Per- and Polyfluoroalkyl Substances (PFASs) in Food and Human

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Review

Per- and polyfluoro alkyl substances (PFASs) in Food and Human Dietary Intake: A Review of the Recent Scientific Literature Jose L. Domingo, and Marti Nadal J. Agric. Food Chem., Just Accepted Manuscript • DOI: 10.1021/acs.jafc.6b04683 • Publication Date (Web): 04 Jan 2017 Downloaded from http://pubs.acs.org on January 6, 2017

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Journal of Agricultural and Food Chemistry is published by the American Chemical Society. 1155 Sixteenth Street N.W., Washington, DC 20036 Published by American Chemical Society. Copyright © American Chemical Society. However, no copyright claim is made to original U.S. Government works, or works produced by employees of any Commonwealth realm Crown government in the course of their duties.

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Journal of Agricultural and Food Chemistry

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Per- and polyfluoro alkyl substances (PFASs) in Food and

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Human Dietary Intake: A Review of the Recent Scientific

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Literature

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José L. Domingo* and Martí Nadal

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Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV,

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Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain

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ABSTRACT: Because of the important environmental presence and the potential human

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toxicity of per- and poly-fluorinated alkyl substances (PFASs), in recent years the social

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and scientific interest on these compounds has notably increased. Special attention has

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been paid to perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA), the

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most extensively investigated PFASs. Although human exposure to PFASs may occur

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through different pathways, dietary intake seems to be the main route of exposure to these

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compounds. In 2012, we published a wide revision on the state of the science regarding

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the concentrations of PFASs in foodstuffs, the human dietary exposure to these

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compounds and their health risks. In the present review, we have updated the information

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recently (2011-2016) published in the scientific literature. As in our previous review, we

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have also observed considerable differences in the PFASs detected –and their

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concentrations- in the food items analyzed in samples from a number of regions and

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countries. However, fish and other seafood seem to be the food group in which more

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PFASs are detected, and where the concentrations of these compounds are higher. Based

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on the recommendations of the EFSA on the maximum dietary intakes of PFOS and

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PFOA, human health risks would not be of concern for non-occupationally exposed

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populations, at least in the very limited countries for which recent data are available.

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KEYWORDS: per- and poly-fluorinated alkyl substances (PFASs), PFOS, PFOA,

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dietary intake, health risks.

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■ INTRODUCTION

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PFASs and their derivatives are a group of chemicals with a great number of applications.

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They can offer resistance to heat, to other chemicals or to abrasion, being also used as

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dispersion, wetting or surface-treatment agents. Due to this, for over 60 years, the

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properties of these substances have been utilized in a very wide range of products and

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applications (food packaging, nonstick cookware, cleaning agents, surfactant, coating

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materials, etc).1

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However, the social and scientific interest/concern on their environmental impacts and

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the potential health risks in humans is much more recent. Thus, using Scopus

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(https://www.scopus.com/) as database and “perfluorinated compounds” -an old but more

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extended term to refer to PFASs- and “human health risks” as search terms, the first

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citation does not appear until 1989.2 The second indexed paper was published 12 years

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after,3 although it is not an experimental study. During that time, a review-article on

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extraperoxisomal targets of peroxisome proliferators, in which perfluorinated straight-

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chain monocarboxylic fatty acids is revised, can be also found.4 The scientific

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information during subsequent years is also very scarce, ranging between 2 and 7

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citations in 2004 and 2009, respectively. In contrast, during the current decade, the

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number of citations has notably increased with the maximum number (20) corresponding

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to 2013 (15 citations in 2015). Moreover, using “perfluorinated compounds” and

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“environmental impact” as terms of search, the number of citations has maintained a very

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similar trend, with 26 and 20 references in 2014 and 2015, respectively.

