A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects.,Journal of Exposure Science and Environmental Epidemiology

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A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects.
Journal of Exposure Science and Environmental Epidemiology ( IF 4.1 ) Pub Date : 2018-11-23 , DOI: 10.1038/s41370-018-0094-1
Elsie M Sunderland _{1,

2} , Xindi C Hu _{1,

2} , Clifton Dassuncao _{1,

2} , Andrea K Tokranov ₂ , Charlotte C Wagner ₂ , Joseph G Allen ₁

Affiliation

Here, we review present understanding of sources and trends in human exposure to poly- and perfluoroalkyl substances (PFASs) and epidemiologic evidence for impacts on cancer, immune function, metabolic outcomes, and neurodevelopment. More than 4000 PFASs have been manufactured by humans and hundreds have been detected in environmental samples. Direct exposures due to use in products can be quickly phased out by shifts in chemical production but exposures driven by PFAS accumulation in the ocean and marine food chains and contamination of groundwater persist over long timescales. Serum concentrations of legacy PFASs in humans are declining globally but total exposures to newer PFASs and precursor compounds have not been well characterized. Human exposures to legacy PFASs from seafood and drinking water are stable or increasing in many regions, suggesting observed declines reflect phase-outs in legacy PFAS use in consumer products. Many regions globally are continuing to discover PFAS contaminated sites from aqueous film forming foam (AFFF) use, particularly next to airports and military bases. Exposures from food packaging and indoor environments are uncertain due to a rapidly changing chemical landscape where legacy PFASs have been replaced by diverse precursors and custom molecules that are difficult to detect. Multiple studies find significant associations between PFAS exposure and adverse immune outcomes in children. Dyslipidemia is the strongest metabolic outcome associated with PFAS exposure. Evidence for cancer is limited to manufacturing locations with extremely high exposures and insufficient data are available to characterize impacts of PFAS exposures on neurodevelopment. Preliminary evidence suggests significant health effects associated with exposures to emerging PFASs. Lessons learned from legacy PFASs indicate that limited data should not be used as a justification to delay risk mitigation actions for replacement PFASs.

中文翻译：

回顾人类接触多氟烷基物质和全氟烷基物质 (PFAS) 的途径，并提出对健康影响的了解。

在此，我们回顾了目前对人类接触多氟烷基物质和全氟烷基物质 (PFAS) 的来源和趋势的了解，以及对癌症、免疫功能、代谢结果和神经发育影响的流行病学证据。人类已制造了超过 4000 种 PFAS，并在环境样本中检测到了数百种。由于产品中使用而导致的直接接触可以通过化学生产的转变而迅速淘汰，但由海洋和海洋食物链中 PFAS 积累以及地下水污染引起的接触会长期持续存在。全球范围内，人类中遗留 PFAS 的血清浓度正在下降，但新型 PFAS 和前体化合物的总暴露量尚未得到很好的表征。在许多地区，人类从海鲜和饮用水中接触到的遗留 PFAS 保持稳定或增加，这表明观察到的下降反映了消费产品中遗留 PFAS 使用的逐步淘汰。全球许多地区不断发现因水成膜泡沫 (AFFF) 使用而受到 PFAS 污染的地点，特别是机场和军事基地附近。由于化学环境迅速变化，传统的 PFAS 已被难以检测的各种前体和定制分子所取代，食品包装和室内环境中的暴露是不确定的。多项研究发现 PFAS 暴露与儿童不良免疫结果之间存在显着关联。血脂异常是与 PFAS 暴露相关的最强代谢结果。癌症的证据仅限于暴露量极高的生产地点，并且没有足够的数据来描述 PFAS 暴露对神经发育的影响。初步证据表明，接触新出现的 PFAS 会对健康产生重大影响。从旧 PFAS 中汲取的经验教训表明，有限的数据不应成为推迟替代 PFAS 风险缓解行动的理由。

更新日期：2019-05-16

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