFHxS & PFOS) but not PFOS present significant risk to exclusively breastfed infants in South Africa. The results of this study reflect the widespread occurrence of short chain (i.e., C < 6) and long chain (i.e., C₁₁ - C₁₃) PFAS and provide preliminary data for future human biomonitoring of PFAS and other persistent organic pollutants in South Africa, and indeed the African continent.

PFAS Molecules: A Major Concern for the Human Health and the Environment

Per- and polyfluoroalkyl substances (PFAS) are a group of over 4700 heterogeneous compounds with amphipathic properties and exceptional stability to chemical and thermal degradation. The unique properties of PFAS compounds has been exploited for almost 60 years and has largely contributed to their wide applicability over a vast range of industrial, professional and non-professional uses. However, increasing evidence indicate that these compounds represent also a serious concern for both wildlife and human health as a result of their ubiquitous distribution, their extreme persistence and their bioaccumulative potential. In light of the adverse effects that have been already documented in biota and human populations or that might occur in absence of prompt interventions, the competent authorities in matter of health and environment protection, the industries as well as scientists are cooperating to identify the most appropriate regulatory measures, substitution plans and remediation technologies to mitigate PFAS impacts. In this review, starting from PFAS chemistry, uses and environmental fate, we summarize the current knowledge on PFAS occurrence in different environmental media and their effects on living organisms, with a particular emphasis on humans. Also, we describe present and provisional legislative measures in the European Union framework strategy to regulate PFAS manufacture, import and use as well as some of the most promising treatment technologies designed to remediate PFAS contamination in different environmental compartments.

Can breastfeeding affect the rest of our life?

The breastfeeding period is one of the most important critical windows in our development, since milk, our first food after birth, contains several compounds, such as macronutrients, micronutrients, antibodies, growth factors and hormones that benefit human health. Indeed, nutritional, and environmental alterations during lactation, change the composition of breast milk and induce alterations in the child's development, such as obesity, leading to the metabolic dysfunctions, cardiovascular diseases and neurobehavioral disorders. This review is based on experimental animal models, most of them in rodents, and summarizes the impact of an adequate breast milk supply in view of the developmental origins of health and disease (DOHaD) concept, which has been proposed by researchers in the areas of epidemiology and basic science from around the world. Here, experimental advances in understanding the programming during breastfeeding were compiled with the purpose of generating knowledge about the genesis of chronic noncommunicable diseases and to guide the development of public policies to deal with and prevent the problems arising from this phenomenon. This review article is part of the special issue on "Cross talk between periphery and brain".

Immunotoxicity of F53B, an alternative to PFOS, on zebrafish (Danio rerio) at different early life stages

As an alternative to perfluorooctane sulfonate (PFOS), 6:2 chlorinated polyfluorinated ether sulfonate (F53B) has emerged in the Chinese market in recent years and has been frequently detected in the aquatic environment, but its ecological risk assessment is limited. In this study, zebrafish embryos and larvae were separately exposed to F53B, and their 96-h LC₅₀ values were estimated to be 15.1 mg/L and 2.4 mg/L, respectively, suggesting that embryos were more resistant to F53B than larvae. The bioconcentration factor in larvae was basically higher than that of embryos, and the body growth of larvae was significantly affected by F53B rather than embryos, indicating that F53B may cause more severe toxicity to larvae. In addition to the excessive production of ROS and NO, the expression of many immune-related genes was increased in both embryos and larvae, but the number of dysregulated genes in larvae was more than that in embryos. Finally, the results of Point of Departure (PoD) indicated that the immunotoxicity of F53B was more sensitive to larvae than embryos at the molecular level. Our findings revealed the ecological risk of F53B by exploring the adverse effects of immunoregulation at different early life stages of zebrafish and indicated that the zebrafish larvae were more sensitive than embryos.

