Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan, 430071, PR China.
Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, PR China.
Environ Pollut. 2022 Aug 1;306:119442. doi: 10.1016/j.envpol.2022.119442. Epub 2022 May 11.
Vaccines are essential for children to defend against infection. Per- and polyfluoroalkyl substances (PFAS) are emerging contaminants with the characteristics of persistence and bioaccumulation. PFAS exposure can affect the function of the nervous, endocrine, and immune system of animals and humans. We aimed to conduct a systematic review and meta-analysis of the epidemiological studies investigating potential relationships between PFAS exposure and vaccine antibody levels, and assessed whether PFAS would affect vaccine response in healthy children. A literature search was conducted in PubMed, Web of Science, and Scopus databases up to February 2022. We chose studies that measured serum vaccines antibodies and PFAS concentrations of the participants. Essential information, including mean difference of percentage change, regression coefficient, odds ratio, Spearman correlation coefficient, and 95% confidence intervals, were extracted from the selected studies to conduct descriptive analysis and meta-analysis where appropriate. The qualities of these studies were evaluated as well. Finally, nine epidemiological studies about children met our inclusion criteria. A high degree of heterogeneity is observed in terms of breastfeeding time, confounder control, and detection method. Exposure to perfluorooctanoic acid and perfluorohexane sulfonic acid is negatively associated with tetanus antibody level in children without heterogeneity by Cochran's Q test (p = 0.26; p = 0.55), and exposure to perfluorohexane sulfonate is negatively associated with tetanus antibody level but with heterogeneity (p = 0.04). This comprehensive review suggests that PFAS can have adverse health effects on children by hindering the production of vaccine antibodies. There are some consistent and negative associations between children exposure to certain PFAS and tetanus antibody level. The association of the other four vaccines (measles, rubella, mumps, and influenza) with PFAS remains uncertain, because very few studies are available. Further studies are needed to validate the possible associations.
疫苗对于儿童抵御感染至关重要。全氟和多氟烷基物质（PFAS）是具有持久性和生物累积性的新兴污染物。PFAS 暴露会影响动物和人类的神经、内分泌和免疫系统的功能。我们旨在对调查 PFAS 暴露与疫苗抗体水平之间潜在关系的流行病学研究进行系统评价和荟萃分析，并评估 PFAS 是否会影响健康儿童的疫苗反应。我们在 PubMed、Web of Science 和 Scopus 数据库中进行了文献检索，检索截至 2022 年 2 月。我们选择了测量参与者血清疫苗抗体和 PFAS 浓度的研究。从选定的研究中提取了必要信息，包括百分比变化的均数差、回归系数、比值比、斯皮尔曼相关系数和 95%置信区间，以进行描述性分析和适当的荟萃分析。我们还评估了这些研究的质量。最后，有 9 项关于儿童的流行病学研究符合我们的纳入标准。在母乳喂养时间、混杂因素控制和检测方法方面存在高度异质性。通过 Cochran's Q 检验，发现全氟辛酸和全氟己烷磺酸暴露与儿童破伤风抗体水平呈负相关，无异质性（p=0.26；p=0.55），而全氟己烷磺酸盐暴露与破伤风抗体水平呈负相关，但具有异质性（p=0.04）。这项全面的综述表明，PFAS 通过阻碍疫苗抗体的产生，对儿童的健康产生不良影响。某些 PFAS 暴露与破伤风抗体水平之间存在一些一致的负相关关系。由于可用的研究很少，因此其他四种疫苗（麻疹、风疹、腮腺炎和流感）与 PFAS 的关联仍不确定。需要进一步的研究来验证可能的关联。
