Remove legacy perfluoroalkyl acids and emerging per- and polyfluoroalkyl ether acids by single-use and regenerable anion exchange resins: Rapid small-scale column tests and model fits

Rapid small-scale column tests (RSSCT) are used to study the removal of per- and polyfluoroalkyl substances (PFAS) for drinking water treatment by ion exchange. Breakthroughs of 15 emerging per- and perfluoroalkyl ether acids and six legacy perfluoroalkyl acid analogs are studied using a single-use PFAS-selective anion exchange resin (AER1) and a regenerable, generic anion exchange resin (AER2). The Bohart-Adams model was used to describe and predict breakthrough, with the modeled results reasonably aligned with RSSCT results in most cases, enabling shorter RSSCT duration for future applications. AER1 exhibited high uptake capacity with no breakthrough for 11 of the 21 tested PFAS during the 144,175 BV continuous operation, allowing compliance with the new National Primary Drinking Water Regulation in many application scenarios. AER2 exhibited much faster breakthroughs for most PFAS and is not a promising option for drinking water treatment. However, the summed PFAS capacity via model fit and total PFAS adsorbed via measurement were only <0.01 % of both resin capacities at full breakthrough, suggesting PFAS could only occupy a tiny portion of the ion exchange sites even for the PFAS-selective AER1. Ether group insertion in the PFAS group leads to later breakthrough, and linear isomers were better captured by the resins than the branched isomers. Overall, PFAS uptake capacity increases and kinetics decrease when the PFAS molecular volume increases. Regeneration using 10 % NaCl solutions partially released PFAS from AER2 but not from AER1, with more short-chain PFAS released than long-chain ones. Ether group insertion decreased the PFAS recoveries during the regeneration of AER2. The regenerated resins showed much faster breakthroughs than the pristine resins, making them unfavorable for drinking water treatment applications. Adsorption displacement of short-chain PFAS by long-chain PFAS was observed in pristine AER1, and post-regeneration leaching occurred for both resins, both phenomena making the resins a possible PFAS source in long-term use.

Assessment of Potential Accumulation of Trifluoroacetate in Terminal Lakes

Trifluoroacetate (TFA) is the anionic form of the shortest perfluorocarboxylic acid (PFCA) and is ubiquitous in the environment at concentrations that are typically much higher than those of other PFCAs. As a stable and nonvolatile anion, it is expected to accumulate in terminal lakes in endorheic basins. This research sampled eight terminal lakes in the Western United States to determine the degree to which TFA is concentrating in these lakes and compare the data to samples collected from three of these lakes 25 years ago. The first observation was that three of the six terminal lakes sampled had higher TFA concentrations than their input streams, while the last two lakes lacked surface water inputs at the sampling time. The TFA concentrations in Mono Lake effectively remained constant over 25 years despite the input stream concentrations increasing 6.5-fold. In contrast, Pyramid Lake concentrations increased approximately the expected amount based on a simplistic analysis of input flows and concentrations. An additional observation was that lakes in basins with agricultural activity appeared to have higher TFA concentrations, which suggests an agricultural input.

Per- and polyfluoroalkyl substances (PFAS) in final treated solids (Biosolids) from 190 Michigan wastewater treatment plants

Trends in concentration, distribution, and variability of per- and polyfluoroalkyl substances (PFAS) in biosolids are characterized using an extensive dataset of 350 samples from 190 wastewater treatment plants (WWTPs) across Michigan. All samples are comprised of final treated solids generated at the end of the wastewater treatment process. Concentrations of both individual and Σ24 PFAS are lognormally distributed, with Σ24 PFAS concentrations ranging from 1-3200 ng/g and averaging 108 ± 277 ng/g dry wt. PFAS with carboxyl and sulfonic functional groups comprise 29% and 71% of Σ24 PFAS concentrations, respectively, on average. Primary sample variability in concentration is associated with long-chain PFAS with higher tendency for partitioning to biosolids. Short-chain carboxylic compounds, most notably PFHxA, are responsible for secondary concentration variability. Usage of FTSA and PFBS replacements to long-chain sulfonic compounds also contributes to variance in biosolids concentrations. Sulfonamide precursor compounds as a collective group are detected at a similar frequency as PFOS and often have higher concentrations. Trends in PFAS enrichment for individual PFAS vary at least 3 orders-of-magnitude and generally increase with compound hydrophobicity; however, partitioning of PFAS onto solids in WWTPs is a complex process not easily described nor constrained using experimentally-derived partitioning coefficients.

Production of perfluoroalkyl acids (PFAAs) from precursors in contaminated agricultural soils: Batch and leaching experiments

Contamination of soils with per- and polyfluoroalkyl substances (PFAS) (e.g., aqueous film forming foams (AFFFs) or PFAS containing biosolids applied to agricultural soils) can lead to large scale groundwater pollution. For site management, knowledge about the extent and time scales of PFAS contamination is crucial. At such sites, often persistent perfluoroalkyl acids (PFAAs) and so-called precursors, which can be transformed into PFAAs, co-occur. In this study, the release of PFAAs from 14 soil samples from an agricultural site in southwest Germany contaminated via compost/paper sludge was investigated. Rapid leaching of C4-C8 perfluoroalkyl carboxylic acids (PFCA) was observed in saturated column tests, while slowing down with increasing chain-length (≥ C9 PFCAs). Two selected samples were further incubated in batch-tests after removal of existing C4-C8 PFCAs in extensive column leaching tests until a liquid-solid ratio of 10 l/kg. During 60 days of incubation, aqueous concentrations of C4-C8 PFCAs increased linearly by a factor of 29-222, indicating continuous production by transformation of precursors. The potential PFAA-precursor reservoir was estimated by the direct total oxidizable precursor (dTOP) assay. PFCA concentrations after the dTOP increased up to two orders of magnitude. Production rates determined in batch-tests combined with the results of dTOP assay were used to estimate time scales for the duration of C4-C8 PFCAs emission from the contaminated agricultural soils which likely will last for several decades.

