Abstract

Per- or polyfluoroalkyl substances (PFAS), a family of synthetic polyfluorinated compounds, are widely used in consumer products. Ubiquitous exposures to PFAS, in consideration of their persistence, bioaccumulation potential, and toxicities have led to concerns regarding possible harmful effects during critical periods of development in early-life and long-term consequences on health. The potential effects of PFAS depend on various factors including the type of PFAS and the timing and level of exposure. We performed a systematic review of the epidemiologic literature to assess the effects of early-life PFAS exposure on prenatal and postnatal growth, adiposity, and puberty in children and adolescents. For birth size, most studies indicated that prenatal PFAS exposure, in particular long-chain PFAS, may impair fetal growth, albeit some reports of null associations with maternal PFAS. For growth within 2 years of age, prenatal PFAS exposure showed no associations with height and either null or negative associations with weight. However, postnatal PFAS exposures were inversely related to height and weight at 2 years in a cross-sectional study. For postnatal adiposity, prenatal PFAS may mostly have negative associations with body mass index in the first 2 years of life, but positive relationships with adiposity in childhood and adolescence, although some studies showed null associations. For puberty, the evidence for associations between early-life PFAS exposure and pubertal development or sex hormone levels were limited and inconclusive. From experimental studies, plausible mechanisms through which PFAS may affect early-life growth and puberty include PFAS-induced activation of peroxisome proliferator-activated receptor, alterations of thyroid or steroid hormone synthesis and metabolism, and their weak estrogenic or anti-androgenic properties. Although the published literature suggests possible effects of PFAS exposures on early-life growth, adiposity, and puberty, current human evidence is limited in establishing PFAS-induced effects on early-life physical development. Further investigation is warranted to clarify PFAS-induced effects on growth and physical development in consideration of the critical time-window of exposure, concomitant exposure to chemical mixtures including various PFAS types, and possible non-monotonic dose-response relationship for growth and adiposity trajectories.

Highlights

  • Per- or polyfluoroalkyl substances (PFAS) are a group of highly stable synthetic polyfluorinated compounds that exhibit unique physical and chemical characteristics, including water and oil repellency, thermal stability and surfactant properties [1]

  • PFAS are grouped into perfluoroalkyl carboxylic acids (PFCA) and perfluoroalkyl sulfonic acids (PFSA)

  • Exposure was defined as exposure to PFOA, perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA), perfluorotridecanoic acid (PFTrDA), perfluorotetradecanoic acid (PFTeDA), perfluorohexadecanoic acid (PFHxDA), perfluorooctane sulfonic acid (PFOS), perfluoroheptanane sulfonic acid (PFHpS), perfluorohexane sulfonic acid (PFHxS), perfluorodecane sulfonic acid (PFDS), pentafluorobenzoic acid (PFBA), perfluoropentanoic acid (PFPeA), perfluorohexanoic acid (PFHxA), perfluoroheptanoic acid (PFHpA), perfluorobutane sulfonic acid (PFBS), perfluorooctane sulfonamide (PFOSA), N-ethyl-perfluorooctane sulfonamidoacetic acid (Et-PFOSAAcOH), or N-methyl-perfluorooctane sulfonamidoacetic acid (Me-PFOSA-AcOH)

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Summary

INTRODUCTION

Per- or polyfluoroalkyl substances (PFAS) are a group of highly stable synthetic polyfluorinated compounds that exhibit unique physical and chemical characteristics, including water and oil repellency, thermal stability and surfactant properties [1]. Since their first production in the 1940s and 1950s, PFAS have been incorporated into numerous products such as food packaging material, cookware, clothing, carpets, and fire extinguishers [1]. PFAS are resistant to environmental degradation and remain in the human body for a long time Their half-lives are 3.8, 5.4, and 8.5 years for PFOA, PFOS, and PFHxS, respectively [8]. We review the current epidemiologic evidence of the effects of prenatal and postnatal PFAS exposures on growth, adiposity, and puberty in children

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