Association between exposure to perfluoroalkyl substances (PFAS) and endometriosis in the ENDEA case-control study De Haro Romero, Teresa Peinado, Francisco M. Vela Soria, Fernando Lara Ramos, Ana Fernández Parra, Jorge Molina López, Ana Ubiña, Alfredo Ocón Hernández, Olga Artacho Cordón, Francisco Freire, Carmen Endometriosis Perfluoroalkyl substances Endocrine disruption Female reproductive health Case-control This study was supported by grants from the Instituto de Salud Carlos III (ISCIII) (PI17/01743) and the ‘Antonio Chamorro/Alejandro Otero’ Research Chair. In addition, this study was partly supported by the European Union Commission (The European Human Biomonitoring Initiative H2020-EJP-HBM4EU), the ISCIII (CP16/00085, PI16/01820, PI16/01812, PI16/01858, and PI17/01526), and the Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP). Background Perfluoroalkyl substances (PFAS) are environmental contaminants present in a wide range of consumer products and frequently detected in drinking water. They have been linked to adverse reproductive health outcomes in women, but there is limited human evidence on the association of PFAS exposure with endometriosis. Objective/Aim To explore the association between plasma concentrations of several PFAS, considered individually and as a mixture, and the risk of endometriosis in women of childbearing age. Methods Between 2018 and 2020, 42 patients with endometriosis and 90 controls undergoing abdominal surgery were recruited at two public hospitals in Granada, Spain. The presence or absence of endometriosis was ascertained by laparoscopic inspection of the pelvis and biopsy of suspected lesions (histological diagnosis). Concentrations of 10 PFAS were quantified in plasma samples from participants. Unconditional logistic regression was employed to examine associations of individual PFAS and summed concentrations of short (∑SC) and long-chain (∑LC) PFAS with odds of endometriosis, and quantile g-computation was used to assess their mixture effect. Results In models adjusted for age, schooling, and parity, perfluorotridecanoic acid (PFTrDA) was associated with higher odds of endometriosis (odds ratio [OR] = 1.74; 95 % CI = 1.11–2.73 per 2-fold increase in plasma concentrations), while marginally significant associations were found for perfluorohexane sulfonate (PFHxS) (OR = 1.45, 95 % CI = 0.94–2.21) and ∑SC PFAS (OR = 1.48; 95 % CI = 0.96–2.30). No associations were found for the remaining PFAS. The PFAS mixture was non-significantly associated with 1.7-fold higher odds of endometriosis (95 % CI = 0.73–3.80), with perfluorononanoic acid (PFNA), PFHxS, and PFTrDA being the major contributors to this effect. Conclusions These findings suggest that exposure to certain PFAS may increase the odds of endometriosis. However, given the modest sample size, further studies are warranted to verify these results. 2024-09-13T11:33:30Z 2024-09-13T11:33:30Z 2024-11-15 journal article T. de Haro-Romero et al. Association between exposure to perfluoroalkyl substances (PFAS) and endometriosis in the ENDEA case-control study. Science of the Total Environment 951 (2024) 175593. doi: 10.1016/j.scitotenv.2024.175593. Epub 2024 Aug 22. PMID: 39179042 https://hdl.handle.net/10481/94420 10.1016/j.scitotenv.2024.175593 eng info:eu-repo/grantAgreement/EC/H2020/EJP-HBM4EU open access Elsevier