Legacy perfluoroalkyl acids and their oxidizable precursors in plasma samples of Norwegian women

Humans are exposed to perfluoroalkyl acids (PFAA) mainly through direct pathways, such as diet and drinking water, but indirect exposure also occurs when PFAA precursors break down to form legacy PFAA. Exposure to PFAA precursors raises particular concern, as neither the exposure nor the precursors themselves have been well described. In the present study, we aimed to assess the indirect contribution of oxidizable PFAA precursors to the total per- and polyfluoroalkyl substances (PFAS) burden in human plasma following the voluntary phase-out of production of long-chain PFAS. In addition, multiple logistic regression was used to explore associations between selected lifestyle and dietary factors and the oxidizable PFAA precursors fraction. This study included 302 cancer-free participants of the Norwegian Women and Cancer postgenome cohort. PFAS analyses were performed in plasma samples to determine PFAS concentrations before and after oxidation with the Total Oxidizable Precursor (TOP) assay. In pre-TOP analyses, perfluorooctane sulfonic acid (PFOS) was the dominant compound, followed by perfluorooctanoic acid (PFOA).The vast majority (98%) of the study population had increased post-TOP concentrations for at least one PFAA. The formation of PFAA accounted for 12% of the total PFAS burden, with seven PFAA observed post-TOP in at least 30% of study participants. PFHpA, br- PFOA, and PFDA were only detected in post-TOP analyses and showed the highest increase in concentrations. Of the PFAA with increased concentrations, we noted significant associations for year of birth, parity, BMI, and some dietary factors, although they were not consistent between the different PFAA. These results indicate that while the TOP assay might not provide a complete assessment of total PFAS burden in humans, it offers comprehensive assessment of unknown PFAA precursors that might be present in plasma, and it could therefore be implemented as an auxiliary tool in this regard.

Underestimation of Per- and Polyfluoroalkyl Substances in Biosolids: Precursor Transformation During Conventional Treatment

Wastewater treatment plants generate a solid waste known as biosolids. The most common management option for biosolids is to beneficially reuse them as an agricultural amendment, but because of the risk of pathogen exposure, many regulatory bodies require pathogen reduction before biosolids reuse. Per- and polyfluoroalkyl substances (PFAS) are well documented in biosolids, but limited information is available on how biosolids treatment processes impact PFAS. Furthermore, quantification of PFAS has focused on perfluoroalkyl acids (PFAAs) which are a small fraction of thousands of PFAS known to exist. The objective of this study was to quantify 92 PFAS in biosolids collected from eight biosolids treatment facilities before and after four pathogen treatment applications: composting, heat treatment, lime treatment, and anaerobic digestion. Overall, total PFAS concentrations before and after treatment were dominated by PFAA precursor species, in particular, diPAPs which accounted for a majority of the mass of the Σ92PFAS. This differs from historic data that found PFAAs, primarily PFOS, to dominate total PFAS concentrations. Treatment options such as heat treatment and composting changed the ratio of PFAA precursors to PFAAs indicating a transformation of PFAS during treatment. This study finds that PFAA precursors are likely underrepresented by other studies and make up a larger percentage of the total PFAS concentration in biosolids than previously estimated.

Exposure of a single wild boar population in North Rhine-Westphalia (Germany) to perfluoroalkyl acids

Perfluoroalkyl acids (PFAA) are among the leading chemical pollutants in the twenty-first century. Of these, perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) have been widely detected in a large number of animal and environmental samples. Wild boars accumulate PFAA in their livers, but it has not yet been clarified to what extent wild boars of the same population accumulate different PFAA in their livers or whether any conclusions can be drawn from any differences found in regard to environmental contamination. In this study, liver samples from wild boars killed during driven hunts in 2019 and 2020 from a defined forest area in North Rhine-Westfalia, Germany were analyzed for 13 different PFAA. A mean load of 493 µg/kg (± 168 µg/kg) PFAA was measured in 2020. Perfluorosulfonic acids accounted for 87% of the total load in both years, with PFOS dominating this group. These results were similar to those of 14 liver samples collected from other regions of Germany for comparison. In addition, the livers of hunted pregnant sows and fetuses were examined. The load of short-chain perfluorocarboxylic acids (< C8) in the fetus liver was as high as that of the sows, whereas the concentrations of long-chain perfluorocarboxylic acids (≥ C8) were lower than in the dams. This result shows for the first time that fetuses take up PFAA from their mothers in utero. Our study shows that PFAA content in wild boar livers is comparably high in all animals in a local population and indicates a need for further research regarding a nationwide background exposure to PFAA in wild boars and their surrounding environment.

Perfluoroalkylated compounds in the eggs and feathers of resident and migratory seabirds from the Antarctic Peninsula

In this study, we investigated factors that influence the differences in exposure of perfluoroalkyl acids (PFAAs) from eight species of Antarctic seabirds, including Pygoscelis penguins, Stercorarius maccormicki, and Macronectes giganteus. We analyzed the relationship between foraging ecology (based on δ¹³C, δ¹⁵N, and δ³⁴S values) and PFAAs accumulated in eggs and breast feathers. Ten out of 15 targeted PFAAs were detected in eggs compared to eight in feathers. Mean ∑PFAA concentrations in feathers ranged from 0.47 in P. antarcticus to 17.4 ng/g dry weight (dw) in S. maccormicki. In eggs, ∑PFAA concentrations ranged from 3.51 in P. adeliae to 117 ng/g dw in S. maccormicki. The highest concentrations of most PFAAs were found in trans-equatorial migrators such as S. maccormicki, probably due their high trophic position and higher concentrations of PFAAs in the Northern Hemisphere compared to the Southern Hemisphere. Based on stable isotopes correlations, our results suggest that the trophic position (δ¹⁵N) and the foraging area (δ¹³C and δ³⁴S) influence PFAAs concentrations in Antarctic seabirds. Our results point to the possibility that long-distance migratory birds may have as bio-vectors in the transport of pollutants, including PFCAs, in Antarctic environments, although this must be further confirmed in future studies using a mass balanced approach, such as extractable organofluorine (EOF).

