Compostos polifluorados no ambiente de trabalho: avaliação da exposição ocupacional e dos mecanismos de risco de câncer
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Introdução: A exposição ocupacional a substâncias perfluorinadas (PFAS) representa riscos à saúde, especialmente para bombeiros. A mitigação inclui uso mais rigoroso de equipamentos de proteção individual (EPI), alternativas de espumas sem PFAS e monitoramento contínuo da exposição. Objetivo: Resumir as evidências sobre a associação entre a exposição ocupacional aos PFAS e seus impactos à saúde. Métodos: Foi realizada uma revisão sistemática nas bases de dados PubMed e Web of Science, considerando todos os estudos disponíveis no momento da busca, seguindo as diretrizes do PRISMA 2020. Os descritores MeSH utilizados incluíram "occupational exposure and PFAS", “occupational exposures and polyfluorinated compounds”, e "occupational exposures and Per- and polyfluoroalkyl substances (PFAS)". Os artigos foram avaliados por três revisores independentes. A seleção seguiu o modelo PECO. Resultados: Um total de 12 estudos foi recuperado, publicados entre 2010 e 2023. O número de indivíduos nos estudos variou de 11 a 225, distribuídos principalmente entre os Estados Unidos, Europa, China e Austrália. Os principais achados destacam os bombeiros como trabalhadores com maiores cargas corporais de PFAS em comparação com a população geral. Ambientes de escritório e até mesmo salas de aula apresentaram altos níveis de PFNA, PFTeDA e FTOHs e PFOA, PFHxS, respectivamente. Conclusão: Os estudos revisados apontam os bombeiros como tendo maior exposição ocupacional aos PFAS, e uma alternativa para minimizar essa exposição seria a aplicação mais rigorosa de protocolos de uso de EPIs, a substituição de espumas de combate a incêndio contendo PFAS por alternativas mais seguras e o monitoramento constante.
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Referências
1. Lucas K, Gaines LGT, Paris-Davila T, Nylander-French LA. Occupational exposure and serum levels of per- and polyfluoroalkyl substances (PFAS): A review. Am J Ind Med. 2023;66(5):379-92. https://doi.org/10.1002/ajim.23454
2. DeLuca NM, Angrish M, Wilkins A, Thayer K, Cohen Hubal EA. Human exposure pathways to poly- and perfluoroalkyl substances (PFAS) from indoor media: A systematic review protocol. Environ Int. 2021;146:106308. https://doi.org/10.1016/j.envint.2020.106308
3. Paris-Davila T, Gaines LGT, Lucas K, Nylander-French LA. Occupational exposures to airborne per- and polyfluoroalkyl substances (PFAS)-A review. Am J Ind Med. 2023;66(5):393-410. https://doi.org/10.1002/ajim.23461
4. Christensen BT, Calkins MM. Occupational exposure to per- and polyfluoroalkyl substances: a scope review of the literature from 1980-2021. J Expo Sci Environ Epidemiol. 2023;33(5):673-86. https://doi.org/10.1038/s41370-023-00536-y
5. Sunderland EM, Hu XC, Dassuncao C, Tokranov AK, Wagner CC, Allen JG. A review of the pathways of human exposure to poly- and perfluoroalkyl substances (PFASs) and the present understanding of health effects. J Expo Sci Environ Epidemiol. 2019;29(2):131-47. https://doi.org/10.1038/s41370-018-0094-1
6. Lu Y, Gao K, Li X, Tang Z, Xiang L, Zhao H, et al. Mass Spectrometry-Based Metabolomics Reveals Occupational Exposure to Per- and Polyfluoroalkyl Substances Relates to Oxidative Stress, Fatty Acid β-Oxidation Disorder, and Kidney Injury in a Manufactory in China. Environ Sci Technol. 2019;53(16):9800-9. https://doi.org/10.1021/acs.est.9b01608
