A review of cardiovascular effects and underlying mechanisms of legacy and emerging per- and polyfluoroalkyl substances (PFAS).

Cardiovascular disease (CVD) poses the leading threats to human health and life, and their occurrence and severity are associated with exposure to environmental pollutants. Per- and polyfluoroalkyl substances (PFAS), a group of widely used industrial chemicals, are characterized by persistence, long-distance migration, bioaccumulation, and toxicity. Some PFAS, particularly perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA) and perfluorohexanesulfonic acid (PFHxS), have been banned, leaving only legacy exposure to the environment and human body, while a number of novel PFAS alternatives have emerged and raised concerns, such as polyfluoroalkyl ether sulfonic and carboxylic acid (PFESA and PFECA) and sodium p-perfluorous nonenoxybenzene sulfonate (OBS). Overall, this review systematically elucidated the adverse cardiovascular (CV) effects of legacy and emerging PFAS, emphasized the dose/concentration-dependent, time-dependent, carbon chain length-dependent, sex-specific, and coexposure effects, and discussed the underlying mechanisms and possible prevention and treatment. Extensive epidemiological and laboratory evidence suggests that accumulated serum levels of legacy PFAS possibly contribute to an increased risk of CVD and its subclinical course, such as cardiac toxicity, vascular disorder, hypertension, and dyslipidemia. The underlying biological mechanisms may include oxidative stress, signaling pathway disturbance, lipid metabolism disturbance, and so on. Various emerging alternatives to PFAS also play increasingly prominent toxic roles in CV outcomes that are milder, similar to, or more severe than legacy PFAS. Future research is recommended to conduct more in-depth CV toxicity assessments of legacy and emerging PFAS and explore more effective surveillance, prevention, and treatment strategies, accordingly.

Increasing ionic strength and valency of cations enhance sorption through hydrophobic interactions of PFAS with soil surfaces.

The effect of soluble cations on sorption in soils of a range of anionic PFAS is not well studied. We investigated the role of three common cations (Na+, Ca2+, and Mg2+) at varying solution concentrations on the sorption coefficients (Kd) of 18 anionic PFAS in two contrasting soils. The effective charge of the soil suspension (Zeta potential) became less negative as the concentration of these cations increased in the soil solutions. Perfluorinated compounds showed greater sorption than polyfluorinated compounds, with sulfonates of comparable chain lengths showing higher sorption than the carboxylates. We observed that the Kd values of several PFAS in the two soils were positively correlated with the concentration of cations in solution, especially in the presence of polyvalent cations (Ca2+and Mg2+). The changes in sorption with cation concentration were more prominent for long-chain PFAS, with C > 10 PFAS being completely removed from solution at higher cation concentrations. The emerging PFAS (replacement compounds GenX and ADONA) showed negligible or little sorption (Kd < 0.6 L/kg). While several mechanisms contribute towards sorption of PFAS in the presence of cations, we conclude that the primary effect of cations is through screening of negative charges on head groups of PFAS and reorientation of molecules at the interface between organic matter surfaces and soil solution as well as charge neutralisation at soil solid surface. Screening of negative charges allows for greater hydrophobic interaction between hydrophobic tails of PFAS and soil surfaces resulting in greater sorption. Increasing cation concentrations in soil solutions could thus reduce mobility of PFAS through a soil profile.