An assessment of the exposure of Americans to perfluorooctane sulfonate: a comparison of estimated intake with values inferred from NHANES data

General toxicity and screening of reproductive and developmental toxicity following bioaccumulation of oral-dosed perfluorooctanoic acid: Loss of the Golgi apparatus

Despite its widespread use as a stabilizer across various industries over the past several decades, the health effects of chronic exposure to PFOA are still unclear. We administered PFOA by oral gavage (0, 12.5, 50, and 200 μg/day/mouse, eight groups) to male and female mice for six months. Body weight gain decreased with dose accompanied by increased liver weight, and PFOA altered liver damage-related-blood biochemical indicators and induced pathological lesions, including hepatocellular hypertrophy, cholangiofibrosis, and centrilobular hepatocellular vacuolation. Loss of the Golgi apparatus, formation of lamellar body-like structures, and lipid accumulation were observed in the liver of PFOA-treated mice. We also cohabited five pairs of male and female mice for the last ten days of administration, dosed PFOA to dam up to 28 days after birth, and investigated effects on reproduction and development. The survival rate of pups and the sex ratio of surviving mice decreased significantly at the highest dose. PFOA tissue concentration increased with the dose in the parent mice's liver and the pups' blood and brain. Taken together, we suggest that PFOA primarily affects the liver and reproduction system and that disturbance in lipid metabolism and Golgi's structural stability may be involved in PFOA-induced toxicity.

Thyroid dysfunction caused by exposure to environmental endocrine disruptors and the underlying mechanism: A review

Thyroid disease has been rapidly increasing, but its causes remain unclear. At present, many studies have focused on the relationship between environmental endocrine disruptors (EEDs) and the pathogenesis of thyroid disease. Herein, we summarize such studies exploring the effects of exposure to common EEDs on thyrotoxicosis, finding that EEDs appear to contribute to the pathogenesis of thyroid-related diseases such as thyroid cancer, goiter, thyroiditis, hyperthyroidism, and hypothyroidism. To explore this causative effect in detail, we have analyzed the following three aspects of how EEDs are believed to exert their impacts on the occurrence and development of thyroid disease: (1) damage to the thyroid tissue structure, including disrupted mitochondria and the stratification of thyroid follicular epithelial cells; (2) disruption of thyroid hormone signaling, including thyroid hormone synthesis and secretion disorders, destruction of normal function of the hypothalamus-pituitary-thyroid axis, disturbed estrogen signaling in the body, alterations to the level of thyroid-stimulating hormone, inhibition of the release of thyroglobulin from thyroid cells, and reductions in the levels of sodium iodide co-transporters, thyroid peroxidase, deiodinase, and transthyretin; and (3) molecular mechanisms underlying the disruption of thyroid function, including competitive binding to T3 and T4 receptors, disturbance of the hypothalamic-pituitary-thyroid axis, activation of the ERK and Akt pathways, oxidative stress, regulation of the expression of the proto-oncogene k-Ras, tumor suppressor gene PTEN, and thyroid TSHR gene, and induction of autophagy in thyroid cells. Overall, this article reviews how EEDs can affect the occurrence and development of thyroid disease via multiple routes, thus providing new ideas to intervene for the prevention, diagnosis, treatment, and prognosis of thyroid disease.

Associations of a Prenatal Serum Per- and Polyfluoroalkyl Substance Mixture with the Cord Serum Metabolome in the HOME Study

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous and persistent chemicals associated with multiple adverse health outcomes; however, the biological pathways affected by these chemicals are unknown. To address this knowledge gap, we used data from 264 mother-infant dyads in the Health Outcomes and Measures of the Environment (HOME) Study and employed quantile-based g-computation to estimate covariate-adjusted associations between a prenatal (∼16 weeks' gestation) serum PFAS mixture [perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)] and 14,402 features measured in cord serum. The PFAS mixture was associated with four features: PFOS, PFHxS, a putatively identified metabolite (3-monoiodo-l-thyronine 4-O-sulfate), and an unidentified feature (590.0020 m/z and 441.4 s retention time; false discovery rate <0.20). Using pathway enrichment analysis coupled with quantile-based g-computation, the PFAS mixture was associated with 49 metabolic pathways, most notably amino acid, carbohydrate, lipid and cofactor and vitamin metabolism, as well as glycan biosynthesis and metabolism (P(Gamma) <0.05). Future studies should assess if these pathways mediate associations of prenatal PFAS exposure with infant or child health outcomes, such as birthweight or vaccine response.

Let's talk about PFAS: Inconsistent public awareness about PFAS and its sources in the United States

The presence of per- and polyfluoroalkyl substances (PFAS) in U.S. drinking water has recently garnered significant attention from the media, federal government, and public health professionals. While concerns for PFAS exposure continue to mount, the general public's awareness and knowledge of the contaminant has remained unknown. This exploratory study sought to fill this data gap by administering a nationwide survey in which the awareness of PFAS and community contamination, awareness of PFAS containing products and intentions to change product use, and awareness and concern about PFAS in drinking water were assessed. The results indicated that almost half the respondents had never heard of PFAS and do not know what it is (45.1%). Additionally, 31.6% responded that they had heard of PFAS but do not know what it is. A large portion of respondents (97.4%) also responded that they did not believe their drinking water had been impacted by PFAS. Demographic association did not influence knowledge of PFAS or levels of concern with PFAS in drinking water. The strongest predictor of PFAS awareness was awareness due to known community exposure. The respondents aware of community exposure were more likely to have knowledge of PFAS sources, change their use of items with potential PFAS contamination, and answer that their drinking water sources were also contaminated with PFAS. Based on the received responses, PFAS information and health risks need to be better communicated to the public to help increase awareness. These efforts should also be coordinated between government agencies, utilities, the research community, and other responsible entities to bolster their effectiveness.

Elevated Levels of Ultrashort- and Short-Chain Perfluoroalkyl Acids in US Homes and People

Per- and polyfluoroalkyl substances (PFAS) make up a large group of fluorinated organic compounds extensively used in consumer products and industrial applications. Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), the two perfluoroalkyl acids (PFAAs) with 8 carbons in their structure, have been phased out on a global scale because of their high environmental persistence and toxicity. As a result, shorter-chain PFAAs with less than 8 carbons in their structure are being used as their replacements and are now widely detected in the environment, raising concerns about their effects on human health. In this study, 47 PFAAs and their precursors were measured in paired samples of dust and drinking water collected from residential homes in Indiana, United States, and in blood and urine samples collected from the residents of these homes. Ultrashort- (with 2 or 3 carbons [C2-C3]) and short-chain (with 4-7 carbons [C4-C7]) PFAAs were the most abundant in all four matrices and constituted on average 69-100% of the total PFAA concentrations. Specifically, trifluoroacetic acid (TFA, C2) and perfluoropropanoic acid (PFPrA, C3) were the predominant PFAAs in most of the samples. Significant positive correlations (n = 81; r = 0.23-0.42; p < 0.05) were found between TFA, perfluorobutanoic acid (PFBA, C4), and perfluoroheptanoic acid (PFHpA, C7) concentrations in dust or water and those in serum, suggesting dust ingestion and/or drinking water consumption as important exposure pathways for these compounds. This study demonstrates that ultrashort- and short-chain PFAAs are now abundant in the indoor environment and in humans and warrants further research on potential adverse health effects of these exposures.

Low concentrations of perfluoroalkyl acids (PFAAs) in municipal drinking water associated with serum PFAA concentrations in Swedish adolescents

While highly contaminated drinking water (DW) is a major source of exposure to perfluoroalkyl acids (PFAAs), the contribution of low-level contaminated DW (i.e. < 10 ng/L of individual PFAAs) to PFAA body burdens has rarely been studied. To address this knowledge gap, we evaluated the association between concentrations of perflurooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS) and perfluorooctane sulfonic acid (PFOS), and their sum (∑4PFAAs) in DW and serum in Swedish adolescents using weighted least squares regression. We paired serum PFAA concentrations in adolescents (age 10-21 years, n = 790) from the dietary survey Riksmaten Adolescents 2016-17 (RMA) with mean PFAA concentrations in water samples collected in 2018 from waterworks (n = 45) supplying DW to the participant residential and school addresses. The median concentrations of individual PFAAs in DW were < 1 ng/L. Median concentrations of PFNA and PFHxS in serum were < 1 ng/g, while those of PFOA and PFOS were 1-2 ng/g. Significant positive associations between PFAA concentrations in DW and serum were found for all four PFAAs and ∑4PFAAs, with estimated serum/DW concentration ratios ranging from 210 (PFOA) to 670 (PFHxS), taking exposure from sources other than DW (background) into consideration. The mean concentrations of PFHxS and ∑4PFAA in DW that would likely cause substantially elevated serum concentrations above background variation were estimated to 0.9 ng/L and 2.4 ng/L, respectively. The European Food Safety Authority has determined a health concern concentration of 6.9 ng ∑4PFAAs/mL serum. This level was to a large degree exceeded by RMA participants with DW ∑4PFAA concentrations above the maximum limits implemented in Denmark (2 ng ∑4PFAAs/L) and Sweden (4 ng ∑4PFAAs/L) than by RMA participants with DW concentrations below the maximum limits. In conclusion, PFAA exposure from low-level contaminated DW must be considered in risk assessment for adolescents.

