【摘要】 [背景]全氟和多氟烷基物质（PFAS）是一种具有肝毒性、免疫抑制、致癌性等多种不良健康效应的持久性有机污染物，以膳食暴露途径为主，多个国际组织已对其进行风险评估。[目的]探究上海市松江区老年居民食物和饮用水来源的PFAS暴露特征并进行风险评估和健康影响评价。[方法]基于上海郊区自然人群队列（SSACB）在2024年5月至7月于松江区进行横断面研究，通过面对面开展65岁以上老年人膳食调查，收集有效问卷4 583份，结合第六次全国膳食调查和近期发表文献中上海食物和饮用水PFAS浓度估算每日摄入量（EDI），并依据不同组织和研究提出的健康指导值（HBGV）进行风险评估。同时，对PFAS估计摄入与老年人生化指标进行相关性分析和多元线性回归模型分析，评价PFAS潜在不良健康影响。[结果]松江区老年居民的膳食模式呈现“东方健康膳食模式”特点，人群经口摄入PFAS水平最高的是全氟辛酸（PFOA）[均值：1.495 ng·(kg·d^-1)]，其次是全氟辛烷磺酸（PFOS）[均值：0.637 ng·(kg·d^-1)]、全氟己烷磺酸（PFHxS）[均值：0.636 ng·(kg·d^-1)]和全氟丁磺酸（PFBS）[均值：0.273 ng·(kg·d^-1)]。其中饮用水是PFOA主要来源[1.415 ng·(kg·d^-1)，占比94.60%]，水产品是PFOS主要来源[0.278 ng·(kg·d^-1)，占比43.66%]。根据中国流行病学研究推导的HBGV评估显示，PFAS暴露的总风险指数（HI）均值为1.39,54.35%的人群可能存在暴露风险（HI > 1），而采用2024年日本食品安全委员会（FSCJ）标准时，HI均值降为0.11，无明显暴露风险。PFAS暴露估计与老年居民的甘油三酯、肝肾功能指标呈负相关，而与低密度脂蛋白胆固醇和肺癌标志物呈正相关。[结论]松江区老年居民的PFAS暴露以PFOA,PFOS,PFHxS和PFBS为主，饮用水和水产品是主要来源。当前人群暴露水平与脂质和肺癌标志物等生化指标相关，可能造成人群潜在健康风险，亟须建立基于中国人群代谢特征的PFAS健康指导值。更多还原

【Abstract】 [Background] Per-and polyfluoroalkyl substances（PFAS）, a group of persistent organic pollutants associated with adverse health effects including hepatotoxicity, immunosuppression, and carcinogenicity, have undergone risk assessments by multiple international organizations, with dietary exposure being the primary pathway.[Objective] To characterize the exposure to PFAS from food and drinking water sources of elderly residents in Songjiang District of Shanghai and to evaluate associated health risk and health effects.[Methods] A cross-sectional study was conducted from May to July 2024 in Songjiang District based on the Shanghai Suburban Adult Cohort and Biobank（SSACB） cohort. Dietary surveys were administered via face-to-face interviews among older adults aged 65 years and above, yielding 4 583 valid questionnaires. The estimated daily intake（EDI） of PFAS was calculated by integrating data from the Sixth National Dietary Survey and recent literature on PFAS concentrations in food and drinking water in Shanghai. Health risk assessment was performed using health-based guideline values（HBGV） proposed by various institutions and studies. Additionally, correlation analysis and linear regression modeling of EDI and biochemical indicators in the elderly were conducted to evaluate potential adverse health effects.[Results] The elderly population in Songjiang District exhibited dietary characteristics consistent with the Eastern Healthy Diet Pattern.Among PFAS compounds, PFOA showed the highest level of oral exposure [mean: 1.495 ng·(kg·d^-1)], followed by PFOS [mean:0.637 ng·(kg·d^-1)], PFHxS [mean: 0.636 ng·(kg·d^-1)], and PFBS [mean: 0.273 ng·(kg·d^-1)]. Specifically, drinking water was the primary source of PFOA [1.415 ng·(kg·d^-1), accounting for 94.60%], while aquatic products were the major source of PFOS [0.278 ng·(kg·d^-1), accounting for 43.66%]. Using the HBGV derived by China’s epidemiological studies, the mean hazard index（HI） for PFAS exposure was 1.39, indicating 54.35% of the population had potential health risks（HI>1）. Following the 2024 standard established by the Food Safety Commission of Japan（FSCJ）, the HI value dropped to 0.11, suggesting negligible risk. PFAS exposure was negatively associated with triglyceride levels and the indicators of liver and kidney function, but positively associated with low-density lipoprotein cholesterol（LDLC） and lung cancer markers in the elderly residents.[Conclusion] PFAS exposure among the elderly residents in Songjiang District is predominantly attributed to PFOA, PFOS, PFHxS, and PFBS, with drinking water and aquatic products identified as primary exposure sources. Current exposure levels demonstrate significant associations with biomarkers of lipid metabolism and lung cancer markers, suggesting potential population health risks. These findings underscore the urgent need to establish HBGV for PFAS compounds based on Chinese population-specific metabolic characteristics.更多还原