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Environmental Health Perspectives
volume 123 | number 5 | May 2015
A 107
Brief Communication
As scientists and other professionals from a variety of disciplines, we
are concerned about the production and release into the environ-
ment of an increasing number of poly- and perfluoroalkyl substances
(PFASs) for the following reasons:
1. PFASs are man-made and found everywhere. PFASs are highly
persistent, as they contain perfluorinated chains that only
degrade very slowly, if at all, under environmental conditions.
It is documented that some polyfluorinated chemicals break
down to form perfluorinated ones (D’Eon and Mabury 2007).
2. PFASs are found in the indoor and outdoor environments,
wildlife, and human tissue and bodily fluids all over the globe.
They are emitted via industrial processes and military and
firefighting operations (Darwin 2011; Fire Fighting Foam
Coalition 2014), and they migrate out of consumer products
into air (Shoeib et al. 2011), household dust (Björklund et al.
2009), food (Begley et al. 2008; Tittlemier et al. 2007; Trier
et al. 2011), soil (Sepulvado et al. 2011; Strynar et al. 2012),
ground and surface water, and make their way into drinking
water (Eschauzier et al. 2012; Rahman et al. 2014).
3. In animal studies, some long-chain PFASs have been found
to cause liver toxicity, disruption of lipid metabolism and
the immune and endocrine systems, adverse neurobehavioral
effects, neonatal toxicity and death, and tumors in mul-
tiple organ systems (Lau et al. 2007; Post et al. 2012). In the
growing body of epidemiological evidence, some of these
effects are supported by significant or suggestive associations
between specific long-chain PFASs and adverse outcomes,
including associations with testicular and kidney cancers
(Barry et al. 2013; Benbrahim-Tallaa et al. 2014), liver
malfunction (Gallo et al. 2012), hypo thyroidism (Lopez-
Espinosa et al. 2012), high cholesterol (Fitz-Simon et al.
2013; Nelson et al. 2009), ulcerative colitis (Steenland et al.
2013), lower birth weight and size (Fei et al. 2007), obesity
(Halldorsson et al. 2012), decreased immune response to vac-
cines (Grandjean et al. 2012), and reduced hormone levels
and delayed puberty (Lopez-Espinosa et al. 2011).
4. Due to their high persistence, global distribution, bio-
accumulation potential, and toxicity, some PFASs have been
listed under the Stockholm Convention (United Nations
Environment Programme 2009) as persistent organic
pollutants (POPs).
5. As documented in the Helsingør Statement (Scheringer
et al. 2014),
a. Although some of the long-chain PFASs are being regu-
lated or phased out, the most common replacements are
short-chain PFASs with similar structures, or compounds
with fluorinated segments joined by ether linkages.
b. While some shorter-chain fluorinated alternatives seem to
be less bioaccumulative, they are still as environ mentally
persistent as long-chain substances or have persistent deg-
radation products. us, a switch to short-chain and other
fluorinated alternatives may not reduce the amounts of
PFASs in the environment. In addition, because some of
the shorter-chain PFASs are less effective, larger quantities
may be needed to provide the same performance.
c. While many fluorinated alternatives are being marketed,
little information is publicly available on their chemical
structures, properties, uses, and toxicological profiles.
d. Increasing use of fluorinated alternatives will lead to increas-
ing levels of stable perfluorinated degradation products in the
environment, and possibly also in biota and humans. This
would increase the risks of adverse effects on human health
and the environment.
6. Initial efforts to estimate overall emissions of PFASs into the
environment have been limited due to uncertainties related to
product formulations, quantities of production, production
locations, efficiency of emission controls, and long-term trends
in production history (Wang et al. 2014).
7. e technical capacity to destroy PFASs is currently insufficient
in many parts of the world.
Global action through the Montreal Protocol (United Nations
Environment Programme 2012) success fully reduced the use of the
highly persistent ozone-depleting chloro fluorocarbons (CFCs), thus
allowing for the recovery of the ozone layer. However, many of the
or ganofluorine replacements for CFCs are still of concern due to their
high global warming potential. It is essential to learn from such past
efforts and take meas ures at the international level to reduce the use
of PFASs in products and prevent their replacement with fluorinated
alternatives in order to avoid long-term harm to human health and the
For these reasons, we call on the international community to
cooperate in limiting the production and use of PFASs and in devel-
oping safer nonfluorinated alternatives. We therefore urge scientists,
governments, chemical and product manufacturers, purchasing
organizations, retailers, and consumers to take the following actions:
1. Assemble, in collaboration with industry and governments, a
global inventory of all PFASs in use or in the environment,
including precursors and degradation products, and their
functionality, properties, and toxicology.
2. Develop analytical methods for the identification and quanti-
fication of additional families of PFASs, including fluorinated
3. Continue monitoring for legacy PFASs in different matrices and
for environmental reservoirs of PFASs.
4. Continue investigating the mechanisms of toxicity and exposure
(e.g., sources, fate, transport, and bioaccumulation of PFASs),
and improve methods for testing the safety of alternatives.
5. Bring research results to the attention of policy makers, industry,
the media, and the public.
1. Enact legislation to require only essential uses of PFASs, and
enforce labeling to indicate uses.
2. Require manufacturers of PFASs to
a. conduct more extensive toxicological testing,
b. make chemical structures public,
c. provide validated analytical methods for detection of
PFASs, and
d. assume extended producer responsibility and implement safe
disposal of products and stockpiles containing PFASs.
3. Work with industry to develop public registries of products con-
taining PFASs.
4. Make public annual statistical data on production, imports, and
exports of PFASs.
A Sectio n 508–co nformant HT ML version o f this articl e
is available at
The Madrid Statement on Poly- and
Perfluoroalkyl Substances (PFASs)
Brief Communication
A 108
volume 123 | number 5 | May 2015
Environmental Health Perspectives
5. Whenever possible, avoid products containing, or manu-
factured using, PFASs in government procurement.
6. In collaboration with industry, ensure that an infrastructure is
in place to safely transport, dispose of, and destroy PFASs and
PFAS-containing products, and enforce these measures.
Chemical manufacturers:
1. Make data on PFASs publicly available, including chemical
structures, properties, and toxicology.
2. Provide scientists with standard samples of PFASs, including
precursors and degradation products, to enable environmental
monitoring of PFASs.
3. Work with scientists and governments to develop safe disposal
methods for PFASs.
4. Provide the supply chain with documentation on PFAS content
and safe disposal guidelines.
5. Develop nonfluorinated alternatives that are neither persistent
nor toxic.
Product manufacturers:
1. Stop using PFASs where they are not essential or when safer
alternatives exist.
2. Develop inexpensive and sensitive PFAS quantification methods
for compliance testing.
3. Label products containing PFASs, including chemical identity
and safe disposal guidelines.
4. Invest in the development and use of nonfluorinated alternatives.
Purchasing organizations, retailers, and individual consumers:
1. Whenever possible, avoid products containing, or manufac-
tured using, PFASs. These include many products that are
stain- resistant, waterproof, or nonstick.
2. Question the use of such fluorinated “performance” chemicals
added to consumer products.
The views expressed in this statement are solely those of the authors and
signatories. The authors declare they have no actual or potential competing
financial interests.
