A Review of the Pathways of Human Exposure to Poly- and Perfluoroalkyl Substances (PFASs) and Present Understanding of Health Effects

By E. Sunderland, Xindi C. Hu, Clifton Dassuncao, Andrea K. Tokranov, Charlotte C. Wagner, Joseph G. Allen. Journal of Exposure Science and Environmental Epidemiology, 2018

2,189 citations recorded by the source corpus.

Here, we review present understanding of sources and trends in human exposure to poly- and perfluoroalkyl substances (PFASs) and epidemiologic evidence for impacts on cancer, immune function, metabolic outcomes, and neurodevelopment. More than 4000 PFASs have been manufactured by humans and hundreds have been detected in environmental samples. Direct exposures due to use in products can be quickly phased out by shifts in chemical production but exposures driven by PFAS accumulation in the ocean and marine food chains and contamination of groundwater persist over long timescales. Serum concentrations of legacy PFASs in humans are declining globally but total exposures to newer PFASs and precursor compounds have not been well characterized. Human exposures to legacy PFASs from seafood and drinking water are stable or increasing in many regions, suggesting observed declines reflect phase-outs in legacy PFAS use in consumer products. Many regions globally are continuing to discover PFAS contaminated sites from aqueous film forming foam (AFFF) use, particularly next to airports and military bases. Exposures from food packaging and indoor environments are uncertain due to a rapidly changing chemical landscape where legacy PFASs have been replaced by diverse precursors and custom molecules that are difficult to detect. Multiple studies find significant associations between PFAS exposure and adverse immune outcomes in children. Dyslipidemia is the strongest metabolic outcome associated with PFAS exposure. Evidence for cancer is limited to manufacturing locations with extremely high exposures and insufficient data are available to characterize impacts of PFAS exposures on neurodevelopment. Preliminary evidence suggests significant health effects associated with exposures to emerging PFASs. Lessons learned from legacy PFASs indicate that limited data should not be used as a justification to delay risk mitigation actions for replacement PFASs.

Subfields: Environmental Chemistry, Health, Toxicology and Mutagenesis

View Paper: https://www.semanticscholar.org/paper/da9ab49d9dc184966e90b5c960d678e87cb4df51

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In Environmental Chemistry

1. Qingyang Shi
2. X. Jiao
3. J. Gan
4. Zhanyun Wang

In Health, Toxicology and Mutagenesis

1. Qingyang Shi
2. X. Jiao
3. J. Gan
4. Zhanyun Wang
5. E. Sunderland

Citations in the corpus

• Per- and polyfluoroalkyl substances in the environment (2022, positive): “PFAS exposures via food chains are more difficult to resolve, and dietary exposure through drinking water and contaminated food sources (e.g., seafood and other animal products) are among the greatest exposure sources for ecosystems and human populations alike (109, 111).”
• Uptake, accumulation and metabolism of PFASs in plants and health perspectives: A critical review (2020, background): “It is widely agreed that dietary exposure is a major exposure route of PFASs in general populations (Domingo & Nadal, 2017; Sunderland et al., 2019; Vestergren et al., 2012).”
• PFAS Exposure Pathways for Humans and Wildlife: A Synthesis of Current Knowledge and Key Gaps in Understanding (2020, background): “The volume of research publications over the past decade identifying PFAS in environmental media, humans, and wildlife is staggering, with several comprehensive review publications (Houde et al. 2011; Jian et al. 2018; Sunderland et al. 2019; Wang et al. 2019).”
• Per- and polyfluoroalkyl substances in water and wastewater: A critical review of their global occurrence and distribution (2021, methodology): “For instance, (Rayne and Forest, 2009; Houde et al., 2011; Ahrens, 2011; Ahrens and Bundschuh, 2014; Rahman et al., 2014; Jian et al., 2017; Xiao, 2017; Sunderland et al., 2019; Vo et al., 2020; Schulz et al., 2020; Winchell et al., 2021), reviewed the occurrence, fate, effect, exposure of PFAS in t”