Per-and polyfluoroalkyl substances (PFAS) and immune system-related diseases: Results from the Flemish Environment and Health Study (FLEHS) 2008–2014
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Abstract Background The successive FLEHS campaigns assess internal exposure to pollutants and associated early biological and health effects in participants of different age groups. Materials and methods Mother–newborn pairs (N = 220 in 2008–2009, age 18–42 years; N = 269 in 2013–2014, age 18–44 years), 197 adolescents 14–15 years (2010–2011), 201 adults 20–40 years (2008–2009) and 205 adults 50–65 years (2014) were recruited. For the various groups of subjects different sets of PFAS were assessed. Perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorobutane sulfonate (PFBS) were determined in cord plasma and peripheral serum as these were the PFAS compounds for which we had access to high quality measurements and which were expected to be present in the highest concentrations. Participants filled out a questionnaire based on the European Community Respiratory Health Survey questionnaire on asthma and allergy. In these cross-sectional studies associations were assessed using stepwise multiple logistic regression, with confounders (including smoking and familial occurrence of the disease) and potential covariates selected on the basis of experience in our previous studies and a literature search. Forest plots of odds ratios summarize the associations between the various PFAS on the one hand and the different immune outcomes on the other hand. Results For several self-reported immune system-related diseases inverse associations with PFAS serum concentrations were observed. These inverse associations were more pronounced in mothers and adults than in adolescents. A significant inverse association was observed in adults and mothers (for mothers based on measurements on cord plasma) between PFNA, PFOS, and PFHxS and asthma (for mothers also for PFOA), in mothers between PFHxS, PFNA and PFOS and allergic rhinitis, in mothers and adults between PFHxS and PFOS and some forms of allergy (for mothers also for PFOA), in adults between PFOA and eczema, and in adolescents between PFOS and systemic allergy. Conclusion Internal exposure to PFAS was associated with changes in immunological processes consistent with what has been reported in the literature. Whereas these changes were observed in many publications to be associated with adverse health effects, our findings suggest that they can also lead to inverse associations with certain immune system-related diseases.
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Children face increased risks of respiratory, immune, and developmental issues from PFAS exposure.
“children face increased risks of respiratory, immune, and developmental issues”
From Industrial Applications, Environmental Fate, Human Exposure, and Health Effects of PFAS (2025) · cites this paper as [233]
The Background (page not provided) says PFAS may have immunotoxic effects, might cause developmental effects, and may pose greater risks in early life. The Discussion reports some positive associations with childhood asthma and evidence of weaker vaccine responses or more infections, but also describes inverse associations and says the evidence for an asthma link is insufficient. The claim overstates these qualified, mixed findings as established increased risks across all three categories. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPFAS exposure reduces immune function and increases autoimmune diseases, with high risk in children.
“| Immune System | Reduces immune function, increases autoimmune diseases. | High | Children | Long-term immune dysfunction | [233] |”
From Industrial Applications, Environmental Fate, Human Exposure, and Health Effects of PFAS (2025) · cites this paper as [233]
The Discussion (page unavailable) says PFAS can disturb immune regulation and cites evidence of weaker vaccine responses and increased infection risk. It says endocrine-disrupting compounds such as PFAS can lead to autoimmune disease, but does not establish that PFAS increases autoimmune disease in this study. It also does not establish that children face higher risk than other groups or that the dysfunction is long-term. (LLM, conf=0.86)
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Crépet, A., McKeon, H., Angeli, K., Bil, W., Cox, B., Govarts, E., McVey, E. A., Palmont, P., Vrijenhoek, N., Kruisselbrink, J. W., et al. (2026) · Environment International · doi:10.1016/j.envint.2026.110560
- Authors
- van Larebeke, N., Koppen, G., De Craemer, S., Colles, A., Bruckers, L., Den Hond, E., Govarts, E., Morrens, B., Schettgen, T., Remy, S., Coertjens, D., Nawrot, T., Nelen, V., Baeyens, W., & Schoeters, G.
- Affiliations
- Flemish Institute for Technological Research (BE)
- Hasselt University (BE)
- University of Antwerp (BE)
- RWTH Aachen University (DE)
- Provincial Institute for Hygiene (BE)
- Vrije Universiteit Brussel (BE)
- ORCID
- Venue
- Environmental Sciences Europe
- Published
- 2023-04-21
- Volume
- 35
- Issue
- 1
- ISSN
- 2190-4715 (ISSN-L)
- OpenAlex
- W4366774373
- Cited by
- 23
- References
- 55
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 11
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Environmental Sciences Europe (publishedVersion, cc-by)
- Document Server@UHasselt (UHasselt) (submittedVersion, cc-by)
- Lirias (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Vlaamse regering
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Fluorine in Organic Chemistry
- Physical Sciences › Materials Science › Polymers and Plastics › Synthesis and properties of polymers
- Keywords
- per- and polyfluoroalkyl substances, PFAS, asthma, allergic rhinitis, atopic dermatitis, allergy, perfluorooctanoic acid, PFOS, PFHxS, PFBS, cord plasma, serum concentration, internal radiation exposure
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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