Association between prenatal exposure to perfluorinated compounds and symptoms of infections at age 1–4years among 359 children in the Odense Child Cohort

Abstract

Introduction: Perfluorinated alkylated substances (PFAS) are persistent industrial chemicals that have resulted in global environmental exposures. Previous epidemiological studies have reported possible effects on the immune system after developmental PFAS exposure, but the possible impact on childhood infectious disease is unclear.Objectives: To investigate the association between prenatal exposure to PFAS and symptoms of infections at age 1-4 years. Methods:The Odense Child Cohort is an on-going prospective study on children's health, where serum concentrations of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorodecanoic acid (PFDA) and perfluorononanoic acid (PFNA) were measured in 649 pregnant women before gestational week 16. Of these women, 359 reported on symptoms of infection in their child every two weeks for a one-year period. The association between prenatal exposure to PFAS and the symptoms was estimated using a logistic regression model and a negative binomial regression model. For the latter, the outcome was reported as an incidence rate-ratio (IRR), and all models were adjusted for maternal age, educational level, parity and child age.Results: On average, and accounting for incomplete reporting, the children experienced symptoms of infection 23% of the time during one year. PFOS exposure in the high tertile compared to the low tertile was associated with a statistically significant increased proportion of days with fever (IRR: 1.65 (95% CI: 1.24, 2.18), p-trend<0.001) and an increased odds of experiencing days with fever above the median (OR: 2.35 (95%CI: 1.31, 4.11). The latter tendency was also apparent for PFOA (OR: 1.97 (95%CI: 1.07, 3.62). Further, higher concentrations of PFOS and PFOA tended to increase the number of episodes of cooccurrence of fever and coughing and fever and nasal discharge during the one-year study period. 4 Conclusion:We found a positive association between prenatal exposure to PFOS and PFOA and the prevalence of fever, which may be a sensitive marker of infection. This finding is in agreement with an immunotoxic effect of prenatal exposure to PFAS. The wider implications for childhood infectious disease deserve attention.

Estimated exposures to perfluorinated compounds in infancy predict attenuated vaccine antibody concentrations at age 5-years

“…Thus, increased incidence of common cold and gastroenteritis in 3-year-olds were recorded in relation to higher maternal serum PFOA concentrations during pregnancy (Granum et al 2013), and a greater incidence of infection was also linked with lower vaccine antibody concentrations (Pennings et al 2016). Similarly, the incidence of disease with high fever in small children was positively associated with the mother’s serum-PFAS concentrations in early pregnancy (Dalsager et al 2016). While serum concentrations of PFOS and PFOA during pregnancy were apparently not associated with the total hospitalization rate for infectious diseases in school-age children (Fei et al 2010), quality concerns regarding the serum-PFAS analyses in this cohort (Bach et al 2015) questions the validity of this report.…”

Internal exposure to perfluoroalkyl substances (PFASs) and biological markers in 101 healthy 1-year-old children: associations between levels of perfluorooctanoic acid (PFOA) and vaccine response

“…The few previous studies on the susceptibility to infections in young children focused on the prenatal PFAS exposure only (based on levels of PFASs in maternal blood at delivery or cord blood) and in part reported positive associations, e.g. with the prevalence of fever at the age of 1 to 4 years (Dalsager et al 2016), while others did not find such associations (e.g. Okada et al 2012).…”

Developmental Exposures to Perfluoroalkyl Substances (PFASs): An Update of Associated Health Outcomes

“…Three studies, however, did find PFASs to be related to infections. Higher maternal PFOA and PFOS concentrations were found to be associated with a greater proportion of days with fever and an increased number of episodes of fever and coughing and fever and nasal discharge in Danish children aged 1 to 3 years [50]. In Norway, positive associations between maternal PFOA and PFNA concentrations and the number of episodes of common cold and between PFOA and PFHxS and the number of episodes of gastroenteritis in offspring were reported [58], but this group did not see associations with otitis media.…”