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As for many other organic substances of environmental concern, food consumption is

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one of the main routes of human exposure to PFASs.5-11 In recent years, a number of

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investigators have determined the concentrations of PFASs in foodstuffs, while some

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studies have also assessed the dietary intake of some of the most well known PFASs,

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mainly PFOS and PFOA. In 2011, we assessed the state-of-the-art regarding human

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health risks of the dietary exposure to PFASs.7 Because of the interest that this topic still

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generates in both, the public opinion and the scientific community, we have now updated

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the existing information related with this topic.

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■ PFAS CONCENTRATIONS IN FOOD AND DIETARY INTAKE IN A

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NUMBER OF COUNTRIES

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PubMed (https://www.ncbi.nlm.nih.gov/pubmed) and Scopus were used as databases,

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while search terms were “PFASs and food” and “PFASs and dietary intake”.

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Notwithstanding, a complementary search was carried out by using the old term

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“perfluorinated compounds”. Publications from regulatory organizations and other

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authorities, as well as grey literature available through Internet, were intentionally

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excluded. Therefore, this review was only focused on scientific publications. The period

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of this new review covered between May 2011 and October 2016. Although only

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scientific publications within this period were gathered, some of the reported data may be

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referred to samples collected or analyzed in previous years.12 However, some of the

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reported data refer to previous years In general terms, most of the studies here reviewed

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have been carried out in European countries, being only some of them conducted in North

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America and Asia (Table 1). Besides chekcing articles reporting the levels of PFASs in

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foodstuffs, this review was particularly aimed at evaluating the state-of-the-art on the

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dietary intake of PFASs, which is estimated by multiplying PFAS concentrations and

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food consumption data.

81 82

European countries

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Germany. Our search terms produced one published article during the assessed period.

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It belongs to Hölzer et al.,13 who measured the concentrations of various PFASs in

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samples of several fish species collected at the Lake Möhne (Sauerland area). The levels

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of PFOS ranged between 4.5 and 150 ng/g, being the highest median PFOS

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concentrations found in perches (96 ng/g) and eels (77 ng/g), followed by pikes (37 ng/g),

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whitefish (34 ng/g), and roaches (6.1 ng/g). Interestingly, in a food surveillance program

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only 11% of fishes at retail sale were found to contain PFOS at detectable levels. In this

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same study, plasma samples of anglers of the zone were also collected and analyzed for

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the same PFASs. For PFOS, the concentrations in plasma of anglers consuming fish 2-3

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times per month were 7 times higher, compared to those without any fish consumption

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from Lake Möhne.

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The Netherlands. Noorlander et al.14 determined the levels of 14 PFASs in foodstuffs

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(pooled samples) purchased in several Dutch retail store chains with nation-wide

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coverage. Six PFASs (PFHpA, PFOA, PFNA, PFDA, PFHxS and PFOS) could be

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quantified in most food categories. The highest concentration of the sum of these six

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compounds was found in crustaceans (825 pg/g product, PFOS: 582 pg/g product) and in

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lean fish (481 pg/g product, PFOS: 308 pg/g product). In contrast, beef, fatty fish, flour, 4 ACS Paragon Plus Environment

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butter, eggs, and cheese showed lower concentrations (20 and 100 pg/g product; PFOS,

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29-82 pg/g product). Milk, pork, bakery products, chicken, vegetable, and industrial oils

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showed concentrations lower than 10 pg/g product (PFOS not detected). The median

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long-term intake for PFOS was 0.3 ng/kg body weight (bw)/day, and for PFOA 0.2 ng/kg

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bw/day. These intakes were well below the TDI values of both compounds (PFOS, 150

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ng/kg bw/day; PFOA, 1500 ng/kg bw/day). The results of that survey showed that

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vegetables/fruits and flour were important contributors of PFOA intake, while milk, beef,

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and lean fish were important contributors of PFOS intake.