Temporal decline in serum PFAS concentrations among metropolitan firefighters: Longitudinal study on post-exposure changes following PFAS foam cessation

Firefighters are at a high risk of exposure to per- and polyfluoroalkyl substances (PFAS) due to their frequent use of PFAS-containing foams in training and emergency situations. This longitudinal study aimed to investigate the changes in serum PFAS levels among firefighters following cessation of their exposure to PFAS-containing foams. The study involved 130 firefighters from the South Australian Metropolitan Fire Services (SAMFS), and serum samples were collected at two time points: baseline in 2018-19 and follow-up in 2021-22. Along with the collection of samples, a survey questionnaire was administered to gather information on firefighters' employment and demographic characteristics. Regression models were employed to assess the association between these factors and the outcome variable (annual percentage change in serum PFAS concentration). The results indicated a decline in serum PFAS concentrations over time, with the main contaminants being perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorooctanoic acid (PFOA). The median and Interquartile Range (IQR) of total PFAS (∑PFAS) concentration reduced from 21.5 ng/ml (IQR: 11 to 53 ng/ml) at baseline to 15 ng/ml (IQR: 8 to 33 ng/ml) at follow-up. On average, there was an annual reduction of 13%, 7%, and 4.4% in serum concentrations of PFOS, PFHxS, and PFOA, respectively. Firefighters under the age of 55, those who used PFAS in the past ten years, or those who had little to no frequency of PFAS exposure in their previous employment, encountered a significantly higher annual percentage reduction (P < 0.05) in both ∑PFAS and PFOS concentrations. None of the independent variables analysed could significantly predict the annual percentage change in PFOA and PFHxS. This study provides evidence for a declining temporal trend in serum PFAS concentrations among metropolitan firefighters following workplace interventions that involved the removal of PFAS-containing foams.

Domestic Dogs and Horses as Sentinels of Per- and Polyfluoroalkyl Substance Exposure and Associated Health Biomarkers in Gray's Creek North Carolina

Central North Carolina (NC) is highly contaminated with per- and polyfluoroalkyl substances (PFAS), in part due to local fluorochemical production. Little is known about the exposure profiles and long-term health impacts for humans and animals that live in nearby communities. In this study, serum PFAS concentrations were determined using liquid chromatography high-resolution mass spectrometry and diagnostic clinical chemistry endpoints were assessed for 31 dogs and 32 horses that reside in Gray's Creek NC at households with documented PFAS contamination in their drinking water. PFAS were detected in every sample, with 12 of the 20 PFAS detected in ≥50% of samples from each species. The average total PFAS concentrations in horses were lower compared to dogs who had higher concentrations of PFOS (dogs 2.9 ng/mL; horses 1.8 ng/mL), PFHxS (dogs 1.43 ng/mL, horses < LOD), and PFOA (dogs 0.37 ng/mL; horses 0.10 ng/mL). Regression analysis highlighted alkaline phosphatase, glucose, and globulin proteins in dogs and gamma glutamyl transferase in horses as potential biomarkers associated with PFAS exposure. Overall, the results of this study support the utility of companion animal and livestock species as sentinels of PFAS exposure differences inside and outside of the home. As in humans, renal and hepatic health in domestic animals may be sensitive to long-term PFAS exposures.

Up in the air: Polyfluoroalkyl phosphate esters (PAPs) in airborne dust captured by air conditioning (AC) filters

Per- and polyfluoroalkyl substances (PFAS) are ubiquitously present in our indoor living environments. Dust is thought to accumulate PFAS released indoors and serve as an exposure pathway for humans. Here, we investigated whether spent air conditioning (AC) filters can be exploited as opportunistic samplers of airborne dust for assessing PFAS burden in indoor environments. Used AC filters from campus facilities (n = 19) and homes (n = 11) were analyzed for 92 PFAS via targeted ultra-high pressure liquid chromatography - tandem mass spectrometry (UHPLC-MS/MS). While 27 PFAS were measured (in at least one filter), the predominant species were polyfluorinated dialkylated phosphate esters (diPAPs), with the sum of 6:2-, 8:2-, and 6:2/8:2diPAPs accounting for approximately 95 and 98 percent of ∑₂₇PFAS in campus and household filters, respectively. Exploratory screening of a subset of the filters revealed the presence of additional species of mono-, di-, and tri-PAPs. Considering the constant human exposure to dust indoors and the potential of PAPs to degrade into terminal species with well-established toxicological risks, assessing dust for these precursor PFAS warrants further investigation with respect to both human health and PFAS loading to landfills from this under studied waste stream.

Estimating historical exposure to perfluoroalkyl acids in Security, Fountain, and Widefield Colorado: use of water-infrastructure blending and toxicokinetic models

Drinking water can be a major source of poly- and perfluoroalkyl substance (PFAS) exposure for humans. The lack of historic data on PFAS drinking-water concentrations and consumption patterns are a limiting factor for developing estimates of past exposure. Here, in contribution to a community-scale PFAS health effects study near fire training facilities that contaminated a local aquifer with PFASs, we present a novel water-infrastructure, mass-balance mixing model coupled to a non-steady state, single-compartment toxicokinetic model that used Monte Carlo simulations to estimate the start of PFAS exposure in drinking water for individuals within three PFAS-impacted communities in El Paso County, Colorado. Our modeling focused on perfluorohexane sulfonic acid (PFHxS) because median serum PFHxS concentrations in a sample of local residents (n = 213) were twelve times the median observed in the U.S. National Health and Nutrition Examination Survey (2015-2016). Modeling results for study participants were grouped according to their community of residence, revealing a median start of exposure for the town of Fountain of 1998 (25-75% interquartile range [IQR], 1992 to 2010), 2006 (IQR 1995 to 2012) for Security, and 2009 (IQR 1996-2012) for Widefield. Based on the towns' locations relative to an identified hydraulically upgradient PFAS source, the modeled exposure sequencing does not completely align with this conceptual flow model, implying the presence of an additional PFAS source for the groundwater between Widefield and Fountain.

Associations of Pregnancy Per- and Polyfluoroalkyl Substance Concentrations and Uterine Fibroid Changes across Pregnancy: NICHD Fetal Growth Studies - Singletons Cohort

BACKGROUND

Fibroids (hormonally responsive benign tumors) often undergo volume changes in pregnancy. Because per- and polyfluoroalkyl substances (PFAS) disrupt hormonal signaling, they might affect fibroid growth. We assessed associations between PFAS and fibroid changes in pregnancy.

METHODS

We analyzed seven PFAS, including perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA), in plasma collected at 10-13 wk gestation from 2,621 women in the NICHD Fetal Growth Studies - Singletons cohort (2009-2013). Sonographers recorded fibroid number and volume of the three largest fibroids during up to six timed ultrasounds. Generalized linear models assessed associations of baseline log 2 - transformed PFAS and fibroid number, volume, and presence, and weighted quantile sum regression evaluated the PFAS mixture. Generalized linear mixed models with random intercepts assessed associations of PFAS and longitudinal fibroid number and total volume. Volume analyses were stratified by total volume at first visualization [equivalent to a fibroid < 1 cm (small), 1  to < 3 cm (medium), or ≥ 3 cm (large) in diameter].

RESULTS

Fibroid prevalence was 9.4% (n = 245 women). PFAS were not associated with changes in fibroid number, but were associated with volume trajectory, depending on baseline volume. Among women with small volume, PFAS were associated with fibroid growth: Each doubling in PFHxS and PFOS concentrations was associated with 3.6% [95% confidence interval (CI): 0.2, 7.0 and 5.2% (95% CI: - 0.4 , 11.1)] greater weekly fibroid growth, respectively. Among women with medium volume, PFAS were associated with shrinking: Doublings in PFOS, PFDA, and PFUnDA concentrations were associated with 1.9% (95% CI: 0.4, 3.3), 1.2% (95% CI: 0.1, 2.4), and 1.6% (95% CI: 0.4, 2.8) greater weekly fibroid volume reduction, respectively.

DISCUSSION

Certain PFAS were associated with fibroid growth among women with small fibroids and decreases among women with medium fibroids. PFAS were not associated with fibroid prevalence or number; therefore, PFAS may influence prevalent fibroids rather than initiating fibroid development. https://doi.org/10.1289/EHP11606.

Health Risk Exposure Assessment of Migration of Perfluorooctane Sulfonate and Perfluorooctanoic Acid from Paper and Cardboard in Contact with Food under Temperature Variations

Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) are extensively used in food-contact paper and cardboard. However, they may migrate from food-contact materials to food, and the migration rate may be increased at elevated temperatures. In addition, there is a positive association of PFOS/PFOA levels with total cholesterol. Therefore, this study aims to assess the human health risk of increased total cholesterol associated with long-term exposure to PFOS and PFOA migration from food-contact paper and cardboard under temperature variation scenarios in adults. An exposure assessment was performed using an uptake dose model to estimate the uptake doses of PFOS and PFOA for the high-, intermediate-, and low-exposure scenarios. Benchmark dose (BMD) modeling was conducted to describe the dose-response relationships between PFOS/PFOA and total cholesterol levels. Finally, a margin of exposure (MOE) approach was used to characterize the risk. The results of the exposure assessment showed that PFOS and PFOA uptake doses in the high-exposure scenarios were around one and two orders of magnitude greater than those in the intermediate- and low-exposure scenarios, respectively. Under high-exposure scenarios, the uptake levels of hundredth-percentile PFOS and PFOA at high temperatures may raise health concerns (MOE < 1). This study provides a methodology to assess the health risks associated with exposure to migration of food contaminants from various types of paper and cardboard that come into contact with food.

