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5080195 
Journal Article 
Using 2003-2014 U.S. NHANES data to determine the associations between per- and polyfluoroalkyl substances and cholesterol: Trend and implications 
Dong, Z; Wang, H; Yu, YY; Li, YB; Naidu, R; Liu, Y 
2019 
Yes 
Ecotoxicology and Environmental Safety
ISSN: 0147-6513
EISSN: 1090-2414 
Netherlands 
173 
461-468 
English 
Exposure to per- and polyfluoroalkyl substances (PFASs) is a major concern due to their widespread occurrence and adverse health outcomes. The possible binding of PFASs to peroxisome proliferator-activated receptors (PPARs) and nuclear receptors raises concerns that PFASs may impact cholesterol levels in human. In this study, the U.S. National Health and Nutrition Examination Survey (NHANES) data were employed to address the temporal trend for PFAS concentrations in biomonitoring and associations between cholesterol levels and PFAS exposure. Compared to the PFAS levels in 2003-2004, the median perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) levels in human serum in 2013-2014 decreased from 3.7 to 1.8 ng/mL, 19.2-4.7 ng/mL, 1.7 ng/mL to 1.3 ng/mL and 0.8 ng/mL to 0.6 ng/mL, respectively. Also, an estimate of 1.5 ± 0.7 mg/dL (95% confidence interval: 0.2 - 2.8) and 0.4 ± 0.2 mg/dL (95% confidence interval: 0.1 - 0.6) total cholesterol increases for unit PFOA and PFOS increase (ng/mL), respectively. By using hybrid approach, RfDs were estimated to be 2.0 ng PFOS/kg per day and 0.8 ng PFOA/kg per day. However, it should be cautious when using proposed RfDs based on data obtained from cross-sectional datasets, especially evidence based on data originating from experimental or animal studies is still controversial. 
Per- and polyfluoroalkyl substances; Cholesterol; Temporal trend; Reference dose 
PFAS
• Additional PFAS (formerly XAgency)
     Literature Search November 2019
          Other Sources
               Reference list review of included studies
               TEDX
     Screened Studies
          Excluded
               Exclude (TIAB)
• Expanded PFAS SEM (formerly PFAS 430)
     Litsearch: September 2019
          PubMed
          Other Sources
               PFAS TOX Database
     Screened Studies
          Excluded
               Exclude (TIAB)
     Not prioritized for screening
     Perfluorooctane
     Potassium perfluorooctanoate
     Sodium perfluorooctanoate
• PFAS 150
     Literature Search Update December 2020
          PubMed
          WOS
     Literature Search August 2019
          PubMed
          Web of Science
          Other sources
               Reference list review of included studies
               PFAS TOX Database
     Not prioritized for screening
     Ammonium perfluorooctanoate
     Perfluorohexanesulfonic acid
     Perfluorononanoic acid
     Perfluorooctane
     Perfluorooctanesulfonic acid
     Perfluorooctanoic acid
• PFDA
     June 2022 Pelch Database
     Literature Searches (through April 2023 update and post-public comment/peer review)a    
          Other
               Published PFAS SEMs
          Title & Abstract Screening
               Tagged as Supplemental
                    Full Text Screening
                         Studies Meeting PECO
                              Human health effects studies
• PFHxS
     Database searches
          Pubmed
          WOS
          Scopus
          Pelch PFAS SEM
     Inclusion
          TiAb
          Full Text
               Human Study
• PFNA
     Literature Search
          Pubmed
          WOS
     PFNA May 2019 Update
          Pubmed
          Web of Science
     LitSearch: May 2019 - May 2020
          WoS
     Title and Abstract Screening
          Full Text Screening
               Studies Meeting PECO
                    Human health effects studies
     June 2022 Pelch Database
• PFOA (335-67-1) and PFOS (1763-23-1)
     Literature Search Update (2013-2019)
          PubMed
• PFOA and PFOS OW MCLG Approaches
     Cited in White Papers