Arlene Blum,1,2 Simona A. Balan,2 Martin Scheringer,3,4 Xenia Trier,5
Gretta Goldenman,6 Ian T. Cousins,7 Miriam Diamond,8 Tony Fletcher,9
Christopher Higgins,10 Avery E. Lindeman,2 Graham Peaslee,11
Pim de Voogt,12 Zhanyun Wang,4 and Roland Weber13
1Department of Chemistry, University of California at Berkeley, Berkeley, California,
USA; 2Green Science Policy Institute, Berkeley, California, USA; 3Leuphana University,
Lüneburg, Germany; 4Safety and Environmental Technology Group, Institute for
Chemical and Bioengineering, ETH Zürich, Zürich, Switzerland; 5Division of Food
Chemistr y, National Food Institute, Technical University of Denmark, Kongens Lyngby,
Denmark; 6European Centre on Sustainable Policies for Human and Environmental
Rights, Brussels, Belgium; 7Department of Applied Environmental Science, Stockholm
University, Stockholm, Sweden; 8Depar tment of Earth Sciences, Universit y of Toronto,
Toronto, Ontario, Canada; 9Department of Social and Environmental Health Research,
London School of Hygiene & Tropical Medicine, London, United Kingdom; 10 Department
of Civil and Environmental Engineering, Colorado School of Mines, Golden, Colorado,
USA; 11Chemistry D epartment, Hope College, Holland, Michigan, USA; 12 Institute
for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the
Netherlands; 13POPs Environmental Consulting, Schwäbisch Gmünd, Germany
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Brief Communication
Environmental Health Perspectives
volume 123 | number 5 | May 2015
A 109
Ovokeroye Abafe, Researcher, School
of Chemistry and Physics, University of
Kwazulu-Natal, Durban, South Africa
Marlene Ågerstrand, PhD, Researcher,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Lutz Ahrens, PhD, Research Scientist,
Department of Aquatic Sciences and
Assessment, Swedish University of
Agricultural Sciences, Uppsala, Sweden
Beatriz H. Aristizabal, PhD, Professor,
Department of Chemical Engineering,
National University of Colombia,
Manizales, Colombia
Abel Arkenbout, PhD, Chairman,
ToxicoWatch Foundation, Harlingen, the
Misha Askren, MD, Physician, Urgent
Care, Kaiser Permanente, Los Angeles,
California, USA
Jannicke Bakkejord, Senior Engineer,
National Institute of Nutrition and
Seafood Research, Bergen, Norway
Georg Becher, PhD, Professor Emeritus,
Department of Exposure and Risk
Assessment, Norwegian Institute of
Public Health, Oslo, Norway
ea Bechshoft, PhD, Postdoctoral
Fellow, University of Southern Denmark,
Odense, Denmark
Peter Behnisch, PhD, Director,
BioDetection System, A msterdam, the
Susanne Bejerot, MD, Assistant
Professor, Department of Clinical
Neuroscience, Karolinska Institute,
Stockholm, Sweden
Stephen Bent, MD, Associate Professor
of Medicine, Epidemiology and
Biostatistics, and Psychiatry, University
of California at San Francisco, San
Francisco, California, USA
Urs Berger, PhD, Associate Professor,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Åke Bergman, PhD, Executive Director
and Professor, Swedish Toxicology
Sciences Research Center, Södertälje,
Vladimir Beškoski, PhD, Assistant
Professor, Faculty of Chemistry,
University of Belgrade, Belgrade, Serbia
Emmanuelle Bichon, Scientific and
Technical Support Manager, Oniris,
Nantes-Atlantic College of Veterinary
Medicine, Food Science and Engineering,
Nantes, France
Filip Bjurlid, PhD Student, Man–
Technology–Environment Research
Centre, Örebro University, Örebro,
Tara Blank, PhD, Consultant, Elixir
Environmental, Ridgefield, Connecticut,
Daniel Borg, PhD, Toxicology
Consultant, Trossa AB, Stockholm,
Carl-Gustaf Bornehag, PhD, Professor,
Department of Health and Environment,
Karlstad University, Karlstad, Sweden
Hindrik Bouwman, PhD, Lecturer,
Zoology Group, North-West University,
Mahikeng, South Africa
Lindsay Bramwell, MSc, Research
Associate, Institute of Health and Society,
Newcastle University, Newcastle upon
Tyne, United Kingdom
Knut Breivik, PhD, Senior Scientist and
Professor, NILU–Nor wegian Institute for
Air Research, Kjeller, Norway
Katja Broeg, PhD, Researcher, Baltic
Sea Centre, Stockholm University,
Stockholm, Sweden
Phil Brown, PhD, University
Distinguished Professor of Sociology and
Health Sciences, and Director, Social
Science Environmental Hea lth Research
Institute, Northeastern University,
Boston, Massachusetts, USA
omas Bruton, MS, PhD Student,
Department of Civil and Environmental
Engineering, University of California,
Berkeley, Berkeley, California, USA
David Camann, MS, Technical
Advisor, Southwest Research Institute,
San Antonio, Texas, USA
Louise Camenzuli, PhD Student,
Safety and Environmental Technology
Group, Institute for Chemical and
Bioengineering, ETH Zürich, Zürich,
Argelia Castaño, PhD, Head of
Department, Area of Environmental
Toxicology, Instituto de Salud Carlos III,
Majadahonda, Spain
Carmela Centeno, Industrial
Development Officer, United Nations
Industrial Development Organization,
Vienna, Austria
Ibrahim Chahoud, PhD, Professor,
Department of Toxicology, Charité
Universitätsmedizin Berlin, Berlin,
Kai Hsien Chi, PhD, Associate
Professor, Institute of Environmental and
Occupational Health Sciences, National
Yang-Ming University, Taipei, Taiwan
Eliza Chin, MD, MPH, Executive
Director, American Medical Women’s
Association, Reston, Virginia, USA
Carsten Christophersen, PhD,
Adjunct Professor, Systems Biology,
Technical University of Denmark,
Kongens Lyngby, Denmark
eo Colborn (1927–2014), PhD,
President Emeritus, TEDX (e
Endocrine Disruption Exchange), Paonia,
Colorado, USA
Terrence J. Collins, PhD, Teresa
Heinz Professor of Green Chemistry,
Department of Chemistry, Carnegie
Mellon University, Pittsburgh, PA, USA;
and Director, Institute for Green Science,
Pittsburgh, Pennsylvania, USA
Johanna Congleton, MSPH, PhD,
Senior Scientist, Environmental Working
Group, Washington, DC, USA
Adrian Covaci, PhD, Professor,
Toxicological Center, University of
Antwerp, Antwerp, Belgium
Craig Criddle, PhD, Professor,
Department of Civil and Environmental
Engineering, Stanford University,
Stanford, California, USA
Oscar H. Ferná ndez Cubero,
Technician, National Food Center,
Majadahonda, Spain
Jordi Dachs, PhD, Research Scientist,
Institute of Environmental Assessment
and Water Research, Spanish Council for
Scientific Research, Barcelona, Spain
