Association between exposure to per- and polyfluoroalkyl substances (PFAS) and chronic cough in American adults: Results from NHANES 2003–2012

Chronic cough, which affects approximately 10 % of the global population, is recognized as a significant health issue, especially among females. Recent research suggests that chronic cough may be an independent disease rather than merely a symptom of other conditions. This study focuses on the potential role of exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) in the development of chronic cough, noting that PFAS exposure has been linked to various adverse health outcomes. We aimed to explore the association between PFAS exposure and the risk of chronic cough in the U.S. population, analyzing data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2012 and examining potential sex-based differences. Our findings reveal several factors independently associated with an increased incidence of chronic cough, including elevated levels of serum perfluorobutane sulfonic acid (PFBS) and perfluoroheptanoic acid (PFHP). The multi-pollutant models consistently demonstrated a significant positive correlation between PFAS exposure and a higher risk of chronic cough in adult males, with PFBS and PFHP as the primary contributors. However, due to the cross-sectional design of the NHANES study, further research is necessary to elucidate the precise mechanisms by which PFAS contribute to chronic cough.