Perfluoroalkyl substances (PFASs) and mercury in never-pregnant women of fertile age: association with fish consumption and unfavorable lipid profile

Anne-Lise Bjorke-Monsen, Kristin Varsi, Maria Averina, Jan Brox, Sandra Huber, Anne-Lise Bjorke-Monsen, Kristin Varsi, Maria Averina, Jan Brox, Sandra Huber

Abstract

Objectives: To examine concentrations of perfluoroalkyl substances (PFASs) and lifestyle factors that may contribute to higher levels of pollutants in never-pregnant women of fertile age.

Design: Observational cross-sectional study.

Setting: Participants were recruited among employees and students at Haukeland University Hospital and the University of Bergen, Norway.

Participants: Healthy, never-pregnant Norwegian women (n=158) of fertile age (18-39 years).

Outcomes: Concentrations of 20 different PFASs, mercury (Hg), lead, cadmium, total, high-density lipoprotein and low-density lipoprotein (LDL) cholesterol, in addition to self-reported data on dietary intake.

Results: Seven PFASs were detected in more than 95% of the women. Women aged 30-39 years had higher concentrations of sum PFAS compared with younger women. Serum PFASs were significantly intercorrelated (rho: 0.34-0.98, p<0.001) and six of them were significantly correlated to whole blood Hg (rho: 0.21-0.74, p<0.01). Fish consumption was the strongest predictor for most serum PFASs and for whole blood Hg. Fish consumption and serum perfluorooctanesulfonic acid (PFOS) concentrations were both positively associated with serum total and LDL cholesterol, established risk factors for cardiovascular disease.

Conclusions: The majority of Norwegian never-pregnant women of fertile age had a mixture of seven different PFASs and Hg detected in their blood. PFAS concentrations were higher in older women and associated with fish intake. As the mean age of women at first birth is increasing, several factors require further consideration including diet, as this may influence the burden of PFAS to the next generation.

Trial registration number: ClinicalTrials.gov ID: NCT03272022, Unique Protocol ID: 2011/2447, Regional Committee for Medical Research Ethics West (2011/2447), 12 January 2012.

Keywords: dietary patterns.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Serum perfluoroundecanoate (PFUnDA) in relation to whole blood mercury (Hg) in never-pregnant women aged 18–39 years, by generalised additive models. The values on the y-axes are given as difference from the respective mean values.
Figure 2
Figure 2
Serum total and low-density lipoprotein (LDL) cholesterol in relation to serum sum PFOS in never-pregnant women aged 18–39 years, by generalised additive models. The values on the y-axes are given as difference from the respective mean values. sum PFOS, sum perfluorooctanesulfonic acid.

