Abstract
BACKGROUND AND AIM: Perfluoroalkyl substances (PFAS) are persistent and bio-accumulative compounds, and animal studies have shown that exposure to PFAS is associated with immunotoxic effects. However, epidemiological studies regarding the impact on infant acute infectious diseases were inconsistent. We aimed to determine if prenatal exposure to PFAS is associated with acute infectious diseases including common cold, tracheitis/pneumonia and diarrhea among 1-year-old infants. METHODS: Ten selected PFASs including PFOA, PFOS, PFNA, PFDA, PFUA, PFDoA, PFHxS, PFBS, PFHpA and PFOSA were detected in maternal serum from a Chinese birth cohort between 2010 and 2013. Of these infants (n = 235), follow-up questionnaires were completed at 1 year old by parents. The association between prenatal exposure to PFASs and the infections was estimated using logistic regressions model and Poisson regression model with the outcome reported as an odds ratios (OR) and an incidence rate-ratio (IRR), respectively. RESULTS:Logistic regression analysis found statistically significant positive associations were seen between PFOA (OR = 4.93, 95% CI = 1.83, 13.30), PFNA (OR = 4.67, 95% CI = 1.10, 19.90) and the risk of diarrhea. Poisson regression analysis found that that frequencies of diarrhea increased by 100% - 150% for each 10-fold increase in PFOA, PFOS, PFNA, PFDA and PFUA, and increased by approximately 500% in PFDoA and PFOSA. WQS analyses found that PFAS mixture was positively associated with the occurrence of diarrhea, with PFOA having the highest individual weights. when stratified by exclusively breastfeeding duration (at least 4 months or not), the adverse effects of PFAS exposures on diarrhea were more pronounced among the breastfed infants. There were no significant associations between PFAS and common cold or tracheitis/pneumonia. CONCLUSIONS:The findings suggest that exposure to specific PFAS is associated with increased occurrence of diarrhea among 12 months infants and indicate a possible role of exclusively breastfeeding in the PFAS-health outcome association. KEYWORDS: Perfluoroalkyl substances, acute infectious disease, diarrhea, exclusive breastfeeding, infant, China
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