Developmental language disorders in preschool children after high exposure to perfluoroalkyl substances from contaminated drinking water in Ronneby, Sweden

Charlotte Stübner, Matilda Martinsson, Kristina Jakobsson, Christopher Gillberg, Christel Nielsen, Carmela Miniscalco

Research output: Contribution to journalArticlepeer-review

Abstract


Background: 

There are indications that early-life exposure to perfluoroalkyl substances (PFAS) can impact neurodevelopment, but results are inconclusive. The objective was to investigate if high early-life exposure to primarily perfluorohexanesulfonic acid (PFHxS) and perfluorooctanesulfonic acid (PFOS) increases the risk of developmental language disorder in children up to seven years of age.
Methods: 

A register-based cohort of all children born 1998–2013 in Blekinge county, Sweden, was studied. Maternal residential history, that is, with or without highly PFAS-contaminated drinking water, during the 5-year period before childbirth was used as a proxy for early-life exposure. Exposure was categorized as high (n = 646), intermediate (n = 1,650), or background (n = 9,599). We used Cox proportional hazards regression to estimate hazard ratios (HR) for (1) referral to a speech- and language pathologist after routine screening at Child Health Services, and (2) subsequent language disorder diagnosis after clinical assessment. Models were adjusted for parity, maternal age, education level, and smoking, and explored effect modification by sex.
Results: 

In children from the high-exposed area, the adjusted HR for referral was 1.23 (95% CI = 1.03, 1.47) and 1.13 (95% CI = 0.97, 1.56) for subsequent diagnosis. There was no increased risk in the intermediate exposure category.
Conclusion: 

Children, particularly girls, with high exposure had an increased risk of both referral and confirmed developmental language disorder. Further research is needed on PFAS in the context of general neurodevelopment, for which language development is a proxy.
Original languageEnglish
Article numbere233
Number of pages8
JournalEnvironmental Epidemiology
Volume7
Issue number1
Early online date2022 Dec 14
DOIs
Publication statusPublished - 2023 Feb

Subject classification (UKÄ)

  • Environmental Health and Occupational Health
  • Public Health, Global Health, Social Medicine and Epidemiology
  • Pediatrics

Free keywords

  • Register-based cohort study
  • Developmental language disorder
  • Early-life exposure
  • Perfluorohexane sulfonic acid (PFHxS)
  • Perfluorooctane sulfonic acid (PFOS)

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