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From the Journals

PFAS Exposure Tied to Hormone Disruption

Growing evidence links even low-level PFAS exposure to endocrine disruption, with a new study identifying n-PFOS as a leading driver of risk among women.

Conexiant

Increasing evidence suggests that even low-level, chronic exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) commonly found in contaminated drinking water, food, indoor dust, outdoor air, and soil may disrupt endocrine function (ED) and harm health. These substances can alter hormone secretion, menstrual cyclicity, and fertility, and affect reproductive tissues directly or indirectly through endocrine disruption.

A cross-sectional study investigating the association between exposure to PFAS and endocrine disruption among women has found that certain PFAS compounds, especially n-PFOS, were associated with higher odds of endocrine disruption among this population. The study by Ripon et al is published in JAMA Network Open.

Study Methodology

The researchers examined data from nearly 2,000 women participating in the National Health and Nutrition Examination Survey from 2015 to 2020. Median age of the women was 56 years; 12.5% were Black, 8.5% were Mexican American, 6.2% identified as other Hispanic, and 63.7% were White.

The primary outcome, endocrine disruption, was defined as a self-reported presence or absence of estrogen or progesterone hormone or both intake. Primary exposure ED was used as a proxy measure for exposure to exogenous estrogen or progesterone, not for clinically diagnosed ED. Primary exposures included serum concentration of seven PFAS analytes, including Me-PFOSA-AcOH, PFNA, PFUnDA, n-PFOA, Sb-PFOA, n-PFOS, and sm-PFOS.

Covariates included self-reported race and ethnicity, smoking status, physical activity, alcohol use, blood pressure, cholesterol level, age, family poverty income ratio, and body mass index.

Before data preparation, the researchers excluded any women with missing ED or survey design variable information. They conducted Bayesian kernel machine regression (BKMR) to assess the association of multiple PFAS exposures with ED.

Results

The researchers found that participants with endocrine disruption were more likely to be non-Hispanic White and older, and had higher median concentrations of several PFAS compounds, including M Me-PFOSA-AcOH, PFNA, PFOA, PFOS, and sm-PFOS.

In regression spline models, n-PFOS showed the highest adjusted estimate in the association with ED, with 10.8 (95% CI, 6.41-15.2) at the first spline, while other PFAS (PFNA and Me-PFOSA-AcOH) also had positive associations with smaller estimates across several spline terms. In BKMR, increasing all PFAS mixture exposures from the 25th to 75th percentile changed associated odds ratios of ED from 0.82 (95% CI, 0.78-0.84) to 1.49 (95% CI, 1.36-1.67); sm-PFOS had the highest posterior inclusion probability (0.95).

“Data from this cross-sectional study show that exposure to single and mixtures of PFAS was associated with higher odds of ED among women. Our findings demonstrated that certain PFAS compounds, particularly n-PFOS, were associated with ED. PFAS are widely used in industry, and increasing evidence suggests that even low-level, chronic exposure may disrupt endocrine function and harm health,” concluded the study authors.

Key Points

  • Certain PFAS compounds, especially n-PFOS, were associated with higher odds of endocrine disruption among women.

  • PFAS are widely used in industry, and increasing evidence suggests that even low-level, chronic exposure may disrupt endocrine function and harm health.