Combined Effects of Multiple Per- and Polyfluoroalkyl Substances Exposure on Allostatic Load Using Bayesian Kernel Machine Regression

PFAS regulations and economic impact: A review of U.S. pulp & paper and textiles industries

Public concern over per- and polyfluoroalkyl substances (PFAS) continues to grow as evidence highlights their persistence, bioaccumulation potential, and adverse health effects. Increasing detections in drinking water, consumer products, and industrial discharges have intensified regulatory scrutiny. This review examines the evolving PFAS regulatory landscape in the United States, focusing on the pulp, paper, and textiles industries, which contribute significantly to PFAS contamination through wastewater discharges, end-product disposal, and the absence of dedicated removal technologies. PFAS emissions from food packaging alone are estimated at 2,300 kg annually. Addressing contamination presents substantial economic challenges, with wastewater treatment costs projected to reach USD 3 billion annually and growing risks of legal liabilities exemplified by paper mill settlements reaching USD 11.9 million for historical pollution. Large-scale remediation of PFAS remains financially prohibitive, with estimates exceeding the global gross domestic product (GDP) of USD 106 trillion. Additionally, healthcare costs for PFAS-linked diseases exceed USD 62 billion and further emphasize the need for prevention. State-level restrictions on PFAS-containing consumer products are expanding, particularly in food packaging and textiles, which are now the most regulated across the United States. As PFAS-containing products face increasing market limitations and potential loss of sustainability certifications, which have already reduced sales growth by 70% in some cases, transitioning to non-fluorinated alternatives could significantly mitigate economic risks for paper and textiles companies. Within this context, this review highlights the urgency of integrating policy, technological innovation, and economic incentives to accelerate the transition away from PFAS and mitigate long-term environmental and financial liabilities.

Prenatal PFAS exposure and outcomes related to maternal gut microbiome composition in later pregnancy

The composition of the gut microbiome is dependent on factors including diet, lifestyle, and exposure to environmental chemicals, and has implications for human health. Per- and polyfluoroalkyl substances (PFAS), a class of man-made chemicals that have nonstick and flame-retardant properties may impact on gut microbiome composition. Our objective was to elucidate links between PFAS and maternal gut microbiome composition in two geographically diverse sites of the Environmental Influences on Child Health Outcomes program. The present analysis includes participants in the Atlanta African American Maternal Child Cohort;ATL AA and a predominately non-Hispanic White subsample of the Michigan Archive for Research on Child Health Cohort;MARCH with serum or plasma PFAS concentrations measured in early or late pregnancy and 16s rRNA sequencing from maternal gut microbiome samples available primarily in later pregnancy (2nd-3rd trimester). Linear regression models tested associations between prenatal PFAS levels (separately for the 1st/3rd trimesters) and measures of alpha diversity, bacterial composition differences, and differential taxonomic abundance. Bayesian Kernel Machine Regression and Elastic net regression mixture modeling were also incorporated. In both cohorts, multiple PFAS were significantly associated with the relative abundance of specific microbiome taxa even after adjustment for covariates including maternal diet, age, race, BMI, and smoking; A total of 16 significant family-level associations were identified for ATL AA (e.g., PFOA with Clostridiaceae; natural log fold change=0.94) and 13 significant family-level associations identified for MARCH e.g., PFOS with Desulfovibrionaceae; natural log fold change=-1.53 (pFDR<0.05), but similarities between cohorts were lacking. Mixture analyses did not identify interactive or combined effects but did provide modest evidence of inclusion of individual PFAS in beta diversity models in both cohorts. In 2 distinct cohorts, there were significant associations between prenatal PFAS and the relative abundance of several bacterial taxa, but these differences were cohort-specific. This work suggests that PFAS may modulate the gut microbiome during pregnancy.

Association of Combined PFOA, PFOS, Metals and Allostatic Load on Hepatic Disease Risk

This study utilizes the National Health and Nutrition Examination Survey (NHANES) 2017-2018 data to explore the relationship between exposure to perfluoroalkyl substances (specifically perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), metals lead (Pb), mercury (Hg), and cadmium (Cd), allostatic load, and hepatic disease markers, including the fatty liver index a measure of the likelihood of non-alcoholic fatty liver disease, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin. The paper identified significant associations and interaction effects by employing descriptive statistics, Spearman's correlation analysis, linear regression, and Bayesian kernel machine regression (BKMR). Descriptive statistics highlight sex-specific differences in contaminant levels. Spearman's analysis underscores strong correlations among metals and per- and polyfluoroalkyl substances (PFAS). Linear regression reveals significant impacts of specific contaminants on AST, ALT, ALP, and bilirubin levels, adjusting for age and alcohol consumption. BKMR results further elucidate the complex, potentially synergistic relationships between these environmental exposures and the likelihood of non-alcoholic fatty liver disease, offering nuanced insights into their combined effects on liver health. The findings emphasize the intricate dynamics of environmental exposures on hepatic function, advocating for targeted public health interventions.

Exploring the Potential Link between PFAS Exposure and Endometrial Cancer: A Review of Environmental and Sociodemographic Factors

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.