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Spain. Human exposure to 18 PFASs through the most widely consumed foodstuffs in

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Catalonia (Spain) was assessed by Domingo et al.15 Two samples of 40 different food

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items were analyzed. PFOS was the compound found in the highest number of samples

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(33 out of 80), followed by PFOA, PFHpA, PFHxS, PFDA and PFDS. Fish and shellfish

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was the food group where more PFASs were detected, and where the highest PFAS

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concentrations were found. The highest dietary intakes corresponded to children,

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followed by male seniors, with values of 1787 and 1466 ng/day, respectively. However,

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the TDIs recommended by the EFSA (150 and 1500 ng/kg bw/day for PFOS and PFOA,

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respectively),10 were not exceeded for any of the age/gender groups of the population of

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Catalonia. When the PFAS levels found in that survey were compared with those

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previously reported for other countries, the concentrations found in foodstuffs purchased

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from Catalonia were generally lower.7 Additionally, the concentrations of 13 PFASs were

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also determined in samples of fish and shellfish collected from coastal areas of

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Catalonia.16 Only seven PFASs were detected in at least one composite sample,

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with PFOS showing the highest mean concentration (2.70 ng/g fresh weight (fw)), and

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being detected in all species with the exception of mussels. In turn, the highest levels of

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PFOA (mean, 0.074 ng/g fw) corresponded to prawn and hake (0.098 and 0.091 ng/g fw,

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respectively). The intake of PFASs through the consumption of the analyzed foodstuffs

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was below the recommended TDI for those compounds for which information is

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currently available.

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France. Munschy et al.17 determined the levels of PFASs in mollusks collected along

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the coasts on mainland France (Atlantic coast, Mediterranean Sea and English Channel).

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The median concentrations of PFOS were 0.18 ng/g wet weight (ww), 0.09 ng/g ww and

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0.04 ng/g ww in samples from the English Channel, the Atlantic coast and the

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Mediterranean coast, respectively. No estimation on human exposure to PFASs through

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mollusks consumption was performed in that study. However, Rivière and co-workers18 5 ACS Paragon Plus Environment

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assessed the human health risks related to the presence of 16 PFASs measured in food

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samples collected for the second total diet study (TDS) performed in France.19 PFOA was

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quantified in meats, poultry and game, delicatessen meats, seafood products, vegetables

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(excluding potatoes), water and mixed dishes. The highest mean concentrations were

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found in mollusks and crustaceans (0.044 µg/kg fw), while PFOS was quantified in

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meats, delicatessen meats, seafood products, vegetables, water, and mixed dishes. As for

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PFOA, the highest mean concentrations were also noted in mollusks and crustaceans

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(0.19 µg/kg fw). In adults, mean exposures to PFOA and PFOS were estimated at 0.74

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and 0.66 ng/kg bw/day, respectively. At the 95th percentile, exposures were estimated at

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1.50 ng/kg bw/day and 1.15 ng/kg bw/day for PFOA and PFOS, respectively. These

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values should not mean risks for the human health. However, due to the lack of

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information for the other PFASs whose toxicological properties are not well known,

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health risks could not be properly evaluated for compounds other than PFOS and PFOA.

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In another study, Yamada et al.20 assessed the dietary exposure to 15 PFASs for 3

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different groups of French adult populations: high seafood consumers, high freshwater

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fish consumers, and pregnant women. The analysis of fish samples showed that

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freshwater fish was the most contaminated group, with a level up to 168.4 ng/g ww (sum

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of 15 analyzed PFASs: PFBA, PFPA, PFHxA, PFHpA, PFOA, PFNA, PFDA, PFUnA,

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PFTrDA, PFTeDA, PFBS, PFHxS, PFHpS, PFOS and PFDS), followed by marine fish

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and seafood (6.8 and 7 ng/g ww, respectively). Freshwater fish contamination was mainly

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due to PFOS (75%), while that of marine fish was due to PFOA (24%), PFOS (20%),

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PFHxA (15%), PFHpA (11%) and PFBA (11%).21 It was found that high freshwater fish

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consumers were the most exposed to PFOS (7.5 ng/kg bw/day), PFUnA (1.3 ng/kg

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bw/day), PFDA (0.4 ng/kg bw/day) and PFHpS (0.03 ng/kg bw/day). In turn, high

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seafood consumers were the most exposed to PFOA (1.2 ng/kg bw/day), PFNA (0.2

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ng/kg bw/day) and PFHxS (0.06 ng/kg bw/day).

