Serum Vaccine Antibody Concentrations in Children Exposed to Perfluorinated Compounds

JAMA   
January 25, 2012, Vol 307, No. 4, pp 335-421
http://jama.ama-assn.org/current.dtl

Original Contributions
Serum Vaccine Antibody Concentrations in Children Exposed to Perfluorinated Compounds
Philippe Grandjean, Elisabeth Wreford Andersen, Esben Budtz-Jørgensen, Flemming Nielsen, Kåre Mølbak, Pal Weihe, Carsten Heilmann
JAMA. 2012;307(4):391-397.doi:10.1001/jama.2011.2034

Abstract
Context
Perfluorinated compounds (PFCs) have emerged as important food contaminants. They cause immune suppression in a rodent model at serum concentrations similar to those occurring in the US population, but adverse health effects of PFC exposure are poorly understood.

Objective
To determine whether PFC exposure is associated with antibody response to childhood vaccinations.

Design, Setting, and Participants
Prospective study of a birth cohort from the National Hospital in the Faroe Islands. A total of 656 consecutive singleton births were recruited during 1999-2001, and 587 participated in follow-up through 2008.

Main Outcome
Measures Serum antibody concentrations against tetanus and diphtheria toxoids at ages 5 and 7 years.

Results
Similar to results of prior studies in the United States, the PFCs with the highest serum concentrations were perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). Among PFCs in maternal pregnancy serum, PFOS showed the strongest negative correlations with antibody concentrations at age 5 years, for which a 2-fold greater concentration of exposure was associated with a difference of −39% (95% CI, −55% to −17%) in the diphtheria antibody concentration. PFCs in the child’s serum at age 5 years showed uniformly negative associations with antibody levels, especially at age 7 years, except that the tetanus antibody level following PFOS exposure was not statistically significant. In a structural equation model, a 2-fold greater concentration of major PFCs in child serum was associated with a difference of −49% (95% CI, −67% to −23%) in the overall antibody concentration. A 2-fold increase in PFOS and PFOA concentrations at age 5 years was associated with odds ratios between 2.38 (95% CI, 0.89 to 6.35) and 4.20 (95% CI, 1.54 to 11.44) for falling below a clinically protective level of 0.1 IU/mL for tetanus and diphtheria antibodies at age 7 years.

Conclusion
Elevated exposures to PFCs were associated with reduced humoral immune response to routine childhood immunizations in children aged 5 and 7 years.