Anemia and Environmental Chemical Exposures
Anemia affects approximately 1.7 billion people globally. Beyond nutritional deficiencies and chronic disease, environmental chemicals that impair erythropoiesis—red blood cell production—contribute to anemia in exposed populations.
PFAS Effects on Bone Marrow
PFAS compounds alter hematopoietic stem cell differentiation, suppressing erythroid progenitor expansion in bone marrow. Reduced erythropoietin receptor sensitivity in PFAS-exposed cells impairs red blood cell production response to physiological demand.
Epidemiological Evidence
NHANES analyses show inverse associations between PFAS serum levels and hemoglobin concentrations, particularly in women and