Per and polyfluoroalkyl substances scientific literature review: water exposure, impact on human health, and implications for regulatory reform

Poly- and perfluoroalkyl substances (PFASs) in amphibians and reptiles - exposure and health effects

Poly- and perfluoroalkyl substances (PFASs) are commonly used in various industries and everyday products, including clothing, electronics, furniture, paints, and many others. PFASs are primarily found in aquatic environments, but also present in soil, air and plants, making them one of the most important and dangerous pollutants of the natural environment. PFASs bioaccumulate in living organisms and are especially dangerous to aquatic and semi-aquatic animals. As endocrine disruptors, PFASs affect many internal organs and systems, including reproductive, endocrine, nervous, cardiovascular, and immune systems. This manuscript represents the first comprehensive review exclusively focusing on PFASs in amphibians and reptiles. Both groups of animals are highly vulnerable to PFASs in the natural habitats. Amphibians and reptiles, renowned for their sensitivity to environmental changes, are often used as crucial bioindicators to monitor ecosystem health and environmental pollution levels. Furthermore, the decline in amphibian and reptile populations worldwide may be related to increasing environmental pollution. Therefore, studies investigating the exposure of amphibians and reptiles to PFASs, as well as their impacts on these organisms are essential in modern toxicology. Summarizing the current knowledge on PFASs in amphibians and reptiles in a single manuscript will facilitate the exploration of new research topics in this field. Such a comprehensive review will aid researchers in understanding the implications of PFASs exposure on amphibians and reptiles, guiding future investigations to mitigate their adverse effects of these vital components of ecosystems.

Inconsistencies in the EU regulatory risk assessment of PFAS call for readjustment

Recognition of per- and polyfluoroalkyl substances (PFAS) as widespread environmental pollutants and a consequent risk to human health, has recently made the European Union (EU) adopt several regulatory measures for their management. The coherence of these measures is challenged by the diversity and the ubiquitous occurrence of PFAS, which also complicates the EU's endeavor to advance justified, harmonized, and transparent approaches in the regulatory assessment of chemical risks. Our study critically reviews the European approach for the risk assessment of PFAS, by applying a comparative analysis of the current and pending regulatory thresholds issued for these chemicals in water bodies, drinking water, and certain foodstuffs. Our study shows that the level of health protection embedded in the studied thresholds may differ by three orders of magnitude, even in similar exposure settings. This is likely to confuse the common understanding of the toxicity and health risks of PFAS and undermine reasonable decision-making and the equal treatment of different stakeholders. We also indicate that currently, no consensus exists on the appropriate level of required health protection regarding PFAS and that the recently adopted tolerable intake value in the EU is too cautious. Based on our analysis, we propose some simple solutions on how the studied regulations and their implicit PFAS thresholds or their application could be improved. We further conclude that instead of setting EU-wide PFAS thresholds for all the environmental compartments, providing the member states with the flexibility to consider case-specific factors, such as regional background concentrations or food consumption rates, in their national regulatory procedures would likely result in more sustainable management of environmental PFAS without compromising the scientific foundation of risk assessment, the legitimacy of the EU policy framework and public health.

Investigation of pH-dependent extraction methods for PFAS in (fluoropolymer-based) consumer products: A comparative study between targeted and sum parameter analysis

Here, we report a comparative study of different sum parameter analysis methods for the extraction of per- and polyfluoroalkyl substances (PFAS) from manufactured consumer products, which can be measured by combustion ion chromatography (CIC). Therefore, a hydrolysis-based extraction method was further developed, which accounts for the addition of hydrolyzable covalently bound polyfluoroalkylated side-chain polymers (SFPs) to the extractable organic fluorine portion of the mass balance proposed as "hydrolyzable organically bound fluorine" (HOF). To test this hypothesis, the method was applied to 39 different consumer products containing fluoropolymers or monomeric PFAS taken from four different categories: outdoor textiles, paper packaging, carpeting, and permanent baking sheets. We also evaluated the method's efficiency by extracting four synthesized fluorotelomer polyacrylate reference compounds. The total fluorine (TF) and extractable organically bound fluorine (EOF) values were measured through CIC using established protocols. The TF values ranged from sub-ppb to %-levels, depending on the compound class. All samples showed results for hydrolyzed organofluorine (HOF) between 0.03 and 76.3 μg/g, while most EOF values were lower ( Collapse

