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3858472 
Journal Article 
Serum concentrations of per- and poly-fluoroalkyl substances and factors associated with exposure in the general adult population in South Korea 
Lee, JH; Lee, CK; Suh, CH; Kang, HS; Hong, CP; Choi, SN 
2017 
Yes 
International Journal of Hygiene and Environmental Health
ISSN: 1438-4639
EISSN: 1618-131X 
220 
1046-1054 
English 
Per- and polyfluoroalkyl substances (PFASs) are ubiquitous contaminants found worldwide, including in South Korea. As a result, they are frequently detected in Koreans. However, there is limited representative data and information on potential sources in Korea. Therefore, we measured the serum concentrations of ten PFASs in nationally representative samples of the Korean population (n=1874, 18-69 years) and evaluated the factors associated with their exposure. Serum PFOS, PFDA, PFOA, and PFNA were detected in nearly all participants (83.1-99.9%). However, serum PFPA, PFHxA, and PFHpA were almost undetected (<0.5% of participants). PFOS had the highest population-weighted geometric mean of 10.23ng/mL (95% CI: 9.99-10.47), which was followed by PFOA with 2.85ng/mL (95% CI: 2.73-2.97) and PFDA with 2.17ng/mL (95% CI: 2.12-2.23). PFNA, PFDA, PFHxS, PFOA, and PFOS concentrations were higher in males (p<0.001) and older adults (p<0.001). PFNA was higher in those who used wax, polish, and water-resistant materials (adjusted proportional change=1.14; 95% CI: 1.08-1.22), and those who ate cooked fish (1.16; 95% CI: 1.03-1.31) compared to those who ate nearly no fish. PFDA was higher in those who used herbicides and pesticides (1.05; 95% CI: 1.02-1.09), those who drank beverages in a plastic bag on a daily basis (1.10; 95% CI: 1.03-1.19), and those who ate raw fish (1.15; 95% CI: 1.03-1.29) or cooked fish (1.13; 95% CI: 1.05-1.23) compared to those who ate nearly no fish. PFHxS was higher in those who used traditional Korean health supplement foods (1.08; 95% CI: 1.01-1.15). PFOA was higher in those who used plastic wrap in a microwave daily or weekly (1.08; 95% CI: 1.00-1.16), and those who used disposable paper cups (1.07; 95% CI: 1.01-1.13). PFOS was lower in underweight participants (0.84; 95%CI: 0.75-0.93) compared to those who were obese, and higher in those who exercised regularly (1.08; 95% CI: 1.03-1.14) or irregularly (1.06, 95% CI: 1.01-1.12) compared to those who did not exercise. Subjects who used severely damaged Teflon appliances had lower concentrations of PFOA (0.78, 95% CI: 0.65-0.95), while regular use of Gore-Tex goods was related to higher PFNA (1.15, 95% CI: 1.03-1.28) and PFDA (1.11; 95% CI: 1.02-1.20) levels. These findings suggest that most Koreans are frequently exposed to PFASs, and that serum concentrations of PFASs vary with age, sex, and exposure factors. 
Exposure-associated factors; Gore-Tex; Per- and poly-fluoroalkyl substances (PFASs); Pesticide; Serum concentration; Teflon 
PFAS
• ^Per- and Polyfluoroalkyl Substances (PFAS)
     PFOA (335-67-1) and PFOS (1763-23-1)
          Literature Search – Adverse outcome pathway (2015-present)
               Pubmed
     PFDA (335-76-2)
          Literature Search
               Pubmed
     PFNA (375-95-1)
          Literature Search
               Pubmed
     PFHpA (375-85-9)
          Literature Search
               Pubmed
     PFHxA (307-24-4)
          Literature Search
               Pubmed
     PFPeA (2706-90-3)
          Literature Search
               Pubmed
     PFHxS (355-46-4)
          Literature search
               Pubmed
• PFBA
     Protocol References
• PFDA
     Literature Search
          Pubmed
          WOS
     Screening Results
          Susceptible populations
     Title and Abstract Screening
          Full Text Screening
          Tagged as Supplemental
               Exposure assessment or qualitative exposure only
• PFHpA
     Literature Search
          Pubmed
     Screening Results
          Susceptible populations
• PFHxA
     Literature Search
          Pubmed
     Literature Search: February 2018 Update
          Toxline
          WoS
     Literature Search
          Pubmed
          Toxline
          WOS
     Screening Results
          Excluded/Not on Topic
     Title and Abstract Screening
          Excluded
               Not relevant to PECO
• PFHxS
     Literature Search
          PubMed
          Toxline
          WOS
     Screening Results
          Susceptible populations
     Title and Abstract Screening
          Full-Text Screening
               Excluded
                    Not relevant to PECO
• PFNA
     PFNA Literature Search pre-2019
          WOS
     Literature Search
          Pubmed
          Toxline
          WOS
     PFNA May 2019 Update
          Pubmed
          Toxnet
          Web of Science
     Screening Results
          Susceptible populations
     Title and Abstract Screening
          Excluded
               Not relevant to PECO
• PFOA (335-67-1) and PFOS (1763-23-1)
     Literature Search – Adverse outcome pathway (2015-present)
          Pubmed
     Screening Results
          Susceptible populations
     Literature Search Update (2013-2019)
          PubMed
          WOS
• PFPeA
     Literature Search
          Pubmed
     Screening Results
          Susceptible populations