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Journal Article 
Dietary intake, drinking water ingestion and plasma perfluoroalkyl substances concentration in reproductive aged Chinese women 
Zhou, W; Zhao, S; Tong, C; Chen, L; Yu, X; Yuan, T; Aimuzi, R; Luo, F; Tian, Y; Zhang, J; Shanghai Birth Cohort study 
Environment International
ISSN: 0160-4120
EISSN: 1873-6750 
BACKGROUND: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals that are widely used in industrial and consumer products. A growing body of literature suggests that exposure to these chemicals are associated with adverse reproductive outcomes in women. However, the sources of PFAS exposure are often poorly characterized in women of child-bearing age.

OBJECTIVES: To examine the association of plasma PFAS concentrations with dietary intake and drinking water sources in reproductive aged women in Shanghai, one of the high PFAS polluted regions in China.

METHODS: Concentrations of ten PFAS in plasma samples were measured in 933 women. Information on dietary intake and type of drinking water was collected by questionnaire. We used multivariable linear regression models to assess the association of PFAS concentrations with dietary intake and drinking water.

RESULTS: After controlling for potential confounders, a higher frequency of intake of aquatic products (freshwater fish, marine fish, shellfish, shrimp and crab) was positively and significantly associated with concentrations of PFOS, PFOA, PFNA, PFDA, PFUA and PFDoA in 900 reproductive aged women. Intake of freshwater fish showed the strongest association with PFAS. Compared with the lowest intake group of freshwater fish, the intermediate intake group had 8-32% increase in the concentrations of these pollutants; and the highest group had 11-57% increase. Conversely, intake of soy products was associated with lower levels of PFDA, PFUA, PFNA, PFOS, and PFDoA. In addition, compared with women drinking tap water, drinking bottled water was associated with significantly decreases in PFHpA, PFDA, PFOA, PFUA and PFBS blood levels by 9-13% in 905 reproductive aged women.

CONCLUSIONS: Intake of freshwater fish, marine fish, shrimp and crab was positively associated with plasma PFAS concentrations, while intake of soy products and bottled water was associated with lower PFAS concentrations in the Chinese women of reproductive age. 
Perfluoroalkyl and polyfluoroalkyl substances (PFAS); Diet; Drinking water; China 
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