Epidemiological perspectives on PFAS: Environmental fate, health risks, and global mitigation strategies
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Global economic growth and advances in science and technology have brought many conveniences to human life, but they have also increased environmental pollution, and its effects finally act on human health. Therefore, governments and researchers around the world are focusing on the risk assessment and control of emerging pollutants, trying to solve the problem of “pollute first, treat later”. This review takes per- and polyfluoroalkyl substances (PFAS), a type of emerging pollutant, as the research subject, and by sorting out their sources, environmental fate, biological transfer, and their effects on the Earth’s environment and human health, it explains the hazards of these compounds in a systematic way. It also compares traditional PFAS with new PFAS alternatives in some sections, clarifies the toxicity of the new alternatives, and summarizes potential low-toxic or non-toxic PFAS substitutes. In addition, this review summarizes the control policies and their effects in major countries around the world, aiming to identify more effective measures, promote the scientific management of PFAS, and achieve the concept of “One Health”, which coordinates the health of the Earth, animals, and humans. • The role of PFAS in MASLD and disrupted lipid metabolism. • Sex-specific impacts on reproductive and developmental systems. • Mechanisms of neurotoxicity involving neurotransmitter imbalance. • Immunosuppressive effects, particularly following prenatal exposure. • Carcinogenic pathways in liver, thyroid, breast, lung, and colorectal cancers.
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Multiple PFAS analytes detected in this study have been associated with adverse health effects in humans, including cancers, developmental delays, and reproductive dysfunction.
“Multiple PFAS analytes detected in this study have been associated with adverse health effects in humans, including cancers, developmental delays, and reproductive dysfunction.7,8”
From Per- and Polyfluoroalkyl Substances in Surface Water and Fluvial Sediments of a Rural Gulf Coast Watershed: A Year-long Spatiotemporal Assessment (2026) · cites this paper as [8]
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Abu-Salah, A., Cesur, M. F., Anchan, A., Ay, M., Langley, M. R., Shah, A., Reina-Gonzalez, P., Strazdins, R., Çakır, T., & Sarkar, S. (2024) · Environmental Science & Technology · doi:10.1021/acs.est.4c05472 · Cited by 25 · see citing works
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Association between per- and polyfluoroalkyl substances and semen quality
Wang, H., Wei, K., Wu, Z., Liu, F., Wang, D., Peng, X., Liu, Y., Xu, J., Jiang, A., & Zhang, Y. (2022) · Environmental Science and Pollution Research · doi:10.1007/s11356-022-24182-3 · Cited by 23 · see citing works
Self-citationAlsen, M., Leung, A. M., & van Gerwen, M. A. G. (2023) · Toxics · doi:10.3390/toxics11090786 · Cited by 21 · see citing works
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Self-citationShao, K., Shen, H., Chen, X., Shao, Z., Liu, Y., Wang, Y., Chen, H., & Wu, X. (2022) · International Immunopharmacology · doi:10.1016/j.intimp.2022.109518 · Cited by 19 · see citing works
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Association of Combined PFOA, PFOS, Metals and Allostatic Load on Hepatic Disease Risk
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Plasma perfluoroalkyl substances and breast cancer risk in Brazilian women: a case–control study
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Self-citationNing, A., Shao, F., Yang, Q., Ren, Y., Zhou, S., Lin, J., Chu, M., & Zhang, Y. (2026) · Toxicology Letters · doi:10.1016/j.toxlet.2026.111849 · Cited by 2 · see citing works
Self-citation
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Sorted by citations
Rodriguez, C. A., Schramm, M., Postma, S., McDonald, T. J., Brinkmeyer-Langford, C., & Ma, X. (2026) · ACS ES&T Water · doi:10.1021/acsestwater.6c00886
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“While legacy compounds are well‐studied and bioaccumulative, emerging PFAS may exhibit different exposure dynamics and health effects, contributing to inconsistencies across epidemiological findings [43, 44].”
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Self-citation
- Authors
- Liu, J., Ge, T., Luo, C., Ning, A., Xi, Y., Li, S., Gu, Q., Li, D., Zhang, X., Hou, Y., Chu, M., & Zhang, Y.
- Affiliations
- Nantong University (CN)
- Corresponding author
- Chu, Minjie
- Zhang, Yan
- Venue
- Ecotoxicology and Environmental Safety
- Publisher
- Elsevier BV
- Published
- 2026-04
- Volume
- 314
- Pages
- 120050
- ISSN
- 0147-6513 (ISSN-L)
- OpenAlex
- W7140867470
- Semantic Scholar
- a466589bf69f9e7ca3bc333253ca6d3f49e6d8db
- Cited by
- 6
- References
- 107
- Citations by year
- 2026: 6
- FWCI
- 3.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Ecotoxicology and Environmental Safety (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Graduate Research and Innovation Projects of Jiangsu Province (KYCX20_2852, KYCX23_3436, KYCX21_3126)
- Science and Technology Project of Nantong City (JC22022002, JC22022004, MS22022062)
- National Key Research and Development Program of China (2022YFC2503202)
- National Natural Science Foundation of China (82203771, 82273715)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Physical Sciences › Materials Science › Polymers and Plastics › Synthesis and properties of polymers
- Keywords
- per- and polyfluoroalkyl substances, PFAS, emerging contaminants, environmental fate, human health risk, PFAS alternatives, PFAS regulation, One Health, non-alcoholic fatty liver disease, lipid metabolism, reproductive toxicity, developmental toxicity, neurotoxicity, immunosuppression, prenatal exposure, carcinogenicity, liver cancer, thyroid cancer, breast cancer, lung cancer, colorectal cancer
- MeSH terms
- Animals, Environmental Exposure, Environmental Pollutants, Environmental Pollution, Fluorocarbons, Humans, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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