Serum concentrations of per-/polyfluoroalkyl substances and risk of type 2 diabetes: A case-control study

Per-/polyfluoroalkyl substances (PFASs), as a group of synthetic chemicals, have been extensively detected in human samples. Recently, epidemiological investigations have reported relationships between exposure to PFASs with risk of type 2 diabetes mellitus (T2DM), but with contradictory results. In this study, a case-control study was conducted to explore associations between serum PFASs and T2DM risk among 252 T2DM cases and 252 controls, who were both diagnosed according to fasting glucose and glycosylated hemoglobin levels. Besides, dose-response relationships were analyzed to clarify effects of PFAS exposure on T2DM risk at different exposure levels. Multivariable logistic regression models showed that compared to the lowest tertiles, elevated odds of T2DM risk were observed in the middle tertiles of perfluorohexane sulfonic acid (PFHxS) [odds ratio (OR): 4.09; 95% confidence interval (CI): 2.23, 7.50; p < 0.01] and perfluorohexane sulfonic acid (PFHpA) (OR: 1.87; 95% CI: 1.06, 3.29; p = 0.03), but not in the highest tertiles, and the restricted cubic spline regression models presented inverted U-shaped dose-response relationships for exposure to PFHxS and PFHpA with T2DM risk, indicating non-monotonic dose-response effect and low-dose effect. Most other PFASs were inversely associated with risk of T2DM, especially at higher exposure levels. Our findings suggested that there are associations between exposure to PFASs and risk of T2DM. Further mechanism research is worthy to be conducted to elucidate the mode of action of different PFASs on T2DM at different exposure levels.

Occurrence, spatiotemporal distribution, seasonal and annual variation, and source apportionment of poly- and perfluoroalkyl substances (PFASs) in the northwest of Tai Lake Basin, China

Poly- and perfluoroalkyl substances (PFASs) have attracted mounting attention due to their potential harmful effects and degradation-resistant property. This study continuously monitored the concentration of PFASs for four seasons in two years in the northwest of Tai Lake Basin. The occurrence, spatiotemporal distribution, seasonal and annual variation, and source apportionment of 13 PFASs were investigated in 60 surface water sampling sites and 33 emission sources. The average concentrations of the total PFASs were 205.6 ng L^-1 and 171.9 ng L^-1 in 2018 and 2019, respectively. This improvement could be mainly attributed to the local industrial restructuring. Furthermore, principal component analysis and heat map-hierarchical cluster analysis were employed to analyze distribution characteristics and the possible sources of PFASs pollution. It showed that perfluorooctane sulfonate (PFOA) mainly originated from the effluents of chemical plants, while the potential source of perfluorohexane sulfonate (PFHxS) included all the three types of emission sources. Besides, two indicators were adopted to evaluate the impact of non-point sources and the result showed the effect of runoff was obvious while the effect of atmospheric deposition was weak. A systematic mass balance calculation showed that the total riverine input flux from Wujin District to Tai Lake was 126.5 kg/a.

Regional occurrence of perfluoroalkane substances in human milk for the global monitoring plan under the Stockholm Convention on Persistent Organic Pollutants during 2016-2019

The human milk monitoring component of the global monitoring plan under the Stockholm Convention on Persistent Organic Pollutants was implemented from 2016 to 2019 and had 44 human milk samples from primiparae collected in 42 countries and analyzed for perfluoroalkane substances (PFAS), at the MTM Research Centre at Örebro University, Sweden. The targeted compounds were restricted to the two listed PFAS (perfluorooctane sulfonic acid, PFOS and perfluorooctane carboxylic acid, PFOA) and the one recommended PFAS (perfluorohexane sulfonic acid, PFHxS). PFOA was quantified in all 44 samples in a quite narrow range (6.20 pg/g-37.4 pg/g); PFHxS was quantifiable in only four samples (max. 111 pg/g), and PFOS in 36 samples across a wide range (<6.2 pg/g-212 pg/g). Branched PFOS isomers on average had a share of 16% of the total PFOS with a maximum of 33%. PFOS was highly correlated with PFHxS (Pearson correlation coefficient R = 0.95) and weakly but still positively with PFOA (R = 0.44). Statistical analysis (all on p<0.05) showed that PFOS and PFOA in European countries were significantly different from those in African and Latin American countries and between high-income and low-income countries. PFOA tends to have higher concentrations in wealthier countries. No correlation was found for population density.