Increases in Trifluoroacetate Concentrations in Surface Waters over Two Decades

Trifluoroacetate (TFA) is a persistent perfluorinated alkanoic acid anion that has many anthropogenic sources, with fluorocarbon refrigerants being a major one. After an initial burst of research in the late 1990s and early 2000s, research on this ubiquitous pollutant declined as atmospheric emissions of the precursor compounds grew rapidly. Thus, there is little contemporaneous information about the concentrations of TFA in the environment and how they have changed over time. This research determined the change in TFA concentrations in streams by resampling a transect that was originally sampled in 1998. The transect was designed to determine the regional distribution of TFA both upwind and downwind of major metropolitan areas in Northern California as well as a set of globally remote sites in Alaska. The results showed that TFA concentrations increased by an average of 6-fold over the intervening 23 years, which resulted in a median concentration of 180 ng/L (range 21.3-2790). The highest concentrations were found in streams immediately downwind of the San Francisco Bay Area, while substantially lower concentrations were found in the upwind, regionally remote, and globally remote sites. The C₃ to C₅ perfluorinated alkanoic acids were also investigated, but they were rarely detected with this methodology.

Estimation of Transport Parameters of Perfluoroalkyl Acids (PFAAs) in Unsaturated Porous Media: Critical Experimental and Modeling Improvements

Predicting the transport of perfluoroalkyl acids (PFAAs) in the vadose zone is critically important for PFAA site cleanup and risk mitigation. PFAAs exhibit several unusual and poorly understood transport behaviors, including partitioning to the air-water interface, which is currently the subject of debate. This study develops a novel use of quasi-saturated (residual air saturation) column experiments to estimate chemical partitioning parameters of both linear and branched perfluorooctane sulfonate (PFOS) in unsaturated soils. The ratio of linear-to-branched air-water interfacial partitioning constants for all six experiments was 1.62 ± 0.24, indicating significantly greater partitioning of linear PFOS isomers at the air-water interface. Standard breakthrough curve analysis and numerical inversion of HYDRUS models support the application of a Freundlich isotherm for PFOS air-water interfacial partitioning below a critical reference concentration (CRC). Data from this study and previously reported unsaturated column data on perfluorooctanoate (PFOA) were reevaluated to examine unsaturated systems for transport nonidealities. This reanalysis suggests both transport nonidealities and Freundlich isotherm behavior for PFOA below the CRC using drainage-based column methods, contrary to the assertions of the original authors. Finally, a combined Freundlich-Langmuir isotherm was proposed to describe PFAA air-water interfacial partitioning across the full range of relevant PFAA concentrations.

Demographic, life-style and physiological determinants of serum per- and polyfluoroalkyl substance (PFAS) concentrations in a national cross-sectional survey of Swedish adolescents

PER: and polyfluoroalkyl substances (PFAS) may affect adolescent health, yet factors related to PFAS concentrations in serum are poorly understood. We studied demographic, life-style and physiological determinants of serum PFAS concentrations in Swedish adolescents from a nation-wide survey, Riksmaten Adolescents 2016-17 (RMA, age 10-21 years, n = 1098). Serum samples were analyzed for 42 PFAS, using liquid chromatography-tandem mass spectrometry. The cumulative probability model was used to estimate associations between serum PFAS and determinants, using ordinal logistic regression. Legacy linear (lin-) perfluorooctanoic acid (PFOA), perfluorononaoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), lin-perfluorohexanesulfonic acid (PFHxS) and lin-/branched (br-) perfluorooctanesulfonic acid (PFOS) were quantifiable in ≥70% of the samples. The emerging PFAS 9-chlorohexanedecafluoro-3-oxanone-1-sulfonic acid (9Cl-PF3ONS) was quantified in 5.4% of the samples, suggesting initiation of long-range transport far from production sites. Median concentrations of all legacy PFAS were <2 ng/g serum, with a few participants having very high (>100 ng/g serum) lin-PFHxS and lin-/br-PFOS concentrations due to previous high exposure from PFAS-contaminated drinking water. Legacy PFAS exposure was strongly associated with birth country of the participants and their mothers. 2-fold higher estimated adjusted mean (EAM) concentrations were seen among high income country participants with mothers from high income countries than among low/lower-middle income country participants with mothers from the same category. Menstruating females had lower br-PFOS EAM concentrations than those who were not. Iron status (plasma ferritin) among females may be a marker of intensity of menstrual bleeding, but it was not significantly associated with legacy PFAS concentrations among females. Further studies are needed to determine how physiological changes occurring around menstruation affect the toxicokinetics of PFAS in females. In conclusion, PFAS are pollutants of the industrialized world and some of the identified determinants may be overlooked confounders/effect modifiers that should be included in future PFAS/health studies among adolescents.

Mechanisms Underlying the Impacts of Lipids on the Diverse Bioavailability of Per- and Polyfluoroalkyl Substances in Foods

Food is a major source of human exposure to per- and polyfluoroalkyl substances (PFASs), yet little is known about their bioavailability in food matrices. Here, the relative bioavailability (RBA) of PFASs in foods was determined using an in vivo mouse model. Pork, which had the highest lipid content, exhibited the greatest effect on bioavailability by increasing the RBAs of perfluoroalkyl acids (PFAAs) while reducing those of fluorotelomer phosphate diesters (diPAPs). During intestinal digestion of lipids, the bioaccessibility of PFAAs increased due to their greater partition into the stable mixed micelles. However, diPAPs were more likely to partition into the undigested oil phase due to their strong hydrophobicity. Both in vitro incubation and molecular docking results indicated that the PFAAs exhibited stronger binding affinities with mouse blood chylomicrons (CMs) than with diPAPs. Collectively, both lipid digestion in the intestine and the carrier effect of CMs played important roles in modulating the bioavailability of PFASs in food. More attention should be given to further evaluating the health risks of PFASs associated with the intake of high-lipid foods.

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.