Key Words

• Combustion ion chromatography (CIC)
• Extractable organically bound fluorine (EOF)
• Hydrolytic extraction
• Per- and polyfluoroalkyl substances (PFAS) sum parameter
• Side-chain fluorinated polymers (SFPs)
• Solid-liquid extraction

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MESH Headings

• Fluorocarbon Polymers/analysis
• Fluorocarbons/analysis
• Chromatography, Liquid
• Fluorine/chemistry
• Tandem Mass Spectrometry
• Hydrogen-Ion Concentration

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Grants Collapse

Affiliation(s)

Philipp Roesch Federal Institute for Materials Research and Testing, Division 4.3 - Contaminant Transfer and Environmental Technologies, Unter den Eichen 87, 12205, Berlin, Germany.
Andrea Schinnen Federal Institute for Materials Research and Testing, Division 4.3 - Contaminant Transfer and Environmental Technologies, Unter den Eichen 87, 12205, Berlin, Germany
Maren Riedel Federal Institute for Materials Research and Testing, Division 4.3 - Contaminant Transfer and Environmental Technologies, Unter den Eichen 87, 12205, Berlin, Germany
Thomas Sommerfeld Federal Institute for Materials Research and Testing, Division 1.7 - Organic Trace and Food Analysis, Richard-Willstätter-Straße 11, 12489, Berlin, Germany
George Sawal German Environment Agency, Colditzstr. 34, 12099, Berlin, Germany
Nicole Bandow German Environment Agency, Colditzstr. 34, 12099, Berlin, Germany
Christian Vogel Federal Institute for Materials Research and Testing, Division 4.3 - Contaminant Transfer and Environmental Technologies, Unter den Eichen 87, 12205, Berlin, Germany
Ute Kalbe Federal Institute for Materials Research and Testing, Division 4.3 - Contaminant Transfer and Environmental Technologies, Unter den Eichen 87, 12205, Berlin, Germany
Franz-Georg Simon Federal Institute for Materials Research and Testing, Division 4.3 - Contaminant Transfer and Environmental Technologies, Unter den Eichen 87, 12205, Berlin, Germany

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Assessment of perfluoroalkyl substances concentration levels in wild bat guano samples

Perfluoroalkyl substances (PFASs) are substances commonly used in the production of various everyday objects, including among others kitchen dishes, cosmetics, or clothes. They penetrate to the environment and living organisms causing disturbances in the functioning of many internal organs and systems. Due to environmental pollution, wildlife is also exposed to PFASs, but the knowledge about this issue is rather limited. The aim of this study was to evaluate the exposure of wild greater mouse-eared bats (Myotis myotis), living in Poland, to six selected PFASs: five perfluoroalkyl carboxylic acids (perfluorobutanoic acid-PFBuA, perfluoropentanoic acid-PFPeA, perfluorohexanoic acid-PFHxA, perfluoroheptanoic acid-PFHpA, perfluorooctanoic acid-PFOA) and perfluorooctane sulfonic acid (PFOS) through the analysis of guano samples with liquid chromatography with tandem mass spectrometry (LC-MS-MS) method. To our knowledge this is the first study concerning the PFASs levels in bats, as well as using guano samples to evaluate the exposure of wild mammals to these substances. A total of 40 guano samples were collected from 4 bats summer (nursery) colonies located in various parts of Poland. The presence of PFASs mentioned were detected in all colonies studied, and concentration levels of these substances were sampling dependent. The highest concentration levels were observed in the case of PFPeA [1.34 and 3060 ng/g dry weight (dw)] and PFHxA (8.30-314 ng/g dw). This study confirms the exposure of wild bats to PFASs.