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Sweden. Vestergren and co-workers22 estimated the dietary intake of PFASs using a

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highly sensitive method to analyze a set of archived (1999, 2005 and 2010) food market

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basket samples. Fish and meat were the main contributors to the dietary exposure to

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PFOS (860-1440 pg/kg bw/day), PFUnDA (90-210 pg/kg bw/day), PFDA (50-110 pg kg

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bw/day) and PFNA (70-80 pg/kg bw/day), but not for PFOA (350-690 pg/kg bw/day). An

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interesting conclusion of that survey was that the dietary intake of PFASs had been rather

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constant over the last decade, in which important manufacturing changes occurred.

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However, in a subsequent study conducted by the same researchers,23 in which archived 6 ACS Paragon Plus Environment

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samples (1999-2010) of eggs, milk and farmed rainbow trout were analyzed for

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determining the levels of PFASs, significant decreasing trends were observed for the

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levels of PFOS and PFHxS in fish and eggs. The levels of PFOS in fish and eggs

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decreased by factors of 10 and 40, respectively, while in eggs there was also a significant

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decreasing trend in the levels of PFOA. In a recent report by the same research group,12

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where archived food samples were again analyzed, PFOS precursors were detected in all

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food year (1999, 2005 and 2010) pools, with the highest concentrations corresponding to

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1999. Six diPAPs were detected in the year pools with the highest ∑diPAP

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concentrations found in 1999 and 2005. All precursors were predominantly found in

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meat, fish and eggs, based on analysis of individual food groups from 1999, while the

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lowest precursor contributions were generally found in food samples from 2010. Very

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recently, Sjogren and co-workers24 reported the results of a study whose main objective

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was to examine the cross-sectional relation between blood levels in an elderly Swedish

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population of selected PFASs, and adherence to three predefined dietary patterns: a) a

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WHO recommended diet, b) a Mediterranean-like diet, and c) an LCHP diet. In that

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study, which included 844 elderly Swedish (men and women), all dietary patterns were

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positively associated with blood levels of PFASs, being the highest body burden of these

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compounds found in individuals with high adherence to a Mediterranean-like diet, which

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is characterized by a high fish consumption. In contrast, subjects who more closely

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followed the officially recommended diet, showed a lower body burden of PFASs.

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Joint study in four European countries (Belgium, Czech Republic, Italy and Norway).

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Herzke et al.25 designed a harmonized sampling survey collecting similar food items in a

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uniform procedure enabling direct comparison between four European countries:

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Belgium, Czech Republic, Italy and Norway. In a first study of that survey, only

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vegetables (20 species) were analyzed. In addition to fresh vegetables, processed

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vegetable products as ready-to-cook pommes frites, frozen minced spinach, and mixed

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lettuce were also sampled and analyzed for PFASs concentrations. Only low levels of

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PFASs were detected in all analyzed samples. PFCAs were the main group of detected

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PFASs, being PFOA the most abundant PFCA (with the exception of samples from

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Czech Republic). However, dietary intake estimates for PFOA showed low human

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exposure due to vegetable consumption for adults and children. In a parallel study,

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Hlouskova et al.26 measured the concentrations of 21 PFASs in samples of meat, fish and

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seafood, milk and dairy products, and eggs. Five PFASs were not detected in any of the

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analyzed samples. PFOS was the most frequently detected analyte (range: 0.987 ACS Paragon Plus Environment

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2600 ng/kg). The concentration ranges of individual compounds were the following:

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2.33-76.3 ng/kg for PFSAs (without PFOS), 4.99-961 ng/kg for PFCAs, 10.6-95.4 ng/kg

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for PFPAs, and 1.61-519 ng/kg for FOSA. The levels of PFASs in the analyzed

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foodstuffs decreased in the order: seafood > pig/bovine liver >> freshwater/marine

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fish > hen egg > meat >> butter. Subsequently, the dietary exposure to 7 selected PFASs