Endocrine-disrupting substances: I. Relative risks of PFAS in drinking water

Concentrations of per and polyfluorinated alkyl substances (PFAS) in drinking water are significantly lower than in vivo levels of the native target hormone. These concentrations are orders of magnitude lower than the hormone in question, particularly when corrected for transactivation. A pregnant woman can excrete about 7,000 μg/day of total estrogens. A low-dose oral contraceptive pill contains 20 μg estradiol. Soy-based baby formula contains phytoestrogens equivalent to a low-dose oral contraceptive pill. A woman on a low-dose oral hormone replacement therapy consumes about 0.5-2 mg/day of one or more estrogens. The levels of endocrine-disrupting substances (EDSs) exposure by oral, respiratory, or dermal routes have the potential to make removing PFAS from drinking water due to its estrogenic activity divert valuable resources. These levels become even less of a threat when their estrogenic potencies are compared with those of the target hormones present as contaminants in water and even more so when compared with levels commonly present in human tissues. The fact that PFAS constitute a tiny fraction compared to exposure to phytoestrogens makes the effort even more insignificant. If PFAS are to be removed from drinking water, it is not due to their estrogenic activity.

A Scoping Assessment of Implemented Toxicokinetic Models of Per- and Polyfluoro-Alkyl Substances, with a Focus on One-Compartment Models

Toxicokinetic (TK) models have been used for decades to estimate concentrations of per-and polyfluoroalkyl substances (PFAS) in serum. However, model complexity has varied across studies depending on the application and the state of the science. This scoping effort seeks to systematically map the current landscape of PFAS TK models by categorizing different trends and similarities across model type, PFAS, and use scenario. A literature review using Web of Science and SWIFT-Review was used to identify TK models used for PFAS. The assessment covered publications from 2005-2020. PFOA, the PFAS for which most models were designed, was included in 69 of the 92 papers, followed by PFOS with 60, PFHxS with 22, and PFNA with 15. Only 4 of the 92 papers did not include analysis of PFOA, PFOS, PFNA, or PFHxS. Within the corpus, 50 papers contained a one-compartment model, 17 two-compartment models were found, and 33 used physiologically based pharmacokinetic (PBTK) models. The scoping assessment suggests that scientific interest has centered around two chemicals-PFOA and PFOS-and most analyses use one-compartment models in human exposure scenarios.

Association between perfluoroalkyl substances exposure and the prevalence of nonalcoholic fatty liver disease in the different sexes: a study from the National Health and Nutrition Examination Survey 2005-2018

There is evidence that perfluoroalkyl substances (PFASs) have effects on liver toxicity, and the effects may exhibit sex differences. Our study aims to explore the association between exposure to four PFASs (perfluorooctanoic acid, PFOA; perfluorooctane sulfonate, PFOS; perfluorohexane sulfonate, PFHxS; and perfluorononanoate, PFNA) and the risk of nonalcoholic fatty liver disease (NAFLD) in adults ≥ 20 years old in the US population. The data were based on the National Health and Nutrition Examination Survey (NHANES) 2005-2018. We used Poisson regression to explore the association between the four PFASs and NAFLD. We included 3464 participants; of these, 1200 (34.64%) individuals were defined as having NAFLD, and the prevalence of NAFLD was 39.52% in men and 30.40% in women. After Poisson regression, among the premenopausal and postmenopausal and total women, PFOA had a significantly positive association with NAFLD (p < 0.05). After principal component analysis, the "composite PFAS" was associated with NAFLD in postmenopausal and total women, and the RRs (95% CIs) were 1.306 (1.075, 1.586) and 1.161 (1.007, 1.339), respectively. In adults, we found that PFASs were associated with NAFLD, and the associations varied by sex, particularly for PFOA and PFNA, which had a positive association with NAFLD in women.

A Machine Learning Model to Estimate Toxicokinetic Half-Lives of Per- and Polyfluoro-Alkyl Substances (PFAS) in Multiple Species

Per- and polyfluoroalkyl substances (PFAS) are a diverse group of man-made chemicals that are commonly found in body tissues. The toxicokinetics of most PFAS are currently uncharacterized, but long half-lives (t½) have been observed in some cases. Knowledge of chemical-specific t½ is necessary for exposure reconstruction and extrapolation from toxicological studies. We used an ensemble machine learning method, random forest, to model the existing in vivo measured t½ across four species (human, monkey, rat, mouse) and eleven PFAS. Mechanistically motivated descriptors were examined, including two types of surrogates for renal transporters: (1) physiological descriptors, including kidney geometry, for renal transporter expression and (2) structural similarity of defluorinated PFAS to endogenous chemicals for transporter affinity. We developed a classification model for t½ (Bin 1: <12 h; Bin 2: <1 week; Bin 3: <2 months; Bin 4: >2 months). The model had an accuracy of 86.1% in contrast to 32.2% for a y-randomized null model. A total of 3890 compounds were within domain of the model, and t½ was predicted using the bin medians: 4.9 h, 2.2 days, 33 days, and 3.3 years. For human t½, 56% of PFAS were classified in Bin 4, 7% were classified in Bin 3, and 37% were classified in Bin 2. This model synthesizes the limited available data to allow tentative extrapolation and prioritization.

Does Using Corsi-Rosenthal Boxes to Mitigate COVID-19 Transmission Also Reduce Indoor Air Concentrations of PFAS and Phthalates?

The COVID-19 pandemic brought new emphasis on indoor air quality. However, few studies have investigated the impact of air filtration, a COVID-mitigation approach, on indoor air concentrations of semivolatile organic compounds (SVOCs). Using a quasi-experimental design, we quantified the impact of a relatively low-cost "do-it-yourself" air filter (Corsi-Rosenthal Box; CR Box) on indoor air concentrations of 42 PFAS and 24 other SVOCs. We sampled air before (October-November 2021) and during (February-March 2022) deployment of CR Boxes in 17 rooms located in an occupied Providence, Rhode Island office building. We measured sound levels in rooms with CR Boxes operating and not operating. While CR Boxes were deployed, concentrations of seven PFAS (N-EtFOSE, N-EtFOSA, FBSA, PFBS, PFHxS, PFOS, PFNA) were 28-61% lower and concentrations of five phthalates (DMP, DEP, DiBP, BBzP, DCHP) were 29-62% lower. Concentrations of five PFAS and one phthalate increased 23-44% during the intervention period, but the 95% CI of most of these estimates included the null. Daytime sound levels increased 5.0 dB when CR Boxes were operating. These results indicate that CR Boxes reduced exposure to several lower-volatility phthalates and sulfonated PFAS previously reported to be found in office building materials and products, with potentially distracting increases in sound levels.

Computational estimates of daily aggregate exposure to PFOA/PFOS from 2011 to 2017 using a basic intake model

BACKGROUND

Human exposure to per- and polyfluoroalkyl substances has been modeled to estimate serum concentrations. Given that the production and use of these compounds have decreased in recent years, especially PFOA and PFOS, and that additional concentration data have become available from the US and other industrialized countries over the past decade, aggregate median intakes of these two compounds were estimated using more recent data.

METHODS

Summary statistics from secondary sources were collected, averaged, and mapped for indoor and outdoor air, water, dust, and soil for PFOA and PFOS to estimate exposures for adults and children. European dietary intake estimates were used to estimate daily intake from food.

RESULTS

In accordance with decreased concentrations in media, daily intake estimates among adults, i.e., 40 ng/day PFOA and 40 ng/day PFOS, are substantially lower than those reported previously, as are children's estimates of 14 ng/day PFOA and 17 ng/day PFOS. Using a first-order pharmacokinetic model, these results compare favorably to the National Health and Nutrition Examination Survey serum concentration measurements.

CONCLUSION

Concomitant blood concentrations support this enhanced estimation approach that captures the decline of PFOA/PFOS serum concentration over a decade.

Bayesian Estimation of Human Population Toxicokinetics of PFOA, PFOS, PFHxS, and PFNA from Studies of Contaminated Drinking Water

BACKGROUND

Setting health-protective standards for poly- and perfluoroalkyl substances (PFAS) exposure requires estimates of their population toxicokinetics, but existing studies have reported widely varying PFAS half-lives (T_½) and volumes of distribution (V_d).

OBJECTIVES

We combined data from multiple studies to develop harmonized estimates of T_½ and V_d, along with their interindividual variability, for four PFAS commonly found in drinking water: perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS).

METHODS

We identified published data on PFAS concentrations in human serum with corresponding drinking water measurements, separated into training and testing data sets. We fit training data sets to a one-compartment model incorporating interindividual variability, time-dependent drinking water concentrations, and background exposures. Use of a hierarchical Bayesian approach allowed us to incorporate informative priors at the population level, as well as at the study level. We compared posterior predictions to testing data sets to evaluate model performance.

