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3858476 
Journal Article 
Perfluorinated alkyl substances in Spanish adults: Geographical distribution and determinants of exposure 
Bartolomé, M; Gallego-Picó, A; Cutanda, F; Huetos, O; Esteban, M; Pérez-Gómez, B; Bioambient.es; Castaño, A 
2017 
Science of the Total Environment
ISSN: 0048-9697
EISSN: 1879-1026 
Elsevier 
AMSTERDAM 
603-604 
Elsevier 
352-360 
English 
Per- and polyfluoroalkyl substances (PFAS) are widely found in humans and the environment. Their persistence, bioaccumulation and toxicity make them a source of increasing public health concern. In this study, we analyzed the concentrations and geographical distribution of six PFAS in the serum of 755 Spanish adults aged 18-65. The geometric mean concentrations (and P95 values) for PFOS (perfluoroctane sulfonate), PFOA (perfluorooctanoic acid), PFHxS (perfluorohexane sulfonate), PFNA (perfluorononanoic acid) and PFDA (perfluorodecanoic acid) were 7.67 (19.3), 1.99 (5.48), 0.91 (2.84), 0.96 (2.44) and 0.42 (0.99) μg/L, respectively. N-Methylperfluorooctane sulfonamide (N-MeFOSAA) was detected in only 3.3% of samples. Residents in northeast (Catalonia) and northwest of Spain (Galicia) were found to have the highest serum values, whereas residents in the Canary Islands had the lowest values for almost all PFAS. Men presented higher levels than women, and we confirm that lactation (breastfeeding) contributes to a reduced body burden for all PFAS in women. Our data provide new information on exposure to PFAS in a national cross section sample of Spanish adults, thus providing a proxy for reference values for the Spanish population and forming the base for following temporal trends in the future. 
Exposure Spanish adults; Human biomonitoring; Human serum samples; Perfluorinated alkyl substances 
PFAS
• Additional PFAS (formerly XAgency)
     Literature Search November 2019
          PubMed
          Web of Science
          ToxNet
     Screened Studies
          Supplemental
     2-(N-Methylperfluorooctanesulfonamido)acetic acid
• Expanded PFAS SEM (formerly PFAS 430)
     Litsearch: September 2019
          Web of Science
     Not prioritized for screening
     Perfluorooctane
     2-(N-Methylperfluorooctanesulfonamido)acetic acid
• NMeFOSAA
     Literature Search
          Pubmed
     Screening Results
          Susceptible populations
• ^Per- and Polyfluoroalkyl Substances (PFAS)
     PFOA (335-67-1) and PFOS (1763-23-1)
          Literature Search – Adverse outcome pathway (2015-present)
               Pubmed
               WOS
     PFDA (335-76-2)
          Literature Search
               Pubmed
     PFNA (375-95-1)
          Literature Search
               Pubmed
     PFHxS (355-46-4)
          Literature search
               Pubmed
     NMeFOSAA (2355-31-9)
          Literature Search
               Pubmed
• PFAS 150
     Literature Search Update December 2020
          PubMed
          WOS
     Literature Search August 2019
          PubMed
          Web of Science
     Not prioritized for screening
     Ammonium perfluorooctanoate
     Perfluorodecanoic acid
     Perfluorohexanesulfonic acid
     Perfluorononanoic acid
     Perfluorooctane
     Perfluorooctanesulfonic acid
     Perfluorooctanoic acid
• PFBA
     Protocol References
• PFDA
     Literature Search
          Pubmed
          WOS
     Scopus: April 2021
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     Title and Abstract Screening
          Full Text Screening
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               Exposure assessment or qualitative exposure only
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          Title & Abstract Screening
               Tagged as Supplemental
                    Full Text Screening
                    Exposure assessment or qualitative exposure only
• PFHxS
     Database searches
          Pubmed
          Toxline
          WOS
          Scopus
     Excluded
          TiAb
• PFNA
     Literature Search (August 2017)
          Pubmed
     Litsearch Update 2017-2018
          PFAS Untag
     Litsearch Addl Synonyms 2018
          WOS
     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
          WOS
     Screening Results
          Susceptible populations
     Literature Search Update (2013-2019)
          PubMed
          WOS