TY - JOUR
T1 - A critical review of perfluorooctanoate and perfluorooctanesulfonate exposure and immunological health conditions in humans
AU - Chang, Ellen T.
AU - Adami, Hans Olov
AU - Boffetta, Paolo
AU - Wedner, H. James
AU - Mandel, Jack S.
N1 - Publisher Copyright:
© 2016 Exponent, Inc. Published by Taylor & Francis.
PY - 2016/4/20
Y1 - 2016/4/20
N2 - Whether perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS), two widely used and biopersistent synthetic chemicals, are immunotoxic in humans is unclear. Accordingly, this article systematically and critically reviews the epidemiologic evidence on the association between exposure to PFOA and PFOS and various immune-related health conditions in humans. Twenty-four epidemiologic studies have reported associations of PFOA and/or PFOS with immune-related health conditions, including ten studies of immune biomarker levels or gene expression patterns, ten studies of atopic or allergic disorders, five studies of infectious diseases, four studies of vaccine responses, and five studies of chronic inflammatory or autoimmune conditions (with several studies evaluating multiple endpoints). Asthma, the most commonly studied condition, was evaluated in seven studies. With few, often methodologically limited studies of any particular health condition, generally inconsistent results, and an inability to exclude confounding, bias, or chance as an explanation for observed associations, the available epidemiologic evidence is insufficient to reach a conclusion about a causal relationship between exposure to PFOA and PFOS and any immune-related health condition in humans. When interpreting such studies, an immunodeficiency should not be presumed to exist when there is no evidence of a clinical abnormality. Large, prospective studies with repeated exposure assessment in independent populations are needed to confirm some suggestive associations with certain endpoints.
AB - Whether perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS), two widely used and biopersistent synthetic chemicals, are immunotoxic in humans is unclear. Accordingly, this article systematically and critically reviews the epidemiologic evidence on the association between exposure to PFOA and PFOS and various immune-related health conditions in humans. Twenty-four epidemiologic studies have reported associations of PFOA and/or PFOS with immune-related health conditions, including ten studies of immune biomarker levels or gene expression patterns, ten studies of atopic or allergic disorders, five studies of infectious diseases, four studies of vaccine responses, and five studies of chronic inflammatory or autoimmune conditions (with several studies evaluating multiple endpoints). Asthma, the most commonly studied condition, was evaluated in seven studies. With few, often methodologically limited studies of any particular health condition, generally inconsistent results, and an inability to exclude confounding, bias, or chance as an explanation for observed associations, the available epidemiologic evidence is insufficient to reach a conclusion about a causal relationship between exposure to PFOA and PFOS and any immune-related health condition in humans. When interpreting such studies, an immunodeficiency should not be presumed to exist when there is no evidence of a clinical abnormality. Large, prospective studies with repeated exposure assessment in independent populations are needed to confirm some suggestive associations with certain endpoints.
KW - Asthma
KW - CAS No. 1763-23-1
KW - CAS No. 335-67-1
KW - autoimmune diseases
KW - epidemiology
KW - hypersensitivity
KW - immune system
KW - immunization
KW - immunological factors
KW - infection
KW - perfluoroalkyl substances
KW - polyfluoroalkyl substances
UR - http://www.scopus.com/inward/record.url?scp=84954207170&partnerID=8YFLogxK
U2 - 10.3109/10408444.2015.1122573
DO - 10.3109/10408444.2015.1122573
M3 - Review article
C2 - 26761418
AN - SCOPUS:84954207170
SN - 1040-8444
VL - 46
SP - 279
EP - 331
JO - Critical Reviews in Toxicology
JF - Critical Reviews in Toxicology
IS - 4
ER -