A state-of-art-review on emerging contaminants: Environmental chemistry, health effect, and modern treatment methods

Pollution problems are increasingly becoming e a priority issue from both scientific and technological points of view. The dispersion and frequency of pollutants in the environment are on the rise, leading to the emergence have been increasing, including of a new class of contaminants that not only impact the environment but also pose risks to people's health. Therefore, developing new methods for identifying and quantifying these pollutants classified as emerging contaminants is imperative. These methods enable regulatory actions that effectively minimize their adverse effects to take steps to regulate and reduce their impact. On the other hand, these new contaminants represent a challenge for current technologies to be adapted to control and remove emerging contaminants and involve innovative, eco-friendly, and sustainable remediation technologies. There is a vast amount of information collected in this review on emerging pollutants, comparing the identification and quantification methods, the technologies applied for their control and remediation, and the policies and regulations necessary for their operation and application. In addition, This review will deal with different aspects of emerging contaminants, their origin, nature, detection, and treatment concerning water and wastewater.

Screening for 26 per- and polyfluoroalkyl substances (PFAS) in German drinking waters with support of residents

The occurrence of per- and polyfluoroalkyl substances (PFAS) in water cycles poses a challenge to drinking water quality and safety. In order to counteract the large knowledge gap regarding PFAS in German drinking water, 89 drinking water samples from all over Germany were collected with the help of residents and were analyzed for 26 PFAS by high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). The 20 PFAS recently regulated by sum concentration (PFAS∑20), as well as six other PFAS, were quantified by targeted analysis. In all drinking water samples, PFAS∑20 was below the limit of 0.1 μg/L, but the sum concentrations ranged widely from below the limit of quantification up to 80.2 ng/L. The sum concentrations (PFAS∑4) of perfluorohexanesulfonate (PFHxS), perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorononanoate of 20 ng/L were exceeded in two samples. The most frequently detected individual substances were PFOS (in 52% of the samples), perfluorobutanesulfonate (52%), perfluorohexanoate (PFHxA) (44%), perfluoropentanoate (43%) and PFHxS (35%). The highest single concentrations were 23.5 ng/L for PFHxS, 15.3 ng/L for PFOS, and 10.1 ng/L for PFHxA. No regionally elevated concentrations were identified, but some highly urbanized areas showed elevated levels. Concentrations of substitution PFAS, including 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)propanoate and 2,2,3-trifluor-3-[1,1,2,2,3,3-hexafluor-3-(trifluormethoxy)propoxy]-propanoate (anion of ADONA), were very low compared to regulated PFAS. The most frequently detected PFAS were examined for co-occurrences, but no definite correlations could be found.

Molecular detection of per- and polyfluoroalkyl substances in water using time-of-flight secondary ion mass spectrometry

Detection of per- and polyfluoroalkyl substances (PFASs) is crucial in environmental mitigation and remediation of these persistent pollutants. We demonstrate that time-of-flight secondary ion mass spectrometry (ToF-SIMS) is a viable technique to analyze and identify these substances at parts per trillion (ppt) level in real field samples without complicated sample preparation due to its superior surface sensitivity. Several representative PFAS compounds, such as perfluorooctanesulfonic acid (PFOS), perfluorobutanoic acid (PFBA), perfluoropentanoic acid (PFPeA), perfluoheptanoic acid (PFHpA), and perfluorononanoic acid (PFNA), and real-world groundwater samples collected from monitoring wells installed around at a municipal wastewater treatment plant located in Southern California were analyzed in this work. ToF-SIMS spectral comparison depicts sensitive identification of pseudo-molecular ions, characteristic of reference PFASs. Additionally, principal component analysis (PCA) shows clear discrimination among real samples and reference compounds. Our results show that characteristic molecular ion and fragments peaks can be used to identify PFASs. Furthermore, SIMS two-dimensional (2D) images directly exhibit the distribution of perfluorocarboxylic acid (PFCA) and PFOS in simulated mixtures and real wastewater samples. Such findings indicate that ToF-SIMS is useable to determine PFAS compounds in complex environmental water samples. In conclusion, ToF-SIMS provides simple sample preparation and high sensitivity in mass spectral imaging, offering an alternative solution for environmental forensic analysis of PFASs in wastewater in the future.

