Abstract
Per- and Polyfluoroalkyl substances (PFAS) are persistent environmental contaminants widely used in consumer and industrial applications including stain- and water-repellent textiles, nonstick cookware, firefighting foams, and food packaging. Their persistence and bioaccumulation potential raise concerns about early-life exposure through breastfeeding. Despite increasing international attention, no biomonitoring data on PFAS in breast milk have been reported from Saudi Arabia. The study aim to quantify perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) in breast milk from lactating women in Riyadh and estimate infant exposure via breastfeeding using standardized exposure assessment methods. Breast milk samples were collected from 25 mothers within 30 days postpartum. Samples were analyzed by LC–MS/MS following solid-phase extraction. Estimated daily intake (EDI) for PFOA and PFOS was calculated using the equation EDI = (CBM × VBM) / BW, assuming an average infant body weight of 2.5 kg and daily milk intake of 292.5 mL during early infancy. Quantifiable concentrations (> LLOQ = 25 ng/L) were detected in 4 of 25 participants. PFOA concentrations ranged from < LLOQ to 73.3 ng/L, and PFOS concentrations ranged from < LLOQ to 85.2 ng/L. Median concentrations for both compounds remained < LLOQ. Infant EDI values were below the U.S. EPA oral reference dose (20 ng/kg-bw/day) but exceeded EFSA benchmark values in 12% of samples for PFOA (EFSA = 0.857 ng/kg-bw/day) and 16% of samples for PFOS (EFSA = 1.857 ng/kg-bw/day). This study provides the first biomonitoring evidence of PFAS in breast milk in Saudi Arabia, demonstrating low but measurable exposure among lactating women. The findings underscore a need for expanded biomonitoring and assessment of potential exposure sources in the region.
Similar content being viewed by others
Data availability
The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
References
OECD. Series on risk management No. 61: Reconciling terminology of the universe of per- and polyfluoroalkyl substances: Recommendations and practical guidance. (2018). https://www.oecd.org/chemicalsafety/portal-perfluorinated-chemicals/terminology-per-and-polyfluoroalkyl-substances.pdf
Kotthoff, M., Müller, J., Jürling, H., Schlummer, M. & Fiedler, D. Perfluoroalkyl and polyfluoroalkyl substances in consumer products. Environ. Sci. Pollut. Res. 22 (19), 14546–14559. https://doi.org/10.1007/s11356-015-4202-7 (2015).
Phelps, D. W., Parkinson, L. V., Boucher, J. M., Muncke, J. & Geueke, B. Per- and polyfluoroalkyl substances in food packaging: Migration, toxicity, and management strategies. Environ. Sci. Technol. (2024). https://pubmed.ncbi.nlm.nih.gov/38501683/
Gravesen, C. R., Lee, L. S., Choi, Y. J., Silveira, M. L. & Judy, J. D. PFAS release from wastewater residuals as a function of composition and production practices. Environ. Pollut. 322, 121167. https://doi.org/10.1016/j.envpol.2023.121167 (2023).
Hall, S. M. et al. Per- and polyfluoroalkyl substances in dust collected from residential homes and fire stations in North America. Environ. Sci. Technol. 54 (22), 14558–14567. https://doi.org/10.1021/acs.est.0c04777 (2020).
Wang, Z., Cousins, I. T., Scheringer, M. & Hungerbuehler, K. Hazard assessment of fluorinated alternatives to long-chain perfluoroalkyl acids (PFAAs) and their precursors: Status quo, ongoing challenges and possible solutions. Environ. Int. 75, 172–179. https://doi.org/10.1016/j.envint.2014.11.013 (2015).
Lau, C. et al. Perfluoroalkyl acids: A review of monitoring and toxicological findings. Toxicol. Sci. 99 (2), 366–394. https://doi.org/10.1093/toxsci/kfm128 (2007).
EFSA CONTAM PANEL. Risk to human health related to the presence of perfluoroalkyl substances in food. EFSA J. 18 (9), e06223. https://doi.org/10.2903/j.efsa.2020.6223 (2020).
Rickard, B. P., Rizvi, I. & Fenton, S. E. Per- and poly-fluoroalkyl substances (PFAS) and female reproductive outcomes: PFAS elimination, endocrine-mediated effects, and disease. Toxicology 465, 153031. https://doi.org/10.1016/j.tox.2021.153031 (2022).
Ding, N., Harlow, S. D., Randolph, J. F., Loch-Caruso, R. & Park, S. K. Perfluoroalkyl and polyfluoroalkyl substances and their effects on the ovary. Hum. Reprod. Update. 26 (5), 724–752. https://doi.org/10.1093/humupd/dmaa017 (2020).
Zahm, S. H. et al. Carcinogenicity of perfluorooctanoic acid and perfluorooctanesulfonic acid. Lancet Oncol. 25 (1), 16–17. https://doi.org/10.1016/S1470-2045 (2024). (23)00606-0.
Steenland, K. & Winquist, A. PFAS and cancer: A scoping review of the epidemiologic evidence. Environ. Res. 194, 110690. https://doi.org/10.1016/j.envres.2020.110690 (2021).