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(including PFOS and PFOA) was estimated for the population of the Czech Republic,

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Italy, Belgium and Norway, the countries where the food samples were collected.27 For

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both, adults and children, the intake was generally below or close to 1 ng/kg bw/day for

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all the selected PFASs. According to the TDIs proposed by the EFSA10 for PFOS (150

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ng/kg bw/day) and PFOA (1500 ng/kg bw/day), no concerns were identified. As

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expected, the different dietary exposure patterns among countries, which is a

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consequence of different food consumption and contamination patterns, showed different

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results among countries. Fruits and vegetables were the most important contributors to

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the dietary exposure to PFOA, while for PFOS, food of animal and plant origin showed a

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rather similar contribution. In a recent study also conducted in the context of the same

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European project, D’Hollander et al.28 determined the concentrations of 12 PFASs in

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samples of 14 food items (fruits, cereals, sweets and salt) collected in the same four

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European countries. Ten PFASs could be detected in 67% of the analyzed samples.

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PFOA was the most abundant compound (detection frequency of 49%) followed by

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PFOS (29%), while PFHxA and PFNA were found in 20% of the samples. The highest

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concentration corresponded to PFOS (539 pg/g), followed by PFNA, PFHxS, PFHpA,

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PFHxA and PFOA, all showing similar maximum levels (approximately 200 pg/g). The

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dietary intake of PFOS and PFOA was clearly below the tolerable levels,10 although they

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contributed to the total daily intake.

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Italy. The dietary intake by children of selected PFASs (PFHxA, PFOA, PFNA,

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PFDA, PFUnDA, PFHxS and PFOS) through meals served at school canteens was

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estimated by Dellatte et al.29 For PFOA and PFOS, Italian school-age children showed

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intakes ranging 0.3-1.1 and 0.5-1.4 ng/kg bw/day, respectively,29 well below the

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corresponding TDIs (1500 and 150 ng/kg bw/day, respectively).10 In another Italian

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study,30 the concentrations of PFOS and PFOA were determined in samples of cereal-

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based products, fish and seafood, meat, eggs, milk and dairy products, fruit and

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vegetables, oils and fats, fruit juices and honey purchased from the city of Siena. For

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PFOS, fish samples were the most contaminated (7.65 ng/g), while mean levels in meat

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and milk and dairy products were similar (1.43 and 1.35 ng/g, respectively). However, in 8 ACS Paragon Plus Environment

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samples of the remaining foodstuffs (cereal-based food, eggs, vegetables, honey and

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beverages), PFOS could not be detected. The estimation of the dietary intake of PFOS

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was not carried out in that study. Interestingly, PFOA could not be detected in any food

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sample. On the other hand, and with respect to freshwater fish, Squadrone et al.31

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measured PFOS and PFOA in samples of European whitefish and European perch

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collected from Lake Maggiore. PFOA was not detected in any sample, but PFOS was

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found in all samples, with levels of up to 46.0 ng/g fw. The authors concluded that PFOS

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intake through fish consumption from Lake Maggiore could be a significant source of

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dietary PFOS exposure. A similar study was also done with samples of the same species

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collected from the Lake Varese. PFOS was detected in all samples with concentrations of

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up to 17.2 ng/g. The conclusion was completely similar: fish from Lake Varese could be

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also a significant source for dietary PFOS exposure.32 On the other hand, Barbarossa et

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al.33 analyzed the concentration of PFOS and PFOA in 67 samples of different types of

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cow milk from Italy. PFOS was often present, but at relatively low concentrations (up to

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97 ng/L). In contrast, PFOA was rarely found. According to the authors, their results, as

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well as previous data from the scientific literature, would indicate that cow milk should

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not be a major source of PFASs, compared with other foods such as fish and seafood.

