Academic journal article Environmental Health Perspectives

Exposure to Polyfluoroalkyl Chemicals and Attention Deficit/hyperactivity Disorder in U.S. Children 12-15 Years of Age

Academic journal article Environmental Health Perspectives

Exposure to Polyfluoroalkyl Chemicals and Attention Deficit/hyperactivity Disorder in U.S. Children 12-15 Years of Age

Article excerpt

BACKGROUND: Polyfluoroalkyl chemicals (PFCs) have been widely used in consumer products. Exposures in the United States and in world populations are widespread. PFC exposures have been linked to various health impacts, and data in animals suggest that PFCs may be potential developmental neurotoxicants.

OBJECTIVES: We evaluated the associations between exposures to four PFCs and parental report of diagnosis of attention deficit/hyperactivity disorder (ADHD).

METHODS: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2003-2004 for children 12-15 years of age. Parental report of a previous diagnosis by a doctor or health care professional of ADHD in the child was the primary outcome measure. Perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) levels were measured in serum samples from each child.

RESULTS: Parents repotted that 48 of 571 children included in the analysis had been diagnosed with ADHD. The adjusted odds ratio (OR) for parentally reported ADHD in association with a 1-[micro]g/E increase in serum PFOS (modeled as a continuous predictor) was 1.03 [95% confidence interval (CI), 1.01-1.05]. Adjusted ORs for 1-[micro]g/L increases in PFOA and PFHxS were also statistically significant (PFOA: OR = 1.12; 95% CI, 1.01-1.23; PFHxS: OR = 1.06; 95% CI, 1.02-1.11), and we observed a nonsignificant positive association with PFNA (OR = 1.32; 95% CI, 0.86-2.02).

CONCLUSIONS: Our results, using cross-sectional data, are consistent with increased odds of ADHD in children with higher serum PFC levels. Given the extremely prevalent exposure to PFCs, follow-up of these data with cohort studies is needed.

KEY WORDS: attention deficit/hyperactivity disorder (ADHD), National Health and Nutrition Examination Survey (NHANES), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), polyfluoroalkyl chemicals (PFCs). Environ Health Perspect 118:1762-1767 (2010). doi:10.1289/ehp.1001898 [Online 15 June 2010]


Polyfluoroalkyl chemicals (PFCs) are a class of highly stable man-made compounds. Composed of a variable-length fluorinated carbon backbone and a carboxylate or sulfonate functional group, PFCs have both hydrophobic and oleophobic portions that enable produces to repel both oil and water and resist staining. PFCs are widely used in industrial applications as surfactants and emulsifiers and in consumer products such as food packaging, nonstick pan coatings, fire-fighting foams, paper and textile coatings, and personal care products (Calafat et al. 2007b; Renner 2001).

PFCs are extremely resistant to environmental and metabolic degradation and have been detected globally in the environment and wildlife (Lau et al. 2007). PFCs have been measured in the blood of occupationally exposed cohorts and in the general population. The source of PFCs in the general population is likely to be environmental exposure to individual PFCs or their precursor molecules; however, the specific source contributions are not well characterized. PFCs released during manufacturing processes or in wastes from the perfluoroalkyl industry are potential sources of exposure for the individuals employed in these industries as well as for the general population (3M Company 2003). Other potential sources of exposure include consumer products containing PFCs, contaminated drinking and surface waters, airborne PFCs, indoor air, and house dust (3M Company 2003; Boulanger et al. 2004; Emmett et al. 2006; Holzer et al. 2008; Martin et al. 2002; Saito et al. 2004; Shoeib et al. 2005; So et al. 2004; Steenland et al. 2009; Stock et al. 2004).

PFCs are absorbed through ingestion and to a lesser extent through inhalation. Once absorbed, PFCs are eliminated from the human body very slowly. …

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