Perfluorinated alkyl substances in Canadian human milk as part of the Maternal-Infant Research on Environmental Chemicals (MIREC) study

Current understanding of human bioaccumulation patterns and health effects of exposure to perfluorooctane sulfonate (PFOS)

Perfluorooctane sulfonate (PFOS) is a persistent organic pollutant of global concern due to its environmental presence,bioaccumulative potential and toxicological impacts. This review synthesizes current knowledge regarding PFOS exposure, bioaccumulation patterns and adverse health outcomes in human population. Analysis of worldwide biomonitoring data, and epidemiological studies reveals PFOS systemic effects, including immunological dysfunction (decreased vaccine response), developmental toxicity (reduced birth weight), hepatic metabolic disruption, potential carcinogenogenicity, and reproductive abnormalities. At the molecular level, PFOS induces toxicity through multiple pathways, including PI3K/AKT/mTOR pathway inhibition, PPARα activation, NF-κB signaling modulation, and oxidative stress induction. Recent advances in analytical methodologies have enhanced our understanding of PFOS distribution and fate, while evolving egulatory frameworks attempts to address its risk. This review identifies critical research gaps and emphasized the need for coordinated multidisciplinary approaches to address this persistent environmental contaminant.

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.

Per- and polyfluoroalkyl substances in paired serum and breastmilk samples among pregnant farmworkers in Thailand

Per- and polyfluoroalkyl substances (PFAS) are widely detected in pregnant persons and can be transferred to the developing fetus in utero. Breastfeeding may represent an important source of PFAS exposure for infants. However, studies quantifying levels of PFAS in breastmilk samples remain scarce, particularly in low- and middle-income countries. We examined breastmilk as a postnatal PFAS exposure source among mother-infant pairs in Thailand. Pregnant farmworkers were enrolled in the Study of Asian Women and their Offspring's Development and Environmental Exposures (SAWASDEE), a prospective birth cohort in Northern Thailand, between 2017 and 2019. We quantified levels of eight PFAS in maternal serum samples obtained during the second trimester, as well as in breastmilk samples obtained at 9.5 months and 11.5 months in infancy (N = 46 matched pairs). For each PFAS, we calculated lactational (serum to milk) transfer efficiencies and lactational estimated daily intake. PFOA, PFOS PFHxS, PFNA, PFDA, and PFUnDA were detected in >90% of serum samples. PFOS was detected in >60% of breastmilk samples obtained at 9.5 and 11.5 months, while PFNA was detected in >50% of 9.5-month breastmilk samples only. All remaining PFAS were detected in <50% of breastmilk samples. The lactational transfer efficiency for PFOS was 7.03% (SD = 5.78) and 5.83% (SD = 5.21) at 9.5 and 11.5 months, respectively. The lactational estimated daily intake for PFOS was 12.1 ng/kg bodyweight/day (SD = 5.49) and 10 ng/kg bodyweight/day (SD = 6.22) at 9.5 and 11.5 months, respectively. For PFNA, the lactational transfer efficiency and estimated daily intake at 9.5 months was 14.7% (SD = 14.3) and 6.14% (SD = 3.40), respectively. Within one of the first PFAS biomonitoring studies conducted in Thailand, we found that legacy PFAS were widely detected in serum, and some compounds were also detected in breastmilk of farmworkers. This study provides new evidence enhancing our understanding of postnatal exposure to PFAS.

Per- and Polyfluoroalkyl Substances (PFAS) in Consumer Products: An Overview of the Occurrence, Migration, and Exposure Assessment

Per- and polyfluoroalkyl substances (PFASs) have been widely used in the production of consumer products globally due to the excellent water and oil resistance and anti-fouling properties. The multiple toxic effects of some PFASs also pose a threat to human health and ecosystem, and the frequent use of certain consumer products increased the risk of human exposure to PFASs. More data on the occurrence, concentration, and migration of PFASs in consumer products is urgently needed to address the possible risks posed by exposure to consumer products. This paper reviews the PFAS concentrations found, the migration characteristics known, and the exposure risks of PFASs arising from several types of consumer products over the last five years. The types of consumer products considered here include food contact materials, textiles, and disposable personal hygiene products. The influence of different factors on the migration process of PFASs from these products are summarized and discussed. Additionally, the main approaches and models of exposure assessment are evaluated and summarized. Current challenges and future research prospects in this field are discussed with a view to providing guidance for the future assessment and regulation of PFASs in consumer products.

