Citation:

LaKind, J., M. Verner, R. Rogers, H. Goeden, D. Naiman, S. Marchitti, G. Lehmann, E. Hines, AND S. Fenton. Current Breast Milk PFAS Levels in the United States and Canada: After All This Time, Why Don’t We Know More? ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, 130(2):1-8, (2022). https://doi.org/10.1289/EHP10359

Impact/Purpose:

Per- and polyfluoroalkyl substances (PFAS) are a large class of more than 9,000 structurally different compounds that have been used in industry and consumer products since the 1950s. They do not occur naturally, are widespread and persistent in the environment, and have been detected in people, wildlife, and fish all over the world. There is widespread exposure to PFAS, even a decade after one legacy PFAS, perfluorooctane sulfonate (PFOS), was taken off the market in the U.S. Despite twenty years of biomonitoring studies of these chemicals in both serum and urine, we have an extremely limited understanding of PFAS concentrations in breast milk of women in the US. The lack of robust information on PFAS concentrations in breast milk and the implications for both the breastfed infants and their families creates a dilemma for those who are trying to make informed decisions regarding the risks and benefits of breastfeeding. This information is also essential for public health agencies, including the EPA, for making recommendations to individuals, clinicians, and communities. In this work, we estimate concentrations of four PFAS (PFOA [perfluorooctanoic acid], PFOS, PFHxS [perfluorohexane sulfonate], PFNA [perfluorononanoic acid]) in breast milk in the US and Canada using milk/serum partitioning data in conjunction with serum PFAS concentrations and compare measured/estimated milk concentrations to public health screening values to illustrate the need for further research into this important topic.

Description:

Background: Despite 20 y of biomonitoring studies of per- and polyfluoroalkyl substances (PFAS) in both serum and urine, we have an extremely limited understanding of PFAS concentrations in breast milk of women from the United States and Canada. The lack of robust information on PFAS concentrations in breast milk and implications for breastfed infants and their families were brought to the forefront by communities impacted by PFAS contamination. Objectives: The objectives of this work are to: a) document published PFAS breast milk concentrations in the United States and Canada; b) estimate breast milk PFAS levels from maternal serum concentrations in national surveys and communities impacted by PFAS; and c) compare measured/estimated milk PFAS concentrations to screening values. Methods: We used three studies reporting breast milk concentrations in the United States and Canada We also estimated breast milk PFAS concentrations by multiplying publicly available serum concentrations by milk:serum partitioning ratios for perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). Measured and estimated breast milk concentrations were compared to children’s drinking water screening values. Discussion: Geometric means of estimated breast milk concentrations ranged over approximately two orders of magnitude for the different surveys/communities. All geometric mean and mean estimated and measured breast milk PFOA and PFOS concentrations exceeded drinking water screening values for children, sometimes by more than two orders of magnitude. For PFHxS and PFNA, all measured breast milk levels were below the drinking water screening values for children; the geometric mean estimated breast milk concentrations were close to—or exceeded—the children’s drinking water screening values for certain communities. Exceeding a children’s drinking water screening value does not indicate that adverse health effects will occur and should not be interpreted as a reason to not breastfeed; it indicates that the situation should be further evaluated. It is past time to have a better understanding of environmental chemical transfer to—and concentrations in—an exceptional source of infant nutrition.

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