References

    1. Sunderland EM, Hu XC, Dassuncao C, et al. . A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects. J Expo Sci Environ Epidemiol 2019;29:131–47. 10.1038/s41370-018-0094-1
    1. Byrne SC, Miller P, Seguinot-Medina S, et al. . Exposure to perfluoroalkyl substances and associations with serum thyroid hormones in a remote population of Alaska natives. Environ Res 2018;166:537–43. 10.1016/j.envres.2018.06.014
    1. Hanssen L, Dudarev AA, Huber S, et al. . Partition of perfluoroalkyl substances (PFASs) in whole blood and plasma, assessed in maternal and umbilical cord samples from inhabitants of Arctic Russia and Uzbekistan. Sci Total Environ 2013;447:430–7. 10.1016/j.scitotenv.2013.01.029
    1. Berg V, Nøst TH, Huber S, et al. . Maternal serum concentrations of per- and polyfluoroalkyl substances and their predictors in years with reduced production and use. Environ Int 2014;69:58–66. 10.1016/j.envint.2014.04.010
    1. Mamsen LS, Björvang RD, Mucs D, et al. . Concentrations of perfluoroalkyl substances (PFASs) in human embryonic and fetal organs from first, second, and third trimester pregnancies. Environ Int 2019;124:482–92. 10.1016/j.envint.2019.01.010
    1. United nations environment programme [Accessed 30 Sep 2018].
    1. EFSA Panel on Contaminants in the Food Chain (CONTAM), Knutsen HK, Alexander J, et al. . Risk to human health related to the presence of perfluorooctane sulfonic acid and perfluorooctanoic acid in food. Efsa J 2018;16:1–293. 10.2903/j.efsa.2018.5194
    1. Panseri S, Chiesa L, Ghisleni G, et al. . Persistent organic pollutants in fish: biomonitoring and cocktail effect with implications for food safety. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2019;36:601–11. 10.1080/19440049.2019.1579926
    1. Martí M, Ortiz X, Gasser M, et al. . Persistent organic pollutants (PCDD/Fs, dioxin-like PCBs, marker PCBs, and PBDEs) in health supplements on the Spanish market. Chemosphere 2010;78:1256–62. 10.1016/j.chemosphere.2009.12.038
    1. Fløtre CH, Varsi K, Helm T, et al. . Predictors of mercury, lead, cadmium and antimony status in Norwegian never-pregnant women of fertile age. PLoS One 2017;12:e0189169. 10.1371/journal.pone.0189169
    1. White SS, Birnbaum LS. An overview of the effects of dioxins and dioxin-like compounds on vertebrates, as documented in human and ecological epidemiology. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 2009;27:197–211. 10.1080/10590500903310047
    1. Rice KM, Walker EM, Wu M, et al. . Environmental mercury and its toxic effects. J Prev Med Public Health 2014;47:74–83. 10.3961/jpmph.2014.47.2.74
    1. Tian Y, Zhou Y, Miao M, et al. . Determinants of plasma concentrations of perfluoroalkyl and polyfluoroalkyl substances in pregnant women from a birth cohort in Shanghai, China. Environ Int 2018;119:165–73. 10.1016/j.envint.2018.06.015
    1. Carolan M. The graying of the obstetric population: implications for the older mother. J Obstet Gynecol Neonatal Nurs 2003;32:19–27. 10.1177/0884217502239797
    1. Kim S. Overview of cotinine cutoff values for smoking status classification. Int J Environ Res Public Health 2016;13. 10.3390/ijerph13121236. [Epub ahead of print: 14 Dec 2016].
    1. Kato K, Wong L-Y, Basden BJ, et al. . Effect of temperature and duration of storage on the stability of polyfluoroalkyl chemicals in human serum. Chemosphere 2013;91:115–7. 10.1016/j.chemosphere.2012.11.013
    1. Huber S, Brox J. An automated high-throughput SPE micro-elution method for perfluoroalkyl substances in human serum. Anal Bioanal Chem 2015;407:3751–61. 10.1007/s00216-015-8601-x
    1. Midttun Øivind, Kvalheim G, Ueland PM. High-throughput, low-volume, multianalyte quantification of plasma metabolites related to one-carbon metabolism using HPLC-MS/MS. Anal Bioanal Chem 2013;405:2009–17. 10.1007/s00216-012-6602-6
    1. EFSA Panel on Contaminants in the Food Chain (CONTAM), Knutsen HK, Alexander J, et al. . Risk to human health related to the presence of perfluorooctane sulfonic acid and perfluorooctanoic acid in food. Efsa J 2018;16:e05194. 10.2903/j.efsa.2018.5194
    1. Bartolomé M, Gallego-Picó A, Cutanda F, et al. . Perfluorinated alkyl substances in Spanish adults: geographical distribution and determinants of exposure. Sci Total Environ 2017;603-604:352–60. 10.1016/j.scitotenv.2017.06.031
    1. Graber JM, Alexander C, Laumbach RJ, et al. . Per and polyfluoroalkyl substances (PFAS) blood levels after contamination of a community water supply and comparison with 2013-2014 NHANES. J Expo Sci Environ Epidemiol 2019;29:172–82. 10.1038/s41370-018-0096-z
    1. Nelson JW, Hatch EE, Webster TF. Exposure to polyfluoroalkyl chemicals and cholesterol, body weight, and insulin resistance in the general U.S. population. Environ Health Perspect 2010;118:197–202. 10.1289/ehp.0901165
