A systematic evidence map of chronic inflammation and immunosuppression related to per- and polyfluoroalkyl substance (PFAS) exposure

BACKGROUND

The ability to induce chronic inflammation and immunosuppression are two key characteristics of carcinogens and important forms of immunotoxicity. The National Toxicology Program (NTP) evaluated the immunotoxicity of two per- and polyfluoroalkyl substances (PFASs), PFOA (perfluorooctanoic acid) and PFOS (perfluorooctane sulfonate), in 2016. However, the potential pro-inflammatory and immunosuppressive effects of other PFASs remain largely uncharacterized.

METHODS

We developed an expanded set of search terms pertaining to the chronic inflammatory and immunosuppressive effects of PFASs based on those of the International Agency for Research on Cancer (IARC) and NTP. To confirm searching effectiveness and scope, we compared our search term results with those of IARC and NTP for both PFASs and two other known carcinogens, chromium (VI) and benzene. Systematic evidence maps (SEMs) were also produced using Tableau to visualize the distribution of study numbers and types reporting immunotoxic effects and specific biomarkers elicited by PFAS exposures.

RESULTS

In total, 1155 PFAS studies were retrieved, of which 321 qualified for inclusion in our dataset. Using our search terms, we identified a greater number of relevant studies than those obtained using IARC and NTP's search terms. From the SEM findings, increased cytokine production strengthened an association between PFAS exposure and chronic inflammation, and decreased B-cell activation and altered levels of T-cell subtypes and immunoglobulins confirmed PFAS-induced immunosuppression.

CONCLUSION

Our SEM findings confirm that several PFASs commonly found in both in the environment, including those that are lesser-known, may induce immunosuppression and chronic inflammation, two key characteristics of carcinogens. This approach, including development of search terms, study screening process, data coding, and evidence mapping visualizations, can be applied to other key characteristics of chemical carcinogens.

Waste incineration of Polytetrafluoroethylene (PTFE) to evaluate potential formation of per- and Poly-Fluorinated Alkyl Substances (PFAS) in flue gas

In recent years, concerns over some per- and polyfluorinated alkyl substances (PFAS) have grown steadily. PFAS are a large group of chemical substances with widely differing properties. While one class of PFAS, fluoropolymers, have been demonstrated to meet the OECD criteria for polymers of low concern during the in use phase of their lifecycle, questions remain regarding waste handling at the end of useful life for products containing fluoropolymers. To show that polytetrafluoroethylene (PTFE) can be almost fully transformed into fluorine (F) (as hydrofluoric acid (HF)) and to study the possible generation of low molecular weight per- and polyfluorinated alkyl substances (PFAS), PTFE combustion under typical waste incineration conditions at the BRENDA (German acronym for "Brennkammer mit Dampfkessel") pilot plant at Karlsruhe Institute of Technology (KIT) was investigated. Results indicate that, within procedural quantitation limits, no statistically significant evidence was found that the PFAS studied were created during the incineration of PTFE. Therefore, municipal incineration of PTFE using best available technologies (BAT) is not a significant source of the studied PFAS and should be considered an acceptable form of waste treatment.

Behaviour and fate of perfluoroalkyl and polyfluoroalkyl substances (PFASs) in drinking water treatment: a review

This article reviews perfluoroalkyl and polyfluoroalkyl substance (PFAS) characteristics, their occurrence in surface water, and their fate in drinking water treatment processes. PFASs have been detected globally in the aquatic environment including drinking water at trace concentrations and due, in part, to their persistence in human tissue some are being investigated for regulation. They are aliphatic compounds containing saturated carbon-fluorine bonds and are resistant to chemical, physical, and biological degradation. Functional groups, carbon chain length, and hydrophilicity/hydrophobicity are some of the important structural properties of PFASs that affect their fate during drinking water treatment. Full-scale drinking water treatment plant occurrence data indicate that PFASs, if present in raw water, are not substantially removed by most drinking water treatment processes including coagulation, flocculation, sedimentation, filtration, biofiltration, oxidation (chlorination, ozonation, AOPs), UV irradiation, and low pressure membranes. Early observations suggest that activated carbon adsorption, ion exchange, and high pressure membrane filtration may be effective in controlling these contaminants. However, branched isomers and the increasingly used shorter chain PFAS replacement products may be problematic as it pertains to the accurate assessment of PFAS behaviour through drinking water treatment processes since only limited information is available for these PFASs.