Cynthia de Wit, PhD, Professor,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Barbara Demeneix, PhD, DSc,
Professor, Department RDDM, National
Museum of Natural History, Paris,
Pascal Diefenbacher, PhD Student,
Safety and Environmental Technology
Group, Institute for Chemical and
Bioengineering, ETH Zürich, Zürich,
Michelle Douskey, PhD, Chemistry
Lecturer, Department of Chemistry,
University of California, Berkeley,
Berkeley, California, USA
Timothy Elgren, PhD, Dean of Arts
and Sciences, Oberlin College, Oberlin,
Ohio, USA
David Epel, PhD, Professor Emeritus,
Hopkins Marine Station, Stanford
University, Pacific Grove, California,
Ulrika Eriksson, PhD Student, Man
Technology–Environment Research
Centre, Örebro University, Örebro,
Alexi Ernstoff, MS, PhD Student,
Quantitative Sustainability Assessment,
Technical University of Denmark,
Kongens Lyngby, Denmark
Igor Eulaers, PhD Student, Department
of Biology, University of Antwerp,
Antwerp, Belgium
Heesoo Eun, PhD, Senior Researcher,
Division of Organochemica ls, National
Institute for Agro-Environmental
Sciences, Tsukuba, Japan
Peter Fantke, PhD, Assistant Professor,
Quantitative Sustainability Assessment
Division, Department of Management
Engineering, Technical University of
Denmark, Kongens Lyngby, Denmark
Marko Filipovic, FilLic, Department
of Applied Environmental Science,
Stockholm University, Stockholm,
Marie Frederiksen, Researcher, Danish
Building Research Institute, Aalborg
University, Copenhagen, Denmark
Carey Friedman, PhD, Postdoctoral
Associate, Center for Global Change
Science, Massachusetts Institute of
Technology, Cambridge, Massachusetts,
Frederic Gallo, PhD, Senior Expert,
Regional Activity Center for Sustainable
Consumption and Production, Barcelona,
Joseph A. Gardella, Jr, PhD,
Distinguished Professor and John and
Frances Larkin Professor of Chemistry,
Department of Chemistry, University
of Buffalo–e State University of New
York, Buffalo, New York, USA
Stephen Gardner, DVM, Veterinarian,
Albany Animal Hospital, Richmond,
California, USA
Caroline Gaus, PhD, Professor,
National Centre for Environmental
Toxicology, e University of
Queensland, Brisbane, Queensland,
Wouter Gebbink, PhD, Researcher,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
David Gee, PhD, Associate Fellow,
Institute of Environment, Health, and
Societies, Brunel University, Brunel,
United Kingdom
Philip Germansdefer, DHC Che, MS
ChE, Director of International Sales and
Marketing, Fluid Management Systems,
Inc., Watertown, Massachusetts, USA
Bondi Nxuma Gevao, PhD, Research
Scientist, Kuwait Institute for Scientific
Research, Safat, Kuwait
Melissa Gomis, MS, PhD Student,
Department of Environmental Science,
Stockholm University, Stockholm,
Belen Gonzalez, PhD Student, Institute
of Environmental A ssessment and Water
Research, Spanish Council for Scientific
Research, Barcelona, Spain
Peter Gringinger, MSc, Principal,
Cardno, Sassafras, Victoria, Australia
Adam Grochowalski, PhD, Professor,
Department of Analytical Chemistry,
Krakow University of Technology,
Kr akow, Poland
Ramon Guardans, Scientific Advisor,
Ministry of Agriculture, Food and
Environment, Madrid, Spain
Alexey Gusev, PhD, Senior Scientist,
European Monitoring and Evaluation
Programme Meteorological Synthesizing
Centre–East, Moscow, Russia
Arno Gutleb, PhD, Project Leader,
Department of Environment and Agro-
Biotechnologies, Luxembourg Institute
of Science and Technology, Belvaux,
Tenzing Gyalpo, PhD Student,
Safety and Environmental Technology
Group, Institute for Chemical and
Bioengineering, ETH Zürich, Zürich,
Johannes Hädrich, PhD, Head,
Research Laboratory, European Union
Reference Laboratory for Dioxins and
PCBs in Feed and Food, Freiburg,
The Madrid Statement on Poly- and Perfluoroalkyl
Substances (PFASs)
(Signatories as of publication date. Institutional affiliations are provided for identification purposes only.)
continued »
Brief Communication
A 110
volume 123 | number 5 | May 2015
Environmental Health Perspectives
Helen Håkansson, PhD, Professor of
Toxicology and Chemicals Health Risk
Assessment, Institute of Environmental
Medicine, Karolinska Institutet,
Stockholm, Sweden
Tomas Hansson, PhD, Researcher,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Mikael Harju, PhD, Senior Scientist,
NILU–Norwegian Institute for Air
Research, Tromsø, Norway
Stuart Harrad, PhD, Professor of
Environmental Chemistry, School of
Geography, Earth and Environmental
Sciences, University of Birmingham,
Edgbaston, United Kingdom
Bernhard Hennig, PhD, Professor of
Nutrition and Toxicology, and Director,
University of Kentucky Superfund
Research Center, Lexington, Kentucky,
Eunha Hoh, PhD, Associate Professor,
Department of Public Health, San Diego
State University, San Diego, California,
Sandra Huber, PhD, Senior Researcher,
Environmental Chemistry, NILU
Norwegian Institute for Air Research,
Tromsø, Norway
François Idcza k, Direction de la
Surveillance de l’Environnement, Institue
Scientifique de Service Public (ISSeP),
Liege, Belgium
Alastair Iles, SJD, Associate Professor,
Department of Environmental Science,
Policy, and Management, University of
California, Berkeley, Berkeley, California,
Ellen Ingre-Khans, MSc, PhD Student,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Alin Constantin Ionas, PhD
Candidate, Toxicological Center,
University of Antwerp, Ant werp, Belgium
Griet Jacobs, Researcher, Flemish
Institute of Technological Research, Mol,
Annika Jahnke, PhD, Researcher,
Department of Cell Toxicology,
Helmholtz Centre for Environmental
Research, Leipzig, Germany
Veerle Jaspers, PhD, Associate
Professor, Department of Biology,
Norwegian University of Science and
Technology, Trondheim, Norway
Allan Astrup Jensen, PhD,
Research Director and CEO, Nipsect,
Frederiksberg, Denmark
Javier Castro Jimenez, PhD Research
Scientist, Institute of Environmental
Assessment and Water Research,
Spanish Council for Scientific Research,
Barcelona, Spain
Ingrid Ericson Jogsten, PhD,
Research Scientist, School of Science and
Technology, Örebro University, Örebro,
Jon E. Joha nsen, Dr techn, Director,
Chiron AS, Trondheim, Norway
Niklas Johansson, Senior Consultant,
Melica Biologkonsult, Upplands Väsby,
Paula Johnson, PhD, MPH, Research
Scientist, California Department of