7. Nilsson H, Kärrman A, Rotander A, van Bavel B, Lindström G, Westberg H. Professional ski waxers' exposure to PFAS and aerosol concentrations in gas phase and different particle size fractions. Environ Sci Process Impacts. 2013;15(4):814-22. https://doi.org/10.1039/C3EM30739E
8. Tefera YM, Gaskin S, Mitchell K, Springer D, Mills S. Temporal decline in serum PFAS concentrations among metropolitan firefighters: Longitudinal study on post-exposure changes following PFAS foam cessation. Environ Int. 2023;179:108167. https://doi.org/10.1016/j.envint.2023.108167
9. Tanner EM, Bloom MS, Wu Q, Kannan K, Yucel RM, Shrestha S, et al. Occupational exposure to perfluoroalkyl substances and serum levels of perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in an aging population from upstate New York: a retrospective cohort study. Int Arch Occup Environ Health. 2018;91(2):145-54. https://doi.org/10.1007/s00420-017-1267-2
10. Pálešová N, Maitre L, Stratakis N, Řiháčková K, Pindur A, Kohoutek J, et al. Firefighters and the liver: Exposure to PFAS and PAHs in relation to liver function and serum lipids (CELSPAC-FIREexpo study). Int J Hyg Environ Health. 2023;252:114215. https://doi.org/10.1016/j.ijheh.2023.114215
11. Řiháčková K, Pindur A, Komprdová K, Pálešová N, Kohoutek J, Šenk P, et al. The exposure of Czech firefighters to perfluoroalkyl substances and polycyclic aromatic hydrocarbons: CELSPAC - FIREexpo case-control human biomonitoring study. Sci Total Environ. 2023;881:163298. https://doi.org/10.1016/j.scitotenv.2023.163298
12. Christensen KY, Raymond M, Thompson BA, Anderson HA. Perfluoroalkyl substances in older male anglers in Wisconsin. Environ Int. 2016;91:312-8. https://doi.org/10.1016/j.envint.2016.03.012
13. Fraser AJ, Webster TF, Watkins DJ, Strynar MJ, Kato K, Calafat AM, et al. Polyfluorinated compounds in dust from homes, offices, and vehicles as predictors of concentrations in office workers' serum. Environ Int. 2013;60:128-36. https://doi.org/10.1016/j.envint.2013.08.012
14. Fraser AJ, Webster TF, Watkins DJ, Nelson JW, Stapleton HM, Calafat AM, et al. Polyfluorinated compounds in serum linked to indoor air in office environments. Environ Sci Technol. 2012;46(2):1209-15. https://doi.org/10.1021/es2038257
15. Goosey E, Harrad S. Perfluoroalkyl compounds in dust from Asian, Australian, European, and North American homes and UK cars, classrooms, and offices. Environ Int. 2011;37(1):86-92. https://doi.org/10.1016/j.envint.2010.08.001
16. D'Hollander W, Roosens L, Covaci A, Cornelis C, Reynders H, Van Campenhout K, et al. Brominated flame retardants and perfluorinated compounds in indoor dust from homes and offices in Flanders, Belgium. Chemosphere. 2010;81(4):478-87. https://doi.org/10.1016/j.chemosphere.2010.07.043
17. Wu N, Cai D, Guo M, Li M, Li X. Per- and polyfluorinated compounds in saleswomen's urine linked to indoor dust in clothing shops. Sci Total Environ. 2019;667:594-600. https://doi.org/10.1016/j.scitotenv.2019.02.287
18. Pierozan P, Cattani D, Karlsson O. Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) induce epigenetic alterations and promote human breast cell carcinogenesis in vitro. Arch Toxicol. 2020;94(11):3893-906. https://doi.org/10.1007/s00204-020-02848-6
19. Pierozan P, Cattani D, Karlsson O. Tumorigenic activity of alternative per-and polyfluoroalkyl substances (PFAS): Mechanistic in vitro studies. Sci Total Environ. 2022;808:151945. https://doi.org/10.1016/j.scitotenv.2021.151945
20. Pierozan P, Cattani D, Karlsson O. High-content analysis shows synergistic effects of low perfluorooctanoic acid (PFOS) and perfluorooctane sulfonic acid (PFOA) mixture concentrations on human breast epithelial cell carcinogenesis. Environ Int. 2023;172:107746. https://doi.org/10.1016/j.envint.2023.107746