Concentrations of perfluoroalkyl substances in donor breast milk in Southern Spain and their potential determinants

BACKGROUND

Breast milk is considered to offer the best nutrition to infants; however, it may be a source of exposure to environmental chemicals such as perfluoroalkyl compounds (PFAS) for breastfeeding infants. PFAS are a complex group of synthetic chemicals whose high stability has led to their ubiquitous contamination of the environment.

OBJECTIVE

To assess the concentrations and profiles of PFAS in breast milk from donors to a human milk bank and explore factors potentially related to this exposure.

METHODS

Pooled milk samples were collected from 82 donors to the Human Milk Bank of the Virgen de las Nieves University Hospital (Granada, Spain). Ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) was applied to determine milk concentrations of 11 PFAS, including long-chain and short-chain compounds. A questionnaire was used to collect information on donors' socio-demographic characteristics, lifestyle, diet, and use of personal care products (PCPs). Factors related to individual and total PFAS concentrations were evaluated by multivariate regression analysis.

RESULTS

PFAS were detected in 24-100% of breast milk samples. PFHpA was detected in 100% of samples, followed by PFOA (84%), PFNA (71%), PFHxA (66%), and PFTrDA (62%). Perfluorooctane sulfonate (PFOS) was detected in only 34% of donors. The median concentrations ranged from <0.66 ng/dL (perfluorohexane sulfonic acid [PFHxS]) to 19.39 ng/L (PFHpA). The median of the sum of PFAS concentrations was 87.67 ng/L and was higher for short-chain than long-chain PFAS. Factors most frequently associated with increased PFAS concentrations included intake of creatin animal food items and use of PCPs such as skin care and makeup products.

CONCLUSIONS

Several PFAS, including short-chain compounds, are detected in pooled donor milk samples. Breast milk may be an important pathway for the PFAS exposure of breastfed infants, including preterm infants in NICUs. Despite the reduced sample size, these data suggest that various lifestyle factors influence PFAS concentrations, highlighting the use of PCPs.

Per- and Polyfluoroalkyl Substances (PFAS) in Breast Milk: Concerning Trends for Current-Use PFAS

This is the first study in the last 15 years to analyze per- and polyfluoroalkyl substances (PFAS) in breast milk collected from mothers (n = 50) in the United States, and our findings indicate that both legacy and current-use PFAS now contaminate breast milk, exposing nursing infants. Breast milk was analyzed for 39 PFAS, including 9 short-chain and 30 long-chain compounds, and 16 of these PFAS were detected in 4-100% of the samples. The ∑PFAS concentration in breast milk ranged from 52.0 to 1850 pg/mL with a median concentration of 121 pg/mL. Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) were the most abundant PFAS in these samples (medians 30.4 and 13.9 pg/mL, respectively). Two short-chain PFAS, including perfluoro-n-hexanoic acid (PFHxA, C6) and perfluoro-n-heptanoic acid (PFHpA, C7), were detected in most of the samples with median concentrations of 9.69 and 6.10 pg/mL, respectively. Analysis of the available breast milk PFAS data from around the world over the period of 1996-2019 showed that while the levels of the phased-out PFOS and PFOA have been declining with halving times of 8.1 and 17 years, respectively, the detection frequencies of current-use short-chain PFAS have been increasing with a doubling time of 4.1 years.

Impact of kidney hyperfiltration on concentrations of selected perfluoroalkyl acids among US adults for various disease groups

Data from the National Health and Nutrition Examination Survey (N = 6141) for the years 2003-2016 for US adults were analyzed to evaluate the impact of glomerular hyperfiltration on the observed concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorodecanoic acid, perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) for several disease groups. Hyperfiltrators were defined as having an estimated glomerular filtration rate (eGFR) ≥ 110 mL/min/1.73 m², and normal filtrators were defined as those having an eGFR between 90 and 110 mL/min/1.73 m². The seven disease groups for which the data were analyzed were as follows: those (i) without any diseases; (ii) with hypertension only; (iii) with albuminuria only; (iv) with anemia only; (v) with diabetes only; (vi) with hypertension and one or more of diabetes, anemia, and albuminuria; and (vii) with two or more of diabetes, anemia, and albuminuria without hypertension. For almost every PFAA, for all seven disease groups except the albuminuria only group, hyperfiltrators had lower adjusted geometric means (AGM) than normal filtrators. For example, for the disease group with hypertension only, for PFOS, the AGMs for hyperfiltrators and normal filtrators were 8.3 and 10.6 ng/mL, respectively, for the total population. For the group with albuminuria only, normal filtrators were found to have higher AGMs than hyperfiltrators for the total population and males. For example, for PFHxS, the AGMs for normal and hyperfiltrators were 0.98 and 1.05 ng/mL, respectively, for the total population. For females, these AGMs for normal and hyperfiltrators were 0.96 and 0.86 ng/mL respectively. Males usually had higher AGMs than females, but the reverse was also true occasionally. Usually, male-female differences were substantially narrower for normal filtrators than hyperfiltrators. Irrespective of the filtration status, the disease group with hypertension only had the highest AGMs for every PFAA. AGMs for the anemia only group were the lowest for every PFAA as compared with other disease groups among hyperfiltrators.

