Abstract
BackgroundPerfluoroalkyl substances (PFASs) have been associated with decreased immunity to childhood tetanus and diphtheria immunizations. If these vaccinations are vulnerable to influence from PFASs, questions arise about associations with other common inoculations.ObjectiveTo examine whether serum PFASs were associated with reduced immunity to rubella immunization, and whether interactions with sex or ethnicity warranted analytic stratification. Usually, toxicology analyses are calculated controlling for race and sex. However, sex differences in immune function have been reported and a reduction of immunity to rubella in women could pose risks such miscarriage.MethodsWe analyzed a nationally representative sample of individuals ≥ 12 years from the National Health and Nutrition Examination Survey (NHANES) for years 1999–2000 and 2003–2004 for whom PFAS measures were available. Our analytic strategy was to start with separate analyses for youth and adults controlling for several covariates including ethnicity and sex, as well as the interaction of these terms with PFASs. If there was a main effect of PFASs and an interaction term, we would stratify analyses of effect size. The outcome variable was Rubella IgG titers by quartile of perfluoroalkyl substances.ResultsAfter exclusion for missing data, the analyzed sample contained 581 adult women, 621 adult men, and 1012 youth. There was no significant effect of PFASs on immunity in youths but a significant effect of both PFOA and PFOS in adults, as well as a significant interaction of PFOA x sex and a borderline significant interaction of PFOS x sex. When effect size analyses were stratified by sex, a significant association between rubella titres and PFOA was found in men but not women and PFOS was not significant in either sex.ConclusionsThese results support our earlier studies showing sex specific responses to PFASs and indicate the importance of thinking carefully about analytic strategies in population based toxicology research.
Highlights
There was no significant effect of Perfluoroalkyl substances (PFASs) on immunity in youths but a significant effect of both perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) in adults, as well as a significant interaction of PFOA x sex and a borderline significant interaction of PFOS x sex
When effect size analyses were stratified by sex, a significant association between rubella titres and PFOA was found in men but not women and PFOS was not significant in either sex
Perfluoroalkyl substances (PFASs), which include perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are synthetic compounds used in fluoropolymer synthesis
Summary
Perfluoroalkyl substances (PFASs), which include perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are synthetic compounds used in fluoropolymer synthesis. PFASs can be ingested from food and contaminated water [7], and seem to be transferred through the placenta during pregnancy [8,9] Exposure to these chemicals has been linked to liver, lung, and kidney damage as well as to immune changes in rats [10] and mice, [11,12,13] at concentrations similar to those found in humans [14]. In a prospective cohort study of children ages 5 and 7 years, it was reported that increased exposure to PFASs was associated with decreased humoral immune response to childhood tetanus and diphtheria immunizations [17]. If these vaccinations are vulnerable to influence from PFASs, questions arise about associations with other common inoculations
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