21. Temkin AM, Hocevar BA, Andrews DQ, Naidenko OV, Kamendulis LM. Application of the key characteristics of carcinogens to per- and polyfluoroalkyl substances. Int J Environ Res Public Health. 2020;17(5):1668. https://doi.org/10.3390/ijerph17051668
22. Liu Q, Liu Y, Li X, Wang D, Zhang A, Pang J, et al. Perfluoroalkyl substances promote breast cancer progression via ERα and GPER-mediated PI3K/Akt and MAPK/Erk signaling pathways. Ecotoxicol Environ Saf. 2023;258:114980. https://doi.org/10.1016/j.ecoenv.2023.114980
23. Benninghoff AD, Orner GA, Buchner CH, Hendricks JD, Duffy AM, Williams DE. Promotion of hepatocarcinogenesis by perfluoroalkyl acids in rainbow trout. Toxicol Sci. 2012;125(1):69-78. https://doi.org/10.1093/toxsci/kfr267
24. Evans N, Conley JM, Cardon M, Hartig P, Medlock-Kakaley E, Gray Jr LE. In vitro activity of a panel of per- and polyfluoroalkyl substances (PFAS), fatty acids, and pharmaceuticals in peroxisome proliferator-activated receptor (PPAR) alpha, PPAR gamma, and estrogen receptor assays. Toxicol Appl Pharmacol. 2022;449:116136. https://doi.org/10.1016/j.taap.2022.116136
25. Feng J, Soto-Moreno EJ, Prakash A, Balboula AZ, Qiao H. Adverse PFAS effects on mouse oocyte in vitro maturation are associated with carbon-chain length and inclusion of a sulfonate group. Cell Prolif. 2023;56(2):e13353. https://doi.org/10.1111/cpr.13353
26. Cui Z, Liu Z, Yuan X, Lu K, Li M, Xu S, et al. PFDA promotes cancer metastasis through macrophage M2 polarization mediated by Wnt/β-catenin signaling. Chemosphere. 2024;362:142758. https://doi.org/10.1016/j.chemosphere.2024.142758
27. Stratakis N, Conti DV, Jin R, Margetaki K, Valvi D, Siskos AP, et al. Prenatal Exposure to Perfluoroalkyl Substances Associated With Increased Susceptibility to Liver Injury in Children. Hepatology. 2020;72(5):1758-70. https://doi.org/10.1002/hep.31483
28. Yang W, Ling X, He S, Cui H, Yang Z, An H, et al. PPARα/ACOX1 as a novel target for hepatic lipid metabolism disorders induced by per- and polyfluoroalkyl substances: An integrated approach. Environ Int. 2023;178:108138. https://doi.org/10.1016/j.envint.2023.108138
29. Beggs KM, McGreal SR, McCarthy A, Gunewardena S, Lampe JN, Lau C, et al. The role of hepatocyte nuclear factor 4-alpha in perfluorooctanoic acid-and perfluorooctanesulfonic acid-induced hepatocellular dysfunction. Toxicol Appl Pharmacol. 2016;304:18-29. https://doi.org/10.1016/j.taap.2016.05.001
30. Sim KH, Oh HS, Lee C, Eun H, Lee YJ. Evaluation of the Effect of Perfluorohexane Sulfonate on the Proliferation of Human Liver Cells. Int J Environ Res Public Health. 2023;20(19):6868. https://doi.org/10.3390/ijerph20196868
31. Janssen AWF, Duivenvoorde LPM, Beekmann K, Pinckaers N, van der Hee B, Noorlander A, et al. Transport of perfluoroalkyl substances across human induced pluripotent stem cell-derived intestinal epithelial cells in comparison with primary human intestinal epithelial cells and Caco-2 cells. Arch Toxicol. 2024;98(11):3777-95. https://doi.org/10.1007/s00204-024-03851-x
32. Pennings JL, Jennen DG, Nygaard UC, Namork E, Haug LS, van Loveren H, et al. Cord blood gene expression supports that prenatal exposure to perfluoroalkyl substances causes depressed immune functionality in early childhood. J Immunotoxicol. 2016;13(2):173-80. https://doi.org/10.3109/1547691X.2015.1029147