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Greece. Vassiliadou and co-workers34 determined the concentrations of 12 PFASs in 7

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species of finfish (anchovy, bogue, hake, picarel, sardine, sand smelt and striped mullet)

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and 3 species of other seafood (mussel, shrimp and squid). Analyses of PFASs were

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conducted not only in raw samples, but also in samples of these species fried in olive oil

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or grilled. PFASs above the detection limit were found in all raw samples with the

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exceptions of sardine, mussel and squid. PFOS was the most abundant compound, with

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its highest level detected in picarel (20.4 ng/g fw). With respect to the effects of cooking,

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the PFAS levels were usually higher after frying or grilling than in raw samples. The

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estimated daily intake for PFOS and PFOA through consumption of the fish and seafood

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species analyzed in that survey, was found to be well below the values proposed by the

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EFSA.10 More recently, Zafeiraki et al.35 analyzed the content of PFASs in home

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produced and commercially produced eggs of chicken from Greece and the Netherlands.

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The egg yolks were analyzed for 11 PFASs by liquid chromatography-tandem mass

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spectrometry using isotope dilution. PFAS levels in yolk were higher in home produced

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eggs from the Netherlands (median 3.1, range < LOQ – 31.2 ng/g) and Greece (median

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1.1, range < LOQ – 15.0 ng/g) compared to the eggs collected from supermarkets. 9 ACS Paragon Plus Environment

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Finland. Koponen et al.36 determined the concentrations of PFASs in fish species –

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collected from the Baltic Sea- commonly consumed in Finland. The main goal of the

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study was to collect data to be used for future dietary intake of PFASs and human

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exposure assessments. The species analyzed were Baltic herring, pike–perch, perch,

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burbot, whitefish, salmon and vendace. In addition, perch and pike–perch were collected

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from Helsinki Vanhankaupunginlahti bay, while perch was also collected from Lake

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Päijänne. Farmed fish species included whitefish and rainbow trout. As it has been found

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in most recent studies on the same topic, PFOS was again the most abundant compound

277

in each fish species. Other 6 PFASs (PFOA, PFNA, PFDA, PFUnA, PFDoA and PFTrA)

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were also detected in fish samples. It was noted that farmed fish in Finland was not a

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significant source of PFAS for humans, while the importance of fish on the total PFAS

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intake and human exposure in Finnish population was unclear.

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Faroe Islands and Greenland. In locally produced food items from Faroe Islands,

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Eriksson et al.37 analyzed the levels of 15 PFASs collected in 2011/2012. Food samples

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included dairy products (milk, yoghurt and crème fraiche), fish and potatoes. Of the 15

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PFASs measured, 13 could be detected in at least one sample. The frequency detection

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of PFASs in food items was the following: PFOS > PFUnDA > PFNA > PFOA, but

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PFUnDA predominated in milk and wild fish (mean concentrations: 170 pg/g). Although

287

no exposure assessment was conducted in that survey, the authors concluded that

288

consumption of the analyzed food items was not expected to exceed the TDI proposed

289

by the EFSA10 for PFOS and PFOA. On the other hand, Carlsson et al.38 measured the

290

concentrations of PCBs, PBDEs and PFASs in traditional Greenlandic seafood items:

291

fresh salmon fillet, smoked salmon fillet, smoked halibut fillet, commercial whale beef

292

narwhal mattak (Greenlandic traditional food consisting of blubber and parts of the

293

skin), and commercial seal meat. With respect to PFASs, 13 compounds were analyzed.

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Again, PFOS was the most common PFASs, while the sum of PFASs was below the

295

limits of detection in most fish fillet samples, varying from 2.9 ng/g ww in whale beef,

296

and 13.5 ng/g ww in seal beef. Because of their high consumption of marine mammals,

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Greenlandic population has been a target population in some biological monitoring

298

studies. A recent example is the investigation of Long et al.,39 who collected blood

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samples and questionnaire data from 207 pregnant women, being PFASs, legacy POPs

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and metals determined in all the samples. Although lower levels of PFOS and PFOA

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were found compared to data from other Arctic regions, PFHxS and PFNA sustained

302

the same level, indicating that the Greenlandic Inuit are still exposed to PFASs. 10 ACS Paragon Plus Environment