Influence of soil on the uptake of perfluoroalkyl acids by lettuce: A comparison between a hydroponic study and a field study

This study explores whether mechanistic understanding of plant uptake of perfluoroalkyl acids (PFAAs) derived from hydroponic experiments can be applied to soil systems. Lettuces (Lactuca sativa) were grown in outdoor lysimeters in soil spiked with 4 different concentrations of 13 PFAAs. PFAA concentrations were measured in soil, soil pore water, lettuce roots, and foliage. The PFAA uptake by the lettuce was compared with uptake measured in a hydroponic study. The foliage:pore water concentration ratios in the lysimeter were similar to the foliage:water concentration ratios from the hydroponic experiment. In contrast, the root:pore water concentration ratios in the lysimeter were 1-2 orders of magnitude lower than in the hydroponic study for PFAAs with 6 or more perfluorinated carbons. Hence, hydroponic studies can be expected to provide a good quantitative measure of PFAA transfer from soil to foliage if one accounts for soil:pore water partitioning and differences in transpiration rate. However, hydroponic studies will be of little value for estimating PFAA transfer from soil to roots because sorption to the root surface is greatly enhanced under hydroponic conditions.

Elevated bioaccumulation of PFAAs in Oryzias melastigma following the increase of salinity is associated with the up-regulated expression of PFAA-binding proteins

Perfluoroalkyl acids (PFAAs) are widely detected in the environment, especially in estuarine and coastal areas where fluctuation of salinity occurs. Salinity alteration affected the distribution of PFAAs and even the bioaccumulation in organisms. However, the inner mechanism is still unclear. In this study, the marine medaka (Oryzias melastigma), a euryhaline fish model, was exposed to four PFAAs congeners under three different salinities (0, 15 and 35 psu). Results showed that the bioaccumulation of PFAAs increased in fish as the water salinity increased. PFAAs with longer lengths of carbon‑fluorine bond showed higher bioaccumulation in the fish. Salinity did not alter the levels of PFAAs in water media, however, the uptake rate of PFAAs from gills did increase with the salinity. Further analysis of the mechanism showed that PFAA bound to branchial proteins as confirmed by fluorescence spectroscopy. Higher expressions of proteins binding to PFAAs including organic anion transporter 1 (OAT1) and fatty acid-binding protein (FABP) facilitated the uptake of PFAAs through gills in fish culturing under higher salinity. In all, our study showed that elevation of salinity can induce the expression of proteins binding to PFAAs in gills, thus facilitate the uptake of water PFAAs. Salinity fluctuation should be taken into consideration when assessing the chemical risk in the estuarine and coastal areas.

Managing health risks of perfluoroalkyl acids in aquatic food from a river-estuary-sea environment affected by fluorochemical industry

Substantial perfluoroalkyl acids (PFAAs) production still occurs in China, and the consumption of aquatic products is a critical exposure pathway of PFAAs in humans. In this study, specimens of 16 freshwater and 40 marine species were collected in the river-estuary-sea environment affected by a mega fluorochemical industry park in China in 2015, and the edible tissues of these organisms were analyzed for PFAA levels. Perfluorooctanoic acid (PFOA) was the dominating contaminant with an overall contribution of more than 90%, and concentrations as high as 2161 ng/g wet weight (measured in the freshwater winkle). All species with the greatest PFOA levels were benthic. The trophic magnification factor (TMF) of PFOA was 1.10 for freshwater species and 1.28 for marine species, indicating that PFOA was slightly magnifying. Analysis of carbon source indicated that freshwater species were more benthic feeding, while marine species were more pelagic feeding. Aquatic food consumption screening values of PFOA were modified according to estimated daily intake (EDI) values, which generated recommendations for limited meal categories and the do-not-eat category. Thus, this study provides recommendations for mitigating the health risks of PFAA-contaminated aquatic food, ranging from food selection to consumption frequency and proper food processing.

Adverse effects of perfluoroalkyl acids on fish and other aquatic organisms: A review

Perfluoroalkyl acids (PFAAs) have been widely used in many industrial and consumer products. They have been detected ubiquitously in ambient water along with other environmental matrices, and their adverse effects on aquatic organisms have been a subject of active investigation. Here, we intended to summarize and synthesize the existing body of knowledge on PFAA toxicity through an extensive literature review, and shed light on areas where further research is warranted. PFAA toxicity appears to be influenced by the sex and developmental stages of aquatic organisms, but not significantly by exposure route. PFAA-induced aquatic toxicity could be classified as metabolism disturbance, reproduction disruption, oxidative stress, developmental toxicity, thyroid disruption, etc. At the molecular level, these responses can be initiated by key events, such as nuclear receptor activation, reactive oxygen species induction, or interaction with a membrane, followed by a cascade of downstream responses. PFAA-induced toxicity involves diverse metabolic processes, and therefore elucidating crosstalk or interactions among diverse metabolic pathways is a challenging task. In the presence of other chemicals, PFAAs can function as agonists or antagonists, resulting in different directions of combined toxicity. Therefore, mixture toxicity with other groups of chemicals is another research opportunity. Experimental evidence supports the trans-generational toxicity of PFAAs, suggesting that their long-term consequences for aquatic ecosystems should become of concern. A recent global ban of several PFAAs resulted in an increasing dependence on PFAA alternatives. The lack of sufficient toxicological information on this emerging group of chemicals warrant caution and rigorous toxicological assessments.

