Future Industries Institute (FII), University of South Australia, Mawson Lakes, South Australia, Australia.
University of Sydney, New South Wales, United Kingdom.
Environ Res. 2022 Sep;212(Pt C):113431. doi: 10.1016/j.envres.2022.113431. Epub 2022 May 13.
Per- and polyfluoroalkyl substances (PFAS) are highly persistent, manufactured chemicals used in various manufacturing processes and found in numerous commercial products. With over 9000 compounds belonging to this chemical class, there is increasing concern regarding human exposure to these compounds due to their persistent, bioaccumulative, and toxic nature. Human exposure to PFAS may occur from a variety of exposure sources, including, air, food, indoor dust, soil, water, from the transfer of PFAS from non-stick wrappers to food, use of cosmetics, and other personal care products. This critical review presents recent research on the health-related impacts of PFAS exposure, highlighting compounds other than Perfluorooctanoic acid (PFOA) and Perfluoroctane sulfonate (PFOS) that cause adverse health effects, updates the current state of knowledge on PFAS toxicity, and, where possible, elucidates cause-and-effect relationships. Recent reviews identified that exposure to PFAS was associated with adverse health impacts on female and male fertility, metabolism in pregnancy, endocrine function including pancreatic dysfunction and risk of developing Type 2 diabetes, lipid metabolism and risk of childhood adiposity, hepatic and renal function, immune function, cardiovascular health (atherosclerosis), bone health including risk for dental cavities, osteoporosis, and vitamin D deficiency, neurological function, and risk of developing breast cancer. However, while cause-and-effect relationships for many of these outcomes were not able to be clearly elucidated, it was identified that 1) the evidence derived from both animal models and humans suggested that PFAS may exert harmful impacts on both animals and humans, however extrapolating data from animal to human studies was complicated due to differences in exposure/elimination kinetics, 2) PFAS precursor kinetics and toxicity mechanism data are still limited despite ongoing exposures, and 3) studies in humans, which provide contrasting results require further investigation of the long-term-exposed population to better evaluate the biological toxicity of chronic exposure to PFAS.
全氟和多氟烷基物质（PFAS）是高度持久的人造化学品，用于各种制造工艺，并存在于众多商业产品中。由于其持久性、生物累积性和毒性，属于这一化学类别的化合物超过 9000 种，人们越来越关注人类接触这些化合物的情况。人类接触 PFAS 可能来自多种暴露源，包括空气、食物、室内灰尘、土壤、水、从不粘包装转移到食物中的 PFAS、化妆品和其他个人护理产品的使用。本综述介绍了最近关于 PFAS 暴露与健康相关影响的研究，重点介绍了除全氟辛酸（PFOA）和全氟辛烷磺酸（PFOS）以外的化合物对健康的不良影响，更新了目前对 PFAS 毒性的认识，并尽可能阐明因果关系。最近的综述确定，接触 PFAS 与女性和男性生育能力、妊娠期间的新陈代谢、内分泌功能（包括胰腺功能障碍和 2 型糖尿病风险）、脂质代谢和儿童肥胖风险、肝肾功能、免疫功能、心血管健康（动脉粥样硬化）、骨骼健康（包括龋齿风险）、骨质疏松症和维生素 D 缺乏症、神经功能以及患乳腺癌的风险有关。然而，尽管许多这些结果的因果关系尚无法明确阐明，但有以下几点发现：1）动物模型和人类的证据均表明 PFAS 可能对动物和人类都产生有害影响，然而由于暴露/消除动力学的差异，将动物数据外推到人类研究中很复杂；2）尽管正在进行接触，PFAS 前体动力学和毒性机制数据仍然有限；3）在人类中的研究结果存在差异，需要进一步研究长期暴露人群，以更好地评估 PFAS 慢性暴露的生物学毒性。