    1. Brantsæter AL, Whitworth KW, Ydersbond TA, et al. . Determinants of plasma concentrations of perfluoroalkyl substances in pregnant Norwegian women. Environ Int 2013;54:74–84. 10.1016/j.envint.2012.12.014
    1. Wang W, Zhou W, Wu S, et al. . Perfluoroalkyl substances exposure and risk of polycystic ovarian syndrome related infertility in Chinese women. Environ Pollut 2019;247:824–31. 10.1016/j.envpol.2019.01.039
    1. Averina M, Brox J, Huber S, et al. . Perfluoroalkyl substances in adolescents in northern Norway: lifestyle and dietary predictors. The Tromsø study, fit futures 1. Environ Int 2018;114:123–30. 10.1016/j.envint.2018.02.031
    1. Shu H, Lindh CH, Wikström S, et al. . Temporal trends and predictors of perfluoroalkyl substances serum levels in Swedish pregnant women in the SELMA study. PLoS One 2018;13:e0209255. 10.1371/journal.pone.0209255
    1. Myrskylä M, Fenelon A. Maternal age and offspring adult health: evidence from the health and retirement study. Demography 2012;49:1231–57. 10.1007/s13524-012-0132-x
    1. Ruzzin J. Public health concern behind the exposure to persistent organic pollutants and the risk of metabolic diseases. BMC Public Health 2012;12:298. 10.1186/1471-2458-12-298
    1. Chen L, Luo K, Etzel R, et al. . Co-exposure to environmental endocrine disruptors in the US population. Environ Sci Pollut Res Int 2019;26:7665–76. 10.1007/s11356-018-04105-x
    1. Haug LS, Thomsen C, Brantsaeter AL, et al. . Diet and particularly seafood are major sources of perfluorinated compounds in humans. Environ Int 2010;36:772–8. 10.1016/j.envint.2010.05.016
    1. Rylander C, Sandanger TM, Frøyland L, et al. . Dietary patterns and plasma concentrations of perfluorinated compounds in 315 Norwegian women: the NOWAC postgenome study. Environ Sci Technol 2010;44:5225–32. 10.1021/es100224q
    1. Vestergren R, Berger U, Glynn A, et al. . Dietary exposure to perfluoroalkyl acids for the Swedish population in 1999, 2005 and 2010. Environ Int 2012;49:120–7. 10.1016/j.envint.2012.08.016
    1. Christensen KY, Raymond M, Blackowicz M, et al. . Perfluoroalkyl substances and fish consumption. Environ Res 2017;154:145–51. 10.1016/j.envres.2016.12.032
    1. Raatz SK, Silverstein JT, Jahns L, et al. . Issues of fish consumption for cardiovascular disease risk reduction. Nutrients 2013;5:1081–97. 10.3390/nu5041081
    1. Tørris C, Molin M, Småstuen MC. Lean fish consumption is associated with beneficial changes in the metabolic syndrome components: a 13-year follow-up study from the Norwegian Tromsø study. Nutrients 2017;9. 10.3390/nu9030247. [Epub ahead of print: 08 Mar 2017].
    1. Mozaffarian D, Rimm EB. Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006;296:1885–99. 10.1001/jama.296.15.1885
    1. Stary HC, Chandler AB, Glagov S, et al. . A definition of initial, fatty streak, and intermediate lesions of atherosclerosis. A report from the Committee on vascular lesions of the Council on arteriosclerosis, American heart association. Circulation 1994;89:2462–78. 10.1161/01.CIR.89.5.2462
    1. Eriksen KT, Raaschou-Nielsen O, McLaughlin JK, et al. . Association between plasma PFOA and PFOs levels and total cholesterol in a middle-aged Danish population. PLoS One 2013;8:e56969. 10.1371/journal.pone.0056969
    1. Aung T, Halsey J, Kromhout D, et al. . Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiol 2018;3:225–34. 10.1001/jamacardio.2017.5205
    1. Abdelhamid AS, Brown TJ, Brainard JS, et al. . Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2018;11:CD003177. 10.1002/14651858.CD003177.pub4
    1. Abbasi J. Another nail in the Coffin for fish oil supplements. JAMA 2018;319:1851–2. 10.1001/jama.2018.2498
    1. Hong MY, Lumibao J, Mistry P, et al. . Fish oil contaminated with persistent organic pollutants reduces antioxidant capacity and induces oxidative stress without affecting its capacity to lower lipid concentrations and systemic inflammation in rats. J Nutr 2015;145:939–44. 10.3945/jn.114.206607
    1. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 2004;80:1678S–88. 10.1093/ajcn/80.6.1678S
    1. Lu Z, Chen TC, Zhang A, et al. . An evaluation of the vitamin D3 content in fish: is the vitamin D content adequate to satisfy the dietary requirement for vitamin D? J Steroid Biochem Mol Biol 2007;103:642–4. 10.1016/j.jsbmb.2006.12.010
    1. Halldorsson TI, Fei C, Olsen J, et al. . Dietary predictors of perfluorinated chemicals: a study from the Danish national birth cohort. Environ Sci Technol 2008;42:8971–7. 10.1021/es801907r
    1. Schiepers OJG, de Groot RHM, Jolles J, et al. . Fish consumption, not fatty acid status, is related to quality of life in a healthy population. Prostaglandins Leukot Essent Fatty Acids 2010;83:31–5. 10.1016/j.plefa.2010.02.030

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