Per- and polyfluoroalkyl substances in human breast milk and current analytical methods

Per- and polyfluoroalkyl substances (PFASs) have since become a major health concern as they have been reportedly found in human tissues, blood and breast milk. The main aim of the study was to review the current data on PFASs in human breast milk, including the challenges of analysis as well as the possible modes of transfer from maternal blood. In this paper, previously published data on the concentrations of PFASs in human breast milk from around the world were reviewed and summarised. Eligible studies with reference lists published before 1 June 2017 were included by searching several databases (including Scopus, ScienceOpen and SciFinder). From this search, studies with the number of participants in each study ranging from 2 to 1237 were identified. The review indicated that based on the structural profiles and concentration levels, there was variation in the geographical distribution of these compounds in breast milk. Although there are no recorded investigations on the modes of transfer from maternal blood to breast milk, literature suggests that the PFASs tend to be transferred through binding to various proteins. The review also examined the different sample preparation and analytical methods employed to measure the concentrations of PFASs in human breast milk. This showed that solid phase extraction was the most common extraction method. After extraction, liquid chromatography coupled with tandem mass spectrometry was the most common analysis method. Since several of these methods were initially dedicated to monitoring PFASs in food and water, they demonstrate some limitations with regard to specificity and sensitivity to human fluids. Additionally, there are currently no published records of certified reference materials and/or proficiency scheme devoted to standardising PFAS concentrations in breast milk.