6:2 Chlorinated Polyfluoroalkyl Ether Sulfonates Exert Stronger Thyroid Homeostasis Disruptive Effects in Newborns than Perfluorooctanesulfonate: Evidence Based on Bayesian Benchmark Dose Values from a Population Study

Growing toxicologic evidence suggests that emerging perfluoroalkyl substances (PFASs), like chlorinated polyfluoroalkyl ether sulfonate (Cl-PFESA), may be as toxic or more toxic than perfluorooctanesulfonate (PFOS) and perfluorooctanoic acid (PFOA). However, further investigations are needed in terms of the human health risk assessment. This study examined the effects of emerging and legacy PFAS exposure on newborn thyroid homeostasis and compared the thyroid disruption caused by 6:2 Cl-PFESA and PFOS using a benchmark dose approach. The health effects of mixture and individual exposure were estimated using the partial least-squares (PLS) model and linear regression, respectively. A Bayesian benchmark dose (BMD) analysis determined the BMD value for adverse effect comparison between 6:2 Cl-PFESA and PFOS. The median (interquartile range) concentrations of 6:2 Cl-PFESA (0.573 [0.351-0.872] ng/mL), PFOS (0.674 [0.462-1.007] ng/mL), and PFOA (1.457 [1.034, 2.405] ng/mL) were found to be similar. The PLS model ranked the PFAS variables' importance in projection (VIP) scores as follows: 6:2 Cl-PFESA > PFOS > PFOA. Linear regression showed that 6:2 Cl-PFESA had a positive association with free triiodothyronine (FT3, P = 0.006) and triiodothyronine (T3, P = 0.014), while PFOS had a marginally significant positive association with FT3 alone (P = 0.042). The BMD analysis indicated that the estimated BMD10 for 6:2 Cl-PFESA (1.01 ng/mL) was lower than that for PFOS (1.66 ng/mL) in relation to a 10% increase in FT3. These findings suggest that 6:2 Cl-PFESA, an alternative to PFOS, has a more pronounced impact on newborns' thyroid homeostasis compared to PFOS and other legacy PFASs.

Research Progress of Perfluoroalkyl Substances in Edible Oil-A Review

Perfluoroalkyl substances (PFASs) have been widely used in different types of consumer and industrial applications such as surfactants, household cleaning products, textiles, carpets, cosmetics, firefighting foams, and food packaging because of their good stability and special physicochemical properties of hydrophobicity, oleophobicity, high temperature resistance, etc. Meanwhile, PFASs are considered an emerging organic pollutant due to their persistence and potential toxicity to human health. PFASs occur in edible oil, an important component of the global diet, mainly in three ways: raw material contamination, process contamination, and migration from oil contact materials. Thus, the occurrence of PFAS in edible oils has drawn more and more attention in recent years. In this work, the pertinent literature of the last two decades from the Web of Science database was researched. This review systematically addressed the potential sources, the contamination levels, and the progress of the determination of PFASs in edible oil. It aims to provide a relatively whole profile of PFASs in edible oil, render assistance to minimise human exposure to PFASs, and standardise the detection methods of perfluoroalkyl substances in edible oil.

Assessment of exposure to perfluorinated industrial substances and risk of immune suppression in Greenland and its global context: a mixed-methods study

BACKGROUND

Perfluoroalkyl substances (PFASs) are ubiquitous global contaminants that do not readily biodegrade and are therefore routinely found worldwide in wildlife, humans, and the environment. There is a paucity of global assessments to understand regional and continental differences in exposure to PFASs and the associated health risks, including those for Indigenous Arctic communities who consume high trophic marine diets. We aimed to estimate the long-term exposure of dietary PFASs from consumption of polar bear and ringed seal meat and establish its association with blood serum concentrations of PFASs in Inuit in Ittoqoortoormiit (Scoresby Sound), East Greenland. We also aimed to assess the risk of immune suppression on the basis of European Food Safety Authority (EFSA) thresholds for weekly intake and blood serum concentrations of PFASs. Last, we conducted a worldwide risk assessment based on blood concentrations of PFASs emphasising Arctic exposure in a global context.

