Associations of Maternal Serum Perfluoroalkyl Substances Concentrations with Early Adolescent Bone Mineral Content and Density: The Health Outcomes and Measures of the Environment (HOME) Study

Abstract

Background: Per- and polyfluoroalkyl substances (PFAS) may impair bone accrual and strength via endocrine disruption and nuclear receptor agonism, but human studies are primarily of adults or cross-sectional. Objectives: We assessed associations of individual PFAS and their mixture during pregnancy with child bone mineral content (BMC) and areal bone mineral density (aBMD) at age 12 y. Methods: Among 206 mother–child pairs enrolled in a prospective cohort (2003–2006), we quantified perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS) in maternal serum collected during gestation or delivery. When children were age 12 y, we performed dual energy X-ray absorptiometry and calculated BMC, aBMD, and bone mineral apparent density (BMAD) -scores for six skeletal sites. We estimated covariate-adjusted -score differences per doubling of individual PFAS using linear regression and assessed the PFAS mixture using quantile g-computation and Bayesian kernel machine regression. We explored whether associations were modified by child’s sex or mediated by whole-body lean mass. Results: In covariate-adjusted models, we found that higher maternal serum concentrations of PFOA, PFNA, and the PFAS mixture were associated with lower total hip and forearm (one-third distal radius) BMC -scores in children. Differences in forearm BMC -scores were [95% confidence interval (CI): , 0.01] and (95% CI: , ) per doubling of PFOA and PFNA, respectively, and (95% CI: , ) per quartile increase in the PFAS mixture. Child’s sex modified PFOA associations for some skeletal sites; for example, differences in spine BMAD -score per doubling were (95% CI: , ) among males and 0.07 (95% CI: , 0.30) among females (modification ). Except for PFNA among females, these associations were not mediated by whole-body lean mass. Discussion: Maternal PFAS concentrations during pregnancy may be associated with lower bone mineral accrual and strength in early adolescence. https://doi.org/10.1289/EHP9424

Bone Accrual During Adolescence: Do Endocrine-Disrupting Chemicals Play a Role?

“…The authors found that higher concentrations of several PFAS and phthalate biomarkers were associated with lower total body less head aBMD Z scores in males, while there were modest positive associations with aBMD for some chemicals among females. Similar to prior epidemiologic studies examining prenatal ( 4 , 5 ) or childhood ( 6 , 7 ) PFAS exposures, Carwile and colleagues found the strongest magnitude of association for exposure to perfluorooctanoate.…”

Association between perfluoroalkyl substances concentration and bone mineral density in the US adolescents aged 12-19 years in NHANES 2005-2010

“…Also in a prospective study, PFOA and PFOS were associated with low BMD at several sites including spine, total hip, femoral neck, and hip rotor, and similar correlations were found for PFHxS, PFNA, and perfluorodecanoic acid (PFDA) in the intertransverse region of the hip ( 32 ). In addition to reports examining the relationship between a specific population’s autologous PFAS exposure and bone mineral density, several studies have found a negative correlation between serum PFAS concentrations in women exposed prenatally to PFAS and their offspring’s site-specific bone mineral density ( 14 , 33 , 34 ).…”

“…Although the use PFASs is now widely restricted ( ), a significant percentage of the global population is still exposed to them. PFAS have been classified as endocrine-disrupting chemicals (EDCs) ( 9 ), which together with other EDCs have been shown to be strongly associated with a wide range of human health issues including male and female reproductive health, obesity and metabolism, neurodevelopment, and bone health ( 10 , 11 ), however, few studies have reported on the effects of such environmental pollutant exposures on adolescent bone health ( 12 , 13 ), and previous studies on PFAS exposure in adolescent bone health have only primarily collected maternal prenatal PFAS exposure levels ( 14 , 15 ), therefore the extent of the effect of different PFAS on BMD in adolescents is unclear. However, on the basis of the limited available data suggesting a negative association between PFAS exposure and BMD, we proceeded to test the hypothesis that higher PFAS concentrations are associated with lower BMD in the NHANES 2005-2010 cross-sectional survey of adolescents aged 12-19 years.…”

Hollow Covalent Organic Framework with “Shell‐Confined” Environment for the Effective Removal of Anionic Per‐ and Polyfluoroalkyl Substances

“…[ 2 ] Since they were widely measured in wildlife and the human body from the early 21 st century, the escalating contamination by PFAS has attracted sustained attention. [ 3 ] Exposure to PFAS through contaminated water has been linked to adverse health effects such as diabetes, [ 4 ] osteoporosis, [ 5 ] and miscarriage. [ 6 ] With restricted regulations aiming at anionic PFAS elimination, millions of dollars have been invested in handling these “forever chemicals”.…”