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Asia

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China. Zhao and co-workers40 determined the concentrations of various PFASs in

306

freshwater (10 species) and marine fish (10 species) collected from Hong Kong and

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Xiamen, China. Risk assessment of local people exposure to PFASs through fish

308

consumption was subsequently assessed. PFOS, PFOA, PFNA, PFDA, PFUnDA and

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PFTrDA were detected. Total concentrations of PFASs ranged between 0.27-8.4 ng/g and

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0.37-8.7 ng/g for Hong Kong and Xiamen, respectively. PFOS was the predominant

311

PFAS in fish, ranging between 0.27 and 4.5 ng g−1, wet weight (ww). The authors also

312

calculated the HR by dividing the average daily intake by the RfD. The HR of PFOS for

313

all fish was < 1.0, while that of PFOA was < 0.01 for all analyzed species of fish. In

314

another study also conducted in China, the levels of 10 PFASs were analyzed in samples

315

of edible freshwater fish and seafood.41 The estimated daily intake of PFOS and PFOA

316

via fish and seafood consumption ranged from 0.10 to 2.51 ng/kg bw/day and 0.13 to

317

0.38 ng/kg bw/day, respectively, for different age groups (toddlers, adolescents and

318

children, and adults) from 4 selected locations. Fish and seafood consumption of the

319

analyzed species accounted for 7%-84% of PFOS intake, indicating important regional

320

differences in human dietary exposure to PFOS. Additional data on the concentrations of

321

PFASs in seafood from China were reported by Wu et al.42, who analyzed the levels of 13

322

PFASs in 47 fatty fish and 45 shellfish samples, collected from 6 coastal provinces. The

323

daily intakes of PFASs via seafood consumption by residents, as well as the healthy

324

effect of local inhabitants in these 6 regions, were subsequently estimated. PFASs were

325

detected in 92% of the 92 seafood samples, being PFOS, PFOA, PFNA and PFUnDA the

326

most predominant compounds, while the remaining 9 PFASs were only found in a few

327

samples (< 30%) at trace concentrations. The levels of PFOS ranged from liver > brain > muscle

PFOS: 0.24 Total PFASs: 0.44

Shi et al.44

The frequent consumption of yellow coraker fish may pose an unacceptable risk to human health

PFOS: Urban: 0.42-0.84. Rural: 0.37 PFOA: Urban: 0.02-0.18. Rural: 0.06

He et al.45

PFOS: 0.47-3.03 PFOA: 0.17-1.68

Heo et al.47

n.a.

Kim et al.48

Fish and dairy products were the major contributors of PFOS and PFOA, respectively. Tap water intake might have also a key role in PFOA intake Because of the low number of samples, no correlations between PFAS levels in diet and serum were found.

10 PFASs, including PFOS and PFOA

PFOS dominated the PFAS profile in the different fish species and sampling locations.

n.a.

Gewurtz et al.49

12 PFASs, including PFOS and PFOA, as well as diPAPs

Relatively minor differences in changes in the fish PFAS amounts after cooking depended on fish species and cooking method used.

n.a.

Bhavsar et al.50

9 PFASs, including PFOS and PFOA

PFASs can enter and bioaccumulate in food crops irrigated with reclaimed water

n.a.

Blaine et al.53

13 PFASs, including PFOS and PFOA

PFOS was the most frequently detected compound

n.a.

Stahl et al.54

ACS Paragon Plus Environment

Journal of Agricultural and Food Chemistry

Four countries: Brazil, Saudi Arabia, Spain and Serbia

Analysis of PFASs in 283 food items from representative countries of the diet in South America, Western Asia, Mediterranean area and South-Eastern Europe

21 PFASs, including PFOS and PFOA

Fish and seafood were identified as the major PFASs contributors to the diet in all the countries.

a

When not provided in these units, the dietary intake for the adults was recalculated by assuming 70 kg as body weight. n.a.: not available.

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Total PFASs: 33-54

Pérez et al.55

Page 25 of 25

Journal of Agricultural and Food Chemistry

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