33. Johnson PI, Stapleton HM, Mukherjee B, Hauser R, Meeker JD. Associations between brominated flame retardants in house dust and hormone levels in men. Sci Total Environ. 2013;445-6:177-84. https://doi.org/10.1016/j.scitotenv.2012.12.017
34. Mao H, Lin T, Huang S, Xie Z, Jin S, Shen X, et al. The impact of brominated flame retardants (BFRs) on pulmonary function in US adults: a cross-sectional study based on NHANES (2007–2012). Sci Rep. 2024;14(1):6486. https://doi.org/10.1038/s41598-024-57302-9
35. Malarkey DE, Hoenerhoff M, Maronpot R. Carcinogenesis: mechanisms and manifestations. In: Haschek and Rousseaux's Handbook of Toxicologic Pathology. 3rd. 2013;107-46. https://doi.org/10.1016/B978-0-12-415759-0.00005-4
36. Singh N, Hsieh CYJ. Exploring potential carcinogenic activity of per-and polyfluorinated alkyl substances utilizing high-throughput toxicity screening data. Int J Toxicol. 2021;40(4):355-66. https://doi.org/10.1177/10915818211010490
37. Tao L, Kannan K, Aldous KM, Mauer MP, Eadon GA. Biomonitoring of perfluorochemicals in plasma of New York State personnel responding to the World Trade Center disaster. Environ Sci Technol. 2008;42(9):3472-8. https://doi.org/10.1021/es8000079
38. Muensterman DJ, Titaley IA, Peaslee GF, Minc LD, Cahuas L, Rodowa AE, et al. Disposition of fluorine on new firefighter turnout gear. Environ Sci Technol. 2022;56(2):974-83. https://doi.org/10.1021/acs.est.1c06322
39. Peaslee GF, Wilkinson JT, Mcguinness SR, Tighe M, Caterisano N, Lee S et al. Another Pathway for Firefighter Exposure to Per- and Polyfluoroalkyl Substances: Firefighter Textiles. Environ Sci Technol Lett. 2020;7(8):594-9. https://doi.org/10.1021/acs.estlett.0c00410
40. Tefera YM, Gaskin S, Mitchell K, Springer D, Mills' S, Pisaniello D. Food grown on fire stations as a potential pathway for firefighters' exposure to per- and poly-fluoroalkyl substances (PFAS). Environ Int. 2022;168:107455. https://doi.org/10.1016/j.envint.2022.107455
41. Batzella E, Girardi P, Russo F, Pitter G, Re F, Fletcher T, et al. Perfluoroalkyl substance mixtures and cardio-metabolic outcomes in highly exposed male workers in the Veneto Region: A mixture-based approach. Environ Res. 2022;212(Pt A):113225. https://doi.org/10.1016/j.envres.2022.113225
42. Batzella E, Jeddi MZ, Pitter G, Russo F, Fletcher T, Canova C. Associations between mixtures of perfluoroalkyl substances and lipid profile in a highly exposed adult community in the Veneto Region. Int J Environ Res Public Health. 2022;19(19):12421. https://doi.org/10.3390/ijerph191912421
43. Gaines LGT, Nylander-French LA. Occupational exposure to PFAS: Research and protection needed. Am J Ind Med. 2023;66(5):424-6. https://doi.org/10.1002/ajim.23467
44. Nilsson S, Smurthwaite K, Aylward LL, Kay M, Toms LM, King L, et al. Serum concentration trends and apparent half-lives of per- and polyfluoroalkyl substances (PFAS) in Australian firefighters. Int J Hyg Environ Health. 2022;246:114040. https://doi.org/10.1016/j.ijheh.2022.114040
45. Rosenfeld PE, Spaeth KR, Remy LL, Byers V, Muerth SA, Hallman RC, et al. Perfluoroalkyl substances exposure in firefighters: Sources and implications. Environ Res. 2023;220:115164. https://doi.org/10.1016/j.envres.2022.115164
46. Mazumder NU, Hossain MT, Jahura FT, Girase A, Hall AS, Lu J, et al. Firefighters' exposure to per-and polyfluoroalkyl substances (PFAS) as an occupational hazard: A review. Front Mater. 2023;10:1143411. https://doi.org/10.3389/fmats.2023.1143411
47. Tansel B. PFAS use in electronic products and exposure risks during handling and processing of e-waste: A review. J Environ Manage. 2022;316:115291. https://doi.org/10.1016/j.jenvman.2022.115291