Serum vaccine antibody concentrations in children exposed to perfluorinated compounds.
Article Type: Clinical report
Subject: Vaccines (Health aspects)
Children (Health aspects)
Biopharmaceutics (Health aspects)
Authors: Grandjean, P.
Andersen, E.W.
Budtz-Jorgensen
Pub Date: 03/01/2012
Publication: Name: Alternative Medicine Review Publisher: Thorne Research Inc. Audience: Academic; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 Thorne Research Inc. ISSN: 1089-5159
Issue: Date: March, 2012 Source Volume: 17 Source Issue: 1
Product: Product Code: E121920 Children SIC Code: 2836 Biological products exc. diagnostic
Organization: Government Agency: United States. Centers for Disease Control and Prevention
Accession Number: 286390899
Full Text: Grandjean P, Andersen EW, Budtz-Jorgensen et al. JAMA 2012;307:391-397.

CONTEXT: Perfluorinated compounds (PFCs) have emerged as important food contaminants. They cause immune suppression in a rodent model at serum concentrations similar to those occurring in the US population, but adverse health effects of PFC exposure are poorly understood.

OBJECTIVE: To determine whether PFC exposure is associated with antibody response to childhood vaccinations.

DESIGN, SETTING, AND PARTICIPANTS: Prospective study of a birth cohort from the National Hospital in the Faroe Islands. A total of 656 consecutive singleton births were recruited during 1999-2001, and 587 participated in follow-up through 2008.

MAIN OUTCOME MEASURES: Serum antibody concentrations against tetanus and diphtheria toxoids at ages 5 and 7 years.

RESULTS: Similar to results of prior studies in the United States, the PFCs with the highest serum concentrations were perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). Among PFCs in maternal pregnancy serum, PFOS showed the strongest negative correlations with antibody concentrations at age 5 years, for which a 2-fold greater concentration of exposure was associated with a difference of -39% (95% CI, -55% to -17%) in the diphtheria antibody concentration. PFCs in the child's serum at age 5 years showed uniformly negative associations with antibody levels, especially at age? years, except that the tetanus antibody level following PFOS exposure was not statistically significant. In a structural equation model, a 2- fold greater concentration of major PFCs in child serum was associated with a difference of -49% (95% CI, -67% to -23%) in the overall antibody concentration. A 2- fold increase in PFOS and PFOA concentrations at age S years was associated with odds ratios between 2.38 (95% CI, 0.89 to 6.35) and 4.20 (95% CI, 1.54 to 11.44) for falling below a clinically protective level of 0.1 IU/mL for tetanus and diphtheria antibodies at age 7 years.

CONCLUSION: Elevated exposures to PFCs were associated with reduced humoral immune response to routine childhood immunizations in children aged 5 and 7 years. PMID: 22274686

Commentary

The two perfluorocarbons (PFCs) mentioned in this study--PFOS and PFOA--are man-made fluorosurfactants (i.e., they repel substances in things they are applied to). They are used directly in, or in the manufacturing of, consumer products such as stain repellants (PFOS was the active ingredient in Scotchguard[TM]), water repellants (PFOA is used in the production of Gore-Text), food contact paper (PFOA is used in microwave popcorn bags, fast food wrappers, candy wrappers, and other situations where preventing oil from soaking into paper is desired), and non-stick coatings (PFOA has been detected in some non-stick cookware coatings). PFOS and PFOA were found ubiquitously in the U.S. population (reported by the Centers for Disease Control and Prevention (CDC) in the Fourth National Report on Human Exposure to Environmental Chemicals [CDC Fourth Report]). Fluorosurfactants are considered to be bioaccumulative, with exceptionally long serum half-life in humans--averaging 4 years. This means that even very small levels of exposure can dramatically build up over time. In addition to their persistence in the environment and widespread occurrence in the blood of the general population, possible adverse health effects have been reported. Two recent studies have revealed that these compounds imbalance the immune system to be more dominated by Th2 cells (see the article in this issue titled Do Environmental Toxicants Contribute to Allergy and Asthma?) leading to reduced cellular immunity and increased allergy and autoimmune tendencies. The study by Dr. Grandjean and his team now reports that PFOS and PFOA, at levels commonly found in the CDC Fourth Report, were associated with lower antibody responses in children who were immunized. Their antibody production was so compromised as to result in antibody levels insufficient to provide long-term protection from tetanus and diphtheria. Is use of non-stick cookware or eating microwave popcorn really worth this?
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