Public Health, Richmond, California,
Jill Johnston, PhD, Postdoctoral Fellow,
Department of Epidemiology, University
of North Carolina at Chapel Hill, Chapel
Hill, North Carolina, USA
Olga-Ioanna Kalantzi, PhD, Assistant
Professor, University of the Aegean,
Mytilene, Greece
Anna Kärrman, PhD, Associate
Professor, Man–Technology
Environment Research Centre, Örebro
University, Örebro, Sweden
Naila Khalil, MBBS, MPH, PhD,
Assistant Professor, Boonshoft School
of Medicine, Wright State University,
Kettering, Ohio, USA
Maja Kirkegaard, PhD, Cand Scient,
Research Advisory, Head of Chemicals
Group, Worldwatch Institute Europe,
Copenhagen, Denmark
Jana Klanova, PhD, Professor,
Research Center for Toxic Compounds
in the Environment, Faculty of Science,
Masaryk University, Brno, Czech
Susan Klosterhaus, PhD, Vice
President, Science and Certification,
Cradle to Cradle Products Innovation
Institute, San Francisco, California, USA
Candice Kollar, LEED AP, Design
Strategist, Kollar Design | EcoCreative,
San Francisco, California, USA
Janna G. Koppe, PhD, Professor
Emeritus of Neonatolog y, Emma
Children’s Hospital/Academic Medical
Center, University of Amsterdam,
Loenersloot, the Netherlands
Ingjerd Sunde Krogseth, PhD,
Postdoctoral Fellow, NILU–Nor wegian
Institute for Air Research, Tromsø,
Petr Kukucka, PhD, Junior Researcher,
Research Center for Toxic Compounds
in the Environment, Faculty of Science,
Masaryk University, Brno, Czech
Perihan Binnur Kurt Karakus,
PhD, Associate Professor, Department
of Environmental Engineering, Bursa
Technical University, Bursa, Turkey
Henrik Kylin, PhD, Professor,
Department of ematic Studies—
Environmental Change, Linköping
University, Linköping, Sweden
Remi Laane, PhD, Professor,
Department of Environmental
Chemistry, University of Amsterdam,
Deltares, Voorburg, the Netherlands
Jon Sanz Landaluze, PhD, Assistant
Professor, Department of Analytical
Chemistry, Universidad Complutense de
Madrid, Madrid, Spain
Le i Hai Le, PhD, Department
Deputy Director, Ministry of Natural
Resources and Environment, Ha Noi,
Jong-Hyeon Lee, PhD, Director,
NeoEnBiz, Gyeonggi-do, South Korea
Marike Martina Leijs, PhD, Professor,
Department of Dermatology, University
Hospital RWTH Aachen, Aachen,
Xiaodong Li, PhD, Professor, Faculty
of Engineering, Zhejiang University,
Hangzhou, China
Yifan Li, PhD, Professor, International
Joint Research Center for Persistent
Toxic Substances, Harbin Institute of
Technology, Harbin, China
Danuta Ligocka, PhD, Senior
Researcher, Department of Toxicology
and Carcinogenesis, Nofer Institute of
Occupational Medicine, Łódź, Poland
Monica Lind, PhD, Scientist,
Occupational and Environmental
Medicine, Uppsala University, Uppsala,
Lee Lippincott, PhD, Assistant
Professor of Chemistry, Allied Health
Sciences, Mercer County Community
College, West Windsor, New Jersey, USA
Mariann Lloyd-Smith, PhD, Senior
Advisor, National Toxics Network, East
Ballina, New South Wales, Australia
Karin Löfstrand, PhD, Postdoctoral
Fellow, Department of Applied
Environmental Science, Stock holm
University, Stockholm, Sweden
Rainer Lohmann, PhD, Associate
Professor, Graduate School of
Oceanography, University of Rhode
Island, Kingston, Rhode Island, USA
Donald Lucas, PhD, Research Scientist,
Lawrence Berkeley National Laboratory,
Berkeley, California, USA
José Vinicio Macias, PhD, Researcher,
Autonomous University of Baja
California, Baja California, Mexico
Karl Mair, Magister, Senior
Environmental Chemist, Eco Research,
Bolzano, Italy
Govindan Malarvannan, PhD,
Research Scientist, Faculty of
Pharmaceutical, Biomedical and
Veterinary Sciences, University of
Antwerp, Antwerp, Belgium
Svetlana Malysheva, PhD, Research
Scientist, Scientific Institute of Public
Health, Ghent University, Brussels,
Jonathan Martin, PhD, Professor,
Division of Analytical and
Environmental Toxicolog y, University of
Alberta, Edmonton, Alberta, Canada
Lisa Mattioli, MSc, Scientist,
Department of Chemistry, Carleton
University Ottawa, Ontario, Canada
Michael McLachlan, PhD, Professor,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Lisa Melymuk, PhD, Junior Researcher,
Research Center for Toxic Compounds
in the Environment, Faculty of Science,
Masaryk University, Brno, Czech
Annelle Mendez, PhD Student,
Safety and Environmental Technology
Group, Institute for Chemical and
Bioengineering, ETH Zürich, Zürich,
Tom Mu ir, MS, Consultant (retired),
Environment Canada, Burlington,
Ontario, Canada
Marie Danielle Mulder, PhD Student,
Research Center for Toxic Compounds
in the Environment, Faculty of Science,
Masaryk University, Brno, Czech
Jochen Müller, PhD, Professor,
National Research Centre for
Environmental Toxicolog y, e
University of Queensland, Brisbane,
Queensland, Australia
Patricia Murphy, ND, LAc,
Naturopathic Physician, Portland,
Oregon, USA
Takeshi Nakano, PhD, Specially
Appointed Professor, Graduate School of
Engineering, Osaka University, Osaka,
Amgalan Natsagdorj, PhD, Associate
Professor, Department of Chemistry,
National University of Mongolia,
Ulaanbaatar, Mongolia
Seth New ton, PhD Student,
Department of Applied Environmental
Science, Stockholm University, Täby,
Carla Ng, PhD, Senior Scientist,
Safety and Environmental Technology
Group, Institute for Chemical and
Bioengineering, ETH Zürich, Zürich,
Bo Normander, PhD, Executive
Director, Worldwatch Institute Europe,
Copenhagen, Denmark
Kees Olie, PhD, Retired, Institute for
Biodiversity and Ecosystem Dynamics,
Amsterdam, the Netherlands
Bindu Panikkar, PhD, Research
Associate, Arctic Institute of North
America, Calgary, Alberta, Canada
Richard Peterson, PhD, Professor,
Department of Pharmaceutical Sciences,
University of Wisconsin, Madison,
Wisconsin, USA
Arianna Piersanti, PhD, Lead
Chemist, Food of Environmental Control
Department, Istituto Zooprofilattico
Sperimentale dell-Umbria e dell Marche,
Perugia, Italy
Merle Plassmann, PhD, Researcher,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Anuschka Polder, PhD, Scientist,
Department of Food Safety and Infection
Biology, Norwegian University of Life
Sciences, Oslo, Norway
The Madrid Statement on Poly- and Perfluoroalkyl
Substances (PFASs)
(Signatories as of publication date. Institutional affiliations are provided for identification purposes only.)
