Perfluoroalkyl and polyfluoroalkyl substances and hypertensive disorders of pregnancy: A systematic review and meta-analysis

Prenatal per- and polyfluoroalkyl substances and blood pressure trajectories in the New Hampshire Birth Cohort Study

Per- and polyfluoroalkyl substances (PFAS) have been associated with increased risk of hypertensive disorders of pregnancy, but whether PFAS influence blood pressure (BP) trajectories among normotensive pregnant women is unknown. We examined associations between PFAS mixtures and BP trajectories during pregnancy among normotensive women. PFAS concentrations, including perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), and perfluorodecanoate (PFDA), were measured in plasma collected at ∼28 gestational weeks among pregnant women enrolled in the New Hampshire Birth Cohort Study (2009-2018). Systolic BP (SBP) and diastolic BP (DBP) were abstracted from pregnancy medical records. We identified BP trajectories using latent class trajectory modeling and evaluated associations between PFAS mixtures and BP trajectories using probit Bayesian kernel machine regression and multinomial quantile g-computation. We used linear mixed models to examine individual PFAS and BP changes during the third trimester. Models were adjusted for sociodemographic, lifestyle, and reproductive factors, and gestational week of blood sample collection. During late pregnancy, plasma PFOS was associated with greater increases in SBP and PFHxS was associated with greater increases in DBP. Over the third trimester, each doubling in plasma PFOS was associated with 0.07 mmHg (95% CI: -0.01, 0.14) increase per week in SBP, and each doubling in plasma PFHxS was associated with 0.07 mmHg (95% CI: 0.02, 0.12) increase per week in DBP. Our study provides additional evidence suggesting that PFAS may adversely influence blood pressure even among normotensive women.

Health Impacts of Per- and Polyfluoroalkyl Substances (PFASs): A Comprehensive Review

Per- and polyfluoroalkyl substances (PFASs) are among the persistent organic pollutants characterized by their persistence in the environment, high mobility, and adverse impact not only on the ecosystem but also on human health. The biggest challenges in human biomonitoring are the low concentrations of PFASs in biological matrices and the presence of matrix interferents in samples. The combination of liquid chromatography with tandem mass spectrometry (LC-MS/MS) and solid-phase extraction (SPE) as a sample preparation technique appears to be the most suitable solution for achieving the desired selectivity and sensitivity in PFAS determination. The aim of this review is to describe possible sources of PFASs, their presence in various human matrices, analytical methods for determining PFASs in different biological matrices using various pretreatment techniques for complex samples, as well as adverse health risks associated with PFAS exposure. The most studied PFASs include PFOA and PFOS, which are most frequently detected in matrices such as plasma, serum, and breast milk. The average concentrations of PFOA range from 1.0 to 2.6 ng.mL-1 in plasma, 1.9 to 2.4 ng.mL-1 in serum, and 0.4 to 3.1 ng.mL-1 in breast milk. For PFOS, the average concentrations were 2.0-4.0 ng.mL-1, 3.7-4.6 ng.mL-1, and 3.6-4.8 ng.mL-1 for plasma, serum, and breast milk, respectively. The most significant health effects associated with exposure to long-chain PFASs (such as PFOA and PFOS) include lipid disorders, hypertension, diabetes mellitus, thyroid disorders, infertility, cancer, obesity, autism, neurodevelopmental issues, cardiovascular diseases, and kidney and liver disorders. It is of utmost importance to monitor PFAS exposure, predict their toxicity, and develop effective strategies to mitigate their potential effects on human health.

Engaging, recruiting, and retaining pregnant people from marginalized communities in environmental health cohort studies: a scoping review

OBJECTIVES

To identify barriers to and strategies for improving the representation of pregnant people from marginalized communities in pregnancy cohort studies that measure environmental chemicals.

METHODS

Guided by the Arksey O'Malley and Levac Frameworks, we conducted a scoping review of peer-reviewed literature published between 2000 and 2022. Included studies discussed barriers and/or strategies related to engaging, recruiting, and retaining pregnant participants or participants of reproductive age from marginalized communities into environmental health research.

RESULTS

Twenty-nine peer-reviewed articles were included in the review. Overall, 31% (9/29) of the studies reported on engagement, recruitment, and retention of participants from racialized communities, 10% (3/29) reported on involvement of participants identifying as Indigenous, and 10% (3/29) of studies reported on participants living in households or areas of low socioeconomic status. We identified four key barriers: participant burden, social inequities, lack of trust, and lack of cultural relevance. We reported identified strategies to mitigate these barriers.

