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Perfluorooctanoate and Neuropsychological Outcomes in Children

Stein, Cheryl R.; Savitz, David A.; Bellinger, David C.

doi: 10.1097/EDE.0b013e3182944432

Background: In animal studies, perfluorinated compounds affect fetal growth, development, viability, and postnatal growth. The limited epidemiologic findings on child neurobehavioral development are mixed.

Methods: We recruited and evaluated 320 children who participated in the C8 Health Project, a 2005–2006 survey in a Mid-Ohio Valley community highly exposed to perfluorooctanoate (PFOA) through contaminated drinking water. We examined associations among estimated in utero PFOA exposure, measured childhood PFOA serum concentration, and subsequent performance on neuropsychological tests 3–4 years later at ages 6–12 years. We assessed Intelligence Quotient (IQ) reading and math skills, language, memory and learning, visual-spatial processing, and attention. All multivariable linear regression models were adjusted for age, sex, home environment, test examiner, and maternal IQ. Models with measured childhood PFOA were additionally adjusted for child body mass index.

Results: Children in the highest as compared with lowest quartile of estimated in utero PFOA had increases in Full Scale IQ (β 4.6, 95% confidence interval [CI] = 0.7–8.5) and decreases in characteristics of attention deficit/hyperactivity disorder as measured by the Clinical Confidence Index of Connors’ Continuous Performance Test–II (β −8.5, 95% CI = −16.1 to −0.8). There were negligible associations between PFOA and reading or math skills or neuropsychological functioning.

Conclusion: These results do not suggest an adverse association between the levels of PFOA exposure experienced by children in this cohort and their performance on neuropsychological tests.

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From the aDepartment of Preventive Medicine, Mount Sinai School of Medicine, New York, NY; bDepartments of Epidemiology, Obstetrics and Gynecology, Brown University, Providence, RI; and cDepartments of Neurology, Environmental Health, Harvard Medical School, Harvard School of Public Heath, Boston Children’s Hospital, Boston, MA.

This research was funded by the C8 class action settlement agreement (Jack W. Leach, et al. v. E.I. du Pont de Nemours & Company (no. 01-C-608 W.Va., Wood County Circuit Court, WV) between DuPont and plaintiffs. Funds were administered by the Garden City Group (Melville, NY) that reports to the court. C.R.S. was supported by the National Institute of Environmental Health Sciences (K01 ES019156).

The authors declare no conflicts of interest.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( This content is not peer-reviewed or copy-edited; it is the sole responsibility of the author.

Correspondence: Cheryl R. Stein, Department of Preventive Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1057, New York, NY 10029–6574. E-mail:

Received September 10, 2012

Accepted October 5, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.