Jing, L. & Shi, Z. Per- and polyfluoroalkyl substances exposure might be a risk factor for thyroid cancer. EBioMedicine 98, 104866. https://doi.org/10.1016/j.ebiom.2023.104866 (2023).
Shearer, J. J. et al. Serum concentrations of per- and polyfluoroalkyl substances and risk of renal cell carcinoma. J. Natl Cancer Inst. 113 (5). https://doi.org/10.1093/jnci/djaa064 (2020).
US EPA. Fact sheet: 2010/2015 PFOA stewardship program. (2016). https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/fact-sheet-20102015-pfoa-stewardship-program
Sunderland, E. M. et al. A review of the pathways of human exposure to poly- and perfluoroalkyl substances and present understanding of health effects. J. Expo. Sci. Environ. Epidemiol. 29 (2), 131–147. https://doi.org/10.1038/s41370-018-0094-1 (2019).
Zheng, P. et al. Prenatal and postnatal exposure to emerging and legacy PFAS: Levels and transfer in maternal serum, cord serum, and breast milk. Sci. Total Environ. 812, 152446. https://doi.org/10.1016/j.scitotenv.2021.152446 (2022).
Verner, M. A. et al. A simple pharmacokinetic model of prenatal and postnatal exposure to PFAS. Environ. Sci. Technol. 50 (2), 978–986. https://doi.org/10.1021/acs.est.5b04017 (2016).
Mondal, D. et al. Breastfeeding as a potential excretion route and implications for infant exposure to perfluoroalkyl acids. Environ. Health Perspect. 122 (2), 187–192. https://doi.org/10.1289/ehp.1306613 (2013).
LaKind, J. S., Berlin, C. M. & Naiman, D. Q. Infant exposure to chemicals in breast milk in the United States. Environ. Health Perspect. 109 (1), 75–88. https://doi.org/10.1289/ehp.0110975 (2001).
Wikström, S., Lin, P. I., Lindh, C. H., Shu, H. & Bornehag, C. G. Maternal serum levels of perfluoroalkyl substances in early pregnancy and offspring birth weight. Pediatr. Res. 87 (6), 1093–1099. https://doi.org/10.1038/s41390-019-0710-3 (2020).
Chen, Q. et al. Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances and childhood atopic dermatitis: A prospective birth cohort study. Environ. Health. 17 (1). https://doi.org/10.1186/s12940-018-0372-5 (2018).
Mogensen, U. B., Grandjean, P., Nielsen, F., Weihe, P. & Budtz-Jørgensen, E. Breastfeeding as an exposure pathway for perfluorinated alkylates. Environ. Sci. Technol. 49 (17), 10466–10473. https://doi.org/10.1021/acs.est.5b02237 (2015).
Alderete, T. L. et al. Perfluoroalkyl substances, metabolomic profiling, and alterations in glucose homeostasis among overweight and obese Hispanic children. Environ. Int. 126, 445–453. https://doi.org/10.1016/j.envint.2019.02.046 (2019).
Liu, D., Yan, S., Liu, Y., Chen, Q. & Ren, S. Association of prenatal exposure to perfluorinated and polyfluoroalkyl substances with childhood neurodevelopment: A systematic review and meta-analysis. Ecotoxicol. Environ. Saf. 271, 115939. https://doi.org/10.1016/j.ecoenv.2023.115939 (2024).
Braun, J. M. Early-life exposure to endocrine-disrupting chemicals: Role in childhood obesity and neurodevelopment. Nat. Rev. Endocrinol. 13 (3), 161–173. https://doi.org/10.1038/nrendo.2016.186 (2017).
LaKind, J. S., Naiman, J., Verner, M. A., Lévêque, L. & Fenton, S. Per- and polyfluoroalkyl substances in breast milk and infant formula: A global issue. Environ. Res. 219, 115042. https://doi.org/10.1016/j.envres.2022.115042 (2023).
Kadar, H. et al. Development of an analytical strategy based on LC–HRMS for measuring perfluorinated compounds in human breast milk. Chemosphere 85 (3), 473–480. https://doi.org/10.1016/j.chemosphere.2011.07.008 (2011).
Yao, J. et al. Emerging and legacy perfluoroalkyl substances in breastfed Chinese infants: Renal clearance, body burden, and implications. Environ. Health Perspect. 131 (3). https://doi.org/10.1289/EHP11156 (2023).
Rios-Leyvraz, M. & Yao, Q. The volume of breast milk intake in infants and young children: A systematic review and meta-analysis. Breastfeed. Med. https://doi.org/10.1089/bfm.2022.0241 (2023).
El-Mouzan, M. I., Al-Herbish, A. S., Al-Salloum, A. A., Qurachi, M. M. & Al-Omar, A. A. Growth charts for Saudi children and adolescents. Saudi Med. J. 28 (10), 1555–1568 (2007). https://pubmed.ncbi.nlm.nih.gov/17914520/
Ali, A. M., Higgins, C. P. & Alarif, W. M. Per- and polyfluoroalkyl substances in contaminated coastal marine waters of the Saudi Arabian Red Sea: A baseline study. Environ. Sci. Pollut. Res. 28, 2791–2803. https://doi.org/10.1007/s11356-020-09897-5 (2021).