continued »
Brief Communication
Environmental Health Perspectives
volume 123 | number 5 | May 2015
A 111
Malte Posselt, BSc, MS Student,
German Federal Environment Agency,
Berlin, Germany
Deborah O. Raphael, Director, San
Francisco Department of the
Environment, San Francisco, California,
Shay Reicher, PhD, Risk Assessment
Director, Ministry of Health, Tel Aviv,
Efstathios Reppas-Chrysovitsinos,
MEng, PhD Candidate, Department
of Applied Environmental Science,
Stockholm University, Stockholm,
Crystal Reul-Chen, DEnv, Senior
Environmental Scientist, California
Environmental Protection Agency,
Sacramento, California, USA
David Roberts, PhD, Kenan
Professor of Physics, Department of
Physics, Brandeis University, Waltham,
Massachusetts, USA
Mary Roberts, PhD, Professor, Merkert
Chemistry Center, Boston College,
Chestnut Hill, Massachusetts, USA
Camilla Rodrigues, PhD, Researcher,
Environmental Sanitation Technology
Company, San Paulo, Brazil
Ott Roots, Dr sc nat ETH, Director of
the Institute/Leading Research Scientist,
Estonian Environmental Research
Institute, Tallinn, Estonia
Maria Ros Rodriguez, Laboratory
Technician, Instituto de Química
Orgánica General-Consejo Superior
de Investigaciones Científicas, Madrid,
Anna Rotander, PhD, Postdoctoral
Researcher, Man–Technology–
Environment Research Centre, Örebro
University, Örebro, Sweden; and National
Research Centre for Environmental
Toxicology, e University of
Queensland, Brisbane, Queensland,
Ruthann Rudel, MS, Director of
Research, Silent Spring Institute,
Newton, Massachusetts, USA
Christina Rudén, PhD, Professor,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Andreas Béguin Safron, MSc, PhD
Candidate, Department of Applied
Environmental Science, Stock holm
University, Stockholm, Sweden
Amina Salamova, PhD, Research
Scientist, School of Public and
Environmental Affairs, Indiana
University, Bloomington, Indiana, USA
Samira Salihovic, PhD, Postdoctoral
Fellow, Department of Medical Sciences,
Uppsala University, Uppsala, Sweden
Johanna Sandahl, MS, President,
Swedish Society for Nature Conservation,
Stockholm, Sweden
Erik Sandell, Consulting Specialist,
Nab Labs Oy, Espoo, Finland
Andreas Schaeffer, PhD, Institute
Director, Institute for Environmental
Research, RWTH Aachen University,
Aachen, Germany
Julia Schaletzky, PhD, Senior Group
Leader, Cytokinetics, South San
Francisco, California, USA
Arnold Schecter, PhD, Professor,
School of Public Health, University of
Texas–Dallas Campus, Dallas, Texas,
Ted Sch ettle r, MD, MPH, Science
Director, Science and Environmental
Health Network, Ames, Iowa, USA
Margret Schlumpf, Dr sc nat ETH,
Co-Director, Group for Reproductive,
Endocrine and Environmental
Toxicology, University of Zürich, Zürich,
Peter Schmid, PhD, Senior Scientist,
Department of Organic Chemistry, Swiss
Federal Institute for Material Research
and Testing, Dübendorf, Switzerland
Lara Schultes, MSc, PhD Student,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Susan Shaw, PhD, Professor, School
of Public Health, University at A lbany–
State University of New York, Albany,
New York, USA; and Director, Marine
Environmental Research Institute, Blue
Hill, Maine, USA
Omotayo Sindiku, Research Assistant,
Basel Convention Coordinating Center,
Ibadan, Nigeria
Line Småstuen Haug, PhD, Senior
Scientist, Department of Exposure and
Risk A ssessment, Norwegian Institute of
Public Health, Oslo, Norway
Anna Sobek, PhD, Researcher,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Ana Sousa, PhD, Postdoctoral
Researcher, Health Sciences Research
Centre, University of Beira Interior,
Covilhã, Portugal
Martin Sperl, Technician, Austria
Metall AG, Ranshofen, Austria
omas Steiner, PhD, CEO,
MonitoringSystems GmbH, Pressbaum,
Christine Steinlin, PhD Student,
Safety and Environmental Technology
Group, Institute for Chemical and
Bioengineering, ETH Zürich, Zürich,
Alex Stone, ScD, Senior Chemist,
Hazardous Waste and Toxics Reduction
Program, Washington State Department
of Ecology, Lacey, Washington, USA
William Stubbings, PhD Student,
University of Birmingham, Edgbaston,
United Kingdom
Roxana Sühring, PhD Student,
Helmholtz-Zentrum Geesthacht,
Lüneburg, Germany
Kimmo Suominen, PhD, Senior
Researcher, Finish Food Safety Authority,
Risk A ssessment Research Unit, Helsinki,
Rebecca Sutton, PhD, Senior Scientist,
San Francisco Estuary Institute,
Richmond, California, USA
Joel Svedlund, BSc, Sustainability
Manager, Klättermusen AB, Åre, Sweden
David Szabo, PhD, Senior Scientist,
Research and Development, Reynolds
American, Winston-Salem, North
Carolina, USA
Öner Tat li, Lab Manager, A&G Pür
Analysis Laboratory, Izmir, Turkey
Neeta acker, MSc, PhD, Former
Chief Scientist and Quality Manager,
Analytical Instruments Division,
National Environmental Engineering
Research Institute, Nagpur, India
Dien Nguyen anh, PhD Student,
Environment Preservation Research
Center, Kyoto University, Kyoto, Japan
Joao Paulo Machado Torres, PhD,
Associate Professor, Instituto de Biofisica
Carlos Chagas Filho, R io de Janeiro
Federal University, Rio de Janeiro, Brazil
Matt hew Tras s, PhD, Research
Scientist, Phenomenex, Torrance,
California, USA
eodora Tsongas, PhD, MS,
Environmental Health Scientist and
Consultant, Portland, Oregon, USA
Mary Turyk, PhD, Associate Professor,
Department of Epidemiology and
Biostatistics, University of Illinois at
Chicago, Chicago, Illinois, USA
Anthony C. Tweedale, MS,
Consultant, Rebutting Industry
Science with Knowledge Consultancy,
Eastpointe, Michigan, USA
Marta Venier, PhD, Scientist, School
of Public and Environmental A ffairs,
Indiana University, Bloomington,
Indiana, USA
Robin Vestergren, PhD, Postdoctoral
Researcher, Environmental Chemistry,
NILU–Norwegian Institute for Air
Research, Tromsø, Norway
Stefan Voorspoels, PhD, Research
Manager, Flemish Institute of
Technological Research, Mol, Belgium
Shu-Li Wang, PhD, Investigator and
Professor, Department of Environmental
Health and Occupational Medicine,
National Health Research Institute,
Chunan, Miaoli, Taiwan
Glenys Webster, PhD, Postdoctoral
Fellow, Developmental Neurosciences
and Child Health, Child and Family
Research Institute, and Faculty of Health
Sciences, Simon Fraser University,
Vancouver, British Columbia, Canada
Larry Weiss, MD, Chief Marketing
Officer, AOBiome, LLC, San Francisco,
California, USA
Philip White, Organics Analyst,
Marine Institute, Galway, Ireland
Karin Wiberg, PhD, Professor,
Department of Aquatic Sciences and
Assessment, Swedish University of
Agricultural Sciences, Uppsala, Sweden
Gayle Windham, PhD, Research
Scientist, Division of Environmental
and Occupational Health Control,
California Department of Public Health,
Richmond, California, USA
Hendrik Wolschke, PhD Student,
Helmholtz Zentrum Geesthacht-Centre
for Materials and Coastal Research,
Geesthacht, Germany
Bo Yu an, PhD, Postdoctoral Fellow,
Department of Applied Environmental
Science, Stockholm University,
Stockholm, Sweden
Elena Zaffonato, Organics Analyst,
Chelab Sri, Resana Treviso, Italy
Ling yan Zhu, PhD, Professor,
College of Environmental Science and
Engineering, Nankai University, Tianjin,
Robert Zoeller, PhD, Professor,
Department of Biolog y, University
of Massachusetts Amherst, Amherst,
Massachusetts, USA
The Madrid Statement on Poly- and Perfluoroalkyl
Substances (PFASs)
(Signatories as of publication date. Institutional affiliations are provided for identification purposes only.)
