Childhood Exposure to Per- and Polyfluoroalkyl Substances (PFAS) and Neurobehavioral Domains in Children at Age 8 Years
Open accessAbstract
BACKGROUND: Toxicological studies have raised concerns regarding the neurotoxic effects of per- and polyfluoroalkyl substances (PFAS). However, observational evidence from human studies investigating the association between childhood PFAS and neurobehavior is limited and remains unclear. OBJECTIVES: To examine whether childhood PFAS concentrations are associated with neurobehavior in children at age 8 years and whether child sex modifies this relationship. METHODS: We used data from 208 mother-child dyads in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort (Cincinnati, OH, USA). We quantified PFAS in child serum at 3 and 8 years. We assessed neurobehavioral domains using the Behavior Assessment System for Children-2 at 8 years. We used multiple informant models to estimate score changes per ln-increase in repeated PFAS concentrations. RESULTS: Childhood PFAS were not associated with Externalizing or Internalizing Problems at 8 years. However, we noted effect measure modification by sex, with higher scores in Externalizing Problems among males per ln-unit increase in perfluorononanoate (PFNA) at 3 years (β = 4.3 points, 95% CI: 1.0, 7.7) while females had lower scores (β = -2.8 points, 95% CI: -4.7, -1.0). More Internalizing Problems were observed among males per ln-unit increase in concurrent PFNA concentrations (β = 3.7 points, 95% CI: 0.7, 6.8), but not in females (β = -1.7 points, 95% CI: -4.6, 1.2). Childhood PFNA concentrations were associated with lower scores for attention problems and activity of daily living. CONCLUSION: While findings do not consistently support an association between childhood PFAS serum concentrations and neurobehavior, child sex may play a role in this relationship.
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Studies have shown that trace amounts of PFASs can migrate from polymer coatings or plastic components into fluids administered intravenously or via enteral feeding, raising potential toxicological and bioaccumulation risks.
“Studies have shown that trace amounts of PFASs can migrate from polymer coatings or plastic components into fluids administered intravenously or via enteral feeding, raising potential toxicological and bioaccumulation risks [5,34].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [34]
The Introduction (page unavailable) describes PFAS as persistent chemicals detected in human tissues and links them to health concerns. It does not address migration from polymer coatings or plastic components into intravenous or enteral fluids; searches for those routes found no supporting passage. The Results (page unavailable) report childhood PFAS body burdens, but not bioaccumulation from medical fluids. (LLM, conf=0.84)
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Research works printed but not linked: 1
- Sunderland EM, Hu XC, Dassuncao C, Tokranov AK, Wagner CC, Allen JG, 2019. A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects. J Expo Sci Environ Epidemiol 29(2), 131– 147. 30470793 PMC6380916
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- Authors
- Vuong, A. M., Yolton, K., Xie, C., Dietrich, K. N., Braun, J. M., Webster, G. M., Calafat, A. M., Lanphear, B. P., & Chen, A.
- Affiliations
- University of Nevada, Las Vegas (US)
- Cincinnati Children's Hospital Medical Center (US)
- University of Cincinnati (US)
- Brown University (US)
- Simon Fraser University (CA)
- Centers for Disease Control and Prevention (US)
- University of Pennsylvania (US)
- Corresponding author
- Vuong, Ann M.
- ORCID
- Venue
- Neurotoxicology and Teratology
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 88
- Pages
- 107022
- ISSN
- 0892-0362 (ISSN-L)
- PMC
- PMC8578387
- OpenAlex
- W3193420725
- Cited by
- 22
- References
- 51
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 4
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Neurotoxicology and Teratology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion, cc-by-nc-nd)
- Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (L32 MD015437, EPA P01 R829389)
- EPA
- NIEHS (R00 ES020346, P30ES006096, R01 ES028277, R01 ES020349, R01 ES024381, T32ES010957, R01 ES014575, P01 ES11261, R01 ES025214)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- per- and polyfluoroalkyl substances, PFAS, children's exposure, neurobehavior, externalizing problems, internalizing problems, attention deficits, activities of daily living, perfluorononanoate, sex differences, neurotoxicity, home study
- MeSH terms
- Birth Cohort, Child, Child, Preschool, Environmental Pollutants, Female, Fluorocarbons, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Prospective Studies, Sex Factors, Alkanesulfonic Acids
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