RESULTS

Posterior median (95% CI) estimates of T_½ (in years) for the population geometric mean were 3.14 (2.69, 3.73) for PFOA, 3.36 (2.52, 4.42) for PFOS, 2.35 (1.65, 3.16) for PFNA, and 8.30 (5.38, 13.5) for PFHxS, all of which were within the range of previously published values. The extensive individual-level data for PFOA allowed accurate estimation of population variability, with a population geometric standard deviation of 1.57 (95% CI: 1.42, 1.73); data from other PFAS were also consistent with this degree of population variability. V_d estimates ranged from 0.19 to 0.43L/kg across the four PFAS, which tended to be slightly higher than previously published estimates.

DISCUSSION

These results have direct application in both risk assessment (quantitative interspecies extrapolation and uncertainty factors for interindividual variability) and risk communication (interpretation of monitoring data). In addition, this study provides a rigorous methodology for further refinement with additional data, as well as application to other PFAS. https://doi.org/10.1289/EHP10103.

Bioavailability of inhaled or ingested PFOA adsorbed to house dust

Indoor environments may impact human health due to chemical pollutants in the indoor air and house dust. This study aimed at comparing the bioavailability and distribution of PFOA following both an inhalation and an oral exposure to PFOA coated house dust in rats. In addition, extractable organofluorine (EOF) was measured in different tissue samples to assess any potential influence of other organofluorine compounds in the experimental house dust. Blood samples were collected at sequential time points after exposure and at the time of termination; the lungs, liver, and kidney were collected for quantification of PFOA and EOF. The concentration of PFOA in plasma increased rapidly in both exposure groups attaining a C_max at 3 h post exposure. The C_max following inhalation was four times higher compared to oral exposures. At 48 h post exposure, the levels of PFOA in the plasma, liver, and kidney were twice as high from inhalation exposures. This shows that PFOA is readily bioavailable and has a rapid systemic distribution following an inhalation or oral exposure to house dust coated with PFOA. The proportion of PFOA to EOF corresponded to 65-71% and 74-87% in plasma and tissues, respectively. The mass balance between EOF and target PFOA indicates that there might be other unknown PFAS precursor and/or fluorinated compounds that co-existed in the house dust sample that can have accumulated in rats.

Estimated daily intake of per- and polyfluoroalkyl substances related to different particle size fractions of house dust

Indoor environmental pollutants are a threat to human health. In the current study, we analysed 25 per- and polyfluoroalkyl substances (PFASs) in seven different size fraction of house dust including the two relevant for exposure via ingestion and inhalation. The highest PFAS concentration is found in the inhalable particulate fraction which is explained by the increased surface area as the particulate's sizes decrease. The estimated daily intake (EDI) of the individual PFAS and exposure pathways were calculated for children and adults. In addition, the total EDI for PFOA and its precursors was estimated. The polyfluoroalkyl phosphoric acid diesters (diPAP), followed by PFOA and PFHxA fluortelomer, showed the highest concentrations of PFAS analysed. The cumulative EDI of PFAS for children was 3.0 ng/kg bw per day, a worst-case scenario, which is 17 times higher than the calculated EDI for adults. For children, ingestion of dust was found to result in 800 times higher PFOA exposure than via inhalation. The contribution from PFOA precursors corresponded to only 1% of the EDI from dust indicating PFOA as the main source of exposure. The EDI's of PFOA and PFOS from dust were lower than the calculated EDI's from food ingestion reported by the Swedish Food Agency. Our data indicate that the EDI for the sum of four PFASs: PFOA, PFNA, PFHxS and PFOS from dust intake alone is close to the established tolerable weakly intake of 4.4 ng/kg bw in children, set by European Food Safety Authority (EFSA) in 2020. The combined EDI levels PFOA and PFOS from both dust and food exceeded the EFSA TWI for both children and adults. This study demonstrates that dust is a relevant exposure pathway for PFAS intake and that analysis of relevant particle size fractions is important for evaluation of dust as an exposure pathway.

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

BACKGROUND

Human exposure to per- and polyfluoroalkyl substances (PFAS) has been primarily attributed to contaminated food and drinking water. There is information indicating other sources and pathways of exposure in residential environments, but few studies report relationships between these indoor media and human biomonitoring measurements.

METHODS

This study adapts existing systematic review tools and methodologies to synthesize evidence for PFAS exposure pathways from indoor environment media including consumer products, household articles, cleaning products, personal care products, and indoor air and dust. Studies were identified using innovative machine learning approaches and pathway-specific search strings to reduce time needed for literature search and screening. The included studies and systematic review were evaluated using tools modified specifically for exposure studies. The systematic review was conducted following a previously published protocol (DeLuca et al., 2021) that describes the systematic review methodology used in detail.

RESULTS

Only 7 studies were identified that measured the targeted subset of 8 PFAS chemicals in concordant household media (primarily house dust) and participant serum. Data extracted from the included studies were used to calculate exposure intake rates and estimate a percentage of occupant serum concentrations that could be attributed to the indoor exposure pathways. These calculations showed that exposure to PFOA, PFOS, PFNA, and PFHxS from contaminated house dust could account for 13%, 3%, 7%, and 25% of serum concentrations, respectively. Inhalation of PFAS in indoor air could account for less than 4% of serum PFOA concentrations and less than 2% of serum PFOS and PFNA concentrations. A risk of bias was identified due to participant profiles in most of the studies being skewed towards white, female, and higher socioeconomic status.

CONCLUSIONS

Along with synthesizing evidence for estimated contributions to serum PFAS levels from indoor exposure media, this systematic review also identifies a consistent risk of bias across exposure study populations that should be considered in future studies. It highlights a major research gap and need for studies that measure concordant data from both indoor exposure media and participant serum and the need for continued research on exposure modeling parameters for many PFAS chemicals.

Integration of Toxicogenomics and Physiologically Based Pharmacokinetic Modeling in Human Health Risk Assessment of Perfluorooctane Sulfonate

Toxicogenomics and physiologically based pharmacokinetic (PBPK) models are useful approaches in chemical risk assessment, but the methodology to incorporate toxicogenomic data into a PBPK model to inform risk assessment remains to be developed. This study aimed to develop a probabilistic human health risk assessment approach by integrating toxicogenomic dose-response data and PBPK modeling using perfluorooctane sulfonate (PFOS) as a case study. Based on the available human in vitro and mouse in vivo toxicogenomic data, we identified the differentially expressed genes (DEGs) at each exposure paradigm/duration. Kyoto Encyclopedia of Genes and Genomes and disease ontology enrichment analyses were conducted on the DEGs to identify significantly enriched pathways and diseases. The dose-response data of DEGs were analyzed using the Bayesian benchmark dose (BMD) method. Using a previously published PBPK model, the gene BMDs were converted to human equivalent doses (HEDs), which were summarized to pathway and disease HEDs and then extrapolated to reference doses (RfDs) by considering an uncertainty factor of 30 for mouse in vivo data and 10 for human in vitro data. The results suggested that the median RfDs at different exposure paradigms were similar to the 2016 U.S. Environmental Protection Agency's recommended RfD, while the RfDs for the most sensitive pathways and diseases were closer to the recent European Food Safety Authority's guidance values. In conclusion, genomic dose-response data and PBPK modeling can be integrated to become a useful alternative approach in risk assessment of environmental chemicals. This approach considers multiple endpoints, provides toxicity mechanistic insights, and does not rely on apical toxicity endpoints.

Perfluoroalkyl acids in dust on residential indoor/outdoor window glass in Chinese cities: occurrence, composition, and toddler exposure

The dust on indoor and outdoor surfaces of the window glasses were collected using sterile cotton balls in 11 cities from China. Two sampling campaigns were conducted with the time interval of 7 days to investigate the accumulation especially during the Spring festival holidays. Twenty-nine perfluoroalkyl acids (PFAA) were quantified to investigate concentration, composition, and toddlers' exposure. The concentrations of ∑PFAA ranged from no detection (nd) to 43 ng/m2 (mean 8.9 ± 10 ng/m2). Perfluorobutanoic acid (PFBA) was detected in 78% samples and accounted for 55 ± 21% of ∑PFAA concentrations. 6:2 fluorotelomer sulfonic acid (6:2 FTSA) and hexafluoropropylene oxide dimer acid (HFPO-DA) were detected in more than 50% samples indicating the use of alternatives. Fluorotelomer carboxylic acid (FTCA) and fluorotelomer unsaturated acid (FTUCA) were found in the dust, implying the degradation of fluorotelomer alcohols (FTOH). The highest concentration of ∑PFAA (43 ng/m2) was found in outdoor dust from Xinzhou, Shanxi Province. Higher ∑PFAA concentrations were found in indoor dust than outdoor in 6 paired samples (3 from Feb. 14 and 3 from Feb. 21). In Tianjin and Handan, the concentrations of ∑PFAA from outdoor surfaces were higher in sampling campaign I (SC I, Feb. 21) than in sampling campaign II (SC II, Feb. 14), implying intensive outdoor release. The exposure of 2-year-old toddlers to PFAA via hand-to-mouth ingestion and dermal absorption was estimated; the mean values of intake were 2.1 and 1.5 pg/kg body weight, respectively, assuming an exposure time of 1 h.

