Per- and polyfluoroalkyl substances (PFAS) and immune system-related diseases: results from the Flemish Environment and Health Study (FLEHS) 2008–2014

Environmental Sciences Europe, vol. 35

Abstract

Abstract Background The successive FLEHS campaigns assess internal exposure to pollutants and associated early biological and health effects in participants of different age groups. Materials and methods Mother–newborn pairs (N = 220 in 2008–2009, age 18–42 years; N = 269 in 2013–2014, age 18–44 years), 197 adolescents 14–15 years (2010–2011), 201 adults 20–40 years (2008–2009) and 205 adults 50–65 years (2014) were recruited. For the various groups of subjects different sets of PFAS were assessed. Perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorobutane sulfonate (PFBS) were determined in cord plasma and peripheral serum as these were the PFAS compounds for which we had access to high quality measurements and which were expected to be present in the highest concentrations. Participants filled out a questionnaire based on the European Community Respiratory Health Survey questionnaire on asthma and allergy. In these cross-sectional studies associations were assessed using stepwise multiple logistic regression, with confounders (including smoking and familial occurrence of the disease) and potential covariates selected on the basis of experience in our previous studies and a literature search. Forest plots of odds ratios summarize the associations between the various PFAS on the one hand and the different immune outcomes on the other hand. Results For several self-reported immune system-related diseases inverse associations with PFAS serum concentrations were observed. These inverse associations were more pronounced in mothers and adults than in adolescents. A significant inverse association was observed in adults and mothers (for mothers based on measurements on cord plasma) between PFNA, PFOS, and PFHxS and asthma (for mothers also for PFOA), in mothers between PFHxS, PFNA and PFOS and allergic rhinitis, in mothers and adults between PFHxS and PFOS and some forms of allergy (for mothers also for PFOA), in adults between PFOA and eczema, and in adolescents between PFOS and systemic allergy. Conclusion Internal exposure to PFAS was associated with changes in immunological processes consistent with what has been reported in the literature. Whereas these changes were observed in many publications to be associated with adverse health effects, our findings suggest that they can also lead to inverse associations with certain immune system-related diseases.

Authors 15

1. Nicolas Van Larebeke corresponding

   Vrije Universiteit Brussel · Ghent University Hospital

   Affiliation as printed

   Department of Analytical, Environmental and Geochemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050, Brussels, Belgium

   Study Centre for Carcinogenesis and Primary Prevention of Cancer, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

2. Gudrun Koppen

   Flemish Institute for Technological Research

   Affiliation as printed

   VITO-Health, Boeretang 200, 2400, Mol, Belgium

3. Sam De Craemer

   Vrije Universiteit Brussel

   Affiliation as printed

   Department of Analytical, Environmental and Geochemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050, Brussels, Belgium

4. Ann Colles

   Flemish Institute for Technological Research

   Affiliation as printed

   VITO-Health, Boeretang 200, 2400, Mol, Belgium

5. Liesbeth M. Bruckers

   Hasselt University

   Affiliation as printed

   Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Agoralaan, Gebouw D, 3590, Diepenbeek, Belgium

6. Elly Den Hond

   Provincial Institute for Hygiene

   Affiliation as printed

   Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium

7. Eva Govarts

   Flemish Institute for Technological Research

   Affiliation as printed

   VITO-Health, Boeretang 200, 2400, Mol, Belgium

8. Bert Morrens

   University of Antwerp

   Affiliation as printed

   Department of Sociology, University of Antwerp, Sint-Jacobstraat 2-4, 2000, Antwerp, Belgium

9. Thomas Schettgen Aachen Institut Für Arbeits-, Sozial- Und Umweltmedizin

   RWTH Aachen University

   Affiliation as printed

   Institut für Arbeits-, Sozial- und Umweltmedizin, Pauwelsstrasse 30, 52074, Aachen, Germany

10. Sylvie Rémy

    Flemish Institute for Technological Research

    Affiliation as printed

    VITO-Health, Boeretang 200, 2400, Mol, Belgium

11. Dries Coertjens

    University of Antwerp

    Affiliation as printed

    Department of Sociology, University of Antwerp, Sint-Jacobstraat 2-4, 2000, Antwerp, Belgium

12. Tim S. Nawrot

    Hasselt University

    Affiliation as printed

    Centre of Environmental Sciences, Hasselt University, Agoralaan, Gebouw D, 3590, Diepenbeek, Belgium

13. Vera J. Nelen

    Provincial Institute for Hygiene

    Affiliation as printed

    Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium

14. Willy Baeyens

    Vrije Universiteit Brussel

    Affiliation as printed

    Department of Analytical, Environmental and Geochemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050, Brussels, Belgium

15. Greet E. R. Schoeters

    University of Antwerp · Flemish Institute for Technological Research

    Affiliation as printed

    Department of Biomedical Sciences, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Wilrijk, Belgium

    VITO-Health, Boeretang 200, 2400, Mol, Belgium