Annals of Occupational and Environmental Medicine

  • 제35권
  • /
  • Pages.5.1-5.14
  • /
  • 2023
  • /
  • 1225-3618(pISSN)
  • /
  • 2052-4374(eISSN)
대한직업환경의학회 (The Korean Society of Occupational & Environmental Medicine)
권호 표지
DOI QR코드

DOI QR Code

The association of perfluoroalkyl substances (PFAS) exposure and kidney function in Korean adolescents using data from Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018-2020): a cross-sectional study

  • Jisuk Yun (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Eun-Chul Jang (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Soon-Chan Kwon (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Young-Sun Min (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Yong-Jin Lee (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital)
  • 투고 : 2022.11.28
  • 심사 : 2023.02.09
  • 발행 : 2023.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Perfluoroalkyl substances (PFAS) are chemicals widely used in various products in everyday life. Due to its unique strong binding force, the half-life of PFAS is very long, so bioaccumulation and toxicity to the human body are long-standing concerns. In particular, effects on kidney function have recently emerged and there are no studies on the effect of PFAS on kidney function through epidemiological investigations in Korea. From 2018 to 2020, the Korean National Environmental Health Survey (KoNEHS) cycle 4, conducted an epidemiological investigation on the blood concentration of PFAS for the first time in Korea. Based on this data, the relationship between PFAS blood concentration and kidney function was analyzed for adolescents. Methods: We investigated 5 types of PFAS and their total blood concentration in 811 middle and high school students, living in Korea and included in KoNEHS cycle 4, and tried to find changes in kidney function in relation to PFAS concentration. After dividing the concentration of each of the 5 PFAS and the total concentration into quartiles, multivariable linear regression was performed to assess the correlation with kidney function. The bedside Schwartz equation was used as an indicator of kidney function. Results: As a result of multivariable linear regression, when observing a change in kidney function according to the increase in the concentration of each of the 5 PFAS and their total, a significant decrease in kidney function was confirmed in some or all quartiles. Conclusions: In this cross-sectional study of Korean adolescents based on KoNEHS data, a negative correlation between serum PFAS concentration and kidney function was found. A well-designed longitudinal study and continuous follow-up are necessary.

키워드

과제정보

Thanks to the National Institute of Environmental Research for willingly providing data. To many people, including Lee and reviewers, thanks them for their helpful advice. And above all, I would like to express my greatest gratitude to my wife for her encouragement and advice.

