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      Invited Perspective: The Far Reach of PFAS—Inert Ingredients and Adjuvants in Pesticide Formulations

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          Abstract

          Environmental contamination of per- and polyfluoroalkyl substances (PFAS) has been a growing concern over the last few decades because of their potential adverse human health effects and their biological persistence. 1,2 Many “hot spots” of exposure have been identified, such as the Ohio Valley area of West Virginia 3,4 and the Cape Fear Region of North Carolina. 5 Studies on background exposures not related to hot spots of environmental contamination have burgeoned over the last few years. 1 These studies have evaluated exposures over the life course and potential health outcomes ranging from intrauterine growth and birth outcomes to immunologic effects and cancers. 1 More recent studies have focused on identifying important pathways of environmental exposures. 6 To date, the primary pathway of human exposure is believed to be dietary ingestion of contaminated food and water, with smaller contributions from sources such as household dust (likely resulting from the use of PFAS in stain-resistant textiles and industrial applications) and the use of PFAS-contaminated consumer products. 6 In a commentary in this issue of Environmental Health Perspectives, Donley et al. 7 discuss another potentially significant pathway of exposure to PFAS: the use of pesticides in both agriculture and residential applications. They discuss how fluorination techniques are used to enhance the desirable properties of active ingredients in pesticide formulations. In addition, through their review of pesticide information obtained from the US Environmental Protection Agency (EPA), the Canadian Pest Management Regulatory Agency, the US Geological Survey, and publicly available databases, they have uncovered the use of PFAS as inert ingredients and as adjuvants used to control dispersion properties. Despite the likely presence of PFAS in pesticide formulations and their potential adverse impacts, they have not been considered in pesticide regulatory efforts or in toxicologic evaluations of pesticides. The US EPA regulations of pesticide active ingredients and formulations have always been complex. The 1996 Food Quality and Protection Act 8 mandates that the US EPA consider chronic, acute, aggregate, and cumulative exposures, as well as potential exposures in vulnerable populations, in their pesticide risk assessments. Most of these data are initially provided by the manufacturers of the pesticides, but data published later may be used in reassessments. Currently, manufacturers are not required to list inert or adjuvant ingredients on the labels of their pesticide formulations, which can also include phthalates and volatile organic chemicals. 9,10 However, without a full understanding of all of the components that may be used in pesticides and formulations, especially those that contain PFAS, the true risk associated with their exposures cannot be fully addressed. Donley et al. 7 provide recommendations that would enable a more accurate picture of potential PFAS exposures from pesticide use. They call for a discontinuation of certain manufacturing activities, mandatory disclosure of inert and adjuvant ingredients, comprehensive studies of the full environmental fate and transport of all pesticide components and degradates, and more human biomonitoring studies. Many of these activities should be completed by manufacturers before obtaining registrations for a specific pesticide or formulation use. Although these recommendations would yield important information in understanding holistic exposures related to pesticide use, they would not address the cumulative risk associated with exposure to the pesticide formulation cocktails. The US EPA should also strongly reconsider their risk assessment of pesticides to include human health hazards associated with mixtures of chemicals, which include inert ingredients and adjuvants added to pesticide formulations. The regulations surrounding pesticides are currently outdated and ineffective, 11,12 so this discovery of PFAS presence in pesticide formulations represents a new opportunity for the US EPA to improve the scientific validity of pesticide risk assessment to better capture real-world exposure scenarios.

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          A Review of the Pathways of Human Exposure to Poly- and Perfluoroalkyl Substances (PFASs) and Present Understanding of Health Effects

          Here we review present understanding of sources and trends in human exposure to poly- and perfluoroalkyl substances (PFASs) and epidemiologic evidence for impacts on cancer, immune function, metabolic outcomes, and neurodevelopment. More than 4000 PFASs have been manufactured by humans and hundreds have been detected in environmental samples. Direct exposures due to use in products can be quickly phased out by shifts in chemical production but exposures driven by PFAS accumulation in the ocean and marine food chains and contamination of groundwater persist over long timescales. Serum concentrations of legacy PFASs in humans are declining globally but total exposures to newer PFASs and precursor compounds have not been well characterized. Human exposures to legacy PFASs from seafood and drinking water are stable or increasing in many regions, suggesting observed declines reflect phase-outs in legacy PFAS use in consumer products. Many regions globally are continuing to discover PFAS contaminated sites from aqueous film forming foam (AFFF) use, particularly next to airports and military bases. Exposures from food packaging and indoor environments are uncertain due to a rapidly changing chemical landscape where legacy PFASs have been replaced by diverse precursors and custom molecules that are difficult to detect. Multiple studies find significant associations between PFAS exposure and adverse immune outcomes in children. Dyslipidemia is the strongest metabolic outcome associated with PFAS exposure. Evidence for cancer is limited to manufacturing locations with extremely high exposures and insufficient data are available to characterize impacts of PFAS exposures on neurodevelopment. Preliminary evidence suggests significant health effects associated with exposures to emerging PFASs. Lessons learned from legacy PFASs indicate that limited data should not be used as a justification to delay risk mitigation actions for replacement PFASs.
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            Per‐ and Polyfluoroalkyl Substance Toxicity and Human Health Review: Current State of Knowledge and Strategies for Informing Future Research

