Early-life Exposure to the So-called “forever” Chemicals, the PFAS, and Cardiometabolic Health of Children

[This text has been written by Nikos Stratakis, Postdoctoral Research Fellow at ISGlobal, and Eleni Papadopoulou, researcher at the Norwegian Institute of Public Health]

Studying cardiometabolic health in childhood is important as research has shown that cardiometabolic risk factors tend to track through adolescence and adulthood, posing an increased likelihood for developing later complications such as hypertension, dyslipidemia, diabetes and cardiovascular disease. Recently, it was suggested that exposure to a large group of ubiquitous, synthetic chemicals, known as perfluoroalkyl and polyfluoroalkyl substances or more commonly PFAS, might affect the cardiometabolic system. For this reasons we, along with a multidisciplinary team of researchers from several institutions in Europe and the US, set out to study how PFAS during the critical periods of early human development can affect cardiometabolic health in childhood.

PFAS are a large family of thousands of synthetic chemicals which can be found in firefighting foams, stain repellants, nonstick cookware, waterproof clothing and shoes, fast food wrappers, personal care products, and many other consumer goods

PFAS are a large family of thousands of synthetic chemicals which can be found in firefighting foams, stain repellants, nonstick cookware, waterproof clothing and shoes, fast food wrappers, personal care products, and many other consumer goods. These compounds do not break down easily and as a result of that they are very widespread in the environment and can be found in air, water, and soil. Almost everyone has been exposed to them through the environment or by using of commercial products that contain them . In recent years, scientists have become increasingly concerned by their potential adverse effects on human health. After a proposal from scientific committees from Norway, Germany and Sweden the European Chemicals Agency (ECHA) approved and regulated the restriction of manufacture of PFAS in the EU/EEA. Nevertheless, due to the persistence of PFAS in the environment, we are all still exposed to these chemicals.

After a proposal from scientific committees from Norway, Germany and Sweden the European Chemicals Agency (ECHA) approved and regulated the restriction of manufacture of PFAS in the EU/EEA.

The “Developmental Origins of Health and Disease” hypothesis posits that exposure to environmental chemicals during the critical periods of early human development (pregnancy and early childhood) can permanently alter the body’s physiology and metabolism and increase cardiometabolic disease risk, even after the exposure has occurred. Hence, following this hypothesis, we measured a wide range of cardiometabolic risk factors, including blood pressure, lipid levels, and waist circumference, in children and aimed to examine whether exposure to PFAS early in life associates with these factors.

We used data from 1,101 pregnant mothers and their 8-year-old children participating in the HELIX (Human Early Life Exposome) project

We used data from 1,101 pregnant mothers and their 8-year-old children participating in HELIX (Human Early Life Exposome) , a collaborative study across several countries around Europe (Spain, France, Greece, UK, Lithuania and Norway). We measured concentrations of five prevalent PFAS in blood samples collected from mothers during pregnancy and from their children. PFAS blood concentrations are valid markers of long-term exposure, while it is very important to assess such concentrations at both pregnancy and childhood because the PFAS exposure profile in childhood can substantially differ from that of pregnancy due to the effect of key factors, such as exposure through breastfeeding and later dietary intake.

Further research examining how childhood PFAS levels associate with later cardiometabolic health markers would provide a more clear answer on PFAS effects during childhood

Our findings, recently published in Environment International , were somewhat conflicting. From one hand, higher maternal blood levels of PFAS were prospectively and weakly associated with an unfavorable childhood cardiometabolic profile of lower high-density lipoprotein cholesterol (HDL-C, also known as “good cholesterol” because it helps remove other forms of cholesterol from bloodstream) and increased waist circumference, a marker of central adiposity. On the other hand, higher childhood levels of PFAS were associated with higher HDL-C and lower waist circumference , but for these associations it was more difficult to establish cause-effect relationships as both PFAS and cardiometabolic risk factors were measured at the same time, not allowing to know whether pre-existing health conditions might have affected PFAS blood levels. Further research examining how childhood PFAS levels associate with later cardiometabolic health markers would provide a more clear answer on PFAS effects during childhood.

We are now following up the children into adolesence, which will allow us to gain better insight on the long-term health effects of PFAS exposure

In our study, we also measured inflammatory biomarkers in child plasma and tried to understand what is the role of chronic inflammation in these associations. In this sense, we found a positive relationship between prenatal PFOA (a prevalent PFAS compound) and increased inflammation , as reflected by higher concentrations of the biomarker interleukin-1beta. Notably, this biomarker was itself linked with larger waist circumference. However, we need to learn more about the molecular exacerbations induced by PFAS exposure in order to be able to better understand how these chemicals affect body’s metabolism and cardiometabolic health.

We are now following up the children into adolesence, which will allow us to gain better insight on the long-term health effects of PFAS exposure.

Reference

Eleni Papadopoulou, Nikos Stratakis, Xavier Basagaña, Anne Lise Brantsæter, Maribel Casas, Serena Fossati, Regina Gražulevičienė, Line Småstuen Haug, Barbara Heude, Léa Maitre, Rosemary R C McEachan, Oliver Robinson , Theano Roumeliotaki, Eduard Sabidó, Eva Borràs , Jose Urquiza, Marina Vafeiadi, Yinqi Zhao, Rémy Slama , John Wright, David V Conti, Martine Vrijheid, Lida Chatzi. Prenatal and postnatal exposure to PFAS and cardiometabolic factors and inflammation status in children from six European cohorts. Environ Int. 2021 Dec;157:106853. doi: 10.1016/j.envint.2021.106853. Epub 2021 Sep 6 .