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

Effects of short-chain per- and polyfluoroalkyl substances (PFAS) on human cytochrome P450 (CYP450) enzymes and human hepatocytes: An in vitro study

Short-chain per- and polyfluoroalkyl substances (PFAS) have been developed as alternatives to legacy long-chain PFAS, but they may still pose risks due to their potential to interact with biomolecules. Cytochrome P450 (CYP450) enzymes are essential for xenobiotic metabolism, and disruptions of these enzymes by PFAS can have significant human health implications. The inhibitory potential of two legacy long-chain (PFOA and PFOS) and five short-chain alternative PFAS (PFBS, PFHxA, HFPO-DA, PFHxS, and 6:2 FTOH) were assessed in recombinant CYP1A2, - 2B6, -2C19, -2E1, and -3A4 enzymes. Most of the short-chain PFAS, except for PFHxS, tested did not result in significant inhibition up to 100 μM. PFOS inhibited recombinant CYP1A2, -2B6, -2C19, and -3A4 enzymes. However, concentrations where inhibition occurred, were all higher than the averages reported in population biomonitoring studies, with IC50 values higher than 10 µM. We also evaluated the activities of CYP1A2 and CYP3A4 in HepaRG monolayers following 48 h exposures of the short-chain PFAS at two concentrations (1 nM or 1 µM) and with or without an inducer (benzo[a]pyrene, BaP, for CYP1A2 and rifampicin for CYP3A4). Our findings suggest that both 1 nM and 1 µM exposures to short-chain PFAS can modulate the CYP1A2 activity induced by BaP. Except for PFHxS, the short-chain PFAS appear to have little effect on CYP3A4 activity. Understanding the effects of PFAS exposure on biotransformation can shed light on the mechanisms of PFAS toxicity and aid in developing effective strategies for managing chemical risks, enabling regulators to make more informed decisions.

Perfluorooctanoic acid (PFOA) affects steroidogenesis and antioxidant defence in granulosa cells from swine ovary

PFOA is mainly employed in products with water and oil repellent properties. Due to its persistence, bioaccumulation and critical effects on health, its use has been restricted in several countries. This research was intended to explore PFOA action on the main functions of swine ovarian granulosa cells, a valuable model for translational medicine. Moreover, since we previously demonstrated a disruptive effect on free radical generation we sought to explore PFOA effects on the main antioxidant enzymes. PFOA inhibited cell proliferation (p < 0.001), assessed by BrdU uptake. Steroidogenesis was disrupted: PFOA also stimulated 17β-estradiol production (p < 0.05), increased progesterone production (p < 0.05) at the lowest dose while it displayed an inhibitory effect at higher concentrations (p < 0.05). SOD (p < 0.001), catalase (p < 0.05) and peroxidase (p < 0.01) activities were stimulated. Therefore, our study supports a disruptive effect of PFOA in cultured swine granulosa cells.

An analysis of the use of the relative source contribution term in derivation of drinking water standards using perfluorooctanoic acid as an example

The relative source contribution (RSC) term has long been used by the US Environmental Protection Agency (USEPA) and state regulatory agencies in setting criteria in water. The RSC reflects the proportion of the total daily intake of a chemical that can be derived from water when all other sources of exposure (e.g., food, air) are considered. This term is applied by the USEPA and state regulatory agencies when deriving ambient water quality criteria, maximum contaminant level goals, and drinking water health advisories for noncarcinogenic and threshold carcinogenic compounds. The value assigned to the RSC term affects the calculated criteria directly, with the allowable concentration in water decreasing with a decreasing RSC. A default RSC value of 20%-applied by regulatory entities in the USA for more than 40 years-assumes that 80% of an individual's exposure to a chemical's reference dose is from nonwater sources. Although the RSC is a chemical-specific parameter, there are few instances where a value other than the default of 20% has been approved and used. In 2000, USEPA outlined the process for developing chemical-specific RSC values, yet primary use of the default RSC value has continued since then. This article reviews USEPA's methodology for deriving chemical-specific RSC values and provides a case example using perfluorooctanoic acid (PFOA) to explore how the USEPA and state regulatory agencies are applying USEPA's guidance. The case study highlights inconsistent derivation of the RSC term, rooted in limitations in the current methodology. We suggest additional clarification of and more thoughtful use of the available data that may not meet USEPA's current adequacy requirements. We also recommend that the USEPA discuss recommendations for using biomonitoring data to set RSCs. Integr Environ Assess Manag 2023;19:605-612. © 2022 SETAC.