CONCLUSION

Although there is limited coverage in the literature on strategies to effectively engage people from marginalized communities in environmental health pregnancy cohort studies, our findings suggest that applying a health equity and social justice lens to research may help address barriers that exist at the individual, interpersonal, community, institutional, and policy levels. Findings from this review may have important implications for planning future pregnancy cohort studies and ensuring that communities who are disproportionately affected by environmental chemical exposures may be better represented in research and considered in policy decisions.

PFOS-Induced Perturbations in Trophoblast Functions through the Oip5os1/miR-155/Rnd3 Axis in PE

The widespread use of perfluorooctanesulfonic acid (PFOS) has raised concerns regarding its potential on pregnant women, particularly in relation to the development of pre-eclampsia (PE). This study investigates the impact of PFOS exposure on the LncRNA/Rnd3 axis in pregnant mice and its association with trophoblast cell functions in PE. Bioinformatics analysis revealed PFOS-related gene alterations in PE, with pathways enriched in apoptotic signaling and cytokine interactions. Experimental findings showed the downregulation of Oip5os1 and Rnd3, along with the upregulation of miR-155, affecting trophoblast behavior. Animal experiments confirmed that PFOS-induced gene expression changes are linked to PE progression. PFOS exposure impairs trophoblast proliferation and migration via the Oip5os1/miR-155/Rnd3 axis, contributing to PE development.

Per- and Polyfluoroalkyl Substances and Female Health Concern: Gender-based Accumulation Differences, Adverse Outcomes, and Mechanisms

The deleterious health implications of perfluoroalkyl and polyfluoroalkyl substances (PFAS) are widely recognized. Females, in contrast to males, exhibit unique pathways for PFAS exposure and excretion, leading to complex health outcomes. The health status of females is largely influenced by hormone-related processes. PFAS have been reported to be associated with various aspects of female health, including reproductive system disorders and pregnancy-related diseases. In this article, we provide insights into the correlations between PFAS and female-prevalent diseases. Current epidemiological and toxicological evidence has demonstrated that the adverse effects of PFAS on the health of the female reproductive system are primarily attributed to the disruption of the hypothalamic-pituitary-gonadal (HPG) axis and hormonal homeostasis. However, these findings do not sufficiently elucidate the intricate associations between PFAS and specific diseases. Furthermore, autoimmune disorders, another category that is more prevalent in women compared to men, require additional investigation. Immune biomarkers pertinent to autoimmune disorders have been observed to be influenced by PFAS exposure, although epidemiological evidence is insufficient to substantiate these relations. Further thorough exploration encompassing epidemiological and toxicological studies is essential to elucidating the inherent influence of PFAS on human pathologies. Additionally, comprehensive investigations into female health issues beyond their reproductive functions is essential.

Current trends and patterns of PFAS in agroecosystems and environment: A review

Per- and polyfluoroalkyl substances (PFASs) are one of the more well-known highly persistent organic pollutants with potential risks to agroecological systems. These compounds are of global concern due to their persistence and mobility, and they often lead to serious impacts on environmental, agricultural, and human health. In the past 20 years, the number of science publications on PFAS has risen; despite this, certain fundamental questions about PFAS occurrence, sources, mechanism of transport, and impacts on agroecosystems and the societies dependent on them are still open and evolving. There is a lack of systematic and comprehensive analysis of these concerns in agroecosystems. Therefore, we reviewed the current literature on PFAS with a focus on agroecosystems; our review suggests that PFASs are nearly ubiquitous in agricultural systems. We found the current research has limitations in analyzing PFAS in complex matrices because of their small size, distribution, and persistence within various environmental systems. There is consistency in the properties and composition of PFAS in and around agroecosystems, suggesting evidence of shared sources and similar components within different tropic levels. The introduction of new and varied sources of PFAS appear to be growing, adding to their residual accumulation in environmental matrices and leading to possible new types of chemical compounds that are difficult to assess accurately. This review determines existing research trends, understands mechanisms and incidence of PFAS within agroecosystems and their impact on human health, and thereby recommends further studies to remedy research gaps.

