Evidence map›Paper›PMID 30470793›Full record

ReviewJournal of exposure science & environmental epidemiology2019

A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and present understanding of health effects.

Elsie M Sunderland, Xindi C Hu, Clifton Dassuncao, Andrea K Tokranov, Charlotte C Wagner, Joseph G Allen

Registry-linked trialAbstract readReview
In one paragraph

Review in Journal of exposure science & environmental epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07391397 (Reducing Rural Health Disparities by Empowering People to Minimize PFAS Exposure and Improve Cardiovascular Health), which is not on this map. Cited by 858 papers.

0numbers the graph read from it
0cells of the map it votes in
858citing papers in PubMed
73.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07391397 nacompletednot on this mapstarted 2025, after this paper: background citation

Reducing Rural Health Disparities by Empowering People to Minimize PFAS Exposure and Improve Cardiovascular Health

TypeinterventionalSponsorMillion Marker Wellness, Inc.Ran2025 to 2026Enrolled183ConditionsEnvironmental Health EffectsArmsBlood Test and Report Back
3 · Its place in the literature

Who cites it

858 citing papers in PubMed, 2,478 citations in OpenAlex.

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  12. Dietary and social predictors of PFAS exposure in Hispanic children from Northern Virginia.Journal of exposure science & environmental epidemiology · 2026
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798 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Elsie M SunderlandDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. ems@seas.harvard.edu.
Xindi C HuDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Clifton DassuncaoDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Andrea K TokranovHarvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.
Charlotte C WagnerHarvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.
Joseph G AllenDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Harvard University · US

Funding

Translational Research Support CoreP30ES000002 · NIEHS · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI SUSAN A KORRICK · 1985 to 2026
$44.6M
Sources, Transport, Exposure & Effects of PFAS (STEEP) Center - RENEWALP42ES027706 · NIEHS · UNIVERSITY OF RHODE ISLAND · PI Harrison Dekker · 2017 to 2026
$18.9M
NIEHS NIH HHS P30 ES000002NIEHS NIH HHS P42 ES027706
6 · The paper itself

Abstract

Here, we review present understanding of sources and trends in human exposure to poly- and perfluoroalkyl substances (PFASs) and epidemiologic evidence for impacts on cancer, immune function, metabolic outcomes, and neurodevelopment. More than 4000 PFASs have been manufactured by humans and hundreds have been detected in environmental samples. Direct exposures due to use in products can be quickly phased out by shifts in chemical production but exposures driven by PFAS accumulation in the ocean and marine food chains and contamination of groundwater persist over long timescales. Serum concentrations of legacy PFASs in humans are declining globally but total exposures to newer PFASs and precursor compounds have not been well characterized. Human exposures to legacy PFASs from seafood and drinking water are stable or increasing in many regions, suggesting observed declines reflect phase-outs in legacy PFAS use in consumer products. Many regions globally are continuing to discover PFAS contaminated sites from aqueous film forming foam (AFFF) use, particularly next to airports and military bases. Exposures from food packaging and indoor environments are uncertain due to a rapidly changing chemical landscape where legacy PFASs have been replaced by diverse precursors and custom molecules that are difficult to detect. Multiple studies find significant associations between PFAS exposure and adverse immune outcomes in children. Dyslipidemia is the strongest metabolic outcome associated with PFAS exposure. Evidence for cancer is limited to manufacturing locations with extremely high exposures and insufficient data are available to characterize impacts of PFAS exposures on neurodevelopment. Preliminary evidence suggests significant health effects associated with exposures to emerging PFASs. Lessons learned from legacy PFASs indicate that limited data should not be used as a justification to delay risk mitigation actions for replacement PFASs.

Indexed as

Drinking WaterEnvironmental ExposureEnvironmental PollutantsFluorocarbonsGroundwaterHumansWater Pollutants, ChemicalWater Pollution, ChemicalDrinking WaterEnvironmental PollutantsFluorocarbonsperfluorooctaneWater Pollutants, Chemical

Identifiers

PMID30470793
PMCPMC6380916
OpenAlexW2901377336

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.