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. 2016 Feb;79(2):348-57.
doi: 10.1038/pr.2015.213. Epub 2015 Oct 22.

Perfluoroalkyl and polyfluoroalkyl substances and indicators of immune function in children aged 12-19 y: National Health and Nutrition Examination Survey

Cheryl R Stein  1 , Kathleen J McGovern  1 , Ashley M Pajak  1 , Paul J Maglione  2 , Mary S Wolff  1
Affiliations

Perfluoroalkyl and polyfluoroalkyl substances and indicators of immune function in children aged 12-19 y: National Health and Nutrition Examination Survey

Cheryl R Stein et al. Pediatr Res. 2016 Feb.

Abstract

Background: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are immunotoxic in laboratory studies. Human studies of immune effects are inconsistent. Using the US National Health and Nutrition Examination Survey (NHANES), we examined PFAS serum concentration and indicators of prevalent immune function among 12-19-y-old children.

Methods: In this cross-sectional study, we examined PFAS serum concentration in relation to measles, mumps, and rubella antibody concentrations in NHANES 1999-2000 and 2003-2004 (n = 1,191) and to allergic conditions and allergic sensitization in NHANES 2005-2006 (n = 640).

Results: In adjusted, survey-weighted models, a doubling of perfluorooctane sulfonate (PFOS) concentration among seropositive children was associated with a 13.3% (95% confidence interval (CI): -19.9, -6.2) decrease in rubella antibody concentration and a 5.9% decrease in mumps antibody concentration (95% CI: -9.9, -1.6). We observed no adverse association between exposure and current allergic conditions, including asthma. Children with higher PFOS concentration were less likely to be sensitized to any allergen (odds ratio (OR): 0.74; 95% CI: 0.58, 0.95).

Conclusion: Increased exposure to several PFAS was associated with lower levels to mumps and rubella antibody concentrations, especially among seropositive individuals. These lower antibody concentrations may indicate a less robust response to vaccination or greater waning of vaccine-derived immunity over time.

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Figures

Figure 1
Figure 1
Adjusted odds ratio (95% CI) for any IgE sensitization (IgE ≥0.35 kU/L) among children aged 12 – 19 years, National Health and Nutrition Examination Survey, 2005 – 2006 (n=638). PFAS biomarker concentrations plotted at the median by quartile of exposure. Adjusted for age, sex, race/ethnicity, BMI, cotinine, and survey weights.(a) PFOS, P for trend<0.05. (b) PFOA. (c) PFHxS. (d) PFNA
Figure 2
Figure 2
Adjusted odds ratio (95% CI) for cockroach or shrimp IgE sensitization (IgE ≥0.35 kU/L) among children aged 12 – 19 years, National Health and Nutrition Examination Survey, 2005 – 2006 (n=638). PFAS biomarker concentrations plotted at the median by quartile of exposure. Adjusted for age, sex, race/ethnicity, BMI, cotinine, and survey weights..(a) PFOS, P for trend<0.05. (b) PFOA. (c) PFHxS. (d) PFNA.
Figure 3
Figure 3
Adjusted odds ratio (95% CI) for mold (Alternaria and Aspergillus species) IgE sensitization (IgE ≥0.35 kU/L) among children aged 12 – 19 years, National Health and Nutrition Examination Survey, 2005 – 2006 (n=638). PFAS biomarker concentrations plotted at the median by quartile of exposure. Adjusted for age, sex, race/ethnicity, BMI, cotinine, and survey weights. (a) PFOS, P for trend<0.05. (b) PFOA. (c) PFHxS. (d) PFNA
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References

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