ArticleEnvironmental health perspectives2022
Developing an Exposure Burden Score for Chemical Mixtures Using Item Response Theory, with Applications to PFAS Mixtures.
Article in Environmental health perspectives, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed.
- Quantifying PFAS-Omics Burden Scores for Nontargeted Analysis Using Multidimensional Item Response Theory: An Exploratory Analysis of Novel and Legacy PFAS in Cord Blood.Environmental science & technology · 2026Article
- Associations of perfluoroalkyl and polyfluoroalkyl substances with markers of glycaemic control, insulin secretion and sensitivity, and diabetes risk: a systematic review and meta-analyses.EClinicalMedicine · 2026Article
- Associations of Perfluoroalkyl and Polyfluoroalkyl Substances With Cardiovascular Disease Incidence in Adults With Prediabetes: Findings From the Diabetes Prevention Program.Journal of the American Heart Association · 2026Article
- Associations between per- and polyfluoroalkyl substances and metabolic dysfunction-associated steatotic liver disease in adolescents and young adults: modifying roles of age, lifestyle factors, and PNPLA3 genotype.Environmental research · 2026Article
- Mediating role of proteomics in the association between per- and polyfluoroalkyl substance exposure and blood pressure in youth.Environmental pollution (Barking, Essex : 1987) · 2025Article
- Association between Maternal Exposure to Per- and Polyfluoroalkyl Substances and Childhood Growth Trajectories up to 4 Years of Age: The Japan Environment and Children's Study.Environmental science & technology · 2025Article
- Evaluation and comparison of tools used to quantify aggregate PFAS exposure: Extractable organic fluorine, PFAS burden scores and summed PFAS concentrations.Journal of exposure science & environmental epidemiology · 2025Article
- Nanomedicine-Driven Modulation of the Gut-Brain Axis: Innovative Approaches to Managing Chronic Inflammation in Alzheimer's and Parkinson's Disease.International journal of molecular sciences · 2025Review
- Review
- Prenatal Per- and Polyfluoroalkyl Substance Exposures and Longitudinal Blood Pressure Measurements in Children Aged 3 to 18 Years: Findings From a Racially and Ethnically Diverse US Birth Cohort.Journal of the American Heart Association · 2025Article
- Prenatal per- and polyfluoroalkyl substance mixtures and weight for length from birth to 12 months: The New Hampshire Birth Cohort Study.The Science of the total environment · 2025Article
- Association Between Serum Levels of Perfluoroalkyl and Polyfluoroalkyl Substances and Dental Floss Use: The Double-Edged Sword of Dental Floss Use-A Cross-Sectional Study.Journal of clinical periodontology · 2025Article
- The role of per- and polyfluoroalkyl substances in cognitive impairment and dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
- Degree of food processing and serum poly- and perfluoroalkyl substance concentrations in the US National Health and Nutrition Examination Survey, 2003-2018.International journal of hygiene and environmental health · 2025Article
- Maternal exposure to per- and polyfluoroalkyl substances and epitope level antibody response to vaccines against measles and rubella in children from the Boston birth cohort.Environment international · 2025Article
- Associations of maternal per- and polyfluoroalkyl substance plasma concentrations during pregnancy with offspring polycystic ovary syndrome and related characteristics in project viva.Environmental research · 2025Article
- Exposome Burden Scores to Summarize Environmental Chemical Mixtures: Creating a Fair and Common Scale for Cross-study Harmonization, Report-back and Precision Environmental Health.Current environmental health reports · 2025Review
- The potential mediating role of the gut microbiome and metabolites in the association between PFAS and kidney function in young adults: A proof-of-concept study.The Science of the total environment · 2024Article
- Associations of PFAS concentrations during pregnancy and midlife with bone health in midlife: Cross-sectional and prospective findings from Project Viva.Environment international · 2024Article
- Mid-Childhood Plasma Concentrations of Per- and Polyfluoroalkyl Substances, Modifiable Lifestyle Factors, and Bone Mineral Density Through Late Adolescence.Environmental science & technology · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThere are few existing methods to quantify total exposure burden to chemical mixtures, independent of a health outcome. A summary metric could be advantageous for use in biomonitoring, risk assessment, health risk calculators, and mediation models.
objectiveWe developed a novel exposure burden score method for chemical mixtures, applied it to estimate exposure burden to per- and polyfluoroalkyl substances (PFAS) mixtures, and estimated associations of PFAS burden scores with cardio-metabolic outcomes in the general U.S. POPULATION:
methodsWe applied item response theory (IRT) to biomonitoring data from 1,915 children and adults 12-80 years of age in the 2017-2018 National Health and Examination Survey to quantify a latent PFAS burden score, using serum concentrations of eight measured PFAS biomarkers, each considered an "item." The premise of IRT is that through using both information about a participant's concentration of an individual PFAS biomarker, as well as their exposure patterns for the PFAS mixture, we can estimate the participant's latent PFAS exposure burden, independent of a health outcome. We used linear regression to estimate associations of the PFAS burden score with cardio-metabolic outcomes and compared our findings to results using summed PFAS concentrations as the exposure metric.
resultsPFAS burden scores and summed PFAS concentrations had moderate-high correlation ( DISCUSSION: IRT offers a straightforward way to include exposure biomarkers with low detection frequencies and can reduce exposure measurement error. Further, IRT enables comparisons of exposure burden to chemical mixtures across studies even if they did not measure the exact same set of chemicals, which supports harmonization across studies and consortia. We provide an accompanying PFAS burden calculator (https://pfasburden.shinyapps.io/app_pfas_burden/), enabling researchers to calculate PFAS burden scores based on U.S. population exposure reference ranges. https://doi.org/10.1289/EHP10125.
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