Public Health Risks of PFAS-Related Immunotoxicity Are Real.

IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Current Environmental Health Reports Pub Date : 2024-06-01 Epub Date: 2024-03-25 DOI:10.1007/s40572-024-00441-y
Abigail P Bline, Jamie C DeWitt, Carol F Kwiatkowski, Katherine E Pelch, Anna Reade, Julia R Varshavsky
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Abstract

Purpose of review: The discovery of per- and polyfluoroalkyl substances (PFAS) in the environment and humans worldwide has ignited scientific research, government inquiry, and public concern over numerous adverse health effects associated with PFAS exposure. In this review, we discuss the use of PFAS immunotoxicity data in regulatory and clinical decision-making contexts and question whether recent efforts adequately account for PFAS immunotoxicity in public health decision-making.

Recent findings: Government and academic reviews confirm the strongest human evidence for PFAS immunotoxicity is reduced antibody production in response to vaccinations, particularly for tetanus and diphtheria. However, recent events, such as the economic analysis supporting the proposed national primary drinking water regulations and clinical monitoring recommendations, indicate a failure to adequately incorporate these data into regulatory and clinical decisions. To be more protective of public health, we recommend using all relevant immunotoxicity data to inform current and future PFAS-related chemical risk assessment and regulation. Biological measures of immune system effects, such as reduced antibody levels in response to vaccination, should be used as valid and informative markers of health outcomes and risks associated with PFAS exposure. Routine toxicity testing should be expanded to include immunotoxicity evaluations in adult and developing organisms. In addition, clinical recommendations for PFAS-exposed individuals and communities should be revisited and strengthened to provide guidance on incorporating immune system monitoring and other actions that can be taken to protect against adverse health outcomes.

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与 PFAS 相关的免疫毒性的公共健康风险是真实存在的。
审查目的:全氟烷基和多氟烷基物质(PFAS)在全球环境和人体中的发现引发了科学研究、政府调查以及公众对与接触 PFAS 相关的多种不良健康影响的关注。在这篇综述中,我们讨论了在监管和临床决策中使用 PFAS 免疫毒性数据的情况,并质疑近期的工作是否在公共卫生决策中充分考虑了 PFAS 免疫毒性:政府和学术界的审查证实,PFAS 免疫毒性最有力的人体证据是接种疫苗(尤其是破伤风和白喉疫苗)后抗体生成减少。然而,最近发生的一些事件,如支持拟议的国家初级饮用水法规和临床监测建议的经济分析,表明这些数据未能充分纳入监管和临床决策。为了更好地保护公众健康,我们建议使用所有相关的免疫毒性数据,为当前和未来的全氟辛烷磺酸相关化学品风险评估和监管提供信息。免疫系统影响的生物措施,如接种疫苗后抗体水平降低,应作为健康结果和与 PFAS 暴露相关的风险的有效且信息丰富的标记。应扩大常规毒性测试的范围,纳入对成年和发育中生物的免疫毒性评估。此外,应重新审查和加强针对接触全氟辛烷磺酸的个人和社区的临床建议,为纳入免疫系统监测和其他可采取的行动提供指导,以防止不良健康后果。
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来源期刊
CiteScore
13.60
自引率
1.30%
发文量
47
期刊介绍: Current Environmental Health Reports provides up-to-date expert reviews in environmental health. The goal is to evaluate and synthesize original research in all disciplines relevant for environmental health sciences, including basic research, clinical research, epidemiology, and environmental policy.
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