Prevalence and Implications of Per- and Polyfluoroalkyl Substances (PFAS) in Settled Dust

PURPOSE OF REVIEW

Per- and polyfluoroalkyl substances (PFAS) are a family of more than 7,000 fluorinated compounds. The carbon-fluorine bond of PFAS provides desirable hydrophobic and oleophobic properties and stability that has led to widespread usage in consumer products and industrial applications. The strength of the carbon-fluorine bond also prevents appreciable degradation once released into the environment. Consequently, various household products can release volatile and nonvolatile PFAS into the indoor environment that often concentrate in dust. We discuss the diversity of PFAS in settled dust, emission sources of these chemicals, changes in PFAS profiles in dust over the past century, and the implications for human health.

RECENT FINDINGS

Sources of PFAS found in dust include building materials and furnishings and consumer products used in typical indoor spaces. Daycares and workplaces are emphasized as locations with widespread exposure due to the presence of treated carpeting and industrial-strength cleaners. Comparison and interpretation of findings across studies are complicated by the different ways in which PFAS are screened across studies. We further discuss recent developments in non-targeted software for the comprehensive annotation of PFAS in indoor dust and emphasize the need for comprehensive and harmonized analytical workflows. We highlight the detection and diversity of PFAS in settled dust collected from various indoor spaces, including locations with vulnerable subpopulations. There are opportunities for future research to leverage settled dust as a sentinel environmental matrix to evaluate the link between inhalation and ingestion routes of PFAS exposure to adverse health.

Per- and polyfluoroalkyl substances exposure science: current knowledge, information needs, future directions

BACKGROUND

Per- and polyfluoroalkyl substances have been documented at all spatial scales with concerns of adverse ecological and human health effects. Human exposures and relative pathway contributions depend on the specific population, their exposure scenarios, and pathways of local sources.

OBJECTIVES

Provide a narrative overview of (1) current per- and polyfluoroalkyl substances knowledge for sources, concentrations, and exposures; (2) critical per- and polyfluoroalkyl substances exposure information gaps and needs, and (3) United States Environmental Protection Agency's strategies and action plans in collaboration with other federal, industrial, and academic partners.

METHODS

A literature review was conducted for per- and polyfluoroalkyl substances (primarily perfluorooctane sulfonate and perfluorooctanoic acid) compounds in blood, water, soil, house dust, indoor and outdoor air, consumer products, food, and fish, as well as per- and polyfluoroalkyl substances exposure modeling.

RESULTS

Large variability exists in measured per- and polyfluoroalkyl substances environmental concentrations and human exposures. Literature indicated that ingestion of food ("background"), drinking water ("contaminated" scenarios), and house dust (for children) are main pathways for perfluorooctane sulfonate and perfluorooctanoic acid.

DISCUSSION

Needs for addressing critical data gaps are identified. More information is available on long-chain per- and polyfluoroalkyl substances than for replacement and emerging compounds. A large-scale research effort by the United States Environmental Protection Agency and other federal agencies is underway for a better understanding of per- and polyfluoroalkyl substances exposures.

Investigation of distribution, sources and flux of perfluorinated compounds in major southern Indian rivers and their risk assessment

Perfluorinated compounds (PFCs) are a group of emerging contaminants still less reported in rivers, particularly southern India. Therefore, we investigated the fate of 13 PFCs in three major rivers in southern India during post-monsoon and summer seasons. Twelve PFCs were detected, with an average total PFCs of 1853 ± 1463 pg/l. However, the total PFCs recorded in ppost-monsoon and summer seasons ranged from ND (none detected) to 10,545 pg/l and ND to 4960 pg/l, respectively. Among the individual congeners, perfluoro-n-hexanoic acid (PFHxA) had the highest detection average (929 ± 710 pg/l). The higher detection of short chain PFCs signifies their increasing wide usage as an alternative to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS). Higher levels of PFCs were observed in summer than post-monsoon season in the river Kaveri, which is mainly attributed to the decrease in river flow. A multidimensional source identification revealed domestic and commercial wastewater as the major source. A correlation analysis showed that most of the detected PFCs share the common source and undergo co-migration into rivers. The flux of PFCs into the Bay of Bengal, loaded by the Kaveri (15 kg/yr) and the Tamiraparani (2.2 kg/yr) rivers, signifies lower per capita emissions than other rivers in India and other countries. Further, the PFC levels found in the rivers can be considered safe for human consumption and aquatic organisms based on international guidelines. Being the first hand report in southern Indian rivers, the results warrant further investigation to understand the exact sources, fate and removal in detail.

Temporal variability of indoor dust concentrations of semivolatile organic compounds

The determinants of the temporal variability of indoor dust concentrations of semivolatile organic compounds (SVOCs) remain mostly unexplored. We examined temporal variability of dust concentrations and factors affecting dust concentrations for a wide range of SVOCs. We collected dust samples three times from 29 California homes during a period of 22 months and quantified concentrations of 47 SVOCs in 87 dust samples. We computed intraclass correlation coefficients (ICCs) using three samples collected within the same house. We calculated correlation coefficients (r) between two seasons with similar climate (spring and fall) and between two seasons with opposite climate (summer and winter). Among 26 compounds that were detected in more than 50% of the samples at all three visits, 20 compounds had ICCs above 0.50 and 6 compounds had ICCs below 0.50. For 19 out of 26 compounds, correlation coefficients between spring and fall (r = 0.48-0.98) were higher than those between summer and winter (r = 0.09-0.92), implying seasonal effects on dust concentrations. Our study showed that within-home temporal variability of dust concentrations was small (ICC > 0.50) for most SVOCs, but dust concentrations may vary over time for some SVOCs with seasonal variations in source rates, such as product use.

Per- and polyfluoroalkyl substances and their alternatives in paper food packaging

Per- and polyfluoroalkyl substances (PFAS) have been used in food contact paper and paperboard for decades due to their unique ability to provide both moisture and oil/grease resistance. Once thought to be innocuous, it is now clear that long chain PFAS bioaccumulate and are linked to reproductive and developmental abnormalities, suppressed immune response, and tumor formation. Second-generation PFAS have shorter biological half-lives but concerns about health risks from chronic exposure underscore the need for safe substitutes. Waxes and polymer film laminates of polyethylene, poly(ethylene-co-vinyl alcohol), and polyethylene terephthalate are commonly used alternatives. However, such laminates are neither compostable nor recyclable. Lamination with biodegradable polymers, including polyesters, such as polylactic acid (PLA), polybutylene adipate terephthalate, polybutylene succinate, and polyhydroxyalkanoates, are of growing research and commercial interest. PLA films are perhaps the most viable alternative, but performance and compostability are suboptimal. Surface sizings and coatings of starches, chitosan, alginates, micro- and nanofibrilated cellulose, and gelatins provide adequate oil barrier properties but have poor moisture resistance without chemical modification. Plant proteins, including soy, wheat gluten, and corn zein, have been tested as paper coatings with soy being the most commercially important. Internal sizing agents, such as alkyl ketene dimers, alkenyl succinic anhydride, and rosin, improve moisture resistance but are poor oil/grease barriers. The difficulty in finding a viable replacement for PFAS chemicals that is cost-effective, fully biodegradable, and environmentally sound underscores the need for more research to improve barrier properties and process economics in food packaging products.

The Effects of Soil Organic Carbon Content on Plant Uptake of Soil Perfluoro Alkyl Acids (PFAAs) and the Potential Regulatory Implications

Perfluoro alkyl acids (PFAAs) are known to bioconcentrate in plants grown in contaminated soils; the potential risk from consuming these plants is currently less understood. We determined that the current daily reference doses (RfDs) of the US Environmental Protection Agency (USEPA) could be met by consuming a single radish grown in soils with a perfluorooctanoic acid (PFOA) concentration of 9.7 ng/g or a perfluorooctane sulfonate (PFOS) concentration of 90.5 ng/g. Using a combination of our own research and literature data on plant uptake of PFAAs from soil, we developed equations for predicting PFAA bioconcentration factors (BCFs) for plant shoot and root tissues grown in soils with a known percentage of organic carbon. This calculated BCF was then applied to 6 scenarios with measured soil PFAA concentrations to estimate PFAA concentrations in plants and potential exposure to humans and animals consuming harvested vegetation. Five of the 6 scenarios showed potential for surpassing USEPA PFAA RfDs at soil concentrations as low as 24 ng/g PFOA and 28 ng/g PFOS. Environ Toxicol Chem 2021;40:832-845. © 2020 SETAC.

