Cited by 21Per- and polyfluoroalkyl substances researchEffects and risks of endocrine disrupting chemicalsSynthesis and properties of polymers

Environmental Exposure to Per- and Polyfluorylalkyl Substances (PFASs) and Reproductive Outcomes in the General Population: A Systematic Review of Epidemiological Studies

Open access
Haimbaugh, Alex, Meyer, Danielle N., Connell, Mackenzie L., Blount-Pacheco, Jessica, Tolofari, Dienye, Gonzalez, Gabrielle, Banerjee, Dayita, Norton, John +2 more·2024·International Journal of Environmental Research and Public Health

Abstract

This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review synthesized effects of background levels of per- and polyfluorylalkyl substance (PFAS) levels on reproductive health outcomes in the general public: fertility, preterm birth, miscarriage, ovarian health, menstruation, menopause, sperm health, and in utero fetal growth. The inclusion criteria included original research (or primary) studies, human subjects, and investigation of outcomes of interest following non-occupational exposures. It drew from four databases (Web of Science, PubMed, Embase and Health and Environmental Research Online (HERO)) using a standardized search string for all studies published between 1 January 2017 and 13 April 2022. Risk of bias was assessed by two independent reviewers. Data were extracted and reviewed by multiple reviewers. Each study was summarized under its outcome in terms of methodology and results and placed in context, with recommendations for future research. Of 1712 records identified, 30 were eligible, with a total of 27,901 participants (33 datasets, as three studies included multiple outcomes). There was no effect of background levels of PFAS on fertility. There were weakly to moderately increased odds of preterm birth with higher perfluorooctane sulfonic acid (PFOS) levels; the same for miscarriage with perfluorooctanoic acid (PFOA) levels. There was limited yet suggestive evidence for a link between PFAS and early menopause and primary ovarian insufficiency; menstrual cycle characteristics were inconsistent. PFAS moderately increased odds of PCOS- and endometriosis-related infertility, respectively. Sperm motility and DNA health were moderately impaired by multiple PFAS. Fetal growth findings were inconsistent. This review may be used to inform forthcoming drinking water standards and policy initiatives regarding PFAS compounds and drinking water. Future reviews would benefit from more recent studies. Larger studies in these areas are warranted. Future studies should plan large cohorts and open access data availability to capture small effects and serve the public. Funding: Great Lakes Water Authority (Detroit, MI), the Erb Family Foundation through Healthy Urban Waters at Wayne State University (Detroit, MI), and Wayne State University CLEAR Superfund Research (NIH P42ES030991).

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3390/ijerph21121615

Cites

200 of 201 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • PFAS exposure is associated with reproductive harm, including impaired fertility, miscarriage, and developmental issues, with high risk in pregnant women and children.

    “| Reproductive | Impaired fertility, miscarriage, developmental issues. | High | Pregnant women, children | Long-term fertility issues | [224] |”

    From Industrial Applications, Environmental Fate, Human Exposure, and Health Effects of PFAS (2025) · cites this paper as [224]

    The Conclusions report weak-to-moderate evidence for miscarriage and some infertility-related outcomes, and the Introduction identifies pregnancy as a sensitive period for mother and fetus. But the review found no effect on all-cause fertility and inconsistent fetal-growth findings. It does not establish an overall “high” risk for pregnant women and children or long-term fertility issues. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. [87]The BMJ Correlation and Regression Available online: https://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one/11-correlation-and-regression (accessed on 14 September 2024)
  2. [198]World Health Organization Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction 4th ed. World Health Organization Cambridge, UK 1999

Cited by

Sorted by citations

Authors
Haimbaugh, A., Meyer, D. N., Connell, M. L., Blount-Pacheco, J., Tolofari, D., Gonzalez, G., Banerjee, D., Norton, J., Miller, C. J., & Baker, T. R.
Affiliations
  • Wayne State University (US)
  • University of Florida Health (US)
  • Great Lakes Water Authority (US)
Corresponding author
Baker, Tracie R.
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2024-12-02
Volume
21
Issue
12
Pages
1615
ISSN
1660-4601 (ISSN-L)
OpenAlex
W4404915882
Cited by
21
References
200
Citations by year
2026: 16 · 2025: 5
FWCI
0.67
Type
journal article
Language
en
Open access
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • Great Lakes Water Authority (GLWA) (NIH P42ES030991)
  • Erb Family Foundation through Healthy Urban Waters at Wayne State University, and Wayne State University CLEAR Superfund Research (NIH P42ES030991)
  • NIH Superfund (NIH P42ES030991)
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 › Materials Science › Polymers and Plastics › Synthesis and properties of polymers
Keywords
per- and polyfluoroalkyl substances, PFAS exposure, reproductive outcomes, fertility, preterm birth, miscarriage, perfluorooctanoic acid, PFOS, early menopause, primary ovarian insufficiency, menstrual cycle, polycystic ovary syndrome, endometriosis, sperm motility, sperm DNA damage, fetal growth, drinking water standards, general population
MeSH terms
Environmental Exposure, Environmental Pollutants, Female, Fluorocarbons, Humans, Male, Pregnancy, Reproduction

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 ›

Are you an author, or do you see a problem with this page? Request a review