Maternal concentrations of perfluoroalkyl sulfonates and alterations in white matter microstructure in the developing brains of young children

BACKGROUND

Maternal exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to child neurodevelopmental difficulties. Neuroimaging research has linked these neurodevelopmental difficulties to white matter microstructure alterations, but the effects of PFAS on children's white matter microstructure remains unclear. We investigated associations between maternal blood concentrations of six common perfluoroalkyl sulfonates and white matter alterations in young children using longitudinal neuroimaging data.

METHODS

This study included 84 maternal-child pairs from a Canadian pregnancy cohort. Maternal second trimester blood concentrations of perfluorohexanesulfonate (PFHxS) and five perfluorooctane sulfonate (PFOS) isomers were quantified. Children underwent magnetic resonance imaging scans between ages two and six (279 scans total). Adjusted linear mixed models investigated associations between each exposure and white matter fractional anisotropy (FA) and mean diffusivity (MD).

RESULTS

Higher maternal concentrations of perfluoroalkyl sulfonates were associated with higher MD and lower FA in the body and splenium of the corpus callosum of young children. Multiple sex-specific associations were found. In males, PFHxS was negatively associated with FA in the superior longitudinal fasciculus, while PFOS isomers were positively associated with MD in the inferior longitudinal fasciculus (ILF). In females, PFOS isomers were positively associated with FA in the pyramidal fibers and MD in the fornix, but negatively associated with MD in the ILF.

CONCLUSION

Maternal exposure to perfluoroalkyl sulfonates may alter sex-specific white matter development in young children, potentially contributing to neurodevelopmental difficulties. Larger studies are needed to replicate these findings and examine the neurotoxicity of these chemicals.

Exposure to specific polyfluoroalkyl chemicals is associated with cardiovascular disease in US adults: a population-based study

Background

Polyfluoroalkyl chemicals (PFCs) present potential health risks due to their persistence and bioaccumulation. However, there is currently insufficient evidence regarding their impact on cardiovascular disease (CVD). Consequently, it is imperative to investigate the correlation between PFCs and CVD.

Methods

The data was collected from National Health and Nutrition Examination Survey in 2005-2012. Logistic regression models were employed to assess the association between single PFC and CVD. Generalized additive model (GAM) was used for evaluating nonlinear relationships. Subgroup analyses were conducted to explore interaction effects. Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) models were used to evaluate the joint effect of PFC exposures on CVD.

Results

In logistic regression, PFDE, MPAH, and PFUA were positively associated with CVD. In the GAM, there was a significant nonlinear relationship between MPAH and CVD. Subgroup analysis revealed the interaction of gender and race in the effects of PFCs and CVD. PFUA was positively correlated with CVD in males but show no significant difference in females. PFDE was positively associated with CVD among non-Hispanic white individual. The results of BKMR indicated that the impact of mixed PFCs on CVD increased initially and then weakened, showing an overall positive trend. The results of WQS suggested that PFDO contributed most to the effect.

Conclusion

Our study showed that serum PFDE, MPAH, and PFUA levels were positively correlated with CVD. PUFA was found to interact with gender and race in relation to CVD. A general positive correlation exists between mixed exposure to PFCs and CVD, with PFDO being the most contributory PFC. Our study provided important evidence for probing the impact of PFCs on CVD and laid a foundation for further mechanism research.

Concentrations and exposure risks of per- and polyfluoroalkyl substances in human milk from Southern China during the first 400 days of lactation

