產前全氟碳化物暴露可能改變八歲孩童時期肺功能

Abstract

背景： 全氟碳化物是環境中常見的環境中持續的有機汙染物，次分類包括有全氟辛酸(PFOA)、全氟辛烷磺酸鹽(PFOS)、全氟壬酸(PFNA)及全氟十一酸(PFUA)等。動物實驗證實全氟碳化物會影響改變肺部發展及發炎反應。然而，產前的暴露與孩童時期的暴露全氟碳化物對孩童肺部影響程度大小目前尚不清晰。 研究目的： 本篇研究目的在於探討產前暴露和孩童時期暴露到不同的全氟碳化物，對於孩童肺部發展的影響。 研究方法： 從台灣出生世代追蹤調查研究中，收案165位孩童，從出生時的臍帶血測量其全氟碳化物濃度，在孩童八歲時收取血清再測量其全氟碳化物濃度，方法是以極致液相層析/串聯式質譜儀作分析。並在孩童八歲時做肺功能檢查及兒童氣喘及過敏國際研究問卷調查。 結果： 在165位收案孩童中，臍帶血中的PFOA、PFOS、PFNA和PFUA濃度分別為2.4, 6.4, 6.0, 15.4奈克每毫升。而八歲時的血清中PFOA、PFOS、PFNA和PFUA濃度則分別為2.7, 5.9, 0.6, 0.3奈克每毫升。八歲時期的肺功能平均第一秒用力呼氣量 (FEV1)、用力肺活量( FVC)、最大呼氣流率( PEF)及用力呼氣一秒率(FEV1/FVC)分別為1679毫升、1835毫升、3846毫升每秒及92.0%。本研究發現臍帶血中的PFOA、PFOS、PFNA和PFUA與肺功能的減少有關連性，對於減少肺功能的一致性最高者為臍帶血中PFOS濃度，對於次分類中的較輕出生體重孩童和過敏性鼻炎孩童的肺功能具有顯著的負向影響。 結論： 我們的世代研究發現PFOA、PFOS、PFNA和PFUA在臍帶血中濃度的幾何平均皆大於八歲孩童時期血清濃度。臍帶血中的PFOS濃度對孩童時期的第一秒用力呼氣量 (FEV1)、用力肺活量( FVC)、最大呼氣流率( PEF)有負向影響的趨勢，其中較輕出生體重和有過敏性鼻炎的孩童會有顯著影響。產前的全氟碳化物對於孩童未來的肺部發展可能扮演了重要的角色。

Background: The perfluoroalkyl substances (PFAS), such as perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA) and perfluoroundecanoic acid (PFUA), are common persistent organic pollutants in the environment. Animal studies had indicated PFAS would influence lung development and inflammatory responses. However, the effect of whether prenatal or childhood PFAS exposures affect more children’s lung function is unclear. Aim: The purpose of this study is to investigate the relationships between intra-utero exposure and childhood-exposure to PFAS and lung function development at children stage. Methods: In total, 165 children were recruited from the Taiwan Birth Panel Study (TBPS). Cord blood plasma and children’s serum while they’re eight years old was collected. PFAS were analyzed by ultra-high-performance liquid chromatography/tandem mass spectrometry. Until reached eigth years of age, we enrolled these children to have lung function examinations and detailed questionnaire. Results: Among 165 study children, the mean concentrations of PFOA, PFOS, PFNA and PFUA in cord blood were 2.4, 6.4, 6.0, 15.4 ng/mL, respectively. The concentrations in eight-year-old serum were 2.7, 5.9, 0.6, 0.3ng/mL, respectively. At eight years of age, their mean values of FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), PEF (peak expiratory flow) and FEV1/FVC were 1679 mL, 1835 mL, 3846 mL/sec and 92.0 percent, respectively. PFOA, PFOS, PFNA and PFUA levels in cord blood were inversely associated with FEV1, FVC and PEF values. PFOS in cord blood is the most consistently correlated to decreasing lung function even after adjusting confounding factors. PFOS significantly affects lung function in subgroup of lower birth weight and allergic rhinitis. Conclusions: Our cohort study suggested that the concentrations of PFOA, PFOS, PFNA and PFUA were geometrically higher in cord blood than in eight-year-old serum. There are also trends noted between intrauterine PFOS and decreasing FEV1, FVC and PEF in children stage, especially in subgroups of lower birth weight and allergic rhinitis. Intrauterine PFAS may play an important role in children’s lung development.