Concentration of selected liver enzymes across the stages of glomerular function: the associations with PFOA and PFOS

Kidney function/dysfunction may affect liver function/dysfunction and vice versa. Liver function is indicated by the observed concentrations of several liver enzymes. Kidney function is indicated by the glomerular filtration rate. Consequently, it is logical to study associations between liver enzymes and glomerular filtration rate indicted by the stages of glomerular function (GF). Thus, this study was undertaken to evaluate the associations between selected liver enzymes and the stages of GF for US adults aged >= 20 years. Data (N = 9523) for US adults for the years 2003–2014 from National Health and Nutrition Examination Survey were analyzed to estimate variabilities in concentrations associated with liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphate (APH), and γ-glutamyl transferase (GGT) across the stages of GF and to assess variabilities in associations that perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) may have with these enzymes across the stages of GF. Those with eGFR >90 mL/min/1.73 m² were defined as being in GF-1, those with eGFR between 60 and 89 mL/min/1.73 m² were defined as being in GF-2, those with eGFR between 45 and 59 mL/min/1.73 m² were defined as being in GF-3A, those with eGFR between 15 and 44 mL/min/1.73 m² were defined as being GF-3B/4. Regression models stratified by GF stages with ALT, AST, APH, and GGT as dependent variables were fitted to evaluate the associations of interest. Adjusted levels of ALT decreased with deteriorating kidney function from 25.3 IU/L at GF-1 to 20.9 IU/L at GF-3B/4 for obese adults and from 21.4 IU/L at GF-1 to 16.4 IU/L at GF-3B/4 for nonobese adults. Adjusted levels of AST followed inverted U-shaped distributions with increases from GF-1 to GF-2 followed by decreases from GF-2 to GF-3B/4. Adjusted levels of APH followed inverted U-shaped distributions with increases from GF-1 to GF-3A followed by decreases from GF-3A to GF-3B/4. Adjusted levels of GGT followed inverted U-shaped distribution among obese participants with point of inflection located at GF-3A. For the total population, obese had higher adjusted levels than nonobese at GF-1, GF-2, and GF-3A for ALT, APH, and GGT. Male-female differences in adjusted levels of ALT and GGT continued narrowing as kidney function deteriorated from GF-1 to GF-3B/4. The differences in ALT widened among nonobese smokers and nonsmokers as kidney function deteriorated. The concentrations of liver enzymes across GF stages varied by gender, race/ethnicity, smoking status, and obesity and more often than not, were indicated by inverted U-shaped curves with points of inflections located at G-2 or GF-3A. The associations between PFOA/PFOS with liver enzymes varied in magnitude and/or direction by stages of GF as kidney function deteriorated.

Fate of a perfluoroalkyl acid mixture in an agricultural soil studied in lysimeters

Perfluoroalkyl acids (PFAAs) are environmental contaminants of concern in both food and drinking water. PFAA fate in agricultural soil is an important determinant of PFAA contamination of groundwater and crops. The fate of C4-C14 perfluorinated carboxylic acids (PFCAs) and two perfluorinated sulfonic acids (PFSAs) in an agricultural soil was studied in a field lysimeter experiment. Soil was spiked with PFAAs at four different levels and crops were planted. PFAA concentrations in soil were measured at the beginning and end of the growing season. Lysimeter drainage water was collected and analysed. The concentrations of all PFAAs decreased in the surface soil during the growing season, with the decrease being negatively correlated with the number of fluorinated carbons in the PFAA molecule. PFAA transfer to the drainage water was also negatively correlated with the number of fluorinated carbons. For the C11-C14 PFCAs most of the decrease in soil concentration was attributed to the formation of non-extractable residues. For the remaining PFAAs leaching was the dominant removal process. Leaching was concentration dependent, with more rapid removal from the soils spiked with higher PFAA levels. Model simulations based on measured K_d values under-predicted removal by leaching. This was attributed to mixture effects that reduced PFAA sorption to soil.

Longitudinal trends of per- and polyfluoroalkyl substances in children's serum

Studies suggest negative health impacts from early life exposure to per- and polyfluoroalkyl substances (PFASs). However, information on longitudinal exposure to PFASs during childhood is scarce for background-exposed individuals. This study sought to fill this gap by investigating children's longitudinal exposure trends through measurement of PFAS serum concentrations and calculation of body burdens (μg, total in body). Blood of 54 Finnish children was sampled 2005-2015 and analyzed for 20 PFASs at 1, 6 and 10.5 years of age. The body burden was calculated by multiplying the serum concentration by the volume of distribution and the bodyweight for each individual. Associations between serum concentrations or body burdens and parameters, such as sex, breastfeeding duration, body mass index as well as indoor dust and air PFAS concentrations, were evaluated. Serum concentrations of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorohexane sulfonic acid (PFHxS) decreased significantly (p < 0.001) with age. In contrast to serum concentrations, body burdens stayed unchanged or even increased significantly (p < 0.05), except for PFOA in female children. Breastfeeding duration was positively correlated (p < 0.001) with serum concentrations of PFHxS, PFOS, PFOA and PFNA at 1 year of age. Some associations were found at 10.5 years with sex and indoor PFAS concentrations. Observations of longitudinal decreasing trends of serum concentrations can be misleading for understanding exposure levels from external media during childhood, as the serum concentration is influenced by parallel temporal changes and growth dilution. Body burdens account for growth dilution and thus better reflect differences in early-life to adolescence exposure than serum concentrations.

Concentrations and Distribution Patterns of Perfluoroalkyl Acids in Sewage Sludge and in Biowaste in Hesse, Germany

A total of 201 sewage sludge and 45 biowaste samples were examined for 14 different perfluoroalkyl acids (PFAA). For perfluorooctanesulfonic acid, maximum concentrations of 698 μg/kg dry weight were measured in sewage sludge and for perfluorohexanesulfonic acid 29.0 μg/kg dry weight were found in biowaste. Looking at the fingerprints of both these matrixes it can be see that long-chain PFAA make up 85.9% of the total concentration in sewage sludge whereas short-chain PFAA only account for 14.1%. In contrast, the trend in biowaste is just the opposite, with 53.2% long-chain and 46.8% short-chain PFAA. These results lead to the conclusion that sewage sludge functions as a sink for long-chain PFAA, and the plants preferentially take up short-chain PFAA from the sludge/soil, as seen by the concentrations found in biowaste. It can be calculated that the total yearly amount of PFAA spread onto agricultural lands amount to 15.3 kg.