Per- and polyfluoroalkyl substances (PFASs) pose significant health risks, particularly for infants who are highly susceptible during early life. Although several studies have reported PFASs concentrations and exposure risks in human milk in China, they typically cover only up to 3 months postpartum, failing to align with the WHO recommendation of continued breastfeeding to 2 years of age. Therefore, this study aimed to address this gap by investigating the concentrations and exposure risks of legacy and emerging PFASs in human milk collected during the first 400 days postpartum from Southern China. We detected all the target 23 PFASs compounds, with 22 PFASs found in more than half of the samples. The median concentration of total PFASs in human milk was 151 ng/L, with PFOA, PFOS, 6:2 Cl-PFESA, and 8:2 Cl-PFESA being the most abundant. Total PFASs concentration peaked within the first 45 days postpartum (median, 154 ng/L), significantly higher than that at 200 -240 days (median, 145 ng/L) and 300 -400 days postpartum (median, 148 ng/L). PFBA, PFOA, PFNA, ADONA and PFOS also exhibited similar lactation patterns. Additionally, we calculated the estimated daily intakes (EDIs) of total PFASs for infants by multiplying their concentration in human milk by daily milk consumption, and dividing by body weight. The median EDIs of PFASs were 19.0, 10.2, and 9.03 ng/kg bw/d at 0 -45 days, 200 -240 days, and 300 -400 days postpartum, respectively. The corresponding median hazard quotients of PFASs for infants were 11.2, 5.43, and 5.23, respectively. These findings suggest persistent risks of PFASs exposure for infants through human milk during the first 400 days postpartum. However, breastfeeding remains the optimal choice due to its significant health benefits. It is crucial to reduce human milk PFASs concentrations by minimizing dietary and environmental exposures among lactating women.

PFAS profiles in biosolids, composts, and chemical fertilizers intended for agricultural land application in Quebec (Canada)

Biosolids, sewage sludge, and composts are applied to agricultural land for nutrient recovery and soil organic matter replenishment, aligning with sustainable development goals. However, they may contain per- and polyfluoroalkyl substances (PFAS) that can enter the food chain through plant bioaccumulation and leaching into the groundwater. This study analyzed 80 PFAS compounds in sewage sludge, biosolids, commercial composts, and chemical fertilizers in Quebec, Canada, using UHPLC-HRMS (Orbitrap Q-Exactive). PFAS concentrations ranged from 18 to 59 µg/kg in commercial composts, 9.8 to 213 µg/kg in pulp and paper sludge, 15 to 705 µg/kg in sewage sludge, 12 to 1310 µg/kg in biosolids, and 14.6 µg/kg on average in biosolids ash. Dominant PFAS classes included diPAPs, sulfonamides, PFCAs, and PFSAs. High diPAPs concentrations indicated widespread use in domestic, commercial, or industrial applications. This study also observed a negligible correlation between soil organic carbon and PFAS concentration in the biowastes signifying a stronger influence due to different WWTP configurations, the quality of the wastewater inputs and other medium's properties that could affect PFAS partitioning to the biowastes. Environmental assessments showed PFAS loads of up to 30 µg/kg soil from a single application, within some regulatory limits. However, repeated applications could lead to PFAS accumulation in soil, posing risks to crops and groundwater.

Legacy and alternative per- and polyfluoroalkyl substances spatiotemporal distribution in China: Human exposure, environmental media, and risk assessment

In recent decades, China's rapid development has led to significant environmental pollution from the widespread use of chemical products. Per- and polyfluoroalkyl substances (PFAS) are among the most concerning pollutants due to their persistence and bioaccumulation. This article assesses PFAS exposure levels, distribution, and health risks in Chinese blood, environment, and food. Out of 4037 papers retrieved from November 2022 to December 31, 2023, 351 articles met the criteria. Findings show perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) as the main PFAS in both Chinese populations and the environment. The highest PFOA levels in Chinese populations were in Shandong (53.868 ng/mL), while Hubei had the highest PFOS levels (43.874 ng/mL). Similarly, water samples from Sichuan (2115.204 ng/L) and Jiangsu (368.134 ng/L) had the highest PFOA and PFOS levels, respectively. Although localized areas showed high PFAS concentrations. Additionally, developed areas had higher PFAS contamination. The researches conducted in areas such as Qinghai and Hainan remain limited, underscoring the imperative for further investigation. Temporal analysis indicates declining levels of some PFAS, but emerging alternatives require more research. Limited studies on PFAS concentrations in soil, atmosphere, and food emphasize the need for comprehensive research to mitigate human exposure.

Per- and polyfluoroalkyl substances (PFAS): Trends in mass spectrometric analysis for human biomonitoring and exposure patterns from recent global cohort studies

Per- and polyfluoroalkyl substances (PFAS) are widespread environmental contaminants that have been shown to contribute to human exposure, thereby raising a range of health concerns. In this context, human biomonitoring is essential for linking exposure levels of PFAS with their potential health risks. Mass spectrometry-based analytical techniques have been extensively adopted for the evaluation of PFAS levels across various cohorts. However, challenges arising from the use of biological samples (e.g., plasma, serum, urine, etc.) necessitate ongoing research and refinement of analytical methodologies. This review provides an overview of current trends in mass spectrometry-based approaches for human biomonitoring of PFAS, including sample collection and preparation, and instrumental techniques. We also explore analytical strategies to overcome challenges in obtaining PFAS-free blank matrices and address the risk of background contamination. Moreover, this review examines differing PFAS exposure patterns across regions by analyzing recent international cohort studies, specifically those conducted in the US and China over the past five years. Accordingly, several key research gaps in biomonitoring studies that need to be addressed moving forward are highlighted.

