Targeted and non-targeted analyses of per-and polyfluoroalkyl substances in newborn dried blood spots and risk of childhood acute lymphoblastic leukemia
Menée à l'aide de données californiennes 2000-2015 portant sur 219 témoins et 125 patients atteints d'une leucémie lymphoïde chronique diagnostiquée avant 18 ans, cette étude analyse l'association entre la concentration de 17 substances perfluoroalkylées et polyfluoroalkylées (PFAS), mesurée dans des échantillons de sang séché chez des nouveaux-nés, et le risque de développer la maladie
Background: Per- and polyfluoroalkyl substances (PFAS) have carcinogenic potential but are understudied in relation to childhood cancers.
Objective: We examined associations between targeted and non-targeted PFAS measured in newborn dried blood spots (DBS) and the risk of childhood acute lymphoblastic leukemia (ALL) in Los Angeles County, California, accounting for maternal and child characteristics.
Methods: ALL cases (n = 125) diagnosed before age 18 years during 2000–2015 and controls (n = 219) were selected from a registry-based study using stratified sampling based on birth year and birth address within a PFAS-contaminated water district according to the USEPA Third Unregulated Contaminant Monitoring Rule. We calculated design-based odds ratios (OR) and 95% confidence intervals (CI) for the effect of PFAS exposures, independently and adjusting for other PFAS. We also conducted non-linear and stratified analyses.
Results: Of the 17 PFAS quantified using targeted analysis, perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) had the highest mean concentrations in DBS, with 4690 and 10,307 pg/g dried blood among cases compared to 4245 and 8142 pg/g dried blood among controls, respectively. The highest risks were observed for the 4th exposure quartile compared with the 1st quartile (PFOA OR = 1.56, CI: 0.42, 5.73; PFOS OR = 1.64, CI: 0.44, 6.14). In non-linear statistical analyses of joint PFOA and PFOS exposures adjusted for other detected PFAS, we also found that ALL risk increased with increasing levels of log2-PFOA and log2-PFOS. Non-targeted analysis identified 26 additional PFAS, for which elevated risk of childhood ALL was associated with a doubling of C4HF7O3 exposure (OR = 5.04, CI: 1.08, 23.63) and the highest quartile of C10HF19O5 exposure (OR = 5.20, CI: 1.15, 23.56). Associations were generally stronger among non-Hispanic participants compared to Hispanic participants, but these analyses were limited by small sample sizes and should be considered exploratory.
Significance: There was some suggestion that high PFOA and PFOS exposures measured at birth, as well as certain PFAS detected by non-targeted approaches, were related to childhood ALL risk.
Journal of Exposure Science & Environmental Epidemiology , article en libre accès, 2026