Environmental exposure to per- and polyfluoroalkyl substances and childhood congenital heart disease: a mixed
Xianting Jiao1, Liqing Zhao2, Yuejuan Xu2
1Department of Pediatric Infectious, Department of Pediatric Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Per- and polyfluoroalkyl substances (PFAS) exposure is linked to increased congenital heart disease (CHD) risk in children. Specific PFAS like Perfluorobutanoic acid (PFBA) and Perfluorohexanoic acid (PFHxA) were significant contributors.
Area of Science:
- Environmental Health
- Toxicology
- Pediatric Cardiology
Background:
- Per- and polyfluoroalkyl substances (PFAS) are ubiquitous environmental contaminants linked to various adverse health outcomes.
- Limited research has investigated the association between PFAS exposure and congenital heart disease (CHD) in children.
Purpose of the Study:
- To investigate the relationship between exposure to specific per- and polyfluoroalkyl substances (PFAS) and the risk of congenital heart disease (CHD) in children.
- To analyze the impact of individual PFAS compounds and their mixtures on CHD risk using advanced statistical models.
Main Methods:
- A hospital-based case-control study involving 282 children with CHD and 282 controls.
- Plasma samples analyzed for 19 PFAS congeners using logistic regression, Bayesian kernel-machine regression (BKMR), and weighted quantile sum (WQS) models.
- Mixed analysis approach to assess associations between individual PFAS, PFAS mixtures, and CHD risk.
Main Results:
- Elevated plasma concentrations of multiple PFAS compounds were observed in children with CHD compared to controls.
- Significant associations were found between CHD risk and specific PFAS, including Perfluorobutanoic acid (PFBA), Perfluorohexanoic acid (PFHxA), and others.
- BKMR and WQS analyses identified PFBA, 8:2 Cl-PFESA, PFHxA, and Perfluorotetradecanoic acid (PFTeDA) as key contributors to CHD risk from PFAS mixtures.
Conclusions:
- PFAS mixture exposure is associated with an increased risk of congenital heart disease (CHD) in pediatric populations.
- Specific PFAS, including 6:2 Chlorinated polyfluoroalkyl ether sulfonic acid (6:2 Cl-PFESA), 8:2 Cl-PFESA, PFBA, PFHxA, and PFTeDA, play significant roles in this association.
Background:
Per- and polyfluoroalkyl substances (PFAS) exposure is associated with various health risks. However, limited research has explored their potential connection with congenital heart disease (CHD).
Objective:
This study aimed to investigate the relationship between different types of PFAS and childhood CHD using a mixed analysis approach.
Methods:
A hospital-based case-control study was conducted involving 282 children with CHD and 282 control participants. Plasma samples were analyzed for 19 PFAS congeners. Logistic regression, Bayesian kernel-machine regression (BKMR), and weighted quantile sum (WQS) models were employed to assess the association between individual PFAS and PFAS mixtures with CHD risk.
Results:
Analysis of 564 subjects revealed higher plasma concentrations of various PFAS compounds in the CHD-group. Logistic regression identified significant associations between CHD risk and specific PFAS, notably 6:2 Chlorinated polyfluoroalkyl ether sulfonic acid (6:2 Cl-PFESA) (OR = 1.65; 95%CI: 1.40-1.94), 8:2 8:2 Cl-PFESA (OR = 1.69; 95%CI: 1.69-2.19), Perfluorobutanoic acid (PFBA) (OR = 2.68; 95%CI: 2.28-3.15), Perfluorobutane sulfonic acid (PFBS) (OR = 2.38; 95%CI: 1.77-3.22), Perfluorohexanoic acid (PFHxA) (OR = 2.62; 95%CI: 1.99-3.45), and Perfluorotetradecanoic acid (PFTeDA) (OR = 2.18; 95%CI: 1.81-2.63). BKMR analysis confirmed these findings. WQS analysis emphasized PFBA, 8:2 Cl-PFESA, PFHxA, and PFTeDA as key contributors to the association between PFAS mixture exposure and CHD risk.
Conclusion:
Exposure to PFAS mixtures was associated with an increased risk of CHD in children, with 6:2 Cl-PFESA, 8:2 ClPFESA, PFBA, PFHxA, and PFTeDA playing significant roles.
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