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Objectives Perfluoroalkyl acid surfactants are used in the chemical industry for the synthesis of perfluoroalkyl polymers. In one Italian fluoropolymer plant and in the research and innovation center, two major perfluoroalkyl surfactants have been historically used: PFOA and ADV and a third, cC6O4 substituted PFOA from mid-2013. This work is summarizing occupational exposure to these chemicals in the period 2004–2021, assessed by biological monitoring. Moreover, taking advantage of the phasing out of PFOA, the elimination kinetics of PFOA in humans is investigated. Methods Workers exposed to PFOA (from beginning of the sixties to 2013), ADV (since 1996), and/or cC6O4 (since 2012) in the production of fluoropolymers, in the synthesis, research, and analysis, were periodically surveyed from 2004, measuring the concentration of perfluoroalkyl acid surfactants in serum. Workers of the same plants, not directly exposed, were surveyed as well. Applying the first-order kinetics model, the half-life of PFOA was calculated. Results 809 Workers were investigated with measurements of PFOA (n = 3692), ADV (n = 4288) and cC6O4 (n = 2272) in serum. In the production plant, median PFOA ranged from 1900 to 14 µg/l from 2004 to 2021; median ADV ranged from 434 to 86 µg/l from 2011 to 2021. For cC6O4 the detection percentage ranged from 9 to 47%; in detected samples median cC6O4 ranged from 3 to 16 µg/l in the period 2013–2021. Adopted mitigation measurements included: the phasing out of PFOA, the improvement of the plastomer and elastomer post-treatments; the reinforcement of the staff involved in prevention. Decreasing trends were observed for all chemicals along years (P value for linear trend of means < 0.01). For PFOA, a half-life of 3.16 (95% CI 2.98–3.37) years was calculated. Conclusions In the study plants, several initiatives to reduce exposure and the risk associated with perfluoroalkyl surfactants were undertaken; results of biomonitoring show that they were effective, with a 5- to 136-fold reduction in the concentration of perfluoroalkyl compounds in the serum of workers. [ABSTRACT FROM AUTHOR]

Diagnosis of type I hypersensitivity reactions (IgE-mediated reactions) to penicillins is based on clinical history, skin tests (STs), and drug provocation tests (DPTs). Among in vitro complementary tests, the fluoro-enzyme immunoassay (FEIA) ImmunoCAP® (Thermo-Fisher, Waltham, MA, USA) is the most widely used commercial method for detecting drug-specific IgE (sIgE). In this study, we aimed to analyze the utility of ImmunoCAP® for detecting sIgE to penicillin G (PG) and amoxicillin (AX) in patients with confirmed penicillin allergy. The study includes 139 and 250 patients evaluated in Spain and Italy, respectively. All had experienced type I hypersensitivity reactions to penicillins confirmed by positive STs. Additionally, selective or cross-reactive reactions were confirmed by DPTs in a subgroup of patients for further analysis. Positive ImmunoCAP® results were 39.6% for PG and/or AX in Spanish subjects and 52.4% in Italian subjects. When only PG or AX sIgE where analyzed, the percentages were 15.1% and 30.4%, respectively, in Spanish patients; and 38.9% and 46% in Italian ones. The analysis of positive STs showed a statistically significant higher percentage of positive STs to PG determinants in Italian patients. False-positive results to PG (16%) were detected in selective AX patients with confirmed PG tolerance. Low and variable sensitivity values observed in a well-defined population with confirmed allergy diagnosis, as well as false-positive results to PG, suggest that ImmunoCAP® is a diagnostic tool with relevant limitations in the evaluation of subjects with type I hypersensitivity reactions to penicillins. [ABSTRACT FROM AUTHOR]

Several new per- and polyfluoroalkyl substances (PFASs) have been synthesized to replace traditional (legacy) PFASs frequently without clear information on their structure, use and potential toxicity. Among them, chloroperfluoropolyether carboxylates (ClPFPECAs) are an emerging group used as processing aids in the production of fluoropolymers to replace the ammonium salt of perfluorononanoic acid (PFNA). The Solvay Company has produced ClPFPECAs as a mixture of six congeners (oligomers) since the mid-1990s, but other possible manufacturers and annual quantities synthesized and used worldwide are unknown. Initial studies to monitor their presence were conducted because of public authority concerns about suspect environmental contamination near fluoropolymer plants. As of 2015, these chemicals have been found in soil, water, vegetative tissues and wildlife, as well as in biological fluids of exposed workers and people, in research carried out mainly in the United States (New Jersey) and Italy. Analysis of wildlife collected even in non-industrialized areas demonstrated widespread occurrence of ClPFPECAs. From the analytical point of view, the (presumptive) evidence of their presence was obtained through the application of non-targeted approaches performed by liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS). Available toxicological data show that ClPFPECAs have similar adverse effects than the compounds which they have replaced, whereas their carcinogenic potential and reproductive damage are currently unknown. All these observations once again cast doubt on whether many alternatives to traditional PFAS are actually safer for the environment and health. [Display omitted] • ClPFPECAs are processing aids used in fluoropolymerization since the middle 1990s. • They are a group of congeners recently found in environment and biota. • ClPFPECAs have been determined by means of untargeted approaches using LC-HRMS. • Toxicological properties of ClPFPECAs are not fully known. • In humans ClPFPECA half-life is comparable to that of long chain PFAS. [ABSTRACT FROM AUTHOR]