Anderko Laura, Pennea Emma, Cardon Mary Kathryn, McDermott-Levy Ruth, Mutic Abby
MCN Am J Matern Child Nurs. 2025;50(3):133-140. doi: 10.1097/NMC.0000000000001090. Epub 2025 Apr 29.
Per- and polyfluoroalkyl substances (PFAS) constitute a large class of chemicals with widespread exposure in the United States. They are commonly used in products because they repel water, stain, and grease. Concerns about the health impacts from PFAS exposures continue to grow as science has linked this chemical family with a wide range of health effects. A recent report by the Agency for Toxic Substances and Disease Registry ( ATSDR, 2024 ), along with findings from the National Academies of Sciences, Engineering, and Medicine ( NASEM, 2022 ), found sufficient evidence for the following health effects in children: decreased antibody response, dyslipidemia, and decreases in birthweight. For pregnant patients, health effects include gestational hypertension and preeclampsia. Some of these chemicals can pass through human breastmilk and when tested, are routinely found in umbilical cord blood and fetal organs ( ATSDR, 2021 ). Concerns for human health prompted the U.S. Environmental Protection Agency (EPA) to recently regulate five different PFAS and combinations of them. We offer clinical perspectives based on the most current literature to reduce health effects including methods to reduce exposure, implications of lab testing, and clinical management considerations. This topic is important because of widespread human exposure. PFAS may bioaccumulate in humans; may increase cancer risk; have long half-lives in humans; and may affect the developing fetus and child. PFAS levels exceed EPA's Lifetime Health Advisory (LTHA) in drinking water in most states. An overview of this issue and related health concerns is presented in the context of implications for maternity and pediatric patients.
全氟和多氟烷基物质（PFAS）是一大类化学品，在美国广泛存在。它们常用于产品中，因为具有防水、防污和防油脂的特性。随着科学研究将这类化学物质与广泛的健康影响联系起来，人们对PFAS暴露所产生的健康影响的担忧不断增加。有毒物质和疾病登记署（ATSDR，2024年）最近的一份报告以及美国国家科学院、工程院和医学院（NASEM，2022年）的研究结果发现，有充分证据表明儿童会出现以下健康影响：抗体反应降低、血脂异常和出生体重下降。对于孕妇，健康影响包括妊娠高血压和先兆子痫。其中一些化学物质可以通过人乳传递，经检测，在脐带血和胎儿器官中经常能发现它们（ATSDR，2021年）。对人类健康的担忧促使美国环境保护局（EPA）最近对五种不同的PFAS及其组合进行了监管。我们根据最新文献提供临床观点，以减少健康影响，包括减少接触的方法、实验室检测的意义以及临床管理考虑因素。由于人类广泛接触，这个话题很重要。PFAS可能会在人体内生物蓄积；可能增加癌症风险；在人体内半衰期长；并且可能影响发育中的胎儿和儿童。在大多数州，饮用水中的PFAS水平超过了EPA的终身健康咨询水平（LTHA）。本文在对孕产妇和儿科患者的影响背景下，对这个问题及相关健康问题进行了概述。