Formation of PFAAs in fish through biotransformation: A PBPK approach

A physiologically-based pharmacokinetic (PBPK) model for perfluorinated alkyl acids (PFAAs) in rainbow trout has been updated to include formation of perfluorooctanoic acid (PFOA) from the biotransformation of 8:2 fluorotelomer carboxylic acid (8:2 FTCA). The updated model is dynamic and simulates both uptake and depuration phases. Two empirical studies are used to parameterize and test the model. In the first case, parameters related to fecal elimination and protein binding were optimized. In the second case, parameters were sourced either from literature or from optimized values based on the first study to test model performance. Optimization of parameters resulted in a decrease in the difference between experimental data and simulation results by 57 and 23 percent for the first and the second case, respectively, compared to the original case. Sensitivity analysis was performed to identify important parameters, and uncertainty in model prediction propagated by these parameters was assessed using Monte Carlo analysis. For each case, 80 and 89 percent, respectively, of median predicted values were within the limits of experimental error when comparing simulated and experimental data. This is the first toxicokinetic model that incorporates biotransformation of PFAA precursors and simultaneously predicts the distribution of the precursor and metabolite in different tissues. The model is mechanistic, and could be applied to simulate a variety of scenarios by using the organism-specific physiological properties compiled here with other chemical-specific parameters (e.g. protein interactions).

Occurrence and source identification of perfluoroalkyl acids (PFAAs) in the Metedeconk River Watershed, New Jersey

The Brick Township Municipal Utilities Authority (BTMUA), which relies on the Metedeconk River as its primary source of water supply, initiated a perfluoroalkyl acid (PFAA) source trackdown study in collaboration with the New Jersey Department of Environmental Protection (NJDEP) after discovering that the concentration of one PFAA, perfluorooctanoic acid (PFOA), was elevated at their raw surface water intake. Water samples were collected over eight sampling events between September 2011 and July 2014. Samples included surface water, groundwater, stormwater, sanitary sewer water, and commercial/industrial process water. Each sample was analyzed for ten PFAAs. Results from a set of samples collected from the 80 km² South Branch Metedeconk River watershed directed the focus of this study to a 7.5-km² area of interest. Within this area, a high concentration of PFAA contamination was documented in a localized zone. Subsequent groundwater sampling led to the identification of a plume of groundwater contamination emanating from an industrial/business park. The suspected source of PFAA detected in the river and drinking water intake was identified to a small industrial facility that used materials containing PFOA. Groundwater PFOA concentrations as high as 70,000 ng/L were found in samples taken within 200 m of the parcel and surface water concentrations as high as 130 ng/L were observed in the river. While various PFAAs were detected in the samples, particularly in groundwater samples, PFOA was identified as the primary contaminant of concern with respect to the river and the BTMUA water supply.

A review of contamination of surface-, ground-, and drinking water in Sweden by perfluoroalkyl and polyfluoroalkyl substances (PFASs)

Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are found in aquatic systems, flora, and fauna worldwide. These potentially harmful compounds are also frequently detected in Sweden and have already resulted in severe problems for public drinking water supply, i.e., some wells had to be closed due to high PFAS concentrations both in raw water and produced drinking water. Knowledge on PFAS occurrence in Sweden is still quite low, although monitoring is currently ongoing. This work describes potential sources for PFASs to enter the drinking water supply in Sweden and compares different occurrences of PFASs in raw and drinking water in the country. Moreover, the monitoring history, the legal situation, and remediation actions taken are presented. Finally, future challenges and the way forward in Sweden are discussed.

Variation in perfluoroalkyl acids in the American alligator (Alligator mississippiensis) at Merritt Island National Wildlife Refuge

This study aimed to quantify concentrations of fifteen perfluoroalkyl acids (PFAAs) in the plasma of American alligators (Alligator mississippiensis) inhabiting wetlands surrounding the Kennedy Space Center (KSC) in Florida, USA located at Merritt Island National Wildlife Refuge (MINWR). Approximately 10 male and 10 female alligators (n_total = 229) were sampled each month during 2008 and 2009 to determine if seasonal or spatial trends existed with PFAA burden. PFOS represented the highest plasma burden (median 185 ng/g) and PFHxS the second highest (median 7.96 ng/g). While no significant seasonal trends were observed, unique spatial trends emerged. Many of the measured PFAAs co-varied strongly together and similar trends were observed for PFOS, PFDA, PFUnA, and PFDoA, as well as for PFOA, PFHxS, PFNA, PFTriA, and PFTA, suggesting more than one source of PFAAs at MINWR. Higher concentrations of PFOS and the PFAAs that co-varied with PFOS were collected from animals around sites that included the Shuttle Landing Facility (SLF) fire house and the Neil Armstrong Operations and Checkout (O&C) retention pond, while higher concentrations of PFOA and the PFAA that co-varied with PFOA were sampled from animals near the gun range and the old fire training facility. Sex-based differences and snout-vent length (SVL) correlations with PFAA burden were also investigated.

Perfluoroalkyl and polyfluoroalkyl substances in consumer products

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are used in a wide range of products of all day life. Due to their toxicological potential, an emerging focus is directed towards their exposure to humans. This study investigated the PFAS load of consumer products in a broad perspective. Perfluoroalkyl sulfonic acids (C4, C6-C8, C10-PFSA), carboxylic acids (C4-C14-PFCA) and fluorotelomer alcohols (4:2, 6:2; 8:2 and 10:2 FTOH) were analysed in 115 random samples of consumer products including textiles (outdoor materials), carpets, cleaning and impregnating agents, leather samples, baking and sandwich papers, paper baking forms and ski waxes. PFCA and PFSA were analysed by HPLC-MS/MS, whereas FTOH were detected by GC/CI-MS. Consumer products such as cleaning agents or some baking and sandwich papers show low or negligible PFSA and PFCA contents. On the other hand, high PFAS levels were identified in ski waxes (up to about 2000 μg/kg PFOA), leather samples (up to about 200 μg/kg PFBA and 120 μg/kg PFBS), outdoor textiles (up to 19 μg/m(2) PFOA) and some other baking papers (up to 15 μg/m(2) PFOA). Moreover, some test samples like carpet and leather samples and outdoor materials exceeded the EU regulatory threshold value for PFOS (1 μg/m(2)). A diverse mixture of PFASs can be found in consumer products for all fields of daily use in varying concentrations. This study proves the importance of screening and monitoring of consumer products for PFAS loads and the necessity for an action to regulate the use of PFASs, especially PFOA, in consumer products.