Unknown Organofluorine Mixtures in U.S. Adult Serum:Contribution from Pharmaceuticals?

Organofluorines occur in human serum as complex mixtures of known and unidentified compounds. Human biomonitoring traditionally uses targeted analysis to measure the presence of known and quantifiable per- and polyfluoroalkyl substances (PFAS) in serum, yet characterization of exposure to and quantification of PFAS are limited by the availability of methods and analytical standards. Studies comparing extractable organofluorine (EOF) in serum to measured PFAS using organofluorine mass balance show that measurable PFAS only explain a fraction of EOF in human serum and that other sources of organofluorine may exist. The gap in fluorine mass balance has important implications for human biomonitoring because the total body burden of PFAS cannot be characterized and the chemical species that make up unidentified EOF are unknown. Many highly prescribed pharmaceuticals contain organofluorine (e.g., Lipitor, Prozac) and are prescribed with dosing regimens designed to maintain a therapeutic range of concentrations in serum. Therefore, we hypothesize organofluorine pharmaceuticals contribute to EOF in serum. We use combustion ion chromatography to measure EOF in commercial serum from U.S. blood donors. Using fluorine mass balance, we assess differences in unexplained organofluorine (UOF) associated with pharmaceutical use and compare them with concentrations of organofluorine predicted based on the pharmacokinetic properties of each drug. Pharmacokinetic estimates of organofluorine attributable to pharmaceuticals ranged from 0.1 to 55.6 ng F/mL. Analysis of 44 target PFAS and EOF in samples of commercial serum (n = 20) shows the fraction of EOF not explained by Σ₄₄ PFAS ranged from 15% to 86%. Self-reported use of organofluorine pharmaceuticals is associated with a 0.36 ng F/mL (95% CL: -1.26 to 1.97) increase in UOF, on average, compared to those who report not taking organofluorine pharmaceuticals. Our study is the first to assess sources of UOF in U.S. serum and examine whether organofluorine pharmaceuticals contribute to EOF. Discrepancies between pharmacokinetic estimates and EOF may be partly explained by differences in analytical measurements. Future analyses using EOF should consider multiple extraction methods to include cations and zwitterions. Whether organofluorine pharmaceuticals are classified as PFAS depends on the definition of PFAS.

Short-chain per- and polyfluoralkyl substances (PFAS) effects on oxidative stress biomarkers in human liver, kidney, muscle, and microglia cell lines

Long-chain per- and polyfluoralkyl substances (PFAS) are ubiquitous contaminants implicated in the induction of intracellular reactive oxygen species (ROS), compromising antioxidant defense mechanisms in vitro and in vivo. While a handful of studies have assessed oxidative stress effects by PFAS, few specifically address short-chain PFAS. We conducted an evaluation of oxidative stress biomarkers in vitro following exposures to low (1 nM) and high (1 μM) concentrations of five short-chain PFAS compounds: perfluorobutanesulfonic acid (PFBS), perfluorohexanoic acid (PFHxA), [undecafluoro-2-methyl-3-oxahexanoic acid (HFPO-DA)], 6:2 fluorotelomer alcohol (6:2 FTOH) and perfluorohexanesulfonic acid (PFHxS). We conducted experiments in human kidney (HEK293-hTLR2), liver (HepaRG), microglia (HMC-3), and muscle (RMS-13) cell lines. Fluorescence microscopy measurements in HepaRG cells indicated ROS generation in cells exposed to PFBS and PFHxA for 24 h. Antioxidant enzyme activities were determined following 24 h short-chain PFAS exposures in HepaRG, HEK293-hTLR2, HMC-3, and RMS-13. Notably, exposure to PFBS for 24 h increased the activity of GPX in all four cell types at 1 μM and 1 nM in HepaRG and RMS-13 cells. Every short-chain PFAS evaluated, except for PFHxS, increased the activity of at least one antioxidant enzyme. To our knowledge, this is the first study of its kind to explore antioxidant defense alterations to microglia and muscle cell lines by PFAS. The findings of this study hold great potential to contribute to the limited understanding of short-chain PFAS mechanisms of toxicity and provide data necessary to inform the human health risk assessment process.

