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Exposure to Perfluorinated Alkyl Substances and Health Outcomes in Children: A Systematic Review of the Epidemiologic Literature

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  • Kristen M. Rappazzo

    (Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA
    National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Chapel Hill, NC 27709, USA)

  • Evan Coffman

    (Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA
    Office of Air Quality Planning and Standards, Office of Air and Radiation, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA)

  • Erin P. Hines

    (National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA)

Abstract

Perfluoroalkyl substances (PFAS), chemicals used to make products stain and stick resistant, have been linked to health effects in adults and adverse birth outcomes. A growing body of literature also addresses health effects in children exposed to PFAS. This review summarizes the epidemiologic evidence for relationships between prenatal and/or childhood exposure to PFAS and health outcomes in children as well as to provide a risk of bias analysis of the literature. A systematic review was performed by searching PubMed for studies on PFAS and child health outcomes. We identified 64 studies for inclusion and performed risk of bias analysis on those studies. We determined that risk of bias across studies was low to moderate. Six categories of health outcomes emerged. These were: immunity/infection/asthma, cardio-metabolic, neurodevelopmental/attention, thyroid, renal, and puberty onset. While there are a limited number of studies for any one particular health outcome, there is evidence for positive associations between PFAS and dyslipidemia, immunity (including vaccine response and asthma), renal function, and age at menarche. One finding of note is that while PFASs are mixtures of multiple compounds few studies examine them as such, therefore the role of these compounds as complex mixtures remains largely unknown.

Suggested Citation

  • Kristen M. Rappazzo & Evan Coffman & Erin P. Hines, 2017. "Exposure to Perfluorinated Alkyl Substances and Health Outcomes in Children: A Systematic Review of the Epidemiologic Literature," IJERPH, MDPI, vol. 14(7), pages 1-22, June.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:7:p:691-:d:102800
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    References listed on IDEAS

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    1. Ilona Quaak & Marijke De Cock & Michiel De Boer & Marja Lamoree & Pim Leonards & Margot Van de Bor, 2016. "Prenatal Exposure to Perfluoroalkyl Substances and Behavioral Development in Children," IJERPH, MDPI, vol. 13(5), pages 1-20, May.
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    Cited by:

    1. Charlotte Stübner & Christel Nielsen & Kristina Jakobsson & Christopher Gillberg & Carmela Miniscalco, 2023. "Early-Life Exposure to Perfluoroalkyl Substances (PFAS) and Child Language and Communication Development: A Systematic Review," IJERPH, MDPI, vol. 20(24), pages 1-20, December.
    2. Marialuisa Menegatto & Sara Lezzi & Michele Musolino & Adriano Zamperini, 2022. "The Psychological Impact of Per- and Poly-Fluoroalkyl Substances (PFAS) Pollution in the Veneto Region, Italy: A Qualitative Study with Parents," IJERPH, MDPI, vol. 19(22), pages 1-22, November.
    3. Laura Franza & Rossella Cianci, 2021. "Pollution, Inflammation, and Vaccines: A Complex Crosstalk," IJERPH, MDPI, vol. 18(12), pages 1-16, June.
    4. Hussein F. Hassan & Haneen Bou Ghanem & Joelle Abi Kharma & Mohamad G. Abiad & Jomana Elaridi & Maya Bassil, 2023. "Perfluorooctanoic Acid and Perfluorooctane Sulfonate in Human Milk: First Survey from Lebanon," IJERPH, MDPI, vol. 20(1), pages 1-14, January.
    5. Blake Langenbach & Mark Wilson, 2021. "Per- and Polyfluoroalkyl Substances (PFAS): Significance and Considerations within the Regulatory Framework of the USA," IJERPH, MDPI, vol. 18(21), pages 1-17, October.
    6. Huilun Chen & Qianyu Wang & Yanping Cai & Rongfang Yuan & Fei Wang & Beihai Zhou, 2020. "Investigation of the Interaction Mechanism of Perfluoroalkyl Carboxylic Acids with Human Serum Albumin by Spectroscopic Methods," IJERPH, MDPI, vol. 17(4), pages 1-12, February.
    7. Yanping Cai & Haiyan Chen & Huilun Chen & Haiqing Li & Shuo Yang & Fei Wang, 2019. "Evaluation of Single and Joint Toxicity of Perfluorinated Carboxylic Acids and Copper to Metal-Resistant Arthrobacter Strains," IJERPH, MDPI, vol. 16(1), pages 1-11, January.
    8. Ruijin Lu & Boya Zhang & Anna Birukov & Cuilin Zhang & Zhen Chen, 2024. "A Variance-Based Sensitivity Analysis Approach for Identifying Interactive Exposures," Statistics in Biosciences, Springer;International Chinese Statistical Association, vol. 16(2), pages 520-541, July.
    9. Siti Suhana Abdullah Soheimi & Amirah Abdul Rahman & Normala Abd Latip & Effendi Ibrahim & Siti Hamimah Sheikh Abdul Kadir, 2021. "Understanding the Impact of Perfluorinated Compounds on Cardiovascular Diseases and Their Risk Factors: A Meta-Analysis Study," IJERPH, MDPI, vol. 18(16), pages 1-22, August.
    10. Nicole Marie Brennan & Abigail Teresa Evans & Meredith Kate Fritz & Stephanie Allison Peak & Haley Elizabeth von Holst, 2021. "Trends in the Regulation of Per- and Polyfluoroalkyl Substances (PFAS): A Scoping Review," IJERPH, MDPI, vol. 18(20), pages 1-28, October.
    11. Tiina Mattila & Tiina Santonen & Helle Raun Andersen & Andromachi Katsonouri & Tamás Szigeti & Maria Uhl & Wojciech Wąsowicz & Rosa Lange & Beatrice Bocca & Flavia Ruggieri & Marike Kolossa-Gehring & , 2021. "Scoping Review—The Association between Asthma and Environmental Chemicals," IJERPH, MDPI, vol. 18(3), pages 1-13, February.
    12. Frances M. Nilsen & Jazmin D.C. Ruiz & Nicolle S. Tulve, 2020. "A Meta-Analysis of Stressors from the Total Environment Associated with Children’s General Cognitive Ability," IJERPH, MDPI, vol. 17(15), pages 1-35, July.
    13. Qi Meng & Kosuke Inoue & Beate Ritz & Jørn Olsen & Zeyan Liew, 2018. "Prenatal Exposure to Perfluoroalkyl Substances and Birth Outcomes; An Updated Analysis from the Danish National Birth Cohort," IJERPH, MDPI, vol. 15(9), pages 1-15, August.
    14. Elsi Haverinen & Mariana F. Fernandez & Vicente Mustieles & Hanna Tolonen, 2021. "Metabolic Syndrome and Endocrine Disrupting Chemicals: An Overview of Exposure and Health Effects," IJERPH, MDPI, vol. 18(24), pages 1-19, December.

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