Exposure to poly- and perfluoroalkyl substances and its association with the coagulation system: a mini-review

REVIEW Link between PFAS exposure and coagulation 1 single substance.Chronic exposure to these substances was reported to be associated with certain malignancies, lower birth weight, sex hormone disruption, brain degeneration, and liver damage. 1-4At the same time, metabolic changes, dyslipidemia, insulin resistance, and endothelial dysfunction were shown to contribute to cardiovascular complications. 5Coagulation disorders, particularly thrombosis, can cause acute coronary syndromes, stroke, pulmonary embolism, and peripheral ischemia.However, the direct effect of PFAS exposure on the coagulation system has not been extensively studied.Therefore, the aim of this paper was to review the available literature investigating the relationship between PFASs and coagulation.Methods Prior to the literature search, a Population, Exposure, Comparator, and Outcome Introduction Poly-and perfluoroalkyl substances (PFASs) are a large group of chemicals (>4000) in which carbon-hydrogen bonds are replaced, fully or in part, by carbon-fluorine bonds. 1 They can be found in everyday consumer products, such as food and food packaging, water, carpets, surfactants, textile coating, clothing, paint, paper, dental floss, cosmetic products, cookware coating, and fire-extinguishing foam.Human exposure occurs through the digestive system (or through breast milk), respiratory system, or skin.In humans, PFASs have been detected in serum, tissues, and urine. 1-4Most of these substances are highly resistant to degradation and metabolism, and as persistent organic pollutants, they can accumulate in living organisms over long periods of time. 1,2,4In effect, humans are most often exposed to a mixture of PFASs, making it difficult to attribute the ultimate adverse effects to a