PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents.

Cristina Canova,Andrea Di Nisio,Teresa Dalla Zuanna,Francesca Russo,Erich Batzella,Giulia Barbieri,Tony Fletcher,Gisella Pitter

doi:10.3390/ijerph182412881

Abstract

Background: Residents of a large area of north-eastern Italy were exposed for decades to high concentrations of perfluoroalkyl and polyfluoroalkyl substances (PFAS) via drinking water. Despite the large amount of evidence in adults of a positive association between serum PFAS and metabolic outcomes, studies focusing on children and adolescents are limited. We evaluated the associations between serum PFAS concentrations that were quantifiable in at least 40% of samples and lipid profile, blood pressure (BP) and body mass index (BMI) in highly exposed adolescents and children. Methods: A cross-sectional analysis was conducted in 6669 adolescents (14–19 years) and 2693 children (8–11 years) enrolled in the health surveillance program of the Veneto Region. Non-fasting blood samples were obtained and analyzed for perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglycerides. Low-density lipoprotein cholesterol (LDL-C) was calculated. Systolic and diastolic BP were measured, and BMI z-score accounting for age and sex was estimated. The associations between ln-transformed PFAS (and categorized into quartiles) and continuous outcomes were assessed using generalized additive models. The weighted quantile sum regression approach was used to assess PFAS-mixture effects for each outcome. Analyses were stratified by gender and adjusted for potential confounders. Results: Among adolescents, significant associations were detected between all investigated PFAS and TC, LDL-C, and to a lesser extent HDL-C. Among children, PFOS and PFNA had significant associations with TC, LDL-C and HDL-C, while PFOA and PFHxS had significant associations with HDL-C only. Higher serum concentrations of PFAS, particularly PFOS, were associated with lower BMI z-score. No statistically significant associations were observed between PFAS concentrations and BP. These results were confirmed by the multi-pollutant analysis. Conclusions: Our study supports a consistent association between PFAS concentration and serum lipids, stronger for PFOS and PFNA and with a greater magnitude among children compared to adolescents, and a negative association of PFAS with BMI.

Highlights

Over the past few decades, per- and polyfluoroalkyl substance (PFAS) contamination has grown into a serious global health threat
The general characteristics of children and adolescents who participated in the study are reported in Tables 1 and 2
In this cross-sectional study on 6669 adolescents and 2693 children exposed to high levels of PFAS through contaminated drinking water, we found a significant, non-linear association between serum concentrations of four PFAS congeners and common biomarkers of lipid metabolism

Summary

Introduction

Over the past few decades, per- and polyfluoroalkyl substance (PFAS) contamination has grown into a serious global health threat. PFAS are used in numerous consumer products and industrial applications to confer waterproof, greaseproof, stain-proof and low-friction properties [1]. PFAS are among the most ubiquitous synthetic chemicals in the world, and environmental and human exposure to PFAS can occur throughout the life cycles of these chemicals and products containing them [2]. Humans are exposed to PFAS via ingestion of contaminated food and drinking water [3], inhalation of indoor air and indoor dust [4] and use of consumer products. PFAS half-lives in serum may vary greatly with expected variation in children (small blood volumes and large fraction of exposures coming from drinking) compared to adults [5]. Among the numerous PFAS congeners, only a few PFAS have been thoroughly studied from an epidemiological perspective, especially perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS)

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