Perfluoroalkyl chemicals and human fetal development: An epidemiologic review with clinical and toxicological perspectives
Perfluoroalkyl chemicals and human fetal development: An epidemiologic review with clinical and toxicological perspectives
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DOI：
10.1016/j.reprotox.2009.02.001
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发表时间：
2009-06-01
影响因子：
3.3
通讯作者：
Zobel, Larry R.
中科院分区：
文献类型：
--
作者：
Olsen, Geary W.;Butenhoff, John L.;Zobel, Larry R.
流行病学家开始关注全氟辛烷磺酸(PFOS)和全氟辛酸(PFOA)对人类发育的影响，这是剂量依赖的发育毒理学研究的结果，这些研究报告了存活大鼠和小鼠出生体重降低、出生后死亡率增加和出生后生长减少的影响。引起流行病学兴趣的原因是全氟辛烷磺酸和全氟辛酸在普通人群中广泛存在，人类血清消除半衰期较长，以及通过测量配对的母血和脐带血样本确定全氟辛烷磺酸和全氟辛酸在人类胎盘中的转移。这篇文章的目的是定性地回顾已发表的流行病学文献，因为它与暴露于全氟辛烷磺酸和全氟辛烷磺酸与人类胎儿发育的潜在关联有关。发表的研究重点是出生体重和其他反映人类胎儿发育的测量数据。共审查了8项流行病学研究，重点是6个一般(非职业)和2个职业人口。在六项一般人口研究中，有五项研究考察了出生体重和其他人体测量指标与母亲血液和/或脐带全氟辛烷磺酸和全氟辛烷磺酸浓度之间的关系。在第六项研究中，俄亥俄州华盛顿县的三个地理区域根据其公共饮用水来源进行了分类，这些地区含有全氟辛酸，导致血清浓度高于其他一般人口研究中观察到的浓度。职业研究集中在全氟化学品制造场所(亚利桑那州迪凯特)，根据工作历史和生物监测数据对暴露进行分类。在研究对象中测量全氟辛烷磺酸和全氟辛烷磺酸的五项普通人群研究中，报告的几种不同出生结局的相关性不一致，包括出生体重、出生长度、头围和体重指数。在社区饮用水研究中，没有报告与出生体重或胎龄有关。只有一项普通人群研究检查了6个月和18个月大的婴儿阿普加评分和发育里程碑，没有相关报道。在全氟化学品生产的女性工人中，没有观察到自我报告的出生体重和职业暴露于全氟辛烷磺酸材料。讨论了这些流行病学数据的方法学优势和劣势、与毒理学结果的一致性、研究之间相关性的一致性以及看似合理的替代解释。提供的流行病学、临床和毒理学见解可能对人类健康风险表征有用。计划在未来几年内完成的研究也被引用。这篇综述的附录描述了唯一一项调查的结果，该调查试图确定一般人群中母亲(怀孕4-14周)全氟辛烷磺酸和全氟辛烷磺酸浓度与生育力之间是否存在因果关系，以怀孕时间(TTP)衡量。关于可能限制这项特定研究的推论的方法和数据分析的重要问题被处理。(C)2009 Elsevier Inc.保留所有权利。
Epidemiologists began to focus on human developmental outcomes with perfluorooctanesulfonate(PFOS) and perfluorooctanoate (PFOA) as a consequence of dose-dependent developmental toxicological studies that reported effects of lowered birth weight, increased postnatal mortality, and decreased postnatal growth in surviving rats and mice. Contributing to the epidemiologic interest was the widespread presence of PFOS and PFOA in the general population, lengthy serum elimination half-lives in humans, and the placental transfer of PFOS and PFOA in humans that was established via measurement of paired maternal and umbilical cord blood samples. The purpose of this paper is to qualitatively review the published epidemiologic literature as it pertains to the potential association of exposure to PFOS and PFOA with human fetal development. The published research has focused on birth weight and other measurements that reflect human fetal development. A total of eight epidemiologic studies were reviewed that focused on six general (non-occupational) and two occupational populations. Of the six general population studies, five examined associations between birth weight and other anthropometric measurements in relation to maternal blood and/or umbilical cord concentrations of PFOS and PFOA. In the sixth study, three geographical areas in Washington County, Ohio, were categorized by their public drinking water sources that contained PFOA that had resulted in higher serum concentrations than observed in other general population studies. The occupational studies focused on a perfluorochemical manufacturing site (Decatur, AL) with exposure categorized from work history and biomonitoring data. There were inconsistent associations reported for several different birth outcomes, including birth weight, birth length, head circumference, and ponderal index, among the five general population studies that measured PFOS and PFOA in the study subjects. No association with birth weight or gestational age was reported in the community drinking water study. Only one general population study examined infant Apgar scores and developmental milestones at 6 and 18 months of age with no associations reported. No association with self-reported birth weight and occupational exposure to PFOS materials was observed among female perfluorochemical production workers. These epidemiologic data are discussed in relation to their methodological strengths and weaknesses, coherence with toxicological results, consistency of associations between studies, and plausible alternative explanations. Epidemiological, clinical, and toxicological insights are offered that may be useful for human health risk characterization. Studies scheduled for completion in the next few years are also cited. An appendix to this review describes the results of the only investigation that attempted to determine whether a causal association existed between maternal (4-14 weeks gestation) PFOS and PFOA concentrations in a general population and fecundity, as measured by time to pregnancy (TTP). Important issues are addressed regarding the methods and data analysis that may limit inferences from this particular study. (C) 2009 Elsevier Inc. All rights reserved.