Targeted investigation of per- and polyfluoroalkyl substances from domestic cosmetics and personal care products in China and its implications for human exposure

Per- and polyfluoroalkyl substances (PFASs) are synthetic chemicals reported in daily supplies, and skin absorption is one of the routes for human exposure to PFASs. This study aims to evaluate the potential risk of PFASs exposure from cosmetics and personal care products in China. A random sampling of 44 domestic cosmetics and personal care products, summarized into 6 categories, was conducted to investigate the concentrations of 24 target PFASs. PFASs concentrations of 86.4 % products were lower than 100 ng/g, and 34.2 % products were lower than 10 ng/g. PFCAs and PAPs were dominant. Keywords of "wear-resistant" and "long-lasting" may indicate the presence of PFASs in products. Disabled PFOA, PFOS, and PFHxS were not detected. Notably, the presence of PFHxA should be of concern, and its detection frequency reached 59.1 %, with the maximum concentration of 1274.77 ng/g. Further, the daily exposure dose (DED) of ∑PFASs from skin exposure through cosmetics and personal care products was evaluated to be 3.01 ng/kg-bw/day, which wasn't negligible compared to the prescribed acceptable intake value. Conclusively, this study emphasizes that cosmetics and personal care products are important sources leading to the PFASs skin exposure and provides a basis for future regulation of PFASs as product additive.

Per- and polyfluoroalkyl substances and human health outcomes: An umbrella review of systematic reviews with meta-analyses of observational studies

BACKGROUND

Although evidence on the association between per- and polyfluoroalkyl substances (PFASs) and human health outcomes has grown exponentially, specific health outcomes and their potential associations with PFASs have not been conclusively evaluated.

METHODS

We conducted a comprehensive search through the databases of PubMed, Embase, and Web of Science from inception to February 29, 2024, to identify systematic reviews with meta-analyses of observational studies examining the associations between the PFASs and multiple health outcomes. The quality of included studies was evaluated using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) tool, and credibility of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. The protocol of this umbrella review (UR) had been registered in PROSPERO (CRD 42023480817).

RESULTS

The UR identified 157 meta-analyses from 29 articles. Using the AMSTAR measurement tool, all articles were categorized as of moderate-to-high quality. Based on the GRADE assessment, significant associations between specific types of PFASs and low birth weight, tetanus vaccine response, and triglyceride levels showed high certainty of evidence. Moreover, moderate certainty of evidence with statistical significance was observed between PFASs and health outcomes including lower BMI z-score in infancy, poor sperm progressive motility, and decreased risk of preterm birth as well as preeclampsia. Fifty-two (33%) associations (e.g., PFASs and gestational hypertension, cardiovascular disease, etc) presented low certainty evidence. Additionally, eighty-five (55%) associations (e.g., PFASs with infertility, lipid metabolism, etc) presented very low certainty evidence.

CONCLUSION

High certainty of evidence supported that certain PFASs were associated with the incidence of low birth weight, low efficiency of the tetanus vaccine, and low triglyceride levels.

Association between ambient particulate matter exposure and mitochondrial DNA copy number: A systematic review and meta-analysis

BACKGROUND

Ambient particulate matter (PM) has been recognized as inducing oxidative stress, which could contribute to mitochondrial damage and dysfunction. However, studies investigating the association between ambient PM and mitochondria, particularly mitochondrial DNA copy number (mtDNA-CN), have yielded inconsistent results.

METHODS

We conducted comprehensive literature searches to identify observational studies published before July 17, 2023, examining the association between ambient PM exposure and mtDNA-CN. Meta-analysis using random effects model was employed to calculate the pooled effect estimates for general individual exposures, as well as for prenatal exposure with specific trimester. Additionally, the quality and level of evidence for each exposure-outcome pair was evaluated.

RESULTS

A total of 10 studies were included in the systematic review and meta-analysis. The results indicated that general individual exposure to PM2.5 (β = -0.084, 95 % CI: -0.521, 0.353; I2 = 93 %) and PM10 (β = 0.035, 95 % CI: -0.129, 0.199; I2 = 95 %) did not significantly affect mtDNA-CN. Prenatal exposure to PM2.5 (β = 0.023, 95 % CI: -0.087, 0.133; I2 = 0 %) and PM10 (β = 0.006, 95 % CI: -0.135; 0.147; I2 = 51 %) were also not significantly associated with mtDNA-CN in offspring. The level of evidence for each tested exposure-outcome pair was assessed as "inadequate."

CONCLUSIONS

The findings of this systematic review and meta-analysis indicate that there is an "inadequate" strength of evidence for the association between general individual or prenatal exposure to ambient PM and mtDNA-CN. Future research necessitates studies with more rigorous design, enhanced control of confounding factors, and improved measures of exposure to substantiate our findings.