... PFAS are a large class of fluorinated aliphatic chemicals, which have diversified use (Young et al., 2021). Due to their extreme toxicity, persistency, and bioaccumulation, these chemicals are a significant concern for the environment and human health (Blum et al., 2015;Cousins et al., 2016;Wang et al., 2017;Goldenman et al., 2019). PFAS are detected in the blood serum of over 98% of Americans (Calafat Antonia et al., 2007). ...
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The term "firefighter" and "cancer" have become so intertwined in the past decade that they are now nearly inseparable. Occupational exposure of firefighters to carcinogenic chemicals may increase their risk of developing different types of cancer. PFAS are one of the major classes of carcinogenic chemicals that firefighters are exposed to as occupational hazard. Elevated levels of PFAS have been observed in firefighters' blood serum in recent studies. Possible sources of occupational exposure to PFAS include turnout gear, aqueous film-forming foam, and air and dust at both the fire scene and fire station. Preliminary discussion on PFAS includes definition, classification, and chemical structure. The review is then followed by identifying the sources of PFAS that firefighters may encounter as an occupational hazard. The structural properties of the PFAS used in identified sources, their degradation, and exposure pathways are reviewed. The elevated level of PFAS in the blood serum and how this might associate with an increased risk of cancer is discussed. Our review shows a significant amount of PFAS on turnout gear and their migration to untreated layers, and how turnout gear itself might be a potential source of PFAS exposure. PFAS from aqueous film-forming foams (AFFF), air, and dust of fire stations have been already established as potential exposure sources. Studies on firefighters' cancer suggest that firefighters have a higher cancer risk compared to the general population. This review suggests that increased exposure to PFAS as an occupational hazard could be a potential cancer risk for firefighters.
... Moreover, a recent study demonstrated that PFAS in rainwater on a global scale often greatly exceeds the US and European advisory thresholds for drinking and surface water, making it unsuitable for human consumption, even in the most remote regions (Cousins et al. 2022). Some members of the scientific community call for an urgent ban of all fluorinated organic substances (Sonne et al. 2022), or at the very least limit their production to those demonstrated to be of first importance for health, safety and functioning of society, introducing the concept of "essentiality" for PFAS (Blum et al. 2015;Cousins et al. 2019;2021). However, to date, due to the numerous societal benefits provided by PFAS and their relatively low production cost, there are no known alternatives to the myriad of industrial applications. ...
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The developmental period is a very sensitive phase since it sees the synthesis and maturation of all organs and functions of the future organism. Therefore, any disruption experienced early in life may have substantial subsequent consequences. In the context of the considerable impact of Human activities on wildlife, seabirds are particularly at risk since they are exposed to numerous threats, including fisheries interactions, habitat destruction, or environmental pollution. Among them, the later is maybe the most insidious, since it can also be transferred to the progeny via maternal transfer in eggs, and cause adverse effects as early as during the development. The 20th century saw the emergence of numerous synthetic substances. Among them, the per- and polyfluoroalkyl substances (PFAS) are found in seabird eggs, but little is known about their effects. In this thesis, I aimed at investigating the maternal transfer of PFAS in an Arctic seabird, the black-legged kittiwake (Rissa tridactyla). I also examined the eventual consequences of legacy and emerging PFAS exposure for the embryo in this species and in the yellow-legged gull (Larus michahellis). I found relatively high concentrations of legacy PFAS in eggs as well as some emerging compounds including 7:3 FTCA or PFEcHS. PFAS physicochemical characteristics influenced their transfer efficiency. My results also suggested that females PFAS might affect their transfer of maternal hormones in eggs, which may ultimately affect offspring at short and long term. Finally, I found no indications that PFAS deposited in eggs may affect the developing embryo on biomarkers of ageing (telomere length) or metabolism. I therefore suggested that both studied population should be relatively safe at least at the PFAS concentrations measured in their eggs. Nonetheless, additional studies would be needed to assess how PFAS may affect the endocrine maternal transfer and its consequences for the embryo.
... The presence of PFAS in cosmetics and personal care products and their release from these products into the environment will result in environmental persistence and contamination. 83,84 Because of the environmental burden posed by PFAS, this research was motivated by regulatory and industrial interest in eliminating their non-essential uses. The PFAS in these products are not essential for the health, safety, or functioning of society, and alternative ingredients may exist, based on the rapid phasing out of PFAS ingredients by several cosmetic brands. ...
Per- and polyfluoroalkyl substances (PFAS) are anthropogenic chemicals reported in cosmetics and personal care products as ingredients, possible impurities in the raw material manufacturing process, or degradation products. The purpose of this study was to further delineate contributions of these varying PFAS sources to these products. Thirty-eight cosmetics and personal care products were selected and analyzed for polyfluoroalkyl phosphates (PAPs), perfluoroalkyl carboxylic acids (PFCAs), fluorotelomer sulfonic acids (FTSAs), and perfluoroalkyl sulfonic acids (PFSAs) using targeted liquid chromatography tandem mass spectrometry (LC-MS/MS). A subset of products was also subjected to suspect screening using LC-high resolution mass spectrometry (HRMS) for >200 compounds. Results of LC-MS/MS and LC-HRMS indicated a predominant and ubiquitous presence of PAPs (detection frequency 99.7%, mean and median ΣPAPs 1 080 000 and 299 ng/g). Total median PFCA and PFSA concentrations were 3 and 38 times lower, respectively. There were significant correlations (Spearman's correlation coefficients = 0.60-0.81, p < 0.05) between 6:2 PAPs and their biotransformation products. Low levels of other PFAS classes were detected, including those previously measured in wastewater and human blood (e.g., hydrido-PFCAs), and five compounds associated with aqueous film-forming foams. Overall, these data highlight that cosmetics and personal care products can contain a breadth of PFAS at extremely high levels, leading to human and environmental exposure.
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Chemicals have improved the functionality and convenience of industrial and consumer products, but sometimes at the expense of human or ecological health. Existing regulatory systems have proven to be inadequate for assessing and managing the tens of thousands of chemicals in commerce. A different approach is urgently needed to minimize ongoing production, use, and exposures to hazardous chemicals. The premise of the essential-use approach is that chemicals of concern should be used only in cases in which their function in specific products is necessary for health, safety, or the functioning of society and when feasible alternatives are unavailable. To optimize the essential-use approach for broader implementation in the United States and Canada, we recommend that governments and businesses (1) identify chemicals of concern for essentiality assessments based on a broad range of hazard traits, going beyond toxicity; (2) expedite decision-making by avoiding unnecessary assessments and strategically asking up to three questions to determine whether the use of the chemical in the product is essential; (3) apply the essential-use approach as early as possible in the process of developing and assessing chemicals; and (4) engage diverse experts in identifying chemical uses and functions, assessing alternatives, and making essentiality determinations and share such information broadly. If optimized and expanded into regulatory systems in the United States and Canada, other policymaking bodies, and businesses, the essential-use approach can improve chemicals management and shift the market toward safer chemistries that benefit human and ecological health.
