Polyfluoroalkyl Chemicals and Menopause among Women 20–65 Years of Age (NHANES)

Office of Health Assessment and Translation, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
Environmental Health Perspectives (Impact Factor: 7.98). 11/2013; 122(2). DOI: 10.1289/ehp.1306707
Source: PubMed


Polyfluoroalkyl chemicals (PFCs) such as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) have been associated with early menopause. However, previous cross sectional studies have lacked adequate data to investigate possible reverse causality, i.e., higher serum concentrations due to decreased excretion after menopause.
We investigate the association between PFOS, PFOA, perfluorononanoate (PFNA), and perfluorohexane sulfonate (PFHxS) and age at natural menopause among women ages 20-65 in NHANES.
We used proportional hazard models to estimate hazard ratios (HR) for the onset of natural menopause as a function of age and serum PFC levels, and to investigate reverse causation by estimating associations between PFC levels and rate of hysterectomy. We also used multivariable linear regression to determine whether time since menopause predicted serum PFC levels.
After adjusting for age at survey, race/ethnicity, education, ever smoking, and parity, women with higher levels of PFCs had earlier menopause compared to women with the lowest levels. We observed a monotonic association with PFHxS: the HR was 1.42 (95% CI: 1.08, 1.87) for serum concentrations in the 2(nd) vs. 1(st) tertile, and 1.70 (95% CI: 1.36, 2.12) for the 3(rd) vs. 1(st) tertile. We also found evidence of reverse causation: PFCs were positively associated with rate of hysterectomy, and time since natural menopause was positively associated with serum PFCs.
Our findings suggest a positive association between PFCs and menopause; however, at least part of the association may be due to reverse causation. Regardless of underlying cause, women appear to have higher PFC concentrations after menopause.

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Available from: Kristina Thayer, Jul 05, 2014
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    • "A large number of studies have reported on the presence of multiple compounds in human body fluids (Calafat et al. 2007; NHANES 2013), clearly showing that they are taken up by the body through various routes. Also, epidemiological studies have shown strong associations between compound mixtures and diseases , for instance in relation to human reproduction (Krysiak-Baltyn et al. 2012; Taylor et al. 2014). Therefore, since animal studies have shown effects of human relevant mixtures of environmental compounds given at doses close to No Observed Adverse Effect Levels (NOAELs) for single compounds (Christiansen et al. 2008, 2012; Axelstad et al. 2014), the presence of many of these chemicals simultaneously is of real concern to human health. "
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    • "It has been found that occupational exposure to PFOS and PFOA is associated with an elevated cancer (such as bladder and colorectal cancer) morbidity rate (Alexander et al. 2003; Innes et al. 2014). Epidemiological investigations in the general population have revealed that elevated concentrations of serum PFOS and PFOA are associated with thyroid disease, atopic diseases, low birth weight, menopause, impairment of semen quality, as well as an increased prevalence of attentiondeficit hyperactivity disorder and infectious diseases in children (Apelberg et al. 2007; Darrow et al. 2013; Dong et al. 2013; Humblet et al. 2014; Taylor et al. 2014; Vested et al. 2013; Hoffman et al. 2010; Okada et al. 2012). Furthermore, one recent investigation has provided a profile of PFOS immunotoxicity, showing effects at levels 14-fold lower than the average blood concentrations of occupationally exposed humans and in the upper range of concentrations reported for the general population (Peden-Adams et al. 2008). "
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