Exploring perfluoroalkyl substances contamination in human breast milk: First ghanaian study

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) represent a category of synthetic organic chemical contaminants that have garnered increasing attention due to their potential adverse impacts. Existing research underscores the contamination of human breast milk by PFAS, raising concerns regarding potential deleterious health effects in children. The study aimed to explore the levels of some PFAS in human breast milk in a previously unstudied population to determine the extent of infants' exposure. The research was conducted at Ho Teaching Hospital in Ghana. The study protocol was reviewed and approval by University of Health and Allied Sciences Ethics Research Committee (UHAS-REC). Twenty-nine (29) mothers, aged 18-44 years, were enrolled in the research. Sample collection spanned from December 28, 2020 to June 30, 2021. Ten millilitres (10 mL) of breast milk were collected from each participant into cleaned bottles from day of birth to after two weeks postpartum, following a standardized protocol and stored at -20 °C. Sample preparation and analysis employed solid phase extraction methodology. Subsequently, the processed extracts were subjected to analysis using ultra-high-performance liquid chromatography (UPLC-MS/MS). The data obtained were analysed using IBM SPSS Statistics version 26, Excel 2016, and Xlstat 2022. Descriptive statistics were employed to summarize the study variables. The mean/mode input method was used to treat missing data. The median and interquartile range (IQR) of PFAS concentrations in the breast milk were: PFHxA, 6.0 ng/L(IQR, 2.2 ng/L), PFHpA, 5.6 ng/L(IQR, 2.1 ng/L), PFOA, 72.0 ng/L(IQR, 16.0 ng/L), and PFOS, 93.0 ng/L(IQR, 8.0 ng/L) ng/L) respectively. PFOS and PFOA were the most dominant PFAS in the breast milk which is consistent with worldwide reports. The levels of PFAS, particularly PFOS and PFOA, in breast milk points to seemingly high levels of PFAS exposure and contamination of mothers and neonates in the region.

Personal care product use and per- and polyfluoroalkyl substances in pregnant and lactating people in the Maternal-Infant Research on Environmental Chemicals study

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous chemicals routinely detected in personal care products (PCPs). However, few studies have evaluated the impact of PCP use on PFAS concentrations in pregnant and lactating populations.

OBJECTIVE

We investigated associations between PCP use and PFAS concentrations in prenatal plasma and human milk.

METHODS

We leveraged the Maternal-Infant Research on Environmental Chemicals (MIREC) Study to evaluate the contribution of PCP use on PFAS concentrations in prenatal plasma (6 to 13 weeks' gestation; n = 1,940) and human-milk (2 to 10 weeks' postpartum; n = 664). Participants reported frequency of use across 8 PCP categories during the 1st and 3rd trimesters, 1 to 2 days postpartum, and 2 to 10 weeks' postpartum. We used adjusted linear regression models to quantify percent differences and corresponding 95 % confidence intervals.

RESULTS

In 1st trimester pregnant people, we found higher use of nailcare products (≥once a week vs. never: perfluorooctanoic acid (PFOA): 21 % [9.7 %, 32 %]; perfluorooctane-sulfonic acid (PFOS): 11 % [0.3 %, 23 %]), fragrances (daily vs. never: PFOA: 14 % [7.8 %, 21 %]; PFOS: 7.8 % [1.3 %, 15 %]), makeup (daily vs. never: PFOA: 14 % [5.8 %, 23 %]), hair dyes (never vs. 1-2 times during pregnancy: PFOA: 8.3 % [2.4 %, 15 %]), and hair sprays or gels (daily vs. never: PFOA: 12 % [5.0 %, 19 %], PFOS: 7.1 % [0.2 %, 15 %]) were associated with higher plasma PFAS concentrations. Similar results were observed for 3rd trimester PCP use and 2 to 10 weeks' postpartum human-milk PFAS concentrations. In addition, we also found that people using colored-permanent dye 1 to 2 days postpartum had higher Sm-PFOS (18 % [2.7 %, 35 %]), PFOA (16 % [4.3 %, 29 %]), and perfluorononanoic acid (17 % [3.6 %, 33 %]) postpartum human-milk concentrations.

