浙江省嘉善地区孕妇全氟化合物暴露水平及影响因素

Concentrations and influencing factors of perfluoroalkyl and polyfluoroalkyl substances in plasma of pregnant women from Jiashan,Zhejiang Province

[背景]全氟化合物(PFASs)被广泛应用于工业生产和日常生活用品,有报道称孕妇及胎儿体内可检测到PFASs,但检出水平结果不一致。[目的]了解浙江省嘉兴市嘉善地区孕妇外周血中PFASs的暴露水平,探讨孕妇外周血PFASs暴露水平与社会人口学特征及膳食因素的关系。[方法]基于2016年9月—2018年4月开展的嘉善出生队列,以942例孕妇为研究对象,在孕妇怀孕16~24周产前检查时收集其外周肘静脉血,应用高效液相色谱-串联质谱法检测孕妇外周血中13种常见PFASs的质量浓度(后称浓度),使用结构式问卷调查孕妇的社会人口学特征、生活方式、健康状态、饮食方式以及怀孕期间环境污染物接触史等信息。采用多因素线性回归,以自然对数转换后的PFASs浓度为应变量,分析孕妇人口学特征、生活方式及膳食因素对外周血PFASs浓度的影响。计算影响PFASs浓度相关因素的β值及其95%可信区间,并对估计值进行指数转换,以代表自变量每变化一个单位后PFASs浓度几何均数的比值(GM ratio)。[结果]孕妇外周血中共检测出11种PFASs,包括全氟辛烷磺酸(PFOS)、全氟己烷磺酸(PFHxS)、全氟辛酸(PFOA)、全氟十一烷酸(PFUdA)、全氟壬酸(PFNA)、全氟癸酸(PFDA)、全氟庚酸(PFHpA)、全氟十二烷酸(PFDoA)、全氟十三烷酸(PFTrDA)、全氟十四烷酸(PFTeDA)、十一氟己烷磺酸(PFHxA),全氟癸烷磺酸(PFDS)和全氟十六烷酸(PFHxDA)未检出。其中前9种检出率高达90%以上。总的PFASs中位浓度为37.95μg·L^(-1),各类PFASs中PFOA的中位浓度最高,为11.99μg·L^(-1),其次为PFOS、PFHxS、PFDA、PFUdA、PFNA、PFDoA、PFTrDA和PFHpA。孕妇外周血中PFOS、PFHxS、PFOA、PFDA、PFNA、PFHpA、PFUdA、PFDoA和PFTrDA的浓度之间呈不同程度的相关性(r=0.35~0.94);其中PFDA和PFUdA之间的相关性最强(r=0.94),其次是PFOS和PFDA(r=0.90)。孕妇PFASs暴露水平随着孕妇年龄、孕前体重指数(BMI)、受教育程度的增加而增加至1.42(95%CI:1.05~1.93)~10.06(95%CI:5.01~20.20)倍,经产妇外周血中PFOA的浓度低于初产妇(GM ratio=0.73,95%CI:0.57~0.93)。孕期摄入鱼类、蛋类、动物内脏和豆制品频率较高的孕妇外周血中某些PFASs浓度增加至1.56(95%CI:1.01~2.43)~5.28(95%CI:2.40~11.58)倍,而摄入粗粮频率较高的孕妇外周血中PFOA浓度降低(GM ratio=0.67,95%CI:0.46~0.99),主要饮用桶装纯净水的孕妇外周血中各种PFASs的浓度均降低(GM ratio:0.15~0.50)。[结论]嘉善地区孕妇广泛暴露于多种PFASs。除传统PFOA、PFOS的暴露外,各种新型的PFASs在该地区暴露水平也较高。孕妇年龄、孕前BMI、受教育程度、产次和膳食因素与体内的PFASs暴露水平有关。

[Background]Perfluoroalkyl and polyfluoroalkyl substances(PFASs)are widely used in industrial production and the manufacture of consumer products and are reported to have been detected in pregnant women’s blood,placenta,and fetal cord blood.However,data on PFASs concentrations in pregnant women are inconsistent.[Objective]This study is designed to measure PFASs concentrations in peripheral blood in pregnant women and evaluate sociodemographic and dietary factors as potential determinants of PFASs concentrations.[Methods]The present study was based on the Jiashan Birth Cohort from September 2016 to April 2018.Maternal peripheral venous blood samples(n=942)were collected from 942 pregnant women during prenatal examination at 16-24 weeks of pregnancy,and were analyzed for 13 PFASs using high-performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).A structured questionnaire was used to investigate the social demographic characteristics,lifestyle,health status,dietary style,and exposure history of environmental pollutants during pregnancy.Multiple linear regression was used to examine the associations of ln-transformed PFASs concentrations with maternal sociodemographics,lifestyles,and dietary factors.The β values and 95% confidence intervals(CI)of factors associated with PFASs were calculated,and the log transformed estimates indicated the geometric mean ratio(GM ratio)of PFASs associated with per unit change of independent variables.[Results]A total of 11 PFASs were detected in the peripheral blood of pregnant women,including perfluorooctane sulfonic acid(PFOS),perfluorohexane sulfonate(PFHxS),perfluorooctanoic acid(PFOA),perfluoroundecanoic acid(PFUdA),perfluorononanoic acid(PFNA),perfluorodecanoic acid(PFDA),perfluoroheptanoic acid(PFHpA),perfluorododecanoic acid(PFDoA),perfluorotridecanoic acid(PFTrDA),perfluorotetradecanoic acid(PFTeDA),and perfluorohexanoic acid(PFHxA),of which the detection rates of former 9 PFASs were more than 90%.Perfluorodecane sulfonate(PFDS)and perfluorhecadecanoic acid(PFHxDA)were not detected in the present study.The median concentration of total PFASs was 37.95μg·L^(-1).Among selected PFASs,the median concentration of PFOA was the highest(11.99μg·L^(-1)),followed by PFOS,PFHxS,PFDA,PFUdA,PFNA,PFDoA,PFTrDA,and PFHpA.Varing degrees of correlations were shown among the concentrations of PFOS,PFHxS,PFOA,PFDA,PFNA,PFHpA,PFUdA,PFDoA,and PFTrDA(r=0.35-0.94);PFDA and PFUdA were most strongly correlated(r=0.94),followed by PFOS and PFDA(r=0.90).PFASs concentrations increased 1.42 times(95%CI:1.05-1.93)to 10.06 times(95%CI:5.01-20.20)in pregnant women who were older,well educated,and with higher pre-pregnancy body mass index(BMI).The concentration of PFOA in parous women was lower than that of nulliparous women(GM ratio=0.73,95%CI:0.57-0.93).The concentrations of some PFASs in pregnant women with a higher intake frequency of fish,eggs,animal offal,or soy products during pregnancy increased by 1.56 times(95%CI:1.01-2.43)to 5.28 times(95%CI:2.40-11.58),while concentration of PFOA in pregnant women with a higher intake frequency of whole grainswas lower(GM ratio=0.67,95%CI:0.46-0.99),and the concentrations of PFASs in pregnant women who mainly drank bottled water were lower(GM ratio:0.15-0.50).[Conclusion]Pregnant women in Jiashan are widely exposed to PFASs.Besides PFOA and PFOS,the concentrations of some emerging PFASs are also higher in pregnant women’s peripheral blood.Maternal age,pre-pregnancy BMI,education level,parity,and dietary factors may affect the levels of PFASs exposure.