NEONATAL dried blood spots reveal potential associations between early chemical exposure and childhood acute lymphoblastic leukemia. A new epidemiologic investigation evaluated whether early life exposure to per- and polyfluoroalkyl substances increases pediatric leukemia risk among children born in Los Angeles County, California.
PFAS Exposure and Childhood Acute Lymphoblastic Leukemia
Per- and polyfluoroalkyl substances, commonly known as forever chemicals, are synthetic industrial compounds prized for heat and water resistance. These substances are termed forever chemicals because their resilient carbon-fluorine bonds prevent them from breaking down naturally in human tissue or the environment. Consequently, individuals accumulate these compounds through contaminated drinking water, food packaging, and household dust.
Researchers analyzed newborn dried blood spots from 125 children diagnosed with acute lymphoblastic leukemia and 219 cancer-free controls born between 2000 and 2015. Using targeted and non-targeted mass spectrometry, investigators measured both well-known legacy chemicals and emerging alternative structures.
Among targeted compounds, perfluorooctanoic acid and perfluorooctanesulfonic acid showed the highest mean concentrations in blood spots. Children in the highest exposure quartile for perfluorooctanoic acid had a 56 percent increased odds of leukemia compared with those in the lowest quartile, while the highest quartile of perfluorooctanesulfonic acid was associated with a 64 percent increased odds. Joint non-linear modeling further demonstrated elevated risks when children were exposed to high levels of both chemicals simultaneously.
Evaluating Targeted and Non-Targeted PFAS Findings
Advanced lab tests identified 26 additional synthetic chemicals in newborn blood samples, including newer alternatives created after older compounds were phased out. Some of these replacement chemicals showed a strong link to leukemia. For instance, doubling exposure to one replacement chemical was tied to over five times the risk of disease, while babies with the highest levels of another faced a similarly elevated risk.
Although limited by small sample sizes across certain subcategories, exploratory stratified analyses indicated stronger associations among non-Hispanic participants compared to Hispanic participants. Investigators noted that neonatal blood spot cards offer a valuable archived matrix for tracking early exposures prior to disease onset. Overall, these findings highlight the necessity of examining a broader spectrum of synthetic chemicals beyond standard legacy panels when evaluating PFAS exposure and childhood acute lymphoblastic leukemia risk in clinical and epidemiological research.
Reference
Vieira VM et al. Targeted and non-targeted analyses of per-and polyfluoroalkyl substances in newborn dried blood spots and risk of childhood acute lymphoblastic leukemia. J Expo Sci Environ Epidemiol. 2026;https://doi.org/10.1038/s41370-026-00891-6
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