METHODS

In this mixed-methods study, we conducted interviews to compare dietary exposure of PFASs in anonymous, non-pregnant, Inuit adults (aged ≥18 years) from full-time or part-time hunter families in Ittoqoortoormiit, East Greenland with ESFA toxic threshold values for tolerable weekly intake of the four most immunotoxic PFASs (∑4PFAS; perfluorooctanoic acid, perfluorononanoic acid, perfluorohexanesulfonic acid, and perfluorooctane sulfonate). Independent hospital staff from the local hospital randomly selected participants using simple randomisation using a telephone directory. Blood serum concentrations were then compared with EFSA risk categories: low (0·7-9·5 ng/mL), moderate (>9·5-17·5 ng/mL), high (>17·5-31·9 ng/mL), and severe (>31·9 ng/mL). We also reviewed the available scientific literature of ∑4PFAS concentrations in human blood to place the Inuit dataset in a broader global context.

FINDINGS

Between Sept 21, and Oct 2, 2015, 22 participants were enrolled in the study, of which 12 were male and ten were female. Sex data were obtained from personal social security numbers and options were male or female. As a result of a subsistence diet high in marine mammal muscle, 322 (92%) of 350 people in the Ittoqoortoormiit cohort exceeded the established immunotoxic thresholds of ∑4PFASs set by EFSA's tolerable weekly intake of 4·4 ng/kg, and 301 (86%) were in the most severe risk category (>31·9 ng/mL) based on blood serum concentrations. This Inuit cohort had the highest non-occupational long-term exposure to PFASs worldwide despite their remote location relative to industrial sources. Using country-wide average values across global studies, we found that blood serum concentrations of PFASs in populations from European countries, North America, the Arctic, and Australia were generally higher than those in South America, Africa, and mainland Asia, with the highest concentrations found in people from USA, Canada, Greenland, Faroe Islands, Denmark, Iceland, Norway, Sweden, the UK, Spain, Poland, and Australia. These high exposure countries all fall within the EFSA moderate-risk and high-risk categories.

INTERPRETATION

PFAS contamination of the environment and human populations occurs worldwide. This pollution not only poses substantial risks for immune system adverse events but also cardiovascular, cancerous, and reproductive endpoints. Data on such PFAS exposure is scarce in numerous countries. Therefore, it is important to also map out the exposure in these countries to enable a thorough global assessment of exposure and risks.

FUNDING

Danish Cooperation for Environment in the Arctic.

Acute Exposure of Zebrafish (Danio rerio) to the Next-Generation Perfluoroalkyl Substance, Perfluoroethylcyclohexanesulfonate, Shows Similar Effects as Legacy Substances

Perfluoroethylcyclohexanesulfonate (PFECHS) is an emerging perfluoroalkyl substance (PFAS) that has been considered a potential replacement for perfluorooctanesulfonic acid (PFOS). However, there is little information characterizing the toxic potency of PFECHS to zebrafish embryos and its potential for effects in aquatic environments. This study assessed toxic potency of PFECHS in vivo during both acute (96-hour postfertilization) and chronic (21-day posthatch) exposures and tested concentrations of PFECHS from 500 ng/L to 2 mg/L. PFECHS was less likely to cause mortalities than PFOS for both the acute and chronic experiments based on previously published values for PFOS exposure, but exposure resulted in a similar incidence of deformities. Exposure to PFECHS also resulted in significantly increased abundance of transcripts of peroxisome proliferator activated receptor alpha (pparα), cytochrome p450 1a1 (cyp1a1), and apolipoprotein IV (apoaIV) at concentrations nearing those of environmental relevance. Overall, these results provide further insight into the safety of an emerging PFAS alternative in the aquatic environment and raise awareness that previously considered "safer" alternatives may show similar effects as legacy PFASs.

