Impact of PFAS exposure on prevalence of immune-mediated diseases in adults in the Czech Republic

Environ Res. 2023 Jul 15:229:115969. doi: 10.1016/j.envres.2023.115969. Epub 2023 Apr 26.

Abstract

Background: Per- and polyfluoroalkyl substances (PFASs) are emerging environmental contaminants with multiple hazardous properties including immunomodulation potency. Human exposure to PFASs has been associated with various immune-mediated diseases and outcomes. This study aimed to investigate the association between PFAS exposure and immune-mediated diseases such as allergies, eczemas, and autoimmune diseases in a population of adults in the Czech Republic.

Methods: This study included 309 adults from the Central European Longitudinal Study of Parents and Children: Young Adults (CELSPAC: YA). 12 PFASs were measured in participants' serum by HPLC-MS/MS, 3 PFASs were removed from the subsequent analyses due to low detection frequency. The associations of 9 PFASs with 9 immune-mediated diseases were assessed by logistic regression. Furthermore, Bayesian kernel machine regression (BKMR) was used to estimate the effect of the PFAS mixture on immune-mediated diseases. All analyses were adjusted for sex, age, BMI, smoking, education, and family history of immune-mediated diseases. In cases of a statistically significant interaction of PFASs and sex, stratified analyses were performed for men and women.

Results: Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) were negatively associated with both atopic eczema (OR per IQR increase 0.58 (95% CI 0.37-0.90) for PFOA and 0.56 (0.32-0.95) for PFOS) and contact dermatitis (0.37 (0.16-0.85) for PFOA and 0.33 (0.11-0.94) for PFOS). Perfluoroundecanoate (PFUnDA) was negatively associated with pollen, dust, and mite allergy (0.62 (0.43-0.89)). BKMR modelling showed a negative tendency in the overall effect of PFAS mixture on immune-health outcomes. Based on the stratified analysis, sex was suggested to be an effect modifier in the association of PFOS and atopic eczema.

Conclusion: Our results contribute to the body of literature that observes the immunosuppressive effect of PFAS exposure during eczemas and allergies, both for PFASs individually and as a mixture.

Keywords: Adult cohort; Allergy; Bayesian kernel machine regression; Eczema; Immune system; Perfluoroalkyl substances.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alkanesulfonic Acids* / toxicity
  • Bayes Theorem
  • Child
  • Czech Republic / epidemiology
  • Dermatitis, Atopic* / chemically induced
  • Dermatitis, Atopic* / epidemiology
  • Eczema*
  • Environmental Pollutants* / toxicity
  • Female
  • Fluorocarbons* / toxicity
  • Humans
  • Hypersensitivity*
  • Longitudinal Studies
  • Male
  • Prevalence
  • Tandem Mass Spectrometry
  • Young Adult

Substances

  • Environmental Pollutants
  • perfluorooctane sulfonic acid
  • Alkanesulfonic Acids
  • perfluorooctanoic acid
  • Fluorocarbons