CONCLUSIONS

Our results show that PCP use may be a modifiable source of PFAS exposure in pregnant and lactating populations. These results along with growing scientific evidence can help inform PFAS regulation and guide individual choices to reduce PFAS exposure.

Association Between Prenatal Exposure to Per- and Poly-Fluoroalkyl Substances From Electronic Waste Disassembly Areas and Steroid Hormones in Human Milk Samples

Per- and poly-fluoroalkyl substances (PFAS), which are long-lasting environmental contaminants that are released into the environment during the e-waste disassembly process, pose a threat to human health. Human milk is a complex and dynamic mixture of endogenous and exogenous substances, including steroid hormones and PFAS. Therefore, in this study, we aimed to investigate the association between PFAS and steroid hormones in human milk from women living close to an e-waste disassembly area. In 2021, we collected milk samples from 150 mothers within 4 weeks of delivery and analyzed them via liquid chromatography-tandem mass spectrometry to determine the levels of 21 perfluorinated compounds and five steroid hormones (estrone, estriol, testosterone, progesterone, and androstenedione [A-dione]). We also performed multiple linear regression analysis to clarify the association between maternal PFAS exposure and steroid hormone concentrations. Our results indicated that PFOA and PFOS were positively associated with estrone (β, 0.23; 95% CI, 0.08-0.39) and A-dione (β, 0.186; 95% CI, 0.016-0.357) concentrations in human milk, respectively. Further, the average estimated daily intake of PFOA and PFOS were 36.5 ng/kg bw/day (range, 0.52-291.7 ng/kg bw/day) and 5.21 ng/kg bw/day (range, 0.26-32.3 ng/kg bw/day), respectively. Of concern, the PFAS intake of breastfeeding infants in the study area was higher than the recommended threshold. These findings suggested that prenatal exposure to PFAS from the e-waste disassembly process can influence steroid hormones levels in human milk. Increased efforts to mitigate mother and infant exposure to environmental pollutants are also required.

Serum concentrations of legacy, alternative, and precursor per- and polyfluoroalkyl substances: a descriptive analysis of adult female participants in the MIREC-ENDO study

BACKGROUND

Several legacy and emerging per- and polyfluoroalkyl substances (PFAS) have been regulated around the world. There is growing concern over the proliferation of alternative PFAS, as well as PFAS precursors. Biomonitoring data for PFAS are critical for assessing exposure and human health risk.

METHODS

We collected serum samples from 289 adult female participants in a 2018-2021 follow-up study of the Maternal-Infant Research on Environmental Chemicals (MIREC) Canadian pregnancy cohort. Samples were analyzed for 40 PFAS using ultra-performance liquid chromatography-tandem mass spectrometry. For those compounds with > 50% detection, as well as the sum of these compounds, we describe serum concentrations and patterns of exposure according to sociodemographic and obstetrical history characteristics.

RESULTS

17 out of 40 PFAS were detected in > 50% of samples with 7 of these detected in > 97% of samples. Median [95th percentile] concentrations (µg/L) were highest for PFOS (1.62 [4.56]), PFOA (0.69 [1.52]), PFNA (0.38 [0.81]), and PFHxS (0.33 [0.92]). Geometric mean concentrations of PFOA and PFHxS were approximately 2-fold lower among those with more children (≥ 3 vs. 1), greater number of children breastfed (≥ 3 vs. ≤ 1), longer lifetime duration of breastfeeding (> 4 years vs. ≤ 9 months), and shorter time since last pregnancy (≤ 4 years vs. > 8 years). We observed similar patterns for PFOS, PFHpS, and the sum of 17 PFAS, though the differences between groups were smaller. Concentrations of PFOA were higher among "White" participants, while concentrations of N-MeFOSE, N-EtFOSE, 7:3 FTCA, and 4:2 FTS were slightly higher among participants reporting a race or ethnicity other than "White". Concentrations of legacy, alternative, and precursor PFAS were generally similar across levels of age, education, household income, body mass index, and menopausal status.