            Reports of environmental and human health impacts of per- and polyfluoroalkyl substances (PFAS) have greatly increased in the peer-reviewed literature. The goals of the present review are to assess the state of the science regarding toxicological effects of PFAS and to develop strategies for advancing knowledge on the health effects of this large family of chemicals. Currently, much of the toxicity data available for PFAS are for a handful of chemicals, primarily legacy PFAS such as perfluorooctanoic acid and perfluorooctane sulfonate. Epidemiological studies have revealed associations between exposure to specific PFAS and a variety of health effects, including altered immune and thyroid function, liver disease, lipid and insulin dysregulation, kidney disease, adverse reproductive and developmental outcomes, and cancer. Concordance with experimental animal data exists for many of these effects. However, information on modes of action and adverse outcome pathways must be expanded, and profound differences in PFAS toxicokinetic properties must be considered in understanding differences in responses between the sexes and among species and life stages. With many health effects noted for a relatively few example compounds and hundreds of other PFAS in commerce lacking toxicity data, more contemporary and high-throughput approaches such as read-across, molecular dynamics, and protein modeling are proposed to accelerate the development of toxicity information on emerging and legacy PFAS, individually and as mixtures. In addition, an appropriate degree of precaution, given what is already known from the PFAS examples noted, may be needed to protect human health.
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              Measurement of Novel, Drinking Water-Associated PFAS in Blood from Adults and Children in Wilmington, North Carolina

              Background: From 1980 to 2017, a fluorochemical manufacturing facility discharged wastewater containing poorly understood per- and polyfluoroalkyl substances (PFAS) to the Cape Fear River, the primary drinking water source for Wilmington, North Carolina, residents. Those PFAS included several fluoroethers including HFPO-DA also known as GenX. Little is known about the bioaccumulation potential of these fluoroethers. Objective: We determined levels of fluoroethers and legacy PFAS in serum samples from Wilmington residents. Methods: In November 2017 and May 2018, we enrolled 344 Wilmington residents ≥ 6  years of age into the GenX Exposure Study and collected blood samples. Repeated blood samples were collected from 44 participants 6 months after enrollment. We analyzed serum for 10 fluoroethers and 10 legacy PFAS using liquid chromatography–high-resolution mass spectrometry. Results: Participants’ ages ranged from 6 to 86 y, and they lived in the lower Cape Fear Region for 20 y on average (standard deviation: 16 y). Six fluoroethers were detected in serum; Nafion by-product 2, PFO4DA, and PFO5DoA were detected in > 85 % of participants. PFO3OA and NVHOS were infrequently detected. Hydro-EVE was present in a subset of samples, but we could not quantify it. GenX was not detected above our analytical method reporting limit ( 2  ng / mL ). In participants with repeated samples, the median decrease in fluoroether levels ranged from 28% for PFO5DoA to 65% for PFO4DA in 6 months due to wastewater discharge control. Four legacy PFAS (PFHxS, PFOA, PFOS, PFNA) were detected in most ( ≥ 97 % ) participants; these levels were higher than U.S. national levels for the 2015–2016 National Health and Nutrition Examination Survey. The sum concentration of fluoroethers contributed 24% to participants’ total serum PFAS (median: 25.3  ng / mL ). Conclusion: Poorly understood fluoroethers released into the Cape Fear River by a fluorochemical manufacturing facility were detected in blood samples from Wilmington, North Carolina, residents. Health implications of exposure to these novel PFAS have not been well characterized. https://doi.org/10.1289/EHP6837
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                Author and article information

                Journal
                Environ Health Perspect
                Environ Health Perspect
                EHP
                Environmental Health Perspectives
                Environmental Health Perspectives
                0091-6765
                1552-9924
                24 July 2024
                July 2024
                : 132
                : 7
                : 071304
                Affiliations
                [ 1 ]Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University , Atlanta, Georgia, USA
                Author notes
                Address correspondence to Stephanie M. Eick. Email: stephanie.marie.eick@ 123456emory.edu
                Author information
                https://orcid.org/0000-0002-5566-2138
                Article
                EHP15445
                10.1289/EHP15445
                11268132
                39046249
                08193ffe-afcb-49db-8beb-62a14dd87726

                EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted.

                History
                : 24 May 2024
                : 17 June 2024
                : 18 June 2024
                Categories
                Invited Perspective

                Public health
                Public health

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