Cited by 123Per- and polyfluoroalkyl substances researchAsthma and respiratory diseasesIndoor Air Quality and Microbial Exposure

Perfluoroalkyl substances, airways infections, allergy and asthma related health outcomes–implications of gender, exposure period and study design

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Kvalem, H.E., Nygaard, U.C., Lødrup Carlsen, K.C., Carlsen, K.H., Haug, L.S., Granum, B.·2020·Environment International

Abstract

INTRODUCTION: Exposure to perfluoroalkyl substances (PFASs) has been inconsistently associated with asthma, allergic diseases and airways infections in early childhood. The aim of the study was, therefore, to investigate the effect of childhood exposure to PFASs on asthma and allergy related outcomes and on airways infections before and during puberty using the prospective birth cohort Environment and Childhood Asthma (ECA) Study. Aspects of gender, exposure period and study design (cross-sectional and longitudinal) were also taken into consideration. MATERIAL AND METHODS: Included in the study was 378 participants with PFAS measurements at age 10 years and follow-up data at ages 10 years (cross sectional data) and 16 years (longitudinal data). Eight PFASs with at least 70% of measurements above the limit of quantification (LOQ) in the child's serum were included in the present study: perfluoroheptanoate (PFHpA), perfluorooctanoate (PFOA), perfluourononanoate (PFNA), perfluorodecanoate (PFDA), perfluoroundecanoate (PFUnDA), perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS) and perfluorooctane sulfonate (PFOS). The PFAS levels were converted into interquartile range (IQR). In addition, perfluorooctane sulfonamide (PFOSA) detected in 60% of the samples, was recoded into "not detected /detected". Binomial, multinomial and linear regression were used, followed by Bonferroni adjustment to correct for multiple comparisons. Sensitivity analyses evaluating the effect of extreme PFAS values and gender were performed. RESULTS: In the cross sectional data at 10 years a positive statistically significant association was seen between PFHpA and asthma in girls. In the longitudinal data, PFNA, PFDA and PFUnDA were inversely associated with atopic dermatitis (AD) in girls and with PFHxS in all participants and in boys. Further, PFNA and PFHpS were positively associated with rhinitis in girls and with PFOA in all participants. There seems to be a suggestive pattern of increased risk of allergic sensitisation in all participants and a decreased risk in boys, but due to different results in main and sensitivity analyses these findings should be interpreted with caution. No associations were found between PFASs and lung function. For airways infections and longitudinal data, PFDA was inversely associated with common cold, while positive association was found for PFHpA, PFOA, PFHpS and PFOS and lower respiratory tract infections (LRTI). DISCUSSION AND CONCLUSION: Our results lend further support for an immunosuppressive effect of PFASs on AD and LRTI. Gender seems to be important for some exposure-health associations. No clear pattern in exposure-health associations was observed with regard to exposure period or study design, with the exception of asthma where significant findings have mostly been reported in cross-sectional studies.

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  1. EFSA-CONTAM-Panel Risk to human health related to the presence of perfluorooctane sulfonic acid and perfluorooctanoic acid in food Helle, J.A. et al. (Ed.). 2018. EFSA Journal.

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Authors
Kvalem, H. E., Nygaard, U. C., Lødrup Carlsen, K. C., Carlsen, K. H., Haug, L. S., & Granum, B.
Affiliations
  • Norwegian Institute of Public Health (NO)
  • Oslo University Hospital (NO)
Corresponding author
Granum, B.
Venue
Environment International
Publisher
Elsevier BV
Published
2020-01
Volume
134
Pages
105259
ISSN
0160-4120 (ISSN-L)
OpenAlex
W2989497657
Cited by
123
References
32
Citations by year
2026: 18 · 2025: 24 · 2024: 29 · 2023: 22 · 2022: 13 · 2021: 10 · 2020: 7
FWCI
3.27
Type
journal article
Language
en
Open access
Locations
  • Environment International (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
Funders
Norges Forskningsråd
Topics
  • Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Keywords
perfluorinated compounds, PFAS exposure, childhood asthma, allergic rhinitis, atopic dermatitis, airway infection, allergen sensitization, gender differences, puberty, perfluorooctanoic acid, PFOS, PFHxS
MeSH terms
Asthma, Child, Cross-Sectional Studies, Environmental Pollutants, Female, Fluorocarbons, Humans, Hypersensitivity, Infections, Male, Prospective Studies, Sexual Maturation, Outcome Assessment, Health Care, Alkanesulfonic Acids

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