Organic anion transporter 4 (OAT 4) modifies placental transfer of perfluorinated alkyl acids PFOS and PFOA in human placental ex vivo perfusion system

INTRODUCTION

Perfluorinated alkyl acids (PFAAs) are widely used in industry and consumer products. Pregnant women are exposed to PFAAs and their presence in umbilical cord blood represents fetal exposure. Interestingly, PFAAs are substrates for organic anion transporters (OAT) of which OAT4 is expressed in human placenta.

METHODS

To evaluate the contribution of OAT4 and ATP-binding cassette transporter G2 (ABCG2) proteins in the transplacental transfer of perfluoro octane sulfonate (PFOS) and perfluoro octanoate (PFOA) an ex vivo dual recirculating human placental perfusion was used. Altogether 8 placentas from healthy mothers with uncomplicated pregnancies were successfully perfused.

RESULTS

Both PFOS and PFOA crossed the placenta as suggested by in vivo data in the literature. The expression of OAT4 and ABCG2 proteins were studied by immunoblotting and correlation with the transfer index %(TI %) of PFOS and PFOA at 120 and 240 min (n = 4) was studied. The expression of OAT4 was in negative correlation with TI % of PFOA (R(2) = 0.92, p = 0.043) and PFOS (R(2) = 0.99, p = 0.007) at 120 min while at 240 min the correlation was statistically significant only with PFOA. The expression of ABCG2 did not correlate with TI% of PFOS or PFOA.

DISCUSSION

Data obtained in this study suggest the involvement of OAT4 in placental passage of PFAAs. Placental passage of PFOS and PFOA is modified by the transporter protein OAT4 but not by ABCG2. This is the first study indicating that OAT4 may decrease the fetal exposure to PFAAs and protect the fetus after maternal exposure to PFAAs but further studies are needed to confirm our findings.

Occurrence and point source characterization of perfluoroalkyl acids in sewage sludge

The occurrence and levels of perfluoroalkyl acids (PFAAs) emitted from specific pollution sources into the aquatic environment in Switzerland were studied using digested sewage sludges from 45 wastewater treatment plants in catchments containing a wide range of potential industrial emitters. Concentrations of individual PFAAs show a high spatial and temporal variability, which infers different contributions from industrial technologies and activities. Perfluorooctane sulfonic acid (PFOS) was generally the predominant PFAA with concentrations varying between 4 and 2440μgkg(-1) (median 75μgkg(-1)). Elevated emissions were especially observed in catchments capturing discharges from metal plating industries (median 82μgkg(-1)), aqueous firefighting foams (median 215μgkg(-1)) and landfill leachates (median 107μgkg(-1)). Some elevated perfluoroalkyl carboxylic acids (PFCAs) levels could be attributed to emissions from textile finishing industries with concentrations up to 233μgkg(-1) in sewage sludge. Assuming sorption to sludge for PFOS and PFCAs of 15% and 2%, respectively, concentrations in wastewater effluents up to the low μgL(-1) level were estimated. Even if wastewater may be expected to be diluted between 10 and 100 times by the receiving waters, elevated concentrations may be reached at specific locations. Although sewage sludge is a minor compartment for PFAAs in WWTPs, these investigations are helpful for the identification of hot-spots from industrial emitters as well as to estimate monthly average concentrations in wastewater.

Emission of perfluoroalkyl carboxylic acids (PFCA) from heated surfaces made of polytetrafluoroethylene (PTFE) applied in food contact materials and consumer products

Polytetrafluoroethylene (PTFE) has been widely discussed as a source of perfluorooctanoic acid (PFOA), which has been used in the production of fluoropolymers. PTFE may also contain unintended perfluoroalkyl carboxylic acids (PFCAs) caused by thermolysis of PTFE, which has been observed at temperatures above 300°C. Common PTFE coated food contact materials and consumer goods are operated at temperatures above 200°C. However, knowledge on possible emissions of PFCAs is limited. Therefore, it was the aim of this study to investigate and evaluate the emission of PFCAs from PTFE coated products with both, normal use and overheating scenarios. Four pans, claimed to be PFOA free, and nine consumer products were investigated. At normal use conditions (<230°C), emissions from PTFE surfaces were trapped for 1h. Overheating scenarios (>260°C) recorded emissions during a 30min heating of empty pans on a stove. Emissions were analyzed by LC-ESI-MS. Results indicate the emission of PFCAs, whereas no perfluorinated sulfonic acids were traced. At normal use conditions total emissions of PFCAs accounted for 4.75ng per hour. Overheated pans, however, released far higher amounts with up to 12190ng PFCAs per hour at 370°C. Dominating contributors where PFBA and PFOA at normal use and PFBA and PFPeA during overheating. Temperature seems to be the main factor controlling the emission of PFCAs. A worst case estimation of human exposure revealed that emissions of PFCAs from heated PTFE surfaces would be far below the TDI of 1500ng PFOA per kg body weight.

Associations between serum perfluoroalkyl acids and LINE-1 DNA methylation

Perfluoroalkyl acids (PFAAs) are persistent, synthetic compounds that are used in a number of consumer products. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have been associated with cardiovascular risk factors, and changes in gene expression and DNA methylation in animals and cellular systems. However, whether PFAA exposure is associated with LINE-1 DNA methylation, a potential marker of cardiovascular risk, in humans remains unknown. We sought to evaluate the cross-sectional associations between serum PFAAs and LINE-1 DNA methylation in a population highly exposed to PFOA. We measured serum PFAAs twice four to five years apart in 685 adult participants (47% male, mean age±SD=42±11years). We measured percent LINE-1 DNA methylation in peripheral blood leukocytes at the second time point (follow-up), and estimated absolute differences in LINE-1 methylation associated with an interquartile (IQR) shift in mean PFAA serum levels. IQR increases in mean serum PFOA, PFOS, perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS) were associated with differences of -0.04 (p=0.16), 0.20 (p=0.001), 0.06 (p=0.19), and 0.02 (p=0.57), respectively, in % LINE-1 methylation at follow-up after adjustment for potential confounders. We observed a monotonic increase in LINE-1 DNA methylation across tertiles of PFOS and PFNA (ptrend=0.02 for both associations), but not across tertiles of PFOA or PFHxS (ptrend=0.71 and 0.44, respectively). In summary, serum PFOS was associated with LINE-1 methylation, while serum PFOA, PFHxS, and PFNA were not. Additional research is needed to more precisely determine whether these compounds are epigenetically active.