Unveiling Distribution of Per- and Polyfluoroalkyl Substances in Matched Placenta-Serum Tetrads: Novel Implications for Birth Outcome Mediated by Placental Vascular Disruption

The placenta is pivotal for fetal development and maternal-fetal transfer of many substances, including per- and polyfluoroalkyl substances (PFASs). However, the intraplacental distribution of PFASs and their effects on placental vascular function remain unclear. In this study, 302 tetrads of matched subchorionic placenta (fetal-side), parabasal placenta (maternal-side), cord serum, and maternal serum samples were collected from Guangzhou, China. Eighteen emerging and legacy PFASs and five placental vascular biomarkers were measured. Results showed that higher levels of perfluorooctanoic (PFOA), perfluorooctane sulfonic acid (PFOS), and chlorinated polyfluorinated ether sulfonic acids (Cl-PFESAs) were detected in subchorionic placenta compared to parabasal placenta. There were significant associations of PFASs in the subchorionic placenta, but not in the serum, with placental vascular biomarkers (up to 32.5%) and lower birth size. Birth weight was negatively associated with PFOA (β: -103.8, 95% CI: -186.3 and -21.32) and 6:2 Cl-PFESA (β: -80.04, 95% CI: -139.5 and -20.61), primarily in subchorionic placenta. Mediation effects of altered placental angiopoietin-2 and vascular endothelial growth factor receptor-2 were evidenced on associations of adverse birth outcomes with intraplacental PFOS and 8:2 Cl-PFESA, explaining 9.5%-32.5% of the total effect. To the best of our knowledge, this study is the first to report on differential intraplacental distribution of PFASs and placental vascular effects mediating adverse birth outcomes and provides novel insights into the placental plate-specific measurement in PFAS-associated health risk assessment.

Bioaccessibility of per- and polyfluoroalkyl substances in food and dust: Implication for more accurate risk assessment

Humans are exposed to per- and polyfluoroalkyl substances (PFASs) mainly through oral exposure route, while little is known about their bioaccessibility (BC) in oral matrices. Here, the BC of 13 PFASs in simulated vegetable (VFs) and animal foods (AFs) as well as indoor dust was investigated using a physiology-based extraction test. The BC of PFASs in the AFs (78.5 ± 13.6 %) was distinctly higher than that in the VFs (60.6 ± 13.4 %), because high-saturated and long-chain fatty acids in the animal fat favored formation of more stable micelles. The BC of most long-chain PFASs was positively correlated with the protein content while negatively correlated with the carbohydrate content in the foods. The BC of polyfluoroalkyl phosphate diesters was negatively correlated with the lipid content. The BC of the very long-chain PFASs in the foods was 2.42-6.02 times higher than that in the dust, which might be attributed to their strong sequestration in dust. With the increase in bile salt concentration, the BC of PFASs in food increased and then remained constant, which was related to the changes in fatty acids and stability of the formed micelles. Comparing with the previous results obtained from animal study, the BC obtained in this study has the potential to predict PFAS bioavailability in food.

