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J Hazard Mater . Age disparities in PFAS-associated influenza-like illness among adult females at low exposure levels

tetano

Editor, Senior Moderator
J Hazard Mater


. 2026 Jan 22:504:141225.
doi: 10.1016/j.jhazmat.2026.141225. Online ahead of print.
Age disparities in PFAS-associated influenza-like illness among adult females at low exposure levels

Nan Lin[SUP] 1 [/SUP], Ruimin Yang[SUP] 2 [/SUP], Yanyan Zhang[SUP] 3 [/SUP], Zilin Yang[SUP] 3 [/SUP], Zhiwen Li[SUP] 4 [/SUP], Bin Wang[SUP] 5 [/SUP]


Affiliations
Abstract

The immunotoxicity of per- and polyfluoroalkyl substances (PFAS) have been widely studied in maternal and adolescent populations. However, data on adults particularly the elderly remains limited. This cross-sectional study investigated the association between blood PFAS levels and self-reported influenza-like illness (ILI) among 394 adult females in Shanxi Province, China. Whole blood samples were analyzed for 30 PFAS, and associations with ILI were assessed using logistic regression and Bayesian kernel machine regression (BKMR), with stratification by age (≤50 vs. >50 years). Despite relatively low PFAS concentrations, PFOA (OR=1.42, 95 % CI: 1.03, 1.96), PFNA (OR=1.49, 95 % CI: 1.20, 1.85), and PFDA (OR=1.55, 95 % CI: 1.20, 1.97) were significantly associated with higher odds ratios of reporting ILI in the overall population. BKMR identified PFNA as particularly prominent (PIP=0.997), with consistent single effects across other PFAS percentiles. PFCAs exhibited stronger statistical associations with ILI (OR=1.58, 95 % CI: 1.13, 2.19) than PFSAs, which showed no significant associations. These associations were particularly pronounced in older adult females (>50 years), where the summed concentration of six PFCAs showed more than doubling the OR to 3.37 (95 % CI: 1.87, 6.09). Our findings suggest age-related differences in the associations between PFAS levels and self-reported ILI, even at relatively low exposure levels.

Keywords: Age disparity; Immunotoxicity; Influenza-like illness; Per- and polyfluoroalkyl substances (PFAS).

 
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