Serum concentrations of perfluorinated alkyl acids and their associations with diet and personal characteristics among Swedish adults

SCOPE

In this study, food is suggested as a major source of human exposure to perfluorinated alkyl acids (PFAA). We investigated relations between serum levels of PFAA in adults and diet/lifestyle factors nationwide in Sweden.

METHODS AND RESULTS

In 2010-2011, adults (18-80 years, N = 270) recorded their diet for 4 days and answered a food frequency questionnaire. PFAA were measured in blood serum as well as v-3 fatty acids in plasma phospholipids as a biomarker for fish consumption. Higher levels of PFAA were associated with male sex, increased age, and higher education. Women reporting full breastfeeding for ≥12 months had 32-44% lower levels of perfluorooctane sulfonate, perfluorooctanoic acid, and perfluorohexane sulfonate than women who never nursed their infants full-time. Serum perfluorooctane sulfonate, perfluorononanoic acid, perfluorodecanoic acid, and perfluoroundecanoic acid were positively related to n-3 fatty acids in plasma (partial r = 0.19-0.34, p ≤ 0.05).

CONCLUSION

The relatively strong correlations between biomarkers of fish consumption and certain PFAA suggest that PFAA exposure should be taken into account in health risk and benefit assessment of fish consumption. Breastfeeding appears to be a major source of elimination of certain PFAA among women, and consequently PFAA exposure of nursed infants could be significant.

Peripheral arterial aneurysms: open or endovascular surgery?

Peripheral arterial aneurysms are uncommon; for some aneurysm types, data are limited to case reports and small case series. There is no Level A evidence in most cases to determine the choice between open or endovascular intervention. The evolution of endovascular technology has vastly improved the armamentarium available to the vascular surgeon and interventionalists in the management of these rare and unusual aneurysms. The choice of operative approach will ultimately be determined on an individual basis, dependent on the patient risk factors, and aneurysm anatomy. After consideration, some aneurysms (femoral, subclavian, carotid and ECAA) fare better with an open first approach; renal, splenic and some visceral artery aneurysms do better with an endovascular first approach. In our practice PAAs are treated with an endovascular first approach. For these rare conditions, both open and endovascular therapy will continue to work in harmony to enhance and extend the capabilities of modern surgical management.

Update on aneurysm disease: current insights and controversies: peripheral aneurysms: when to intervene - is rupture really a danger?

Peripheral artery aneurysms are rarer than abdominal aortic aneurysms (AAA), although the true prevalence is not well known. They often coexist with aortic and other peripheral artery aneurysms. In contrast to AAA, where the principal risk is that of rupture, thromboembolism is more common, contributing a bigger risk in the more common lesions. Although rupture does occur, with incidence related to anatomical site, aneurysm diameter cannot be used to guide management with the same confidence as in AAA. In addition, the rarity of these lesions results in a paucity of evidence with which to guide intervention. Consequently they are difficult lesions to manage, and numerous aneurysm and patient factors must be considered to provide treatment individualised for each case. We discuss popliteal, femoral, carotid, subclavian, upper limb, visceral and false aneurysms, focussing on the risk of rupture and thromboembolism, and current thresholds for intervention, based on the available published literature.

Using blood gene signatures for assessing effects of exposure to perfluoroalkyl acids (PFAAs) in humans: the NOWAC postgenome study

Perfluoroalkyl acids (PFAAs) are ubiquitously present in human blood samples and the effects of these compounds on human health are not fully characterized. This study was conducted in order to investigate the applicability of peripheral blood gene expressions for exploring the impact of perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA) and perfluorohexane sulfonate (PFHxS) exposure on the general population. PFOS, PFOA and PFHxS were analyzed in blood samples from a representative group of 270 healthy, postmenopausal Norwegian women (48-62 years). Gene expression was measured in the same samples using the Applied Biosystems microarray platform. Forty-eight different gene sets, all previously linked to PFAA exposure were explored in relation to the selected PFAAs. Two gene sets, both related to the citric acid cycle, were differentially expressed between the "PFOS high" (>30ng/ml, n=42) and the "PFOS low" (<30ng/ml, n=228) group. Based on the results of this study we believe that blood gene signatures have a large potential for elucidating which biological pathways are being affected by environmental pollutants. To the best of our knowledge, this study is the first assessment of the impact of PFAAs on blood gene expressions in humans from the general population.

Do perfluoroalkyl compounds impair human semen quality?

BACKGROUND

Perfluoroalkyl acids (PFAAs) are found globally in wildlife and humans and are suspected to act as endocrine disruptors. There are no previous reports of PFAA levels in adult men from Denmark or of a possible association between semen quality and PFAA exposure.

OBJECTIVES

We investigated possible associations between PFAAs and testicular function. We hypothesized that higher PFAA levels would be associated with lower semen quality and lower testosterone levels.

METHODS

We analyzed serum samples for levels of 10 different PFAAs and reproductive hormones and assessed semen quality in 105 Danish men from the general population (median age, 19 years).

RESULTS

Considerable levels of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid were found in all young men (medians of 24.5, 4.9, and 6.6 ng/mL, respectively). Men with high combined levels of PFOS and PFOA had a median of 6.2 million normal spermatozoa in their ejaculate in contrast to 15.5 million among men with low PFOS-PFOA (p = 0.030). In addition, we found nonsignificant trends with regard to lower sperm concentration, lower total sperm counts, and altered pituitary-gonadal hormones among men with high PFOS-PFOA levels.

CONCLUSION

High PFAA levels were associated with fewer normal sperm. Thus, high levels of PFAAs may contribute to the otherwise unexplained low semen quality often seen in young men. However, our findings need to be corroborated in larger studies.