CONCLUSIONS

We report the first Canadian biomonitoring data for several alternative and precursor PFAS. Our findings suggest that exposure to PFAS, including several emerging alternatives, may be widespread. Our results are consistent with previous studies showing that pregnancy and breastfeeding are excretion pathways for PFAS.

Novel halogenated flame retardants in Canadian human milk from the MIREC study (2008-2011)

Novel halogenated flame retardants (NHFRs) have been developed to replace those brominated flame retardants that have been restricted due to their persistence, bioaccumulation potential and toxicity, therefore, it is important to determine whether these replacement products are present at detectable concentrations in Canadians. NHFRs were measured in human milk samples (n = 541) collected from across Canada between 2008 and 2011, which is the first pan-Canadian dataset for these chemicals in human milk. Among the 15 measured NHFRs and eight methoxy-polybrominated diphenyl ethers (MeO-PBDEs), nine NHFRs and two MeO-PBDEs (6-MeO-PBDE 47 and 2-MeO-PBDE 68) were detected at a frequency of more than 9%. Despite benzene, 1,1'-(1,2-ethanediyl)bis [2,3,4,5,6-pentabromo-]/decabromodiphenylethane [DBDPE] being detected less frequently than the other observed NHFRs, its relative contribution to the sum of nine NHFRs was important when it was present. The maximum ΣNHFR concentration in Canadian human milk was 6930 pg g-1 lipid while the maximum ΣMeO-PBDEs was 1600 pg g-1 lipid. While most NHFR concentrations were significantly correlated with each other, no relationships between maternal age, parity or pre-pregnancy BMI were identified with ΣNHFR concentrations in the milk. In contrast, maternal age was significantly correlated with ΣMeO-PBDE concentrations (r = 0.237, p < 0.001). ΣNHFR concentrations were similarly not related to maternal education, although ΣMeO-PBDE concentrations were found to be higher in milk from women who had graduated from trade schools relative to the other education levels considered. NHFR detection frequency and concentrations observed in the Canadian human milk seem to align well with Europe.

Analytical approaches for screening of per- and poly fluoroalkyl substances in food items: A review of recent advances and improvements

Per and polyfluoroalkyl substances (PFAS) are a group of man-made chemicals characterized by their ubiquitous nature in all environmental compartments which makes them of increasing concern due to their persistence, bioaccumulation, and toxicity (PBT). Several instrumental methodologies and separation techniques have been identified in the literature for the detection and quantification of PFAS in environmental samples. In this review, we have identified and compared common separation techniques adopted for the extraction of PFAS in food items, and analytical methodologies for identification and quantification of PFAS in food items of plant and animal origin, highlighting recent advances in tandem techniques for the high selectivity and separation of PFAS related compounds as well as knowledge gaps and research needs on current analytical methodologies.

First Investigation of the Physiological Distribution of Legacy and Emerging Perfluoroalkyl Substances in Raw Bovine Milk According to the Component Fraction

Bovine milk is a pillar of the human diet and plays a key role in the nutrition of infants. Perfluoroalkyl substances (PFASs) are well-recognized highly stable organic compounds that are able to pollute ecosystems persistently and threaten both human and animal health. The study aimed to analyze the distribution of 14 PFASs within the milk matrix by comparing their content in whole milk, and its skimmed and creamed fractions. Raw milk samples were individually collected from 23 healthy cows (10 primiparous and 13 multiparous) reared on a farm in Northern Italy not surrounded by known point sources of PFASs. Each sample was fractioned in whole, skim, and cream components to undergo PFAS analysis using liquid chromatography-high-resolution mass spectrometry. All samples contained at least one PFAS, with perfluorobutanoic acid (PFBA) being the primary contaminant in all three fractions, followed by perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). PFOS was shown to be significantly (p < 0.001) more concentrated in cream than in raw and skimmed milk. Multiparous cows showed a higher frequency of positive samples in all analyzed fractions. Further research is necessary to assess the risk of dairy diets and high-fat dairy products and to investigate the toxicological effects of PFASs on cattle, even in environments without known PFAS sources.

