PFAS Exposure In Water Can Increase Infections In Children: Study
By Christian Bonawandt

Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may impact the immune system and increase the risk of certain childhood infections, a new study shows. Conducted by researchers at Lund University in Sweden, the study is the largest study of the potential health impacts of PFAS, as well as the first to focus on the link between the chemicals and commonly diagnosed infections in children.
Researchers looked at health records of 17,051 children born between 2003 and 2013 in Ronneby, Sweden, where a portion of the population was exposed to varying levels of PFAS through contaminated drinking water. Data was controlled for different levels of prenatal PFAS exposure by breaking down the mothers’ residential history during the five years before childbirth, noting the level of know PFAS exposure in different parts of the city.
The contaminated water in Ronneby had high concentrations of two specific PFAS: perfluorooctane sulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS). The measured levels were 8000 ng/L for PFOS and 1700 ng/L for PFHxS. For context, the Swedish action limit in 2014 was 90 ng/L for the sum of the 11 most common PFAS. In addition, blood tests showed women in the area with contaminated water had median serum levels of perfluorooctanoic acid (PFOA) of 9 ng/mL. In contrast, women in Ronneby with uncontaminated water had serum levels of 3 ng/mL PFOA, while women in a nearby municipality with uncontaminated water had serum levels of 2 ng/mL PFOA2.
Influence Of PFAS On Infections
The study showed a strong link between prenatal PFAS exposure and the risk of common infections. Specifically, it notes:
- Children with very high prenatal PFAS exposure had an increased risk of ear infections. This finding is consistent across age groups.
- There was a suggestive, but not statistically significant, association between very high prenatal PFAS exposure and an increased risk of eye infections.
- A suggestive, but not statistically significant, association exists between very high prenatal PFAS exposure and an increased risk of urinary tract infections.
- No increased risk of respiratory tract infections was observed in any of the exposure categories in the main analysis. However, in an age-stratified analysis, an increased risk of respiratory tract infection was observed in children aged 6 months to 3 years with high and intermediate exposure.
Overall, the research shows that younger children (6 months to 3 years) may be more susceptible to the effects of PFAS exposure, although the risk appears to decrease in older children. Researchers inferred from this that the developing immune system's response to PFAS may evolve.
More Study Needed
The data seems to show that PFAS exposure may impair immune function, which can lead to an increased susceptibility to infections. In particular, early-life PFAS exposure is not only associated with subclinical effects but also with clinically manifested infections. It also appears that different PFAS compounds and exposure levels might affect different immunological pathways, leading to varying effects on infection risk.
One limitation of the study is that it used residential history as a proxy for PFAS exposure, which may introduce some misclassification. However, this approach allowed for a larger sample size. Similarly, researchers only had access to data from primary care visits, which may not capture milder infections for which parents did not seek medical care. As a result, the connection between PFAS and infections may be understated.
Overall, the study adds to a growing body of evidence about the potential immunotoxicity of early-life PFAS exposure, particularly in highly exposed populations. It also provides a template for which scientists in the U.S. can use residential exposure and health record data to further study the potential health impact of PFAS in drinking water.
Christian Bonawandt is an industrial content writer for Water Online. He has been writing about B2B technology and industrial processes for 24 years.