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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    • "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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    ABSTRACT: Perfluorinated compounds (PFCs), such as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA), are a family of commonly used industrial chemicals whose persistence and ubiquity in blood samples of humans and wildlife have become a growing concern. Despite PFOS and PFOA having been found in human blood and tissue samples from occupationally exposed workers and the general worldwide population, little systematic knowledge has accrued with respect to exposure levels in Uyghurs in the Sinkiang-Uighur Autonomous Region of China, which is predominantly agricultural and pastoral. Our goal was to provide background data for biological monitoring in the general population of this region. In this study, 110 self-reported healthy human serum samples were collected from nonoccupationally exposed Uyghurs volunteers and analyzed by microbore HPLC-electrospray tandem mass spectrometry. Among the 110 blood specimens, PFOS was detected in 102 samples (93 %) and ranged from the lower limit of quantification of 0.01 to 22.63 μg/L with a median of 1.93 μg/L (interquartile range 1.00-3.43 μg/L). The median was higher among males (2.39 μg/L; interquartile range 1.23-4.40 μg/L) than that among females (1.20 μg/L; interquartile range 0.83-2.77 μg/L). No significant difference was observed with respect to age. The concentration of PFOA was lower than that of PFOS and was found only in seven samples (6 %) at concentrations above the limit of quantification. This study is the first investigation to reveal serum PFOS and PFOA levels in the general population of Uyghurs. PFOS and PFOA concentrations found in the present investigation were lower than those found in recent studies consisting of subjects from different geographic locations (PFOS 5.0-44.7 μg/L, PFOA 1.5-10 μg/L).
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    ABSTRACT: A total of 100 serum samples from 50 new couples (none of the females in this study has ever been pregnant) in Tianjin, North China, were analyzed for eleven perfluoroalkyl acids (PFAAs) with isomer-specific method. Among all samples, total perfluorooctanesulfonate (∑PFOS, mean 11.3ng/mL) was predominant followed by total perfluorooctanoate (∑PFOA, 2.95ng/mL), perfluorodecanoate (PFDA, 1.17ng/mL), perfluorononanoate (PFNA, 0.93ng/mL) and perfluorohexanesulfonate (PFHxS, 0.67ng/mL). The mean concentrations of ∑PFOS and PFHxS in males (14.2 and 0.89ng/mL) were significantly higher (p=0.001) than in females (8.36 and 0.45ng/mL). No statistical difference between genders was observed for the other PFAAs. This suggests that menstruation is one important elimination pathway for ∑PFOS and PFHxS in females. Linear PFOA was the dominant isomer with mean proportion of 99.7%, suggesting that telomeric PFOA (and its precursors), which contains almost pure linear isomer, might be the dominant exposure source of PFOA in Tianjin. On average, the proportion of linear PFOS (n-PFOS) was 59.2% of ∑PFOS, which was lower than that in technical PFOS products (ca. 70% linear). Except perfluoroisopropyl PFOS, all the other monomethyl branched PFOS isomers were enriched in human serum compared to the commercial products, suggesting the monomethyl branched PFOS precursors were preferentially biotransformed in humans.
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