Identification and characterization of diverse isomers of per- and polyfluoroalkyl substances in Chinese municipal wastewater

Linear and branched isomers of per- and polyfluoroalkyl substances (PFASs) are simultaneously present in the environment. However, isomer profiles of PFASs in municipal wastewater treatment plants (WWTPs) are still unknown because of the limitations of standards. Here, influent and effluent samples from 148 municipal WWTPs in China were collected. Ion mobility spectrometry was introduced into high-resolution mass spectrometry-based suspect screening methods to identify the target and suspect PFAS isomers. A total of 38 branched isomers of 14 typical PFASs were identified in wastewater samples. Linear PFASs had higher detection rates (22.3%-100%) than branched isomers (2.0%-98%). Compared to the influents, proportions of branched isomers of most PFASs (except for perfluoropentanoic acid and perfluorohexanoic acid) increased in the effluents. The conventional biological treatment processes (such as anaerobic-anoxic-aerobic and oxidation ditch treatments) had poor removal efficiency for linear PFASs (<21.4%) and branched isomers (<13.4%). No difference on removal efficiency among treatment processes was found. Furthermore, isomer composition in the WWTPs showed obvious differences between East China region and other regions, and the usage of short-chain PFASs (perfluorobutanesulfonic acid and perfluorohexanesulfonic acid) may be a key factor for driving this difference. This study sheds lights on the identification and characterization of PFAS isomers in WWTPs, which would be useful for development of monitoring and control strategies of PFASs.

Endocrine-Disrupting Chemicals and Their Effects in Pet Dogs and Cats: An Overview

Over the past few decades, several pollutants classified as environmental endocrine-disrupting chemicals (EDCs) have become a matter of significant public health concern. Companion animals play a major role in human society, and pet ownership is substantially increasing worldwide. These intimate human-pet relationships imply sharing much of the same environment, thus including exposure to similar levels of EDCs in daily routine. Here, we review the current knowledge on the sources and routes of exposure to EDCs in domestic indoor and outdoor environments and discuss whether endocrine disruption is a health concern in pets. We summarize the phenomenon of endocrine disruption, providing examples of EDCs with a known impact on dog and cat health. Then, we propose an overview of the literature on the adverse effects of EDCs in domestic pets, with a special focus on the health of reproductive and thyroid systems. Finally, we explore the potential role of companion animals as unintentional sentinels of environmental exposure to EDCs and the implications for public health risk assessment in a "shared risk" scenario. Overall, this review supports the need for an integrated approach considering humans, animals, and the environment as a whole for a comprehensive assessment of the impact of EDCs on human and animal health.

Screening of structural and functional alterations in duckweed (Lemna minor) induced by per- and polyfluoroalkyl substances (PFASs) with FTIR spectroscopy

As a class of common emerging pollutants, per- and polyfluoroalkyl substances (PFASs) and their alternatives have been widely detected in various environmental matrices, exhibiting a great threat to the ecological environment and human health. Nevertheless, changes in biomolecular structure and function of duckweed caused by PFASs and their alternatives remain unknown thus far. Herein, the effects of four PFASs, including two common legacy PFASs (perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA)) and two PFASs alternatives (perfluorobutane sulfonic acid (PFBS) and 1H,1H,2H, 2H-perfluorooctane sulfonic acid (6:2 FTS)) on duckweed (Lemna minor) at biochemical level were investigated with Fourier transform infrared spectroscopy (FTIR). Although no obvious inhibitions were observed in the growth of L. minor with PFASs exposure at three levels of 1 μg L^-1, 100 μg L^-1, and 10 mg L^-1, significant structural and functional alterations were induced at the biochemical level. In response to PFASs exposure, lipid peroxidation, proteins aggregation and α-helix to β-sheet transformation of the protein conformation, as well as changes of DNA conformations were detected. Moreover, alterations in lipid, protein, and DNA were proved to be concentration-related and compound-specific. Compared to the two legacy PFASs (PFOS and PFOA), alternative ones exhibited greater effects on the biological macromolecules of L. minor. The findings of this study firstly reveal structural and functional alterations in L. minor induced by PFASs exposure, providing further understanding of their toxicity effects.