PFAS Exposure Pathways for Humans and Wildlife: A Synthesis of Current Knowledge and Key Gaps in Understanding

We synthesize current understanding of the magnitudes and methods for assessing human and wildlife exposures to poly- and perfluoroalkyl substances (PFAS). Most human exposure assessments have focused on 2 to 5 legacy PFAS, and wildlife assessments are typically limited to targeted PFAS (up to ~30 substances). However, shifts in chemical production are occurring rapidly, and targeted methods for detecting PFAS have not kept pace with these changes. Total fluorine measurements complemented by suspect screening using high-resolution mass spectrometry are thus emerging as essential tools for PFAS exposure assessment. Such methods enable researchers to better understand contributions from precursor compounds that degrade into terminal perfluoroalkyl acids. Available data suggest that diet is the major human exposure pathway for some PFAS, but there is large variability across populations and PFAS compounds. Additional data on total fluorine in exposure media and the fraction of unidentified organofluorine are needed. Drinking water has been established as the major exposure source in contaminated communities. As water supplies are remediated, for the general population, exposures from dust, personal care products, indoor environments, and other sources may be more important. A major challenge for exposure assessments is the lack of statistically representative population surveys. For wildlife, bioaccumulation processes differ substantially between PFAS and neutral lipophilic organic compounds, prompting a reevaluation of traditional bioaccumulation metrics. There is evidence that both phospholipids and proteins are important for the tissue partitioning and accumulation of PFAS. New mechanistic models for PFAS bioaccumulation are being developed that will assist in wildlife risk evaluations. Environ Toxicol Chem 2021;40:631-657. © 2020 SETAC.

Environmental levels and human body burdens of per- and poly-fluoroalkyl substances in Africa: A critical review

Per- and polyfluoroalkyl substances (PFASs) are known organic pollutants with adverse health effects on humans and the ecosystem. This paper synthesises literature about the status of the pollutants and their precursors, identifies knowledge gaps and discusses future perspectives on the study of PFASs in Africa. Limited data on PFASs prevalence in Africa is available because there is limited capacity to monitor PFASs in African laboratories. The levels of PFASs in Africa are higher in samples from urban and industrialized areas compared to rural areas. Perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) are the dominant PFASs in human samples from Africa. Levels of PFOS and PFOA in these samples are lower than or comparable to those from industrialized countries. PFOA and PFOS levels in drinking water in Africa are, in some cases, higher than the EPA drinking water guidelines suggesting potential risk to humans. The levels of PFASs in birds' eggs from South Africa are higher, while those in other environmental media from Africa are lower or comparable to those from industrialized countries. Diet influences the pollutant levels in fish, while size and sex affect their accumulation in crocodiles. No bioaccumulation of PFASs in aquatic systems in Africa could be confirmed due to small sample sizes. Reported sources of PFASs in Africa include municipal landfills, inefficient wastewater treatment plants, consumer products containing PFASs, industrial wastewater and urban runoff. Relevant stakeholders need to take serious action to identify and deal with the salient sources of PFASs on the African continent.

Per- and Polyfluoroalkyl Substance Exposure, Gestational Weight Gain, and Postpartum Weight Changes in Project Viva

OBJECTIVE

The purpose of this study was to test the extent to which pregnancy per- and polyfluoroalkyl substance (PFAS) concentrations were associated with gestational weight gain and postpartum weight changes.

METHODS

This study was composed of 1,614 women recruited between 1999 and 2002 via the Project Viva cohort with pregnancy plasma concentrations of six PFAS, including perfluorooctanesulfonic acid, perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamido) acetic acid. Gestational weight gain was defined as the difference between last pregnancy weight and prepregnancy weight, 1-year postpartum weight retention as the difference between 1-year postpartum weight and prepregnancy weight, and 3-year postpartum weight change as the difference between 3-year postpartum weight and prepregnancy weight.

RESULTS

During pregnancy, women gained 0.37 kg (95% CI: 0.11-0.62) more weight per doubling of 2-(N-ethyl-perfluorooctane sulfonamido) acetic acid. At 1 year post partum, women retained 0.55 kg (95% CI: 0.07-1.04) more weight per doubling of PFOA. At 3 years post partum, women gained 0.91 kg (95% CI: 0.25-1.56) more weight per doubling in PFOA. Findings were similar after adjustment for all PFAS. Other PFAS were not associated with weight changes. Postpartum associations were stronger among women with higher prepregnancy BMI. Models were adjusted for demographics.

CONCLUSIONS

Pregnancy PFAS were associated with greater gestational weight gain, weight retention, and weight gain years after pregnancy.

Risk to human health related to the presence of perfluoroalkyl substances in food

The European Commission asked EFSA for a scientific evaluation on the risks to human health related to the presence of perfluoroalkyl substances (PFASs) in food. Based on several similar effects in animals, toxicokinetics and observed concentrations in human blood, the CONTAM Panel decided to perform the assessment for the sum of four PFASs: PFOA, PFNA, PFHxS and PFOS. These made up half of the lower bound (LB) exposure to those PFASs with available occurrence data, the remaining contribution being primarily from PFASs with short half-lives. Equal potencies were assumed for the four PFASs included in the assessment. The mean LB exposure in adolescents and adult age groups ranged from 3 to 22, the 95th percentile from 9 to 70 ng/kg body weight (bw) per week. Toddlers and 'other children' showed a twofold higher exposure. Upper bound exposure was 4- to 49-fold higher than LB levels, but the latter were considered more reliable. 'Fish meat', 'Fruit and fruit products' and 'Eggs and egg products' contributed most to the exposure. Based on available studies in animals and humans, effects on the immune system were considered the most critical for the risk assessment. From a human study, a lowest BMDL 10 of 17.5 ng/mL for the sum of the four PFASs in serum was identified for 1-year-old children. Using PBPK modelling, this serum level of 17.5 ng/mL in children was estimated to correspond to long-term maternal exposure of 0.63 ng/kg bw per day. Since accumulation over time is important, a tolerable weekly intake (TWI) of 4.4 ng/kg bw per week was established. This TWI also protects against other potential adverse effects observed in humans. Based on the estimated LB exposure, but also reported serum levels, the CONTAM Panel concluded that parts of the European population exceed this TWI, which is of concern.

Pregnancy Per- and Polyfluoroalkyl Substance Concentrations and Postpartum Health in Project Viva: A Prospective Cohort

CONTEXT

Per- and polyfluoroalkyl substances (PFAS) are environmental chemicals linked to weight gain and type 2 diabetes.

OBJECTIVE

We examined the extent to which PFAS plasma concentrations during pregnancy were associated with postpartum anthropometry and biomarkers.

DESIGN, PATIENTS, AND MEASURES

We studied women recruited between 1999 and 2002 in the Project Viva prospective cohort with pregnancy plasma concentrations of PFAS, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamide) acetic acid (EtFOSAA). Three-year postpartum anthropometry measurements were available from 786 to 801 women, blood pressure from 761 women, and blood biomarkers from 450 to 454 women. We used multivariable regression to evaluate the association of log2-transformed PFAS with postpartum anthropometry, blood pressure, and blood biomarkers (leptin, adiponectin, sex hormone binding globulin [SHBG], hemoglobin A1c, interleukin-6 [IL-6], C-reactive protein), adjusting for age, prepregnancy body mass index, marital status, race/ethnicity, education, income, smoking, parity, and breastfeeding history.

RESULTS

Pregnancy concentrations of certain PFAS were associated with greater adiposity (eg, 0.4 cm [95% confidence interval [95%CI]: -0.1, 0.9] greater waist circumference per doubling in EtFOSAA; 0.2 cm [95%CI: -0.1, 0.5] greater mid-upper arm circumference per doubling in PFOA; 1.2 mm [95%CI: 0.1, 2.2] thicker sum of subscapular and triceps skinfolds per doubling in PFOS) and higher systolic blood pressure (eg, 1.2 mm Hg [95%CI: 0.3, 2.2] per doubling in PFOS) at 3 years postpartum. Higher EtFOSAA concentrations were also associated with 10.8% higher IL-6 (95%CI: 3.3, 18.9) and 6.1% lower SHBG (95%CI: 0.7, 11.2) per doubling.

CONCLUSIONS

Pregnancy concentrations of EtFOSAA, PFOS, and PFOA were associated with adverse postpartum cardiometabolic markers.

Neurotoxic effects of lactational exposure to perfluorooctane sulfonate on learning and memory in adult male mouse

The present study aims to examine the effect of early lactational perfluorooctane sulfonate (PFOS) exposures on learning and memory in male mice and reveal the underlying mechanisms involved. PFOS solution was orally administered to dams from the postpartum days 1-14, so that pups would be exposed through breast milk. At 8-10 weeks of age, we performed object location test (OLT), object recognition test (ORT), and pairwise visual discrimination (VD) task. We also performed in vivo microdialysis, and mRNA and protein analysis of genes responsible for hippocampal development and function. In both OLT and ORT, the performance of mice in the PFOS-exposed group was significantly lower than those in the control group. In the VD task, the PFOS-exposed group learned significantly slower than the control group. Concentrations of glutamate and gamma-aminobutyric acid in the dorsal hippocampus were significantly higher in the PFOS-exposed group than in the control group. No notable differences were shown in our mRNA and protein studies. The present study showed that lactational PFOS exposure has a profound, long-lasting neurotoxic effect in the hippocampus and consequently leads to learning and memory deficits.

Per- and polyfluoroalkyl substances in drinking water and birthweight in the US: A county-level study

Supplemental Digital Content is available in the text.

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous in the serum of the general US population, and were detected in public water systems serving approximately 16.5 million US residents during 2013–2015. Low birthweight was associated with PFAS exposures in previous studies.

