PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents

Cristina Canova, Andrea Di Nisio, Giulia Barbieri, Francesca Russo, Tony Fletcher, Erich Batzella, Teresa Dalla Zuanna and Gisella Pitter
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Cristina Canova: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy
Andrea Di Nisio: Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35131 Padova, Italy
Giulia Barbieri: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy
Francesca Russo: Directorate of Prevention, Food Safety, and Veterinary Public Health-Veneto Region, 30123 Venice, Italy
Tony Fletcher: Public Health, Environments and Society Department, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
Erich Batzella: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy
Teresa Dalla Zuanna: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy
Gisella Pitter: Screening and Health Impact Assessment Unit, Azienda Zero-Veneto Region, 35131 Padua, Italy

IJERPH, 2021, vol. 18, issue 24, 1-18

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.

Keywords: perfluoroalkyl substances (PFAS); children; adolescents; lipid profile; cholesterol; generalized additive model (GAM); weighted quantile sum (WQS) regression; mixture (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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