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Environmental Exposure to Per- and Polyfluorylalkyl Substances (PFASs) and Reproductive Outcomes in the General Population: A Systematic Review of Epidemiological Studies

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  • Alex Haimbaugh

    (Department of Pharmacology, Wayne State University, Detroit, MI 48202, USA
    Department of Environmental and Global Health, University of Florida, Gainesville, FL 32611, USA)

  • Danielle N. Meyer

    (Department of Environmental and Global Health, University of Florida, Gainesville, FL 32611, USA)

  • Mackenzie L. Connell

    (Department of Environmental and Global Health, University of Florida, Gainesville, FL 32611, USA)

  • Jessica Blount-Pacheco

    (Department of Pharmacology, Wayne State University, Detroit, MI 48202, USA)

  • Dienye Tolofari

    (Great Lakes Water Authority, Detroit, MI 48226, USA)

  • Gabrielle Gonzalez

    (Department of Environmental and Global Health, University of Florida, Gainesville, FL 32611, USA)

  • Dayita Banerjee

    (Department of Environmental and Global Health, University of Florida, Gainesville, FL 32611, USA)

  • John Norton

    (Great Lakes Water Authority, Detroit, MI 48226, USA)

  • Carol J. Miller

    (Department of Civil and Environmental Engineering, Wayne State University, Detroit, MI 48202, USA)

  • Tracie R. Baker

    (Department of Pharmacology, Wayne State University, Detroit, MI 48202, USA
    Department of Environmental and Global Health, University of Florida, Gainesville, FL 32611, USA)

Abstract

This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review synthesized effects of background levels of per- and polyfluorylalkyl substance (PFAS) levels on reproductive health outcomes in the general public: fertility, preterm birth, miscarriage, ovarian health, menstruation, menopause, sperm health, and in utero fetal growth. The inclusion criteria included original research (or primary) studies, human subjects, and investigation of outcomes of interest following non-occupational exposures. It drew from four databases (Web of Science, PubMed, Embase and Health and Environmental Research Online (HERO)) using a standardized search string for all studies published between 1 January 2017 and 13 April 2022. Risk of bias was assessed by two independent reviewers. Data were extracted and reviewed by multiple reviewers. Each study was summarized under its outcome in terms of methodology and results and placed in context, with recommendations for future research. Of 1712 records identified, 30 were eligible, with a total of 27,901 participants (33 datasets, as three studies included multiple outcomes). There was no effect of background levels of PFAS on fertility. There were weakly to moderately increased odds of preterm birth with higher perfluorooctane sulfonic acid (PFOS) levels; the same for miscarriage with perfluorooctanoic acid (PFOA) levels. There was limited yet suggestive evidence for a link between PFAS and early menopause and primary ovarian insufficiency; menstrual cycle characteristics were inconsistent. PFAS moderately increased odds of PCOS- and endometriosis-related infertility, respectively. Sperm motility and DNA health were moderately impaired by multiple PFAS. Fetal growth findings were inconsistent. This review may be used to inform forthcoming drinking water standards and policy initiatives regarding PFAS compounds and drinking water. Future reviews would benefit from more recent studies. Larger studies in these areas are warranted. Future studies should plan large cohorts and open access data availability to capture small effects and serve the public. Funding: Great Lakes Water Authority (Detroit, MI), the Erb Family Foundation through Healthy Urban Waters at Wayne State University (Detroit, MI), and Wayne State University CLEAR Superfund Research (NIH P42ES030991).

Suggested Citation

  • Alex Haimbaugh & Danielle N. Meyer & Mackenzie L. Connell & Jessica Blount-Pacheco & Dienye Tolofari & Gabrielle Gonzalez & Dayita Banerjee & John Norton & Carol J. Miller & Tracie R. Baker, 2024. "Environmental Exposure to Per- and Polyfluorylalkyl Substances (PFASs) and Reproductive Outcomes in the General Population: A Systematic Review of Epidemiological Studies," IJERPH, MDPI, vol. 21(12), pages 1-42, December.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:12:p:1615-:d:1535337
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    References listed on IDEAS

    as
    1. 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.
    2. Tuck Seng Cheng & Felix R Day & Rajalakshmi Lakshman & Ken K Ong, 2020. "Association of puberty timing with type 2 diabetes: A systematic review and meta-analysis," PLOS Medicine, Public Library of Science, vol. 17(1), pages 1-20, January.
    3. Maria Skaalum Petersen & Jónrit Halling & Niels Jørgensen & Flemming Nielsen & Philippe Grandjean & Tina Kold Jensen & Pál Weihe, 2018. "Reproductive Function in a Population of Young Faroese Men with Elevated Exposure to Polychlorinated Biphenyls (PCBs) and Perfluorinated Alkylate Substances (PFAS)," IJERPH, MDPI, vol. 15(9), pages 1-14, August.
    4. Jurgen Buekers & Ann Colles & Christa Cornelis & Bert Morrens & Eva Govarts & Greet Schoeters, 2018. "Socio-Economic Status and Health: Evaluation of Human Biomonitored Chemical Exposure to Per- and Polyfluorinated Substances across Status," IJERPH, MDPI, vol. 15(12), pages 1-17, December.
    5. Pheruza Tarapore & Bin Ouyang, 2021. "Perfluoroalkyl Chemicals and Male Reproductive Health: Do PFOA and PFOS Increase Risk for Male Infertility?," IJERPH, MDPI, vol. 18(7), pages 1-20, April.
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