Per- and polyfluoroalkyl substances in paired dust and carpets from childcare centers

Carpets can be a significant source of per- and polyfluoroalkyl substances (PFASs) in the indoor environment and may be an especially important source of exposure for children and toddlers. Most previous studies focused on measuring indoor dust only. In this study, we measured PFAS concentrations in paired carpet and dust samples from 18 California childcare centers in 2018 to investigate carpet as a contributor to PFASs in dust. Median total PFAS concentrations (∑PFASs) in carpets and dust were 471 ng/g and 523 ng/g, respectively. 6:2 FTOH and 6:2 FTSA were the two dominant PFASs, collectively accounting for over 50% of the ∑PFASs in both media. Other frequently detected PFASs included C₄-C₁₄ perfluoroalkylcarboxylic acids, C₄-C₈ perfluoroalkylsulfonic acids, PFDS, 4:2 FTSA, 8:2 FTSA, FOSA, MeFOSE, EtFOSE, 8:2 FTOH, and 10:2 FTOH. We found strong associations between PFAS levels in carpet and dust pairs, suggesting that carpets can be a source and a sink for PFASs. The estimated total perfluoroalkyl acids (PFAA) intake via dust ingestion for children was 0.023, 0.096, and 1.9 ng/kg body weight/day in the low-, intermediate-, and high-exposure scenarios, respectively. Our data suggest that PFASs of emerging concern are playing an increasingly important role in indoor exposure to PFASs.

Flows, Stock, and Emissions of Poly- and Perfluoroalkyl Substances in California Carpet in 2000-2030 under Different Scenarios

In this study, we present a holistic analysis of the stock and emissions of poly- and perfluoroalkyl substances (PFAS) in California carpet in 2000-2030. Our high estimate is that, in 2017, the total PFAS accumulated in in-use carpet stock and landfilled carpet are ∼60 and ∼120 tonnes, respectively, and the resultant PFAS emissions are ∼800 and ∼100 kg, respectively. Among the three subclasses (side-chain polymers, PFAA, and nonpolymeric precursors), side-chain polymers dominate the in-use stock and landfill accumulation, while nonpolymeric precursors dominate the resultant emissions. Our low estimate is typically 8-15% of the high estimate and follows similar trends and subclass breakdowns as the high estimate. California's new Carpet Stewardship Regulations (24% recycling of end-of-life carpet) will reduce the landfilled PFAS by 6% (7 tonnes) at the cost of increasing the in-use stock by 2% (2 tonnes) in 2030. Aggressive PFAS phase-out by carpet manufacturers (i.e., reduce PFAS use by 15% annually starting 2020) could reduce the in-use PFAS stock by 50% by 2030, but its impact on the total landfilled PFAS is limited. The shift toward short-chain PFAS will also significantly reduce the in-use stock of long-chain PFAS in carpet by 2030 (only 25% of the total PFAS will be long-chain). Among the data gaps identified, a key one is the current area-based PFAS emission reporting (i.e., g PFAS emitted/area carpet/time), which leads to the counterintuitive result that reducing the PFAS use in carpet production has no impact on the PFAS emissions from in-use stock and landfills. Future technical studies should either confirm this or consider a mass-based unit (e.g., g PFAS emitted/g PFAS used/time) for better integration into regional substance flow analysis. Other noticeable data gaps include the lack of time-series data on emissions from the in-use stock and on leaching of side-chain polymers from landfills.

Per- and Polyfluoroalkyl Substances and Obesity, Type 2 Diabetes and Non-alcoholic Fatty Liver Disease: A Review of Epidemiologic Findings

Per- and polyfluoroalkyl substances, a group of fluoro-surfactants widely detected in the environment, wildlife and humans, have been linked to adverse health effects. A growing body of literature has addressed their effects on obesity, diabetes and non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis. This review summarizes the brief historical use and chemistry of per- and polyfluoroalkyl substances, routes of human exposure, as well as the epidemiologic evidence for associations between exposure to per- and polyfluoroalkyl substances and the development of obesity, diabetes and non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis. We identified 22 studies on obesity and 32 studies on diabetes, while only 1 study was found for non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis by searching PubMed for human studies. Approximately 2/3 of studies reported positive associations between per- and polyfluoroalkyl substances exposure and the prevalence of obesity and/or type 2 diabetes. Causal links between per- and polyfluoroalkyl substances and obesity, diabetes and non-alcoholic fatty liver disease/ non-alcoholic steatohepatitis, however, require further large-scale prospective cohort studies combined with mechanistic laboratory studies to better assess these associations.

Application of a combined aggregate exposure pathway and adverse outcome pathway (AEP-AOP) approach to inform a cumulative risk assessment: A case study with phthalates

Advancements in measurement and modeling capabilities are providing unprecedented access to estimates of chemical exposure and bioactivity. With this influx of new data, there is a need for frameworks that help organize and disseminate information on chemical hazard and exposure in a manner that is accessible and transparent. A case study approach was used to demonstrate integration of the Adverse Outcome Pathway (AOP) and Aggregate Exposure Pathway (AEP) frameworks to support cumulative risk assessment of co-exposure to two phthalate esters that are ubiquitous in the environment and that are associated with disruption of male sexual development in the rat: di(2-ethylhexyl) phthalate (DEHP) and di-n-butyl phthalate (DnBP). A putative AOP was developed to guide selection of an in vitro assay for derivation of bioactivity values for DEHP and DnBP and their metabolites. AEPs for DEHP and DnBP were used to extract key exposure data as inputs for a physiologically based pharmacokinetic (PBPK) model to predict internal metabolite concentrations. These metabolite concentrations were then combined using in vitro-based relative potency factors for comparison with an internal dose metric, resulting in an estimated margin of safety of ~13,000. This case study provides an adaptable workflow for integrating exposure and toxicity data by coupling AEP and AOP frameworks and using in vitro and in silico methodologies for cumulative risk assessment.

Per- and Polyfluoroalkyl Substances: An Emerging Contaminant of Concern

Concerns about the health impacts from per- and polyfluoroalkyl substances (PFAS) continue to grow as the science continues to emerge associating this chemical family with a wide range of health impacts. PFAS exposure may affect growth, learning, and behavior of infants and older children, and also impact reproductive health, cardiovascular health, and the immune system. PFAS exposure is widespread, with communities surrounding military bases at potentially greater risk of exposure from the use of fire fighting foam that may have entered the drinking water. As trusted health professionals, nurses have been in the frontlines communicating risks regarding PFAS to impacted communities. This chapter describes a large number of PFAS studies in blood and harmful health effects in people. The chapter discusses primary sources of exposure and risk reduction. It explains health advisory levels, minimal risk levels. The chapter provides medical testing and medical management.

Temporal trends of legacy and emerging persistent organic pollutants in inuit preschoolers from Northern Quebec (Canada)

In this study, we report the temporal trends of persistent organic pollutants (POPs) in 181 preschool Inuit children from Nunavik and the influence of confounding factors on blood contaminant levels. From 2006 to 2010, no significant trends were detected in Σpolychlorinated biphenyls (ΣPCBs), Σorganochlorine pesticides (ΣOPs), Σtoxaphene, and Σper- and polyfluoroalkyl substances (ΣPFASs). On the contrary, significant downward trends ranging from 9.3% to 14.3% per year were found for polybrominated diphenyl ethers (PBDEs). Breastfeeding was significantly associated with increased levels of POPs. Age was positively and significantly related to ΣPCBs, ΣOPs and Σtoxaphene. Compared with girls, boys had significantly higher concentrations of ΣPBDEs, but lower concentrations of ΣPFASs. Weight-for-height or body mass index z-scores were negatively and significantly related to ΣPCBs and ΣOPs. Passive smoking was positively and significantly associated with ΣOPs and Σtoxaphene. In conclusion, continued efforts to reduce contaminant exposure are needed to protect children's health and development.

Perfluoroalkyl substances (PFASs) in air-conditioner filter dust of indoor microenvironments in Greece: Implications for exposure

The occurrence of perfluoroalkyl substances (PFASs) was for the first time investigated in various working microenvironments (internet cafes, electronics shops, coffee shops, restaurants, etc.) in Thessaloniki, Greece, using the dust trapped by central air conditioner (A/C) filters. Perfluorooctane sulfonic acid (PFOS) was found in the range from 16 to 227 ng g^-1, however it was detectable in only 30% of samples. On the contrary, perfluorohexanoic acid (PFHxA) was found in 85% of samples in the range from 3.6 to 72.5 ng g^-1, while 90-95% of samples exhibited perfluorooctanoic acid (PFOA), perfluorodecanoic acid (PFDcA) and perfluorododecanoic acid (PFDoDA) in the range from 10-653 ng g^-1, 3.2-7.4 ng g^-1 and 3.8-13.1 ng g^-1, respectively. The PFAS profile varied largely among the different microenvironment categories suggesting different sources. Estimated daily intakes through dust ingestion were calculated.

