Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Environ Health Perspect. 2023 Jan;131(1):17005. doi: 10.1289/EHP11292. Epub 2023 Jan 23.
Infancy perfluoroalkyl substances (PFAS) exposure from breastfeeding is partially determined by the transfer efficiencies (TEs) of PFAS from maternal serum into breast milk. However, to our knowledge there are no studies of such TEs in highly exposed populations.
We estimated the TEs of PFAS from maternal serum into colostrum and breast milk in a cohort of women with a wide range of PFAS exposures.
The Ronneby Mother-Child Cohort was established in 2015 after PFAS contamination was discovered in the public drinking water of Ronneby, Sweden. We measured seven PFAS in matched samples of maternal serum at delivery and colostrum and breast milk. We calculated the TE (in percentage) as the ratio of PFAS in colostrum or breast milk to serum multiplied by 100 and evaluated whether TEs varied by PFAS, lactation stage, or exposure level using a series of linear mixed-effects models with a random intercept for each woman.
This study included 126 mothers. PFAS associated with firefighting foams [i.e., perfluorohexane sulfonic acid (PFHxS) and perfluorooctane sulfonic acid (PFOS)] were substantially elevated in the serum, colostrum, and breast milk samples of highly exposed women in the cohort and showed strong correlation. PFHxS and PFOS also contributed the largest fraction of total PFAS on average in colostrum and breast milk. Median TEs varied from 0.9% to 4.3% and were higher for perfluoroalkyl carboxylic acids, including perfluorooctanoic acid, than perfluoroalkane sulfonic acids, including PFHxS and PFOS. TEs varied by exposure level, but there was not a consistent pattern in this variation.
PFAS concentrations in the colostrum and breast milk of highly exposed women were higher than the concentrations in low-exposed women, and TEs were of a similar magnitude across exposure categories. This implies that breastfeeding may be an important route of PFAS exposure for breastfeeding infants with highly exposed mothers, although the relative contribution of breastfeeding vs. prenatal transplacental transfer remains to be clarified. https://doi.org/10.1289/EHP11292.
婴儿通过母乳喂养摄入全氟烷基物质（PFAS）部分取决于 PFAS 从母体血清向母乳中的转移效率（TE）。然而，据我们所知，在高度暴露的人群中，尚无此类 TE 的研究。
我们在一个 PFAS 暴露范围广泛的女性队列中估计了 PFAS 从母体血清向初乳和母乳中的 TE。
罗尼比母婴队列于 2015 年在瑞典罗尼比市公共饮用水中发现 PFAS 污染后成立。我们在分娩时以及初乳和母乳中测量了母体血清中七种 PFAS。我们将 TE（以百分比表示）计算为初乳或母乳中 PFAS 与血清中 PFAS 的比值乘以 100，并使用一系列具有每个女性随机截距的线性混合效应模型评估 TE 是否因 PFAS、泌乳阶段或暴露水平而异。
这项研究包括 126 位母亲。与消防泡沫相关的 PFAS（即全氟己烷磺酸（PFHxS）和全氟辛烷磺酸（PFOS））在队列中高度暴露的女性的血清、初乳和母乳样本中含量明显升高，且相关性很强。PFHxS 和 PFOS 也平均在初乳和母乳中贡献了最大的 PFAS 部分。中位数 TE 从 0.9%到 4.3%不等，且全氟烷羧酸（包括全氟辛酸）的 TE 高于全氟烷磺酸（包括 PFHxS 和 PFOS）。TE 因暴露水平而异，但这种变化没有一致的模式。
高度暴露女性的初乳和母乳中的 PFAS 浓度高于低暴露女性，且在不同暴露类别中 TE 处于相似的水平。这意味着，对于高度暴露母亲的母乳喂养婴儿，母乳喂养可能是 PFAS 暴露的重要途径，尽管母乳喂养与产前经胎盘转移的相对贡献仍有待阐明。
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