Effect of Prenatal Exposure to Perfluoroalkyl Substances (PFASs) on Childhood Infectious Diseases up to 7 Years of Age: The Hokkaido Study

Abstract

Background/Aim: Perfluoroalkyl substances (PFASs) are persistent industrial chemicals that have possible effects on the immune system. We have reported the possible impact up to 4 years of age, however, effects on childhood infectious disease at later age is still unclear. We aimed to investigate the association between prenatal PFASs exposure and infectious diseases up to 7 years.Methods: A total of 2689 mother-child pairs, who were enrolled in the Hokkaido Study, were included in this data analysis. Eleven PFASs in 3rd trimester plasma were measured using UPLC-MSMS. Doctor diagnosis of otitis media, chicken pox, pneumonia, and respiratory syncytial virus (RSV), up to 7 years were extracted from the mother-reported questionnaires at 2, 4, 7 years of age. The odds ratio (OR) of log[e] transformed PFASs levels, as well as categorical values were calculated by logistic regression models adjusted for potential confounders such as infant sex, maternal age at delivery, gestational week, parity, household income, any allergies at 7y, and duration nursing.Results: Prevalence of otitis media, chicken pox, pneumonia, and RSV were 55.7%, 61.5%, 30.6%, and 16.8%, respectively. After stratified by siblings with (n=2309) and without (n=379), the increased the adjusted ORs (95% confidential interval) of pneumonia were found with PFOS (1.60, 0.94-2.71 p-value for trend in quartile model=0.039), PFDA (1.66, 1.03-2.66, p trend=0.004), and PFDoDA (1.61, 1.04-2.49, p trend=0.624) and increased the adjusted ORs of RSV were found with PFOA (1.91, 1.07-3.42, p trend=0.005) among children without any siblings. However, any of such associations were not found among children with siblings.Conclusion: Prenatal exposure to PFASs were associated with increased risk of pneumonia and RSV up to 7 years of age only among children without any siblings, however, not among children with siblings.