Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.

BACKGROUND: Perfluoroalkyl acids (PFAAs) are a family of commonly used synthetic chemicals that have become widespread environmental contaminants. In human serum, perfluorohexane sulfonate (PFHxS), perflurooctane sulfonate (PFOS), and perfluorooctanoate (PFOA) are most frequently detected, in part o...

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Main Authors: Stephen J Genuis, Yanna Liu, Quentin I T Genuis, Jonathan W Martin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4264749?pdf=render
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author Stephen J Genuis
Yanna Liu
Quentin I T Genuis
Jonathan W Martin
author_facet Stephen J Genuis
Yanna Liu
Quentin I T Genuis
Jonathan W Martin
author_sort Stephen J Genuis
collection DOAJ
description BACKGROUND: Perfluoroalkyl acids (PFAAs) are a family of commonly used synthetic chemicals that have become widespread environmental contaminants. In human serum, perfluorohexane sulfonate (PFHxS), perflurooctane sulfonate (PFOS), and perfluorooctanoate (PFOA) are most frequently detected, in part owing to their long elimination half-lives of between 3.8 yrs (PFOA) and 8.5 yrs (PFHxS). These PFAAs also cross the placenta and have been associated with developmental toxicity, and some are considered likely human carcinogens. Interventions to eliminate PFAAs in highly contaminated individuals would reduce future health risks, but minimal research has been conducted on methods to facilitate accelerated human clearance of these persistent substances. METHODS: Six patients with elevated serum concentrations from a single family were treated by intermittent phlebotomy over a 4-5 year period at intervals similar to, or less frequent than what is done for routine blood donation at Canadian Blood Services. The apparent elimination half-life (HLapp) for PFHxS, PFOS, and PFOA in this treated population was calculated in each patient and compared to the intrinsic elimination half-lives (HLin) from a literature reference population of untreated fluorochemical manufacturing plant retirees (n = 26, age >55 yrs). RESULTS: For all three PFAAs monitored during phlebotomy, HLapp in each of the family members (except the mother, who had a low rate of venesection) was significantly shorter than the geometric mean HL measured in the reference population, and in some cases were even shorter compared to the fastest eliminator in the reference population. CONCLUSION: This study suggests significantly accelerated PFAA clearance with regular phlebotomy treatment, but the small sample size and the lack of controls in this clinical intervention precludes drawing firm conclusions. Given the minimal risks of intermittent phlebotomy, this may be an effective and safe clinical intervention to diminish the body burden of PFAAs in highly exposed people.
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spelling doaj.art-81c2e676e3cd430cbf7f6a6dfa5420e72022-12-22T03:34:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11429510.1371/journal.pone.0114295Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.Stephen J GenuisYanna LiuQuentin I T GenuisJonathan W MartinBACKGROUND: Perfluoroalkyl acids (PFAAs) are a family of commonly used synthetic chemicals that have become widespread environmental contaminants. In human serum, perfluorohexane sulfonate (PFHxS), perflurooctane sulfonate (PFOS), and perfluorooctanoate (PFOA) are most frequently detected, in part owing to their long elimination half-lives of between 3.8 yrs (PFOA) and 8.5 yrs (PFHxS). These PFAAs also cross the placenta and have been associated with developmental toxicity, and some are considered likely human carcinogens. Interventions to eliminate PFAAs in highly contaminated individuals would reduce future health risks, but minimal research has been conducted on methods to facilitate accelerated human clearance of these persistent substances. METHODS: Six patients with elevated serum concentrations from a single family were treated by intermittent phlebotomy over a 4-5 year period at intervals similar to, or less frequent than what is done for routine blood donation at Canadian Blood Services. The apparent elimination half-life (HLapp) for PFHxS, PFOS, and PFOA in this treated population was calculated in each patient and compared to the intrinsic elimination half-lives (HLin) from a literature reference population of untreated fluorochemical manufacturing plant retirees (n = 26, age >55 yrs). RESULTS: For all three PFAAs monitored during phlebotomy, HLapp in each of the family members (except the mother, who had a low rate of venesection) was significantly shorter than the geometric mean HL measured in the reference population, and in some cases were even shorter compared to the fastest eliminator in the reference population. CONCLUSION: This study suggests significantly accelerated PFAA clearance with regular phlebotomy treatment, but the small sample size and the lack of controls in this clinical intervention precludes drawing firm conclusions. Given the minimal risks of intermittent phlebotomy, this may be an effective and safe clinical intervention to diminish the body burden of PFAAs in highly exposed people.http://europepmc.org/articles/PMC4264749?pdf=render
spellingShingle Stephen J Genuis
Yanna Liu
Quentin I T Genuis
Jonathan W Martin
Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.
PLoS ONE
title Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.
title_full Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.
title_fullStr Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.
title_full_unstemmed Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.
title_short Phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family: a retrospective case-series.
title_sort phlebotomy treatment for elimination of perfluoroalkyl acids in a highly exposed family a retrospective case series
url http://europepmc.org/articles/PMC4264749?pdf=render
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