Application of benchmark analysis for mixed contaminant exposures: Mutual adjustment of perfluoroalkylate substances associated with immunotoxicity

Budtz-Jørgensen, E; Grandjean, P

HERO ID

5083631

Reference Type

Journal Article

Year

2018

Language

English

PMID

30339706

HERO ID 5083631
In Press No
Year 2018
Title Application of benchmark analysis for mixed contaminant exposures: Mutual adjustment of perfluoroalkylate substances associated with immunotoxicity
Authors Budtz-Jørgensen, E; Grandjean, P
Journal PLoS ONE
Volume 13
Issue 10
Page Numbers e0205388
Abstract <strong>BACKGROUND: </strong>Developmental exposure to perfluorinated alkylate substances (PFASs) is associated with deficient IgG antibody responses to childhood vaccines. As this immunotoxicity outcome may represent a critical effect, calculation of benchmark dose (BMD) results would be useful for defining protective limits of exposure. However, exposures to the major PFASs that are associated with this adverse effect are interrelated, and mutually adjusted BMD results would be desirable.<br /><br /><strong>METHODS: </strong>We carried out BMD calculations on prospective data from two prospective birth cohort studies from the Faroe Islands with a total of 1,146 children. Exposure data included serum concentrations of five major PFASs at birth and at age 5 years and, as outcome parameters, the serum concentrations of specific IgG antibodies against tetanus and diphtheria at ages 5 and 7. We calculated the BMDs and their lower confidence bounds (BMDLs) and included mutual adjustment for five major PFASs. BMD and BMDL were expressed in terms of the serum concentration of the PFASs.<br /><br /><strong>RESULTS: </strong>The BMDLs for the immunotoxicants were of similar magnitude before and after adjustment. As compared to linear dose-response models, the PFASs showed lower results for a piecewise linear model, which also provided a slightly better fit. Weaker associations with the antibody outcomes were observed after adjustments due to the correlation between the PFASs. However, while the adjustments resulted in elevated BMD results and p values, the BMDL values were not materially changed.<br /><br /><strong>CONCLUSIONS: </strong>Adjustment for co-exposure to a related immunotoxicant increased both the BMD values and their standard errors, though affected the BMDL values only to a negligible extent. Thus, when correlated toxicants appear to affect the same outcome and none of them is known a priori to be solely responsible, all exposures may be considered responsible in BMD calculations. Our BMDL results, both before and after adjustment are generally below current exposure levels and therefore suggest that all five perfluorinated substances should attract regulatory attention, at least until additional evidence shows otherwise.
Doi 10.1371/journal.pone.0205388
Pmid 30339706
Wosid WOS:000447761400012
Url https://www.proquest.com/docview/2123042960?accountid=171501&bdid=35863&_bd=jbWCtouHvRpPxavu8%2F9WMK9Be4o%3D
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English
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