Systematic Evidence Mapping of Potential Exposure Pathways for Per- and Polyfluoroalkyl Substances Based on Measured Occurrence in Multiple Media

Given that human biomonitoring surveys show per- and polyfluoroalkyl substances (PFAS) to be ubiquitous, humans can be exposed to PFAS through various sources, including drinking water, food, and indoor environmental media. Data on the nature and level of PFAS in residential environments are required to identify important pathways for human exposure. This work investigated important pathways of exposure to PFAS by reviewing, curating, and mapping evidence for the measured occurrence of PFAS in exposure media. Real-world occurrence for 20 PFAS was targeted primarily in media commonly related to human exposure (outdoor and indoor air, indoor dust, drinking water, food, food packaging, articles, and products, and soil). A systematic-mapping process was implemented to conduct title-abstract and full-text screening and to extract PECO-relevant primary data into comprehensive evidence databases. Parameters of interest included the following: sampling dates and locations, numbers of collection sites and participants, detection frequencies, and occurrence statistics. Detailed data were extracted on PFAS occurrence in indoor and environmental media from 229 references and on PFAS occurrence in human matrices where available from those references. Studies of PFAS occurrence became numerous after 2005. Studies were most abundant for PFOA (80% of the references) and PFOS (77%). Many studies analyzed additional PFAS, particularly, PFNA and PFHxS (60% of references each). Food (38%) and drinking water (23%) were the commonly studied media. Most studies found detectable levels of PFAS, and detectable levels were reported in a majority of states in the United States. Half or more of the limited studies for indoor air and products detected PFAS in 50% or more of the collected samples. The resulting databases can inform problem formulation for systematic reviews to address specific PFAS exposure queries and questions, support prioritization of PFAS sampling, and inform PFAS exposure measurement studies. The search strategy should be extended and implemented to support living evidence review in this rapidly advancing area.

Determination of 21 per- and poly-fluoroalkyl substances in paper- and cardboard-based food contact materials by ultra-high-performance liquid chromatography coupled to high-resolution mass spectrometry

In this work, a new analytical method was developed and validated for the determination of the total content of 21 per- and poly-fluoroalkyl substances (PFASs) in paper- and cardboard-based food contact materials (FCMs). This method is based on green ultrasound-assisted lixiviation followed by ultra-high-performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS). The method was validated in various paper- and cardboard-based FCMs, showing good linearity (R² ≥ 0.99), limits of quantification (1.7-10 μg kg^-1), accuracy (74-115%), and precision (RSD < 20%). The eco-friendly characteristics of the proposed analytical method were assessed according to the analytical eco-scale, demonstrating that it can be considered an excellent green analytical method (EcoScale score > 75). Finally, 16 field samples of paper- and cardboard-based FCMs, including pizza boxes, popcorn boxes, paper bags and cardboard boxes for potato fries, ice cream tubs, pastry trays, and cardboard-based packaging for cooked Spanish omelets, fresh grapes, frozen fish, and salads were analyzed, showing that they comply with the current European regulations regarding the studied PFASs. The developed method is currently accredited according to UNE-EN ISO/IEC 17025 by the Spanish National Accreditation Body (ENAC) to be implemented for official control analysis of FCMs in the Public Health Laboratory of Valencia, Generalitat Valenciana (Valencia, Spain).

The Psychological Impact of Per- and Poly-Fluoroalkyl Substances (PFAS) Pollution in the Veneto Region, Italy: A Qualitative Study with Parents

Little is known about the psychosocial impact on people who live in polluted areas, and its consequences for the parental role have been neglected. This study addresses this gap, proposing qualitative research referring to the case of per- and poly-fluoroalkyl substances (PFAS) water pollution in the Veneto Region of Italy. The purpose of this study was to investigate the chronic exposure contamination (CEC) experience of parents. Semi-structured interviews were conducted with 32 parents living in the so-called 'Red Area' considered to have had maximum exposure. Grounded theory was used to analyse the data. The three themes to emerge were three phases of a dynamic process: shock around the discovery (phase 1), lifestyle change (phase 2), and living with PFAS (phase 3). The two transitions (loss of innocence and environmental adaptation) linked the phases. Our findings show that PFAS CEC experience is a process whereby parents need to move from the shock of discovery to adapting to the new situation in order to incorporate a change into their daily life, especially in regard to children. Two emerging aspects that characterised the process as a constant were uncertainty and health concerns, while role strains could be a stress source in the context of CEC. We suggest introducing the notion of chronic role strain (CRS).