Current knowledge on the effects of environmental contaminants in early life nutrition

Breast milk represents the optimal source of feeding for newborns, in terms of nutritional compounds and as it provides immunological, metabolic, organic, and neurological well-being. As a complex biological fluid, it consists not only of nutritional compounds but also contains environmental contaminants. Formulas through production, contact with bottles and cups, and complementary feeding can also be contaminated. The current review focuses on endocrine-disrupting chemicals, and made-man xenoestrogens present in the environment and both commonly present in food sources, agricultural practices, packaging, consumer products, industry, and medical care. These contaminants are transferred by passive diffusion to breast milk and are delivered during breastfeeding. They mainly act by activating or antagonizing hormonal receptors. We summarize the effects on the immune system, gut microbiota, and metabolism. Exposure to endocrine-disrupting chemicals and indirect food additives may induce tissue inflammation and polarize lymphocytes, increase proinflammatory cytokines, promote allergic sensitization, and microbial dysbiosis, activate nuclear receptors and increase the incidence of allergic, autoimmune, and metabolic diseases. Breast milk is the most important optimal source in early life. This mini-review summarizes current knowledge on environmental contaminants and paves the way for strategies to prevent milk contamination and limit maternal and infant exposure during pregnancy and the first months of life.

Differences in mirex [dechlorane] and dechlorane plus [syn- and anti-] concentrations observed in Canadian human milk

As part of the pan-Canadian Maternal-Infant Research on Environmental Chemicals (MIREC) study, human milk samples were collected between 2008 and 2011, and analyzed for mirex, an organochlorine insecticide and flame retardant, in addition to dechlorane plus (syn- and anti-DDC-CO), the flame retardant replacement for mirex. Mirex was analyzed separately, using a method for the analysis of existing organochlorine insecticides, while the presence of DDC-CO isomers was determined using a method developed for the detection of emerging flame retardants. Mirex was detected in all samples analyzed (n = 298), while syn- and anti-DDC-CO were present in 61.0% and 79.5% of the samples, respectively (n = 541). Mirex concentrations have declined in human milk since the 1990s. Since this is the first pan-Canadian dataset reporting DDC-CO concentrations in human milk, no temporal comparisons can be made. Maternal age was correlated with concentrations of both compounds although parity did not impact concentrations of either analyte. Given the presence of this relatively recently identified flame retardant (DDC-CO) in human milk from women across Canada, studies to identify dominant sources of this compound are critical. Despite low concentrations of environmental chemicals in human milk from Canadian women, Health Canada supports breastfeeding of infants because of the important health benefits to both the mothers and their infants.

Changes in perfluoroalkyl substances (PFAS) concentrations in human milk over the course of lactation: A study in Ronneby mother-child cohort

BACKGROUND

Little is known about how PFAS concentrations in human milk change over the course of lactation, although this is an important determinant of cumulative infant exposure from breastfeeding.

OBJECTIVE

To estimate changes in PFAS concentrations in human milk over the course of lactation in a population with a wide range of exposure from background-to high-exposed.

METHODS

We measured PFAS concentrations in colostrum and mature milk samples from women in the Ronneby Mother-Child Cohort. For each PFAS, we estimated the change in concentration from colostrum collected 3-4 days postpartum to mature milk collected 4-12 weeks postpartum using linear mixed-effects models. We evaluated whether this estimated change varied by quartiles of colostrum concentrations. In a subset of mothers with at least three mature milk samples, we estimated the change in concentration per month over the first eight months of lactation.

RESULTS

Our study included 77 mother-child pairs, of whom 74 had colostrum and initial mature milk samples and 11 had three or more repeated samples. The concentration change from colostrum to mature milk varied by PFAS. While PFOS increased by 21% (95% CI: 8.9, 35), PFOA decreased by 17% (95% CI: -28, -3.5) and PFHxS decreased by 12% (95% CI: -24, 3.3). In addition, PFAS concentrations tended to increase in women with lower colostrum levels, but decreased or remained the same in women with high colostrum concentrations. When we estimated changes over the course of lactation, we found that PFOA concentrations decreased the most (-12% per month; 95% CI: -22, -1.5), whereas PFHxS and PFOS showed small nonsignificant decreases.

CONCLUSIONS

Models for cumulative infancy exposure from breastfeeding need to account for differences in concentration trajectories by PFAS and possibly by maternal exposure level. Additional research is needed to evaluate the relative exposure from breastfeeding vs prenatal exposure, especially in highly exposed communities where breastfeeding guidance is urgently needed.

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.

