ArticleEnvironmental pollution (Barking, Essex : 1987)2021
Associations of exposure to perfluoroalkyl substances individually and in mixtures with persistent infections: Recent findings from NHANES 1999-2016.
Article in Environmental pollution (Barking, Essex : 1987), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Equity in protection: bridging global data gaps for an EBV vaccine-a systematic review and meta-analysis.BMJ global health · 2025Pooled it
- Exposure to per- and polyfluoroalkyl substances and breast cancer risk: a systematic review and meta-analysis of epidemiologic studies.American journal of epidemiology · 2024Pooled it
- Pediatric effects of forever chemicals may last for a long time.Pediatric research · 2026Review
- Developmental exposure to a PFAS mixture impairs the anamnestic response to influenza A virus infection in mice.Toxicological sciences : an official journal of the Society of Toxicology · 2026Article
- Heavy metals and prevalence of sexually transmitted infections: a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2016.BMC infectious diseases · 2026Article
- Plastic-Derived Pollutants as Emerging Modifiers of Viral Diseases.Pathogens (Basel, Switzerland) · 2026Review
- Developmental exposure to a PFAS mixture impairs the anamnestic response to influenza A virus infection in mice.bioRxiv : the preprint server for biology · 2025Article
- The importance of considering variability in re-expression of effect estimates for use in meta-analyses.BMC medical research methodology · 2025Article
- Identification of four mechanisms of toxicity for per- and polyfluoroalkyl substances through transcriptomic profiling in human liver spheroids exposed to 24 PFAS.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Perfluoroalkyl Substance (PFAS) Mixtures Drive Rheumatoid Arthritis Risk Through Immunosuppression: Integrating Epidemiology and Mechanistic Evidence.International journal of molecular sciences · 2025Article
- Novel and legacy per- and polyfluoroalkyl substances in humans: Long-term temporal variability and metabolic perturbations.Environment international · 2025Article
- County-level associations between drinking water PFAS contamination and COVID-19 mortality in the United States.Journal of exposure science & environmental epidemiology · 2025Article
- Integrating Exposures and Multi-Omics in the Boston Birth Cohort to Elucidate Immune Development across the Life Course: Rationale and Study Design.Precision nutrition · 2025Article
- Article
- Decoding PFAS immunotoxicity: a NAMs-based comparison of short vs. long chains.Frontiers in toxicology · 2025Article
- Differential associations between synthetic endocrine disruptors and renal function impairment across varying degrees in middle-aged and older adult populations.Frontiers in public health · 2025Article
- Binary and quaternary mixtures of perfluoroalkyl substances (PFAS) differentially affect the immune response to influenza A virus infection.Journal of immunotoxicology · 2024Article
- Article
- Developmental perfluorooctane sulfonic acid exposure exacerbates house dust mite induced allergic responses in adult mice.The Science of the total environment · 2024Article
- Environmental chemical-wide associations with immune biomarkers in US adults: A cross-sectional analysis.Environmental research · 2024Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
Abstract
Certain viruses and parasites can cause persistent infections that often co-occur and have been associated with substantial morbidity and mortality. Separate lines of research indicate exposures to per- and polyfluoroalkyl substances (PFAS) suppress the immune system. We hypothesized that PFAS exposures might systematically increase susceptibility to persistent infections resulting in a higher pathogen burden. We used data from 8778 individuals (3189 adolescents, 5589 adults) in the nationally-representative U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2016 to examine cross-sectional associations between serum concentrations of four highly detected PFAS (PFOS, PFOA, PFHxS, PFNA) with the presence of antibodies to cytomegalovirus, Epstein Barr virus, hepatitis C and E, herpes simplex 1 and 2, HIV, T. gondii, and Toxocara spp. Seropositivity was summed to calculate a pathogen burden score reflecting the total number of infections. Separate survey-weighted multivariable regression models were fitted to analyze PFAS individually and quantile g-computation was used to analyze PFAS mixtures. Among adolescents, 38.7% had at least one persistent infection while 14.9% had two or more; among adults, these percentages were 48.0% and 19.7%. Each PFAS was individually associated with significantly higher pathogen burdens and the most pronounced associations were observed in adolescents [e.g., among adolescents, a doubling of PFOS was associated with 30% (95% CI: 25-36%) higher pathogen burden]. Quantile g-computation revealed PFAS mixtures as a whole were also associated with higher pathogen burdens. Taken together, these results suggest PFAS exposure may increase susceptibility to and foster the clustering of persistent infections, particularly among adolescents. Since persistent infections are important contributors to long-term health, prospective data are needed to confirm these findings.
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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.