Toxicokinetic Modeling of Per- and Polyfluoroalkyl Substance Concentrations within Developing Zebrafish (Danio rerio) Populations

Per- and polyfluoroalkyl substances (PFAS) are pervasive environmental contaminants, and their relative stability and high bioaccumulation potential create a challenging risk assessment problem. Zebrafish (Danio rerio) data, in principle, can be synthesized within a quantitative adverse outcome pathway (qAOP) framework to link molecular activity with individual or population level hazards. However, even as qAOP models are still in their infancy, there is a need to link internal dose and toxicity endpoints in a more rigorous way to further not only qAOP models but adverse outcome pathway frameworks in general. We address this problem by suggesting refinements to the current state of toxicokinetic modeling for the early development zebrafish exposed to PFAS up to 120 h post-fertilization. Our approach describes two key physiological transformation phenomena of the developing zebrafish: dynamic volume of an individual and dynamic hatching of a population. We then explore two different modeling strategies to describe the mass transfer, with one strategy relying on classical kinetic rates and the other incorporating mechanisms of membrane transport and adsorption/binding potential. Moving forward, we discuss the challenges of extending this model in both timeframe and chemical class, in conjunction with providing a conceptual framework for its integration with ongoing qAOP modeling efforts.

Leveraging Systematic Reviews to Explore Disease Burden and Costs of Per- and Polyfluoroalkyl Substance Exposures in the United States

Accelerating evidence confirms the contribution of per- and polyfluoroalkyl substances (PFAS) to disease burden and disability across the lifespan. Given that policy makers raise the high cost of remediation and of substituting PFAS with safer alternatives in consumer products as barriers to confronting adverse health outcomes associated with PFAS exposure, it is important to document the costs of inaction even in the presence of uncertainty. We therefore quantified disease burdens and related economic costs due to legacy PFAS exposures in the US in 2018. We leveraged systematic reviews and used meta-analytic inputs whenever possible, identified previously published exposure-response relationships, and calculated PFOA- and PFOS-attributable increases in 13 conditions. These increments were then applied to census data to determine total annual PFOA- and PFOS-attributable cases of disease, from which we calculated economic costs due to medical care and lost productivity using previously published cost-of-illness data. We identified PFAS-attributable disease costs in the US of $5.52 billion across five primary disease endpoints shown to be associated with PFAS exposure in meta-analyses. This estimate represented the lower bound, with sensitivity analyses revealing as much as $62.6 billion in overall costs. While further work is needed to assess probability of causation and establish with greater certainty effects of the broader category of PFAS, the results confirm further that public health and policy interventions are still necessary to reduce exposure to PFOA and PFOS and their endocrine-disrupting effects. This study demonstrates the large potential economic implications of regulatory inaction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12403-022-00496-y.

Polychlorinated dioxins and dibenzofurans (PCDD/F), polybrominated dioxins and dibenzofurans (PBDD/F), polychlorinated biphenyls (PCB), polybrominated diphenyl ethers (PBDE), and per- and polyfluoroalkyl substances (PFAS) in German breast milk samples (LUPE 8)