Plant Uptake of Per- and Polyfluoroalkyl Acids under a Maximum Bioavailability Scenario

Although many studies have evaluated the fate of per- and polyfluoroalkyl acids (PFAAs) in aquatic environments, few have observed their fate in terrestrial environments. It has been proposed that ingestion could be a major PFAA exposure route for humans. We determined PFAA uptake in radish, carrot, and alfalfa under a maximum bioavailability scenario. Bioconcentration factors (BCFs) were determined in the edible tissue of radish (perfluorobutanesulfonate [PFBS] = 72; perfluorohexanesulfonate [PFHxS] = 13; perfluoroheptanoate [PFHpA] = 65; perfluorooctanoate [PFOA] = 18; perfluorooctanesulfonate [PFOS] = 2.9; and perfluorononanoate [PFNA] = 9.6), carrot (PFBS = 5.9; PFHxS = 1.1; PFHpA = 29; PFOA = 3.1; PFOS = 1; and PFNA = 1.4), and alfalfa (PFBS = 107; PFHxS = 12; PFHpA = 91; PFOA = 10; PFOS = 1.4; and PFNA = 1.7). Some of these PFAA BCFs are as much as 2 orders of magnitude higher than those measured previously in plants grown in biosolid-amended soils. Environ Toxicol Chem 2019;38:2497-2502. © 2019 SETAC.

Characteristics and human inhalation exposure of ionic per- and polyfluoroalkyl substances (PFASs) in PM10 of cities around the Bohai Sea: Diurnal variation and effects of heating activity

Atmospheric PM₁₀ (particulate matter with aerodynamic diameter <10 μm) samples were collected in the cities along the Bohai Sea Rim during heating and non-heating periods, and ionic per- and polyfluoroalkyl species (PFASs) in the PM₁₀ were measured. The total concentration of ionic PFASs ranged from 21.8 to 87.0 pg/m³, and the mean concentration of ionic PFASs during the day (42.6 pg/m³) was slightly higher than that at night (35.1 pg/m³). Generally, diurnal variations in the levels of ionic PFASs were consistent with those in the PM₁₀ concentrations. Perfluorooctanoic acid (PFOA, 23.5-33.7%), perfluoropentanoic acid (PFPeA, 28.3-39.9%) and perfluorobutyric acid (PFBA, 17.1-20.1%) accounted for the dominant compositional contributions. Significant positive correlations (p < 0.05) between the main components of PFASs and O₃ implied that oxidative degradation (O₃ served as the main oxidant) in the period of non-heating may affect the short-chain PFASs. The clustering analysis of a 72-h backward trajectory indicated that cross-provincial transport contributed to ionic PFASs at the sampling sites. Compared with ingestion via daily diet, the inhalation of PM₁₀ exhibited an insignificant contribution to the estimated average daily intakes (ADIs) of PFASs by different age groups. In addition, the calculated hazard ratios (HRs) for the non-cancer respiratory risk, based on the air concentrations of PFOA and perfluorooctane sulfonate (PFOS), also manifested lower non-cancer risk through inhalation exposure. CAPSULE: The effects of heating and non-heating activity and diurnal variation on the concentrations of PFASs, dominated by PFOA, PFPeA, and PFBA in PM₁₀, were determined, and atmospheric trans-provincial input served as an important source.

Preliminary assessment of general population exposure to perfluoroalkyl substances through diet in Greece

Food and drinking water intake are the major routes of exposure to perfluoroalkyl substances (PFASs) for humans. In this study an initial oral exposure assessment of the non-occupationally exposed general Greek population to PFASs is presented. Levels of PFOA and PFOS determined in the present study in 128 food items from the Greek market and previously published analytical results of 43 water samples and 76 egg samples from Greece were combined with food availability data of the DAFNE-ANEMOS database for the calculation of oral intake of PFASs. Fish form the food group with the highest concentration in both PFOA and PFOS. For the general Greek population the estimated average daily intake in PFOA and PFOS when applying the lowerbound mean concentrations in food and drinking water samples is 0.49 and 0.91 ng kg^-1 body weight (b.w.) respectively. The main contributor to oral PFAS intake is fish. A pharmacokinetic model is applied to estimate total intake from blood serum levels reported previously and the predicted values are in agreement with lowerbound estimated values. Weekly intake estimated values are below the tolerable weekly intake recently proposed by EFSA.

Occurrence and human exposure assessment of perfluorinated substances in house dust from three European countries

65 house dust samples from three European countries (Belgium, Italy and Spain) were evaluated for the presence of 20 polyflouroalkyl substances (PFASs) including perfluoroalkane sulfonic acids (PFSAs), perfluoroalkyl carboxylic acid (PFCAs) and perfluoroalkane sulfonamides (PFOSAs). The three countries presented similar PFAS levels ranging from 3.13 to 155 ng/g (12.9 ng/g; median), but in all cases PFCAs concentrations (6.92, 15.2 and 8.68 ng/g; median for Belgium, Italy and Spain) were higher than those obtained for PFSAs (2.30, 1.76 and 2.68 ng/g). Interestingly, in comparison to previously published data exhibited an increase in perfluorobutanesulfonate (PFBS) concentrations in Belgian house dust. On the other hand, levels of perfluorooctanesulfonate (PFOS) decreased in Spanish case. Data were examined for relationships between PFAS house dust levels, building and outdoor surrounding characteristics and occupant habits. Main findings revealed a positive association between PFOS concentrations and the building edification age, which could highlight a decrease in the use of this chemical in Europe. Similarly, perfluorohexanesulfonate (PFHxS) levels correlated with the percentage of the floor covered by textiles. Homes located in industrial sites showed higher PFCA levels compared to urban or agricultural locations, revealing the industrial processes as a potential source of these chemicals in Europe. Data obtained were used to perform human exposure assessment for dust intake via oral ingestion. Estimated daily intakes, calculated for toddlers and adults at median and worst case scenarios, were below oral Reference Dose (RfD) and tolerable daily intakes (TDI). However, in perfluorooctanoic acid (PFOA) case, dust ingestion significance to total dietary exposure reached values of 51% for toddlers in the worst case scenario.

Perfluoroalkyls/polyfluoroalkyl substances and dental caries experience in children, ages 3-11 years, National Health and Nutrition Examination Survey, 2013-2014

OBJECTIVE

The objective of this research is to determine the association of seven perfluoroalkyl and polyfluoroalkyl substances versus dental caries experience in US children, ages 3-11 years.

METHODS

A cross-sectional study design was used in the analysis of National Health and Nutrition Examination Survey 2013-2014 serological data of perfluoroalkyl and polyfluoroalkyl substances. The seven perfluoroalkyl and polyfluoroalkyl substances were: 2-(N-methyl-perfluorooctane sulfonamide) acetic acid; perfluorodecanoic acid; perfluorononanoic acid; perfluorohexane sulfonic acid; linear isomers of perfluorooctanoate; linear perfluorooctane sulfonate; and monomethyl branched isomers of perfluorooctane sulfonate. Two summative variables were created: monomethyl branch isomers of perfluorooctane sulfonic acid with linear isomer of perfluorooctane and branch isomers of perfluorooctanoate with linear isomer perfluorooctonate.

RESULTS

In unadjusted logistic regression, in which the comparison was between the less than 75th percentile reference group and the 75th and above percentile group, higher perfluorodecanoic acid was associated with dental caries experience [unadjusted odds ratio: 1.79 (95% CI: 1.19, 2.46; P = 0.0069); adjusted odds ratio: 1.54 (95% CI: 1.03, 2.30; P = 0.0385)].

CONCLUSIONS

Of the seven examined perfluoroalkyl and polyfluoroalkyl substances, only perfluorodecanoic acid had an association with dental caries experience in an unadjusted model and adjusted logistic regression model.

Tap Water Contributions to Plasma Concentrations of Poly- and Perfluoroalkyl Substances (PFAS) in a Nationwide Prospective Cohort of U.S. Women

BACKGROUND

Between 2013 and 2015, concentrations of poly- and perfluoroalkyl substances (PFAS) in public drinking water supplies serving at least six million individuals exceeded the level set forth in the health advisory established by the U.S. Environmental Protection Agency. Other than data reported for contaminated sites, no systematic or prospective data exist on the relative source contribution (RSC) of drinking water to human PFAS exposures.

OBJECTIVES

This study estimates the RSC of tap water to overall PFAS exposure among members of the general U.S.

POPULATION

METHODS

We measured concentrations of 15 PFAS in home tap water samples collected in 1989-1990 from 225 participants in a nationwide prospective cohort of U.S. women: the Nurses' Health Study (NHS). We used a one-compartment toxicokinetic model to estimate plasma concentrations corresponding to tap water intake of PFAS. We compared modeled results with measured plasma PFAS concentrations among a subset of 110 NHS participants.

RESULTS

Tap water perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) were statistically significant predictors of plasma concentrations among individuals who consumed [Formula: see text] cups of tap water per day. Modeled median contributions of tap water to measured plasma concentrations were: PFOA 12% (95% probability interval 11%-14%), PFNA 13% (8.7%-21%), linear perfluorooctanesulfonic acid (nPFOS) 2.2% (2.0%-2.5%), branched perfluorooctanesulfonic acid (brPFOS) 3.0% (2.5%-3.2%), and perfluorohexanesulfonic acid (PFHxS) 34% (29%-39%). In five locations, comparisons of PFASs in community tap water collected in the period 2013-2016 with samples from 1989-1990 indicated increases in quantifiable PFAS and extractable organic fluorine (a proxy for unquantified PFAS).

CONCLUSIONS

Our results for 1989-1990 compare well with the default RSC of 20% used in risk assessments for legacy PFAS by many agencies. Future evaluation of drinking water exposures should incorporate emerging PFAS. https://doi.org/10.1289/EHP4093.