PDF(Pubmed)
Abstract：
The discovery of per- and polyfluoroalkyl substances (PFAS) in the environment and humans worldwide has ignited scientific research, government inquiry, and public concern over numerous adverse health effects associated with PFAS exposure. In this review, we discuss the use of PFAS immunotoxicity data in regulatory and clinical decision-making contexts and question whether recent efforts adequately account for PFAS immunotoxicity in public health decision-making.
Government and academic reviews confirm the strongest human evidence for PFAS immunotoxicity is reduced antibody production in response to vaccinations, particularly for tetanus and diphtheria. However, recent events, such as the economic analysis supporting the proposed national primary drinking water regulations and clinical monitoring recommendations, indicate a failure to adequately incorporate these data into regulatory and clinical decisions. To be more protective of public health, we recommend using all relevant immunotoxicity data to inform current and future PFAS-related chemical risk assessment and regulation. Biological measures of immune system effects, such as reduced antibody levels in response to vaccination, should be used as valid and informative markers of health outcomes and risks associated with PFAS exposure. Routine toxicity testing should be expanded to include immunotoxicity evaluations in adult and developing organisms. In addition, clinical recommendations for PFAS-exposed individuals and communities should be revisited and strengthened to provide guidance on incorporating immune system monitoring and other actions that can be taken to protect against adverse health outcomes.
Government and academic reviews confirm the strongest human evidence for PFAS immunotoxicity is reduced antibody production in response to vaccinations, particularly for tetanus and diphtheria. However, recent events, such as the economic analysis supporting the proposed national primary drinking water regulations and clinical monitoring recommendations, indicate a failure to adequately incorporate these data into regulatory and clinical decisions. To be more protective of public health, we recommend using all relevant immunotoxicity data to inform current and future PFAS-related chemical risk assessment and regulation. Biological measures of immune system effects, such as reduced antibody levels in response to vaccination, should be used as valid and informative markers of health outcomes and risks associated with PFAS exposure. Routine toxicity testing should be expanded to include immunotoxicity evaluations in adult and developing organisms. In addition, clinical recommendations for PFAS-exposed individuals and communities should be revisited and strengthened to provide guidance on incorporating immune system monitoring and other actions that can be taken to protect against adverse health outcomes.
摘要：
目的：在全球环境和人类中发现全氟烷基和多氟烷基物质（PFAS）点燃了科学研究，政府调查,以及公众对与PFAS暴露相关的许多不良健康影响的关注。在这次审查中,我们讨论了在监管和临床决策环境中使用PFAS免疫毒性数据,并质疑最近的努力是否足以在公共卫生决策中考虑PFAS免疫毒性.
结果：政府和学术评论证实，PFAS免疫毒性的最有力的人类证据是疫苗接种后抗体产生减少，特别是破伤风和白喉。然而,最近发生的事件,例如支持拟议的国家初级饮用水法规和临床监测建议的经济分析，表明未能将这些数据充分纳入监管和临床决策。为了更好地保护公众健康，我们建议使用所有相关的免疫毒性数据为当前和未来的PFAS相关化学品风险评估和监管提供信息.免疫系统影响的生物措施，如疫苗接种后抗体水平降低，应用作与PFAS暴露相关的健康结果和风险的有效和信息标记。常规毒性测试应扩大到包括对成年和发育中的生物体的免疫毒性评估。此外,针对PFAS暴露个体和社区的临床建议应重新审视和加强,以便就纳入免疫系统监测和其他可采取的措施提供指导,以防止不良健康结局.
结果：政府和学术评论证实，PFAS免疫毒性的最有力的人类证据是疫苗接种后抗体产生减少，特别是破伤风和白喉。然而,最近发生的事件,例如支持拟议的国家初级饮用水法规和临床监测建议的经济分析，表明未能将这些数据充分纳入监管和临床决策。为了更好地保护公众健康，我们建议使用所有相关的免疫毒性数据为当前和未来的PFAS相关化学品风险评估和监管提供信息.免疫系统影响的生物措施，如疫苗接种后抗体水平降低，应用作与PFAS暴露相关的健康结果和风险的有效和信息标记。常规毒性测试应扩大到包括对成年和发育中的生物体的免疫毒性评估。此外,针对PFAS暴露个体和社区的临床建议应重新审视和加强,以便就纳入免疫系统监测和其他可采取的措施提供指导,以防止不良健康结局.
