Legacy and alternative per- and polyfluoroalkyl substances spatiotemporal distribution in China: Human exposure, environmental media, and risk assessment

In recent decades, China's rapid development has led to significant environmental pollution from the widespread use of chemical products. Per- and polyfluoroalkyl substances (PFAS) are among the most concerning pollutants due to their persistence and bioaccumulation. This article assesses PFAS exposure levels, distribution, and health risks in Chinese blood, environment, and food. Out of 4037 papers retrieved from November 2022 to December 31, 2023, 351 articles met the criteria. Findings show perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) as the main PFAS in both Chinese populations and the environment. The highest PFOA levels in Chinese populations were in Shandong (53.868 ng/mL), while Hubei had the highest PFOS levels (43.874 ng/mL). Similarly, water samples from Sichuan (2115.204 ng/L) and Jiangsu (368.134 ng/L) had the highest PFOA and PFOS levels, respectively. Although localized areas showed high PFAS concentrations. Additionally, developed areas had higher PFAS contamination. The researches conducted in areas such as Qinghai and Hainan remain limited, underscoring the imperative for further investigation. Temporal analysis indicates declining levels of some PFAS, but emerging alternatives require more research. Limited studies on PFAS concentrations in soil, atmosphere, and food emphasize the need for comprehensive research to mitigate human exposure.