Most organic pollutants (POP) are persistent in the environment, accumulate in fatty tissues, and so a transfer through the food chain is probably, thereby causing various health effects. We quantified PCDD/F, PBDD/F, PCB, PBDE, perfluorinated substances, and ADONA in breast milk samples collected in two German federal states and breast milk and blood samples from subjects additionally exposed to PFOA. The median (95th percentile) concentrations were 2.43 (6.58) pgWHO₂₀₀₅TEQ/g l.w. for PCDD/F, 2.45 (4.82) pgWHO₂₀₀₅TEQ/g l.w. for dioxin-like PCB (dl-PCB), and 0.62 (2.69) pgWHO₂₀₀₅TEQ/g l.w. for PBDD/F. The relative contributions of the median values of PCDD/F, dl-PCB, and PBDD/F to the total-TEQ were approximately 41%, 42%, and 11%, respectively. Nondioxin-like PCB (ndl-PCB) concentrations were clearly dominated by the higher chlorinated PCB congeners, with medians of 23.2 ng/g l.w. for PCB 153, 13.9 ng/g l.w. for PCB 138, and 13.0 ng/g l.w. for PCB 180. The sum of the 3 congeners (PCB 138, 153, and 180) were multiplied with 1.64 (total PCB) and showed a median of 82.16 ng/g l.w. and a 95th percentile of 173.3 ng/g l.w. Only PFOA and PFOS could be quantified in 29% and 17% of in total 180 samples with 95th percentiles of 53 ng/l and 33 ng/l, respectively. Milk samples (n = 13) from subjects living on PFOA contaminated sites showed higher levels between 33 and 854 ng/l PFOA (mean: 199 ng/l), whilst PFOS could be quantified only in three samples. The sum of 17 PBDE congeners showed medians (95th percentile) of 1737 pg/g l.w. (22,806 pg/g l.w.), with the highest medians of 422 pg/g l.w. for BDE 209 and 378 pg/g l.w. for BDE 153. Overall, our study confirms the declining contamination level in breast milk during the last decade, but points out the need to further reduce the environmental contamination with persistent substances and subsequently the exposure in childhood.

Toward a Mechanistic Understanding of Poly- and Perfluoroalkylated Substances and Cancer

Simple Summary

Poly- and perfluoroalkylated substances (PFAS) are industrial chemicals found in many household products that persist in the environment. While several excellent review articles exist on the potential harmful effects of PFAS, there are few focused on cancer. This concise and streamlined mini-review focuses on summarizing molecular mechanisms related to the potential cancer-promoting properties of PFAS. This review organizes and interprets the vast primary PFAS cancer biology literature and provides a coherent, unified, and digestible model of the molecular mechanisms that potentially explains PFAS cancer promotion.

Abstract

Poly- and perfluoroalkylated substances (PFAS) are chemicals that persist and bioaccumulate in the environment and are found in nearly all human populations through several routes of exposure. Human occupational and community exposure to PFAS has been associated with several cancers, including cancers of the kidney, testis, prostate, and liver. While evidence suggests that PFAS are not directly mutagenic, many diverse mechanisms of carcinogenicity have been proposed. In this mini-review, we organize these mechanisms into three major proposed pathways of PFAS action—metabolism, endocrine disruption, and epigenetic perturbation—and discuss how these distinct but interdependent pathways may explain many of the proposed pro-carcinogenic effects of the PFAS class of environmental contaminants. Notably, each of the pathways is predicted to be highly sensitive to the dose and window of exposure which may, in part, explain the variable epidemiologic and experimental evidence linking PFAS and cancer. We highlight testicular and prostate cancer as models to validate this concept.

Serum levels of perfluorooctanoic acid and perfluorooctane sulfonic acid in pregnant women: Maternal predictors and associations with birth outcomes in the PIPA Project

AIM

Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) are persistent pollutants associated with adverse birth outcomes. This study aimed to identify predictors of blood PFOA and PFOS concentrations in pregnant women and to estimate their associations with birth outcomes in Brazil.

METHODS

We conducted a cross-sectional study with 139 pregnant women enrolled in the pilot study of the Rio Birth Cohort Study on Environmental Exposure and Childhood Development (PIPA Project). Multiple linear regression was used to estimate associations between PFOA and PFOS with maternal predictors and birth outcomes.

RESULTS

Higher levels of PFOA were observed in women aged 16-19 and 20-39 years, while fish consumption from 0.6 to 2.0 times per week was associated with lower levels of the substance. PFOS levels were higher in women living in houses with up to four rooms but lower in those who reported passive exposure to smoking. Increased newborn length and head circumference were also associated with higher maternal levels of PFOA.

CONCLUSIONS

In our study, age, fish consumption, passive smoking, and the number of rooms in the house were predictors of maternal PFAS levels. However, we did not observe significant associations between maternal plasma PFAS concentrations and birth outcomes.