Antioxidative Molecules in Human Milk and Environmental Contaminants

Breastfeeding provides overall beneficial health to the mother-child dyad and is universally recognized as the preferred feeding mode for infants up to 6-months and beyond. Human milk provides immuno-protection and supplies nutrients and bioactive compounds whose concentrations vary with lactation stage. Environmental and dietary factors potentially lead to excessive chemical exposure in critical windows of development such as neonatal life, including lactation. This review discusses current knowledge on these environmental and dietary contaminants and summarizes the known effects of these chemicals in human milk, taking into account the protective presence of antioxidative molecules. Particular attention is given to short- and long-term effects of these contaminants, considering their role as endocrine disruptors and potential epigenetic modulators. Finally, we identify knowledge gaps and indicate potential future research directions.

Evaluation of Cyto-genotoxicity of Perfluorooctane Sulfonate (PFOS) to Allium cepa

Per- and polyfluoroalkyl substances (PFAS) have emerged as contaminants of global concern. Among several PFAS, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are persistent and bioaccumulative compounds. We investigated the cyto-genotoxic potential of PFOS to Allium cepa root meristem cells. The A. cepa root tips were exposed to 6 different concentrations (1-100 mg L^-1 ) of PFOS for 48 h. Reduction in mitotic index and chromosomal aberrations was measured as genotoxic endpoints in meristematic root cells. Exposure to PFOS significantly affected cell division by reducing the miotic index at higher concentrations (>10 mg L^-1 ). The median effect concentration of PFOS to elicit cytotoxicity based on the mitotic index was 43.2 mg L^-1 . Exposure to PFOS significantly increased chromosomal aberrations at concentrations >25 mg L^-1 . The common aberrations were micronuclei, vagrant cells, and multipolar anaphase. The alkaline comet assay revealed a genotoxic potential of PFOS with increased tail DNA percentage at concentrations >25 mg L^-1 . To our knowledge, this is the first study to report the cyto-genotoxic potential of PFOS in higher plants. Environ Toxicol Chem 2021;40:792-798. © 2020 SETAC.

Influence of soil on the uptake of perfluoroalkyl acids by lettuce: A comparison between a hydroponic study and a field study

This study explores whether mechanistic understanding of plant uptake of perfluoroalkyl acids (PFAAs) derived from hydroponic experiments can be applied to soil systems. Lettuces (Lactuca sativa) were grown in outdoor lysimeters in soil spiked with 4 different concentrations of 13 PFAAs. PFAA concentrations were measured in soil, soil pore water, lettuce roots, and foliage. The PFAA uptake by the lettuce was compared with uptake measured in a hydroponic study. The foliage:pore water concentration ratios in the lysimeter were similar to the foliage:water concentration ratios from the hydroponic experiment. In contrast, the root:pore water concentration ratios in the lysimeter were 1-2 orders of magnitude lower than in the hydroponic study for PFAAs with 6 or more perfluorinated carbons. Hence, hydroponic studies can be expected to provide a good quantitative measure of PFAA transfer from soil to foliage if one accounts for soil:pore water partitioning and differences in transpiration rate. However, hydroponic studies will be of little value for estimating PFAA transfer from soil to roots because sorption to the root surface is greatly enhanced under hydroponic conditions.