참고문헌

  1. OECD. Toward a new comprehensive global database of per-and polyfluoroalkyl substances (PFASs): Summary report on updating the OECD 2007 list of per-and polyfluoroalkyl substances (PFASs). Ser Risk Manag 2018;39:1-24.
  2. Sunderland EM, Hu XC, Dassuncao C, Tokranov AK, Wagner CC, Allen JG. A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects. J Expo Sci Environ Epidemiol 2019;29(2):131-47. https://doi.org/10.1038/s41370-018-0094-1
  3. Armitage J, Cousins IT, Buck RC, Prevedouros K, Russell MH, MacLeod M, et al. Modeling global-scale fate and transport of perfluorooctanoate emitted from direct sources. Environ Sci Technol 2006;40(22):6969-75. https://doi.org/10.1021/es0614870
  4. Yeo MK, Hwang EH, Jeong GH. Distribution characteristics of perfluorinated compounds in major river water and sediment. Anal Sci Technol 2012;25(5):313-23. https://doi.org/10.5806/AST.2012.25.5.313
  5. National Institute of Environmental Research (KR). A Study on Management of Unregulated Trace Hazardous Compounds in Drinking Water. Incheon, Korea: National Institute of Environmental Research; 2020.
  6. Son B, Lee L, Yang M, Park S, Pyo H, Lee W, et al. Distribution and risk assessment of perfluorinated compounds (PFCs) in major drinking water treatment plants, Korea. J Korean Soc Water Wastewater 2017;31(6):491-9. https://doi.org/10.11001/jksww.2017.31.6.491
  7. Kirk M, Smurthwaite K, Braunig J, Trevenar S, D'Este C, Lucas R, et al. The PFAS Health Study: Systematic Literature Review. Canberra, Australia: The Australian National University; 2018.
  8. Ferrari F, Orlando A, Ricci Z, Ronco C. Persistent pollutants: focus on perfluorinated compounds and kidney. Curr Opin Crit Care 2019;25(6):539-49. https://doi.org/10.1097/MCC.0000000000000658
  9. Stanifer JW, Stapleton HM, Souma T, Wittmer A, Zhao X, Boulware LE. Perfluorinated chemicals as emerging environmental threats to kidney health: a scoping review. Clin J Am Soc Nephrol 2018;13(10):1479-92. https://doi.org/10.2215/CJN.04670418
  10. Cui L, Zhou QF, Liao CY, Fu JJ, Jiang GB. Studies on the toxicological effects of PFOA and PFOS on rats using histological observation and chemical analysis. Arch Environ Contam Toxicol 2009;56(2):338-49. https://doi.org/10.1007/s00244-008-9194-6
  11. Qian Y, Ducatman A, Ward R, Leonard S, Bukowski V, Lan Guo N, et al. Perfluorooctane sulfonate (PFOS) induces reactive oxygen species (ROS) production in human microvascular endothelial cells: role in endothelial permeability. J Toxicol Environ Health A 2010;73(12):819-36. https://doi.org/10.1080/15287391003689317
  12. Zhang B, He Y, Huang Y, Hong D, Yao Y, Wang L, et al. Novel and legacy poly- and perfluoroalkyl substances (PFASs) in indoor dust from urban, industrial, and e-waste dismantling areas: the emergence of PFAS alternatives in China. Environ Pollut 2020;263(Pt A):114461.
  13. Jain RB. Perfluoroalkyl acids and their isomers, diabetes, anemia, and albuminuria: variabilities with deteriorating kidney function. Ecotoxicol Environ Saf 2021;208:111625.
  14. Calafat AM, Wong LY, Kuklenyik Z, Reidy JA, Needham LL. Polyfluoroalkyl chemicals in the U.S. population: data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and comparisons with NHANES 1999-2000. Environ Health Perspect 2007;115(11):1596-602. https://doi.org/10.1289/ehp.10598
  15. PFAS in the U.S. population. https://www.atsdr.cdc.gov/pfas/health-effects/us-population.html. Updated 2022. Accessed November 14, 2022.
  16. Landrigan PJ, Goldman LR. Children's vulnerability to toxic chemicals: a challenge and opportunity to strengthen health and environmental policy. Health Aff (Millwood) 2011;30(5):842-50. https://doi.org/10.1377/hlthaff.2011.0151
  17. Renal function tests. https://www.ncbi.nlm.nih.gov/books/NBK507821. Updated 2022. Accessed November 14, 2022.
  18. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int 2021;99(3S):S1-87. https://doi.org/10.1016/j.kint.2020.11.003
  19. Staples A, LeBlond R, Watkins S, Wong C, Brandt J. Validation of the revised Schwartz estimating equation in a predominantly non-CKD population. Pediatr Nephrol 2010;25(11):2321-6. https://doi.org/10.1007/s00467-010-1598-7
  20. Comptox chemicals dashboard. https://comptox.epa.gov/dashboard/chemical-lists/PFASSTRUCTV5. Updated 2022. Accessed November 14, 2022.
  21. Kazancioglu R. Risk factors for chronic kidney disease: an update. Kidney Int Suppl (2011) 2013;3(4):368-71. https://doi.org/10.1038/kisup.2013.79
  22. Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017;140(3):e20171904.
  23. Hur KY, Moon MK, Park JS, Kim SK, Lee SH, Yun JS, et al. 2021 clinical practice guidelines for diabetes mellitus of the Korean Diabetes Association. Diabetes Metab J 2021;45(4):461-81. https://doi.org/10.4093/dmj.2021.0156
  24. Garcia-Esquinas E, Loeffler LF, Weaver VM, Fadrowski JJ, Navas-Acien A. Kidney function and tobacco smoke exposure in US adolescents. Pediatrics 2013;131(5):e1415-23. https://doi.org/10.1542/peds.2012-3201
  25. Lee W, Lee S, Roh J, Won JU, Yoon JH. The association between involuntary smoking exposure with urine cotinine level and blood cadmium level in general non-smoking populations. J Korean Med Sci 2017;32(4):568-75. https://doi.org/10.3346/jkms.2017.32.4.568