Per- and polyfluoroalkyl substances (PFAS) are a novel entity that threaten public health due to their environmental persistence and global contamination. Interdisciplinary collaboration can address this crisis, incorporating governance, scientific, corporate, and community action. We present US perspectives on multi-scalar, multi-stakeholder solutions to protect human and environmental health.
Background: Per- and polyfluoroalkyl substances (PFAS) comprise a large class of chemicals with widespread use and persistence in the environment and in humans; however, most of the epidemiology research has focused on a small subset. Objectives: The aim of this systematic evidence map (SEM) is to summarize the epidemiology evidence on approximately 150 lesser studied PFAS prioritized by the EPA for tiered toxicity testing, facilitating interpretation of those results as well as identification of priorities for risk assessment and data gaps for future research. Methods: The Populations, Exposure, Comparators, and Outcomes (PECO) criteria were intentionally broad to identify studies of any health effects in humans with information on associations with exposure to the identified PFAS. Systematic review methods were used to search for literature that was screened using machine-learning software and manual review. Studies meeting the PECO criteria underwent quantitative data extraction and evaluation for risk of bias and sensitivity using the Integrated Risk Information System approach. Results: 193 epidemiology studies were identified, which included information on 15 of the PFAS of interest. The most commonly studied health effect categories were metabolic (n=37), endocrine (n=30), cardiovascular (30), female reproductive (n=27), developmental (n=26), immune (n=22), nervous (n=21), male reproductive (n=14), cancer (n=12), and urinary (n=11) effects. In study evaluation, 120 (62%) studies were considered High/Medium confidence for at least one outcome. Discussion: Most of the PFAS in this SEM have little to no epidemiology data available to inform evaluation of potential health effects. Although exposure to the 15 PFAS that had data was fairly low in most studies, these less-studied PFAS may be used as replacements for "legacy" PFAS, leading to potentially greater exposure. It is impractical to generate epidemiology evidence to fill the existing gaps for all potentially relevant PFAS. This SEM highlights some of the important research gaps that currently exist.
Data on the occurrences of legacy and alternative per- and polyfluoroalkyl substances (PFASs) in glioma are scarce. It remains unclear if PFASs exposure is related to the prevalence of glioma. A total of 137 glioma and 40 non-glioma brain tissue samples from patients recruited from the Nanfang Hospital, South China were analyzed for 17 PFAS compounds. Perfluorohexanoic acid, perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorooctane sulfonamide (FOSA), and 6:2 chlorinated polyfluorinated ether sulfonate were frequently detected (> 60 %) in glioma. The total concentrations (range; median) of 17 PFASs in glioma (0.20–140; 3.1 ng g⁻¹) were slightly higher than those in non-glioma (0.35–32; 2.2 ng g⁻¹), but without statistical significance. The PFAS concentrations in males were statistically higher (p < 0.05) than those in females. Elevated glioma grades were associated with higher concentrations of PFOA, PFOS, and FOSA. Positive correlations were observed between PFAS concentrations (especially for PFOA) and Ki-67 or P53 expression, pathological molecular markers of glioma. Our findings suggested that exposure to PFASs might increase the probability to develop glioma. This is the first case study demonstrating associations between PFASs exposure and brain cancer. More evidences and potential pathogenic mechanisms warranted further investigations.
Clean, efficient and economical separation of heavy rare earth elements (HREEs) and yttrium has always attracted attention. Herein, a strategy for the separation of HREEs and Y based on ternary...
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In this discussion paper, the transition from long-chain poly- and perfluorinated alkyl substances (PFASs) to fluorinated alternatives is addressed. Long-chain PFASs include perfluoroalkyl carboxylic acids (PFCAs) with 7 or more perfluorinated carbons, perfluoroalkyl sulfonic acids (PFSAs) with 6 or more perfluorinated carbons, and their precursors. Because long-chain PFASs have been found to be persistent, bioaccumulative and toxic, they are being replaced by a wide range of fluorinated alternatives. We summarize key concerns about the potential impacts of fluorinated alternatives on human health and the environment in order to provide concise information for different stakeholders and the public. These concerns include, amongst others, the likelihood of fluorinated alternatives or their transformation products becoming ubiquitously present in the global environment; the need for more information on uses, properties and effects of fluorinated alternatives; the formation of persistent terminal transformation products including PFCAs and PFSAs; increasing environmental and human exposure and potential of adverse effects as a consequence of the high ultimate persistence and increasing usage of fluorinated alternatives; the high societal costs that would be caused if the uses, environmental fate, and adverse effects of fluorinated alternatives had to be investigated by publicly funded research; and the lack of consideration of non-persistent alternatives to long-chain PFASs.
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Perfluorooctanoic acid (PFOA) is a synthetic chemical ubiquitous in serum of US residents. It causes liver, testicular, and pancreatic tumors in rats. Human studies are sparse. Examine cancer incidence in mid-Ohio valley residents exposed to PFOA in drinking water due to chemical plant emissions. The cohort consisted of adult community residents who resided in contaminated water districts or worked at a local chemical plant. Most participated in a 2005/2006 baseline survey in which serum PFOA was measured. We interviewed the cohort in 2008-2011 to obtain further medical history. Retrospective yearly PFOA serum concentrations were estimated for each participant from 1952-2011. Self-reported cancers were validated through medical records and cancer registry review. We estimated the association between cancer and cumulative PFOA serum concentration using proportional hazards models. Participants (n=32,254) reported 2,507 validated cancers (21 different cancer types). Estimated cumulative serum PFOA concentrations were positively associated with kidney and testicular cancer (HR=1.10; 95% CI: 0.98, 1.24 and HR=1.34; 95% CI: 1.00, 1.79, respectively, for 1-unit increases in ln-transformed serum PFOA). Categorical analyses also indicated positive trends with increasing exposures for both cancers (kidney cancer HRs for increasing exposure quartiles= 1.0, 1.23, 1.48, and 1.58, linear trend test p=0.18; testicular cancer HRs = 1.0, 1.04, 1.91, 3.17, linear trend test p=0.04). PFOA exposure was associated with kidney and testicular cancer in this population. Because this is largely a survivor cohort, findings must be interpreted with caution, especially for highly fatal cancers such as pancreatic and lung cancer.
