Systematic evidence mapping of potential correlates of exposure for per- and poly-fluoroalkyl substances (PFAS) based on measured occurrence in biomatrices and surveys of dietary consumption and product use.
Level 4 - case-series / case-control
Systematic evidence mapping of observational cross-sectional and survey-based correlation studies
PubMed 38735219 · doi:10.1016/j.ijheh.2024.114384
What was done
A systematic evidence mapping approach was used to collate human studies evaluating relationships between biomatrix concentrations of 16 per- and poly-fluoroalkyl substances (PFAS) and self-reported dietary consumption (11 categories) or consumer product/article use (11 categories). Parameters extracted across screened publications included sampling details, cohort characteristics, biomatrices measured, specific PFAS compounds, and reported correlation values and statistical strength.
What was found
The mapping included 103 studies (59% published after 2015). Dietary correlates were evaluated in 94 studies, and product use correlates in 56 studies. PFOA and PFOS were examined in nearly all studies; PFHxS, PFNA, and PFDA appeared in >50%, while PFNS and PFPeS had zero studies. Significant correlations with at least one PFAS were identified in 83% (78/94) of dietary studies (most frequently positive for seafood and meats/eggs, and negative for cereals/grains/pulses) and 70% (39/56) of product studies (most frequently positive for smoking/tobacco, cosmetics/toiletries, non-stick cookware, and carpet/flooring/furniture). Six of 11 product categories had five or fewer studies.
Why it matters
This systematic map consolidates evidence linking human internal PFAS burden to specific food and product sources, identifying consistent dietary correlates while highlighting critical data gaps across consumer product categories.
Limits
The underlying evidence base is restricted to observational survey and biomatrix correlation designs, which are subject to recall bias, residual confounding, and exposure misclassification. Several product categories had sparse data (five or fewer studies), and specific correlation coefficients or quantitative effect sizes are not reported in the abstract.