Sources, occurrence, and treatment techniques of per- and polyfluoroalkyl substances in aqueous matrices: A comprehensive review

Per- and polyfluoroalkyl substances (PFAS), a class of synthetic organic pollutants, have prompted concerns about their global prevalence and possible health effects. This review consolidates the most recent data on different aspects of PFAS, such as their occurrence, and prominent sources. The current literature analysis of PFAS occurrence suggests significant variation in their concentration ranging from 0.025 to 1.2 × 10⁸ ng/L in wastewater, 0.01 to 8.9 × 10⁵ ng/L in surface water, and <0.01 to 1.3 × 10⁴ ng/L in groundwater globally. Since conventional treatment techniques are inadequate in remediating PFAS, innovative treatment approaches based on their removal or mineralization mechanism have been comprehensively reviewed. Advanced treatment technologies have shown degradation or removal of PFAS to be around 6 and > 99.9% in different aqueous matrices. However, due to significant drawbacks in their applicability in wastewater treatment plants (WWTPs), a novel treatment train approach has emerged as an effective alternative. This approach synergistically integrates multiple remediation techniques while addressing the impediments of individual treatments. Furthermore, nanofiltration (NF270) combined with electrochemical degradation has been demonstrated to be the most efficient (>98%) treatment train approach in PFAS remediation. If implemented in WWTPs, nanofiltration followed by adsorption using activated carbon is also a viable method for PFAS removal.

The Role of Ferroptosis in the Damage of Human Proximal Tubule Epithelial Cells Caused by Perfluorooctane Sulfonate

Perfluorooctane sulfonate (PFOS) is a typical persistent organic pollutant and environmental endocrine disruptor that has been shown to be associated with the development of many diseases; it poses a considerable threat to the ecological environment and to human health. PFOS is known to cause damage to renal cells; however, studies of PFOS-induced ferroptosis in cells have not been reported. We used the CCK-8 method to detect cell viability, flow cytometry and immunofluorescence methods to detect ROS levels and Western blot to detect ferroptosis, endoplasmic reticulum stress, antioxidant and apoptosis-related proteins. In our study, we found that PFOS could induce the onset of ferroptosis in HK-2 cells with decreased GPx4 expression and elevated ACSL4 and FTH1 expression, which are hallmarks for the development of ferroptosis. In addition, PFOS-induced ferroptosis in HK-2 cells could be reversed by Fer-1. We also found that endoplasmic reticulum stress and its mediated apoptotic mechanism and P53-mediated antioxidant mechanism are involved in the toxic damage of cells by PFOS. In this paper, we demonstrated for the first time that PFOS can induce ferroptosis in HK-2 cells. In addition, we preliminarily explored other mechanisms of cytotoxic damage by PFOS, which provides a new idea to study the toxicity of PFOS as well as the damage to the kidney and its mechanism.

Perfluorooctanoic Acid (PFOA) Induces Redox Status Disruption in Swine Granulosa Cells

Perfluorooctanoic acid (PFOA) is employed in the production and processing of several plastic materials, mainly during the production of waterproof fabrics or nonstick cookware. PFOA is identified as a substance of very high concern, as it is classified as a persistent, bioaccumulative, and toxic (PBT) substance because of its persistence in the environment and its potential accumulation in organisms. Thus, safe levels of exposure cannot be established, and PFOA emissions should be minimized. PFOA has recently been linked to several health concerns in humans. In particular, a disruptive effect on redox status homeostasis has been documented, with a potential impairment of normal reproductive function that requires adequate oxidative balance. Therefore, the aim of the present study was to evaluate the effects of PFOA (2, 20, and 200 ng/mL) on ovarian granulosa cells, a model of reproductive cells. The obtained results reveal that PFOA stimulated cell viability (p < 0.05). Regarding the effects on free radical production, O2−, NO, and H2O2 were significantly inhibited (p < 0.05), while the nonenzymatic antioxidant power was not significantly modified. Collectively, the present results deserve attention since free radical molecules play a crucial role in ovarian follicle development leading to a successful ovulation.