Concentration- and nutrient-dependent cellular responses of microalgae Chlorella pyrenoidosa to perfluorooctanoic acid

Perfluorooctanoic acid (PFOA), an emerging and persistent pollutant, could cause toxicity effects on aquatic organisms. However, this was generally assessed under high exposure concentrations of PFOA and nutrient-enriched conditions, which was not accordant with the actual environments. Therefore, to comprehensively understand the toxicity effects of PFOA on aquatic organisms, the cellular responses of microalgae, Chlorella pyrenoidosa, to PFOA under different concentrations (≤ 1.0 mg/L) and nutrient conditions were investigated in this study. Results show that PFOA at concentrations less than 1.0 mg/L had no significant effects on algal growth and chlorophyll contents, and no oxidative damages were generated to destroy membrane integrity and morphology. However, N,P-limited and -starved conditions significantly decreased algal growth and chlorophyll contents, and induced oxidative stresses to ruin the structure and function of cell membrane. Moreover, the deficiency of P had more severe negative effect on algae than that of N, and they both influenced the toxicity responses of microalgae to 1.0 mg/L PFOA. The adsorption and uptake percentages of PFOA by algal cells were both less than 10%, and increased adsorption but decreased uptake of PFOA amounts occurred under N,P-limited and -starved conditions. These findings will be useful to understand the toxicity effects of PFOA on microalgae in aquatic environments.

Emerging per- and polyfluoroalkyl substances (PFAS) in human milk from Sweden and China

Twenty per- and polyfluoroalkyl substances (PFAS) were determined in human milk from residents of three Chinese cities (Shanghai, Jiaxing, and Shaoxing; [n = 10 individuals per city]), sampled between 2010 and 2016. These data were compared to a combination of new and previously reported PFAS concentrations in human milk from Stockholm, Sweden, collected in 2016 (n = 10 individuals). Across the three Chinese cities, perfluorooctanoate (PFOA; sum isomers), 9-chlorohexadecafluoro-3-oxanone-1-sulfonic acid (9Cl-PF3ONS; also known as 6:2 Cl-PFESA or by its trade name "F53-B"), and perfluorooctane sulfonate (PFOS; sum isomers) occurred at the highest concentrations among all PFAS (up to 411, 976, and 321 pg mL^-1, respectively), while in Stockholm, PFOA and PFOS were dominant (up to 89 and 72 pg mL^-1, respectively). 3H-Perfluoro-3-[(3-methoxy-propoxy)propanoic acid] (ADONA) was intermittently detected but at concentrations below the method quantification limit (i.e. <10 pg mL^-1) in Chinese samples, and was non-detectable in Swedish milk. The extremely high concentrations of F53-B in Chinese milk suggest that human exposure assessments focused only on legacy substances may severely underestimate overall PFAS exposure in breastfeeding infants.

Effect of Perfluorooctanoic Acid on the Epigenetic and Tight Junction Genes of the Mouse Intestine

Perfluorooctanoic acid (PFOA) has been implicated in various toxicities including neurotoxicity, genotoxicity, nephrotoxicity, epigenetic toxicity, immunotoxicity, reproductive toxicity, and hepatotoxicity. However, information on the accumulation of PFOA in the intestine and its toxic effects on intestinal epigenetics and tight junction (TJ) genes is sparse. CD1 mice were dosed with PFOA (1, 5, 10, or 20 mg/kg/day) for 10 days, and its accumulation and induced alterations in the expression of epigenetic and tight junction genes in the small intestine and colon were evaluated using LC-MS and qPCR techniques. PFOA reduced the expression levels of DNA methyltransferases (Dnmt1, Dnmt3a, Dnmt3b) primarily in the small intestine whereas, in the colon, a decrease was observed only at high concentrations. Moreover, ten-eleven translocation genes (Tet2 and Tet3) expression was dysregulated in the small intestine, whereas in the colon Tets remained unaffected. The tight junction genes Claudins (Cldn), Occludin (Ocln), and Tight Junction Protein (Tjp) were also heavily altered in the small intestine. TJs responded differently across the gut, in proportion to PFOA dosing. Our study reveals that PFOA triggers DNA methylation changes and alters the expression of genes essential for maintaining the physical barrier of intestine, with more profound effects in the small intestine compared to the colon.