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Humans are simultaneously exposed to a multitude of chemicals. Human health risk assessment of chemicals is, however, normally performed on single substances, which may underestimate the total risk, thus bringing a need for reliable methods to assess the risk of combined exposure to multiple chemicals. Per- and polyfluoroalkylated substances (PFASs) is a large group of chemicals that has emerged as global environmental contaminants. In the Swedish population, 17 PFASs have been measured, of which the vast majority lacks human health risk assessment information. The objective of this study was to for the first time perform a cumulative health risk assessment of the 17 PFASs measured in the Swedish population, individually and in combination, using the Hazard Index (HI) approach. Swedish biomonitoring data (blood/serum concentrations of PFASs) were used and two study populations identified: 1) the general population exposed indirectly via the environment and 2) occupationally exposed professional ski waxers. Hazard data used were publicly available toxicity data for hepatotoxicity and reproductive toxicity as well as other more sensitive toxic effects. The results showed that PFASs concentrations were in the low ng/ml serum range in the general population, reaching high ng/ml and low μg/ml serum concentrations in the occupationally exposed. For those congeners lacking toxicity data with regard to hepatotoxicity and reproductive toxicity read-across extrapolations was performed. Other effects at lower dose levels were observed for some well-studied congeners. The risk characterization showed no concern for hepatotoxicity or reproductive toxicity in the general population except in a subpopulation eating PFOS-contaminated fish, illustrating that high local exposure may be of concern. For the occupationally exposed there was concern for hepatotoxicity by PFOA and all congeners in combination as well as for reproductive toxicity by all congeners in combination, thus a need for reduced exposure was identified. Concern for immunotoxicity by PFOS and for disrupted mammary gland development by PFOA was identified in both study populations as well as a need of additional toxicological data for many PFAS congeners with respect to all assessed endpoints.
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Background: Little is known about environmental determinants of autoimmune diseases. Objectives: We studied autoimmune diseases in relation to level of exposure to perfluorooctanoic acid (PFOA), which was introduced in the late 1940s and is now ubiquitous in the serum of residents of industrialized countries. Methods: In 2008–2011 we interviewed 32,254 U.S. adults with high serum PFOA serum levels (median, 28 ng/mL) associated with drinking contaminated water near a chemical plant. Disease history was assessed retrospectively from 1952 or birth (if later than 1952) until interview. Self-reported history of autoimmune disease was validated via medical records. Cumulative exposure to PFOA was derived from estimates of annual mean serum PFOA levels during follow-up, which were based on plant emissions, residential and work history, and a fate-transport model. Cox regression models were used to estimate associations between quartiles of cumulative PFOA serum levels and the incidence of autoimmune diseases with ≥ 50 validated cases, including ulcerative colitis (n = 151), Crohn’s disease (n = 96), rheumatoid arthritis (n = 346), insulin-dependent diabetes (presumed to be type 1) (n = 160), lupus (n = 75), and multiple sclerosis (n = 98). Results: The incidence of ulcerative colitis was significantly increased in association with PFOA exposure, with adjusted rate ratios by quartile of exposure of 1.00 (referent), 1.76 (95% CI: 1.04, 2.99), 2.63 (95% CI: 1.56, 4.43), and 2.86 (95% CI: 1.65, 4.96) (ptrend < 0.0001). A prospective analysis of ulcerative colitis diagnosed after the baseline 2005–2006 survey (n = 29 cases) suggested a positive but non-monotonic trend (ptrend = 0.21). Discussion: To our knowledge, this is the first study of associations between this common environmental exposure and autoimmune diseases in humans. We found evidence that PFOA is associated with ulcerative colitis.
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Background: Several epidemiological cross-sectional studies have found positive associations between serum concentrations of lipids and perfluorooctanoic acid (PFOA, or C8). A longitudinal study should be less susceptible to biases from uncontrolled confounding or reverse causality. Methods: We investigated the association between within-individual changes in serum PFOA and perfluorooctanesulfonic acid (PFOS) and changes in serum lipid levels (low-density lipoprotein [LDL] cholesterol, high-density lipoprotein cholesterol, total cholesterol, and triglycerides) over a 4.4-year period. The study population consisted of 560 adults living in parts of Ohio and West Virginia where public drinking water had been contaminated with PFOA. They had participated in a cross-sectional study in 2005-2006, and were followed up in 2010, by which time exposure to PFOA had been substantially reduced. Results: Overall serum concentrations of PFOA and PFOS fell by half from initial geometric means of 74.8 and 18.5 ng/mL, respectively, with little corresponding change in LDL cholesterol (mean increase 1.8%, standard deviation 26.6%). However, there was a tendency for people with greater declines in serum PFOA or PFOS to have greater LDL decrease. For a person whose serum PFOA fell by half, the predicted fall in LDL cholesterol was 3.6% (95% confidence interval = 1.5-5.7%). The association with a decline in PFOS was even stronger, with a 5% decrease in LDL (2.5-7.4%). Conclusions: Our findings from this longitudinal study support previous evidence from cross-sectional studies of positive associations between PFOA and PFOS in serum and LDL cholesterol.
The reproductive toxicity potential of Ammonium Salt of Perfluorinated Hexanoic Acid (PFHxA Ammonium Salt) in pregnant Crl: CD1(ICR) mice was investigated. Twenty females/group were administered the test substance or vehicle once daily from gestation day 6 through 18. Phase 1 doses: 0, 100, 350, and 500 mg/kg/d; phase 2: 0, 7, 35, and 175 mg/kg/d. Parameters evaluated include mortality, viability, body weights, clinical signs, abortions, premature deliveries, pregnancy and fertility, litter observations, maternal behavior, and sexual maturity in the F1 generation. The level of PFHxA Ammonium Salt was measured in the liver of F0 and F1 mice. At doses of 350 and 500 mg/kg/d maternal mortalities, excess salivation and changes in body weight gains occurred. Pup body weights were reduced on postpartum day (PPD) 0 in all the dosage groups, but persisted only in the 350 and 500 mg/kg/d groups. Additional effects at 300 and 500 mg/kg/d included stillbirths, reductions in viability indices, and delays in physical development. Levels of PFHxA Ammonium Salt in the livers of the 100 mg/kg/d dams were all below the lower limit of quantization (0.02 µg/mL); in the 350 mg/kg/d group, 3 of the 8 samples had quantifiable analytical results. In phase 2 no PFHxA Ammonium Salt was found in the liver. Adverse effects occurred only in the 175 mg/kg/d group and consisted of increased stillborn pups, pups dying on PPD 1, and reduced pup weights on PPD 1. Based on these data, the maternal and reproductive no observable adverse effect level of PFHxA Ammonium Salt is 100 mg/kg/d.
This article reviews perfluoroalkyl and polyfluoroalkyl substance (PFAS) characteristics, their occurrence in surface water, and their fate in drinking water treatment processes. PFASs have been detected globally in the aquatic environment including drinking water at trace concentrations and due, in part, to their persistence in human tissue some are being investigated for regulation. They are aliphatic compounds containing saturated carbon-fluorine bonds and are resistant to chemical, physical, and biological degradation. Functional groups, carbon chain length, and hydrophilicity/hydrophobicity are some of the important structural properties of PFASs that affect their fate during drinking water treatment. Full-scale drinking water treatment plant occurrence data indicate that PFASs, if present in raw water, are not substantially removed by most drinking water treatment processes including coagulation, flocculation, sedimentation, filtration, biofiltration, oxidation (chlorination, ozonation, AOPs), UV irradiation, and low pressure membranes. Early observations suggest that activated carbon adsorption, ion exchange, and high pressure membrane filtration may be effective in controlling these contaminants. However, branched isomers and the increasingly used shorter chain PFAS replacement products may be problematic as it pertains to the accurate assessment of PFAS behaviour through drinking water treatment processes since only limited information is available for these PFASs.