Occurrences of legacy and emerging per- and polyfluoroalkyl substances in human milk in China: Results of the third National Human Milk Survey (2017-2020)

Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants widely contaminated and exposed in humans. China is a major manufacturer and consumer of these chemicals. To characterize the occurrences, geographical variations, temporal trends, and exposure risks of legacy and emerging PFAS in perinatal women and their children in China, 30 PFAS were measured in 100 pooled human milk samples consisting of 3531 individual samples collected from 100 sites in 24 provinces during the 2017-2020 National Human Milk Survey. Linear-perfluorooctanoic acid (L-PFOA, 151 pg/mL) and linear-perfluorooctane sulfonate (L-PFOS, 57.0 pg/mL) were the predominant PFAS in human milk, followed by 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA, 25.9 pg/mL). The geographic variation trend of PFOA was different from PFOS and Cl-PFESA, and a special geographic trend of perfluoropentanesulfonate (PFPeS) was observed. Comparison of National Human Milk surveys from different periods showed a sharp decrease of PFAS exposure in old industrial areas including Shanghai and Liaoning, but higher PFAS exposure observed in Shandong and Hubei indicated a possible domestic shift of PFAS manufacture to these areas. Worldwide comparison of PFAS in human milk indicated high PFOA exposure in China. Risk assessments for mothers and breastfeeding infants showed that PFAS exposure is of concern in China.

Infant formula and baby food as a source of perfluoroalkyl substances for infants

The present study reports infants' exposure to fourteen perfluoroalkyl substances (PFASs) in infant formula and baby food. First infant milk, follow-on milk and three types of baby food were analyzed: a variety made of fruits and vegetables, a variety with added fish and one containing meat. The mean lower-bound (LB) concentration of ∑14 PFASs was 0.22 μg/kg wet weight (w.w.) in first infant milk and 0.24 μg/kg w. w. In follow-on milk. Lower levels were noticed in baby food, where the mean LB concentration of ∑14 PFASs was in a 0.019-0.025 μg/kg w. w. Range. Perfluorotetradecanoic acid was found to be in the highest concentration both in baby formula and baby food. Dietary intake of ∑14 PFASs (LB concentration) via infant formula was in 0.3-83.1 ng/kg body weight (b.w.) and 0.3-31.1 ng/kg b. w ranges for first infant milk and follow-on milk respectively. The mean dietary intakes of ∑14 PFASs via one serving of baby food were similar for three varieties and were in a 0.46-0.57 ng/kg b. w. Range. Dietary intake of ∑4 PFASs was negligible in regard to the tolerable weekly intake of 4.4 ng/kg b. w. Recently established by the European Food Safety Authority. This preliminary study brings new information on infant exposure to PFASs in Poland. It is suggested that more sensitive methods be used in the future, and since there are many types of infant foods with different compositions of ingredients, more studies should be conducted.

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.

Perfluorooctanoic Acid and Perfluorooctane Sulfonate in Human Milk: First Survey from Lebanon

Human milk is the primary source of nutrition for infants in their first year of life. Its potential contamination with perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), a group of toxic man-made chemicals, is a health concern that may threatens infants' health. Our study aims to assess the levels of PFOA and PFOS in the breast milk of Lebanese lactating mothers and the maternal factors associated with their presence. High-performance liquid chromatography (HPLC) coupled with a Micromass Quattro micro API triple quadrupole mass spectrometer was used to detect the level of contamination in 57 collected human milk samples. PFOA and PFOS were present in 82.5% and 85.7% of the samples, respectively, while PFOA levels ranged between 120 and 247 pg/mL with a median of 147 pg/mL, and those of PFOS ranged between 12 and 86 pg/mL with a median of 27.5 pg/mL. The median contamination for PFOA exceeded the threshold set by the European Food Safety Authority (EFSA) (60 pg/mL); however, that of PFOS was below the threshold (73 pg/mL). The consumption of bread, pasta, meat, and chicken more than twice per week and that of white tubers and roots at least once per week was significantly associated with higher levels of PFOA (p < 0.05). No significant association was found between maternal age, BMI, parity, level of education, place of residence, source of water used, and smoking with the levels of PFOA and PFOS in the human milk. Additionally, the consumption of cereals at least twice per week was significantly associated with higher levels of PFOS. These findings call for actions to improve the local environmental and agricultural practices, and the regulations and standards for inspecting imported food. It is important to highlight that the benefits of breastfeeding outweigh the reported contamination with PFOS and PFOA in our study.