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Int. J. Environ. Res. Public Health 2017, 14(7), 691; https://doi.org/10.3390/ijerph14070691

Exposure to Perfluorinated Alkyl Substances and Health Outcomes in Children: A Systematic Review of the Epidemiologic Literature

1
Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA
2
National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Chapel Hill, NC 27709, USA
3
Office of Air Quality Planning and Standards, Office of Air and Radiation, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA
4
National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, USA
*
Author to whom correspondence should be addressed.
Received: 31 March 2017 / Revised: 19 June 2017 / Accepted: 21 June 2017 / Published: 27 June 2017
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Abstract

Perfluoroalkyl substances (PFAS), chemicals used to make products stain and stick resistant, have been linked to health effects in adults and adverse birth outcomes. A growing body of literature also addresses health effects in children exposed to PFAS. This review summarizes the epidemiologic evidence for relationships between prenatal and/or childhood exposure to PFAS and health outcomes in children as well as to provide a risk of bias analysis of the literature. A systematic review was performed by searching PubMed for studies on PFAS and child health outcomes. We identified 64 studies for inclusion and performed risk of bias analysis on those studies. We determined that risk of bias across studies was low to moderate. Six categories of health outcomes emerged. These were: immunity/infection/asthma, cardio-metabolic, neurodevelopmental/attention, thyroid, renal, and puberty onset. While there are a limited number of studies for any one particular health outcome, there is evidence for positive associations between PFAS and dyslipidemia, immunity (including vaccine response and asthma), renal function, and age at menarche. One finding of note is that while PFASs are mixtures of multiple compounds few studies examine them as such, therefore the role of these compounds as complex mixtures remains largely unknown. View Full-Text
Keywords: children’s health; perfluorooctane sulfonate (PFOS); perfluorooctanoate (PFOA); puberty; immunity children’s health; perfluorooctane sulfonate (PFOS); perfluorooctanoate (PFOA); puberty; immunity
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Rappazzo, K.M.; Coffman, E.; Hines, E.P. Exposure to Perfluorinated Alkyl Substances and Health Outcomes in Children: A Systematic Review of the Epidemiologic Literature. Int. J. Environ. Res. Public Health 2017, 14, 691.

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