Early-life exposure to per- and poly-fluorinated alkyl substances and growth, adiposity, and puberty in children: a systematic review
Open accessAbstract
Per- or polyfluoroalkyl substances (PFAS), a family of synthetic polyfluorinated compounds, are widely used in consumer products. Ubiquitous exposures to PFAS, in consideration of their persistence, bioaccumulation potential, and toxicities have led to concerns regarding possible harmful effects during critical periods of development in early-life and long-term consequences on health. The potential effects of PFAS depend on various factors including the type of PFAS and the timing and level of exposure. We performed a systematic review of the epidemiologic literature to assess the effects of early-life PFAS exposure on prenatal and postnatal growth, adiposity, and puberty in children and adolescents. For birth size, most studies indicated that prenatal PFAS exposure, in particular long-chain PFAS, may impair fetal growth, albeit some reports of null associations with maternal PFAS. For growth within 2 years of age, prenatal PFAS exposure showed no associations with height and either null or negative associations with weight. However, postnatal PFAS exposures were inversely related to height and weight at 2 years in a cross-sectional study. For postnatal adiposity, prenatal PFAS may mostly have negative associations with body mass index in the first 2 years of life, but positive relationships with adiposity in childhood and adolescence, although some studies showed null associations. For puberty, the evidence for associations between early-life PFAS exposure and pubertal development or sex hormone levels were limited and inconclusive. From experimental studies, plausible mechanisms through which PFAS may affect early-life growth and puberty include PFAS-induced activation of peroxisome proliferator-activated receptor, alterations of thyroid or steroid hormone synthesis and metabolism, and their weak estrogenic or anti-androgenic properties. Although the published literature suggests possible effects of PFAS exposures on early-life growth, adiposity, and puberty, current human evidence is limited in establishing PFAS-induced effects on early-life physical development. Further investigation is warranted to clarify PFAS-induced effects on growth and physical development in consideration of the critical time-window of exposure, concomitant exposure to chemical mixtures including various PFAS types, and possible non-monotonic dose-response relationship for growth and adiposity trajectories.
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Children and adolescents likely have higher PFAS body burdens.
“Children and adolescents should be considered separately when estimating PFAS half-lives, as they likely have higher PFAS body burdens (Lee et al., 2021)”
From Estimation of per- and polyfluoroalkyl substances (PFAS) half-lives in human studies: a systematic review and meta-analysis (2024) · cites this paper as Lee et al., 2021
The Introduction says young children are likely to have higher PFAS body burdens than adults and gives reasons for that comparison. It does not extend the statement to adolescents or recommend estimating their PFAS half-lives separately. (LLM, conf=0.88)
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- Authors
- Lee, Y. J., Jung, H. W., Kim, H. Y., Choi, Y.-J., & Lee, Y. A.
- Affiliations
- Seoul National University (KR)
- Kyung Hee University Medical Center (KR)
- Corresponding author
- Lee, Young Ah
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2021-09-09
- Volume
- 12
- Pages
- 683297-683297
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC8458955
- OpenAlex
- W3198357729
- Cited by
- 96
- References
- 137
- Citations by year
- 2026: 19 · 2025: 21 · 2024: 17 · 2023: 32 · 2022: 5 · 2021: 2
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Research Foundation of Korea
- Seoul National University Hospital
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Keywords
- per- and polyfluoroalkyl substances, PFAS exposure, early life exposure, prenatal exposure, postnatal growth, birth size, childhood adiposity, puberty, sex hormones, peroxisome proliferator-activated receptors, thyroid hormone metabolism, endocrine disruption, body mass index, developmental toxicity
- MeSH terms
- Carboxylic Acids, Child, Child Development, Environmental Exposure, Environmental Pollutants, Fluorocarbons, Humans, Puberty, Gonadal Steroid Hormones, Alkanesulfonic Acids, Fetal Development, Adiposity
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