  26. Tonelli M, Isles C, Craven T, Tonkin A, Pfeffer MA, Shepherd J, et al. Effect of pravastatin on rate of kidney function loss in people with or at risk for coronary disease. Circulation 2005;112(2):171-8. https://doi.org/10.1161/CIRCULATIONAHA.104.517565
  27. Lim JS, Kim EY, Kim JH, Yoo JH, Yi KH, Chae HW, et al. 2017 clinical practice guidelines for dyslipidemia of Korean children and adolescents. Ann Pediatr Endocrinol Metab 2020;25(4):199-207. https://doi.org/10.6065/apem.2040198.099
  28. Korean National Institute of Environmental Research. Guidelines for Using Raw Materials for Korean National Environmental Health Survey (Child, Adolescent)-the Fourth Stage (2018-2020). Incheon, Korea: Korean National Institute of Environmental Research; 2022.
  29. Shankar A, Xiao J, Ducatman A. Perfluoroalkyl chemicals and chronic kidney disease in US adults. Am J Epidemiol 2011;174(8):893-900. https://doi.org/10.1093/aje/kwr171
  30. Watkins DJ, Josson J, Elston B, Bartell SM, Shin HM, Vieira VM, et al. Exposure to perfluoroalkyl acids and markers of kidney function among children and adolescents living near a chemical plant. Environ Health Perspect 2013;121(5):625-30. https://doi.org/10.1289/ehp.1205838
  31. Kataria A, Trachtman H, Malaga-Dieguez L, Trasande L. Association between perfluoroalkyl acids and kidney function in a cross-sectional study of adolescents. Environ Health 2015;14(1):89.
  32. Poothong S, Papadopoulou E, Padilla-Sanchez JA, Thomsen C, Haug LS. Multiple pathways of human exposure to poly- and perfluoroalkyl substances (PFASs): from external exposure to human blood. Environ Int 2020;134:105244.
  33. Fabrega F, Kumar V, Schuhmacher M, Domingo JL, Nadal M. PBPK modeling for PFOS and PFOA: validation with human experimental data. Toxicol Lett 2014;230(2):244-51. https://doi.org/10.1016/j.toxlet.2014.01.007
  34. Perez F, Nadal M, Navarro-Ortega A, Fabrega F, Domingo JL, Barcelo D, et al. Accumulation of perfluoroalkyl substances in human tissues. Environ Int 2013;59:354-62. https://doi.org/10.1016/j.envint.2013.06.004
  35. Han X, Nabb DL, Russell MH, Kennedy GL, Rickard RW. Renal elimination of perfluorocarboxylates (PFCAs). Chem Res Toxicol 2012;25(1):35-46. https://doi.org/10.1021/tx200363w
  36. Zhang Y, Beesoon S, Zhu L, Martin JW. Biomonitoring of perfluoroalkyl acids in human urine and estimates of biological half-life. Environ Sci Technol 2013;47(18):10619-27. https://doi.org/10.1021/es401905e
  37. Worley RR, Yang X, Fisher J. Physiologically based pharmacokinetic modeling of human exposure to perfluorooctanoic acid suggests historical non drinking-water exposures are important for predicting current serum concentrations. Toxicol Appl Pharmacol 2017;330:9-21. https://doi.org/10.1016/j.taap.2017.07.001
  38. Yang CH, Glover KP, Han X. Characterization of cellular uptake of perfluorooctanoate via organic anion-transporting polypeptide 1A2, organic anion transporter 4, and urate transporter 1 for their potential roles in mediating human renal reabsorption of perfluorocarboxylates. Toxicol Sci 2010;117(2):294-302. https://doi.org/10.1093/toxsci/kfq219
  39. Moon J. Perfluoroalkyl substances (PFASs) exposure and kidney damage: Causal interpretation using the US 2003-2018 National Health and Nutrition Examination Survey (NHANES) datasets. Environ Pollut 2021;288:117707.
  40. Blake BE, Pinney SM, Hines EP, Fenton SE, Ferguson KK. Associations between longitudinal serum perfluoroalkyl substance (PFAS) levels and measures of thyroid hormone, kidney function, and body mass index in the Fernald Community Cohort. Environ Pollut 2018;242(Pt A):894-904. https://doi.org/10.1016/j.envpol.2018.07.042
  41. Lin PD, Cardenas A, Hauser R, Gold DR, Kleinman KP, Hivert MF, et al. Per- and polyfluoroalkyl substances and kidney function: follow-up results from the Diabetes Prevention Program trial. Environ Int 2021;148:106375.
  42. Weinstein JR, Anderson S. The aging kidney: physiological changes. Adv Chronic Kidney Dis 2010;17(4):302-7. https://doi.org/10.1053/j.ackd.2010.05.002
  43. De Silva AO, Armitage JM, Bruton TA, Dassuncao C, Heiger-Bernays W, Hu XC, et al. PFAS exposure pathways for humans and wildlife: a synthesis of current knowledge and key gaps in understanding. Environ Toxicol Chem 2021;40(3):631-57. https://doi.org/10.1002/etc.4935
  44. Rahman MF, Peldszus S, Anderson WB. Behaviour and fate of perfluoroalkyl and polyfluoroalkyl substances (PFASs) in drinking water treatment: a review. Water Res 2014;50:318-40. https://doi.org/10.1016/j.watres.2013.10.045
  45. Detected 'perfluorinated compounds' in frying pan coating materials in half of domestic cosmetics survey subjects. http://kfem.or.kr/?p=220037. Updated 2021. Accessed November 14, 2022.
  46. Calderon-Margalit R, Golan E, Twig G, Leiba A, Tzur D, Afek A, et al. History of childhood kidney disease and risk of adult end-stage renal disease. N Engl J Med 2018;378(5):428-38. https://doi.org/10.1056/NEJMoa1700993
  47. Pottel H, Dubourg L, Goffin K, Delanaye P. Alternatives for the bedside Schwartz equation to estimate glomerular filtration rate in children. Adv Chronic Kidney Dis 2018;25(1):57-66. https://doi.org/10.1053/j.ackd.2017.10.002