PFAS (per- and polyfluoroalkyl substances) have been extensively used across numerous industries and consumer goods. Due to their high persistence and mobility, they are ubiquitous in the environment. Exposure to PFAS occurs in people via multiple pathways such as dermal contact, water supply, air inhalation, and dietary intake. Even if some PFAS are being phased out because of their persistent presence in the environment and harmful impacts on human health, mixes of replacement and legacy PFAS will continue to pollute the ecosystem. Numerous toxicological investigations have revealed harmful effects of PFAS exposure on female reproductive health, e.g., polycystic ovaries syndrome, premature ovarian failure, endometriosis, reproductive system tumors, pregnancy complications, and adverse pregnancy outcomes. Despite extensive epidemiological studies on the reproductive toxicity of PFAS, research findings remain inconsistent, and the underlying mechanisms are not well understood. In this review, we give an in-depth description of the sources and pathways of PFAS, and then review the reproductive toxicity of PFAS and its possible mechanisms.

Ambient air pollution has been associated with gestational diabetes mellitus (GDM); however, evidence regarding trimester-specific effects from China remains limited. This case–control study study analyzed data from pregnant women who delivered in Wuhan, China, between 2017 and 2022 (164 GDM cases and 731 controls), integrating geographic information, air quality measurements, and maternal characteristics. Using Inverse Distance Weighting interpolation and Generalized Linear Mixed Models (GLMM), we assessed associations between air pollutant exposure and GDM across different gestational periods. Results indicated that NO₂ demonstrated the strongest association with GDM compared to other pollutants. Specifically, increased NO₂ exposure was consistently associated with higher GDM risk throughout pregnancy. PM_2.5 exposure showed significant associations during early and mid-pregnancy, while SO₂ exposure was significantly associated with GDM risk exclusively in early pregnancy. Sensitivity analyses stratified by urban maternity status and maternal age revealed the stability of the study’s findings. These findings underscore the importance of reducing air pollution exposure during pregnancy and implementing targeted interventions for high-risk populations to prevent GDM development.

Background: The effect of the long-term persistently elevated air pollutants, often referred to as air pollution waves, on sexual function has not been sufficiently addressed. Methods: This nationwide cross-sectional study involved 12,157 participants, with 5496 females and 5039 males. PM waves were characterized by daily average PM concentrations surpassing Grade II thresholds of China’s ambient air quality standards (PM_2.5 > 75 μg/m³, PM₁₀ > 150 μg/m³) for three or more consecutive days (3–8 days). Male sexual function was assessed through the International Index of Erectile Function-5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT), while female sexual function was evaluated using the Female Sexual Function Index (FSFI). A multivariate linear regression model was employed to investigate the link between PM wave exposure and sexual function. Results: Exposure to PM₁₀ waves, defined as 3 (β = −0.0145, 95%CI = −0.0280, −0.0010), 4 (β = −0.0145, 95%CI = −0.0280, −0.0010), 5 (β = −0.0193, 95%CI = −0.0371, −0.0015), 6 (β = −0.0218, 95%CI = −0.0415, −0.0021), 7 (β = −0.0243, 95%CI = −0.0458, −0.0028), and 8 (β = −0.0243, 95%CI = −0.0458, −0.0028) consecutive days, negatively impacted IIEF-5 scores and male sexual function. Moreover, depression levels, as evaluated by the PHQ-9, played a mediating role in the connection between PM₁₀ waves and IIEF-5 scores. The potentially vulnerable subgroups were the younger 20–30 and the low-income groups. Conclusions: Our results suggest for the first time that PM₁₀ waves are associated with decreased IIEF-5 scores, which are mediated by depression score PHQ-9, informing policy formulation for public health interventions and individual safeguarding.