Rappazzo Kristen M, Coffman Evan, Hines Erin P
Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA.
National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Chapel Hill, NC 27709, USA.
Int J Environ Res Public Health. 2017 Jun 27;14(7):691. doi: 10.3390/ijerph14070691.
Perfluoroalkyl substances (PFAS), chemicals used to make products stain and stick resistant, have been linked to health effects in adults and adverse birth outcomes. A growing body of literature also addresses health effects in children exposed to PFAS. This review summarizes the epidemiologic evidence for relationships between prenatal and/or childhood exposure to PFAS and health outcomes in children as well as to provide a risk of bias analysis of the literature. A systematic review was performed by searching PubMed for studies on PFAS and child health outcomes. We identified 64 studies for inclusion and performed risk of bias analysis on those studies. We determined that risk of bias across studies was low to moderate. Six categories of health outcomes emerged. These were: immunity/infection/asthma, cardio-metabolic, neurodevelopmental/attention, thyroid, renal, and puberty onset. While there are a limited number of studies for any one particular health outcome, there is evidence for positive associations between PFAS and dyslipidemia, immunity (including vaccine response and asthma), renal function, and age at menarche. One finding of note is that while PFASs are mixtures of multiple compounds few studies examine them as such, therefore the role of these compounds as complex mixtures remains largely unknown.
全氟烷基物质（PFAS）是用于制造具有防污和防粘性能产品的化学物质，已被证明与成年人的健康影响以及不良出生结局有关。越来越多的文献也探讨了接触PFAS的儿童的健康影响。本综述总结了产前和/或儿童期接触PFAS与儿童健康结局之间关系的流行病学证据，并对文献进行偏倚风险分析。通过在PubMed上搜索关于PFAS与儿童健康结局的研究进行了系统综述。我们确定了64项纳入研究，并对这些研究进行了偏倚风险分析。我们判定各研究的偏倚风险为低到中度。出现了六类健康结局。它们是：免疫/感染/哮喘、心脏代谢、神经发育/注意力、甲状腺、肾脏和青春期开始。虽然针对任何一种特定健康结局的研究数量有限，但有证据表明PFAS与血脂异常、免疫（包括疫苗反应和哮喘）、肾功能以及初潮年龄之间存在正相关。一个值得注意的发现是，虽然PFAS是多种化合物的混合物，但很少有研究将它们作为混合物进行研究，因此这些化合物作为复杂混合物的作用在很大程度上仍然未知。