Ali, A. M. et al. Legacy and emerging per- and polyfluoroalkyl substances in sediment and edible fish from the Eastern Red Sea. Environ. Pollut. 280, 116935. https://doi.org/10.1016/j.envpol.2021.116935 (2021).
Abdallah, M. A. E. et al. Serum concentrations of perfluoroalkyl substances and their association with osteoporosis in a population in Jeddah, Saudi Arabia. Environ. Int. 137, 105547. https://doi.org/10.1016/j.envint.2020.105547 (2020).
Al-Sheyab, N. A., Al-Qudah, K. M. & Tahboub, Y. R. Levels of perfluorinated compounds in human breast milk in Jordan: The impact of sociodemographic characteristics. Environ. Sci. Pollut. Res. 22 (16), 12415–12423. https://doi.org/10.1007/s11356-015-4505-x (2015).
Lee, S. et al. Perfluoroalkyl substances in breast milk from Korea: Time-course trends, influencing factors, and infant exposure. Sci. Total Environ. 612, 286–292. https://doi.org/10.1016/j.scitotenv.2017.08.230 (2018).
Abdallah, M. A. E. et al. Concentrations of perfluoroalkyl substances in human milk from Ireland: Implications for adult and nursing infant exposure. Chemosphere 246, 125724. https://doi.org/10.1016/j.chemosphere.2019.125724 (2020).
Cariou, R., Veyrand, B., Antignac, J. P., Marchand, P. & Le Bizec, B. Perfluoroalkyl acid levels and profiles in breast milk, maternal and cord serum of French women and their newborns. Environ. Int. 82, 1–11. https://doi.org/10.1016/j.envint.2015.05.001 (2015).
Rawn, D. F. K., Dufresne, G., Clément, G., Fraser, W. D. & Arbuckle, T. E. Perfluorinated alkyl substances in Canadian human milk as part of the MIREC study. Sci. Total Environ. 831, 154888. https://doi.org/10.1016/j.scitotenv.2022.154888 (2022).
Beser, M. I., Pardo, O., Beltrán, J. & Yusà, V. Determination of 21 perfluoroalkyl substances and organophosphorus compounds in breast milk by LC-Orbitrap HRMS. Anal. Chim. Acta. 1049, 123–132. https://doi.org/10.1016/j.aca.2018.10.021 (2019).
Fiedler, H. & Sadia, M. Regional occurrence of perfluoroalkane substances in human milk during 2016–2019 for the global monitoring plan under the Stockholm Convention. Chemosphere 277, 130287. https://doi.org/10.1016/j.chemosphere.2021.130287 (2021).
U.S. EPA. Drinking Water Health Advisory for Perfluorooctanoic Acid (PFOA). EPA 822-R-16-005. U.S. Environmental Protection Agency. (2016). https://hero.epa.gov/hero/index.cfm/reference/details/reference_id/3982042 (accessed February 23, 2023).
EFSA CONTAM Panel (EFSA Panel on Contaminants in the Food Chain), Knutsen HK, Alexander J, Barregård L, Bignami M, Brüschweiler B, et al. (2018). Risk to human health related to the presence of perfluorooctane sulfonic acid and perfluorooctanoic acid in food. EFSA J. 16(12), e05194. https://doi.org/10.2903/j.efsa.2018.5194
Acknowledgements
Acknowledgments are part of manuscript.
Funding
Imadul Islam received the funding from King Abdullah International Medical Research Center (KAIMRC) for this project through research grant RC21R/075/03.
Author information
Authors and Affiliations
Contributions
EA, II and EG conception, preparation of samples, writing and reviewing of manuscript EA, WA and AA sample preparation, and data interpretation MA, EA and SA sample collection from hospitalII, RA, MA and BA manuscript review and correction. All authors finalized manuscript with inputs.
Corresponding author
Ethics declarations
Ethics approval and consent to participate
This study was approved by KAIMRC/MNGHA Institutional Review Board (IRB) and written consent was obtained from subjects. Blank forms can be provided upon request.
Competing interests
The authors declare no competing interests.
Ethics declaration
Consistent with the objectives of the Kingdom of Saudi Arabia’s Vision 2030 initiative, which emphasizes environmental sustainability, this study received review and approval from both the ethical committee and the research advisory council. Funding for this work was provided by the King Abdullah International Medical Research Center at King Saud Bin Abdulaziz University for Health Sciences in Riyadh (RC21R/075/03).
Disclosure
All the authors declare that there is no conflict of interest toward this publication.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Alharbi, E., Ghanem, E., Alhussaini, W. et al. Perfluoroalkyl compound levels in breast milk of mothers in Riyadh, Kingdom of Saudi Arabia. Sci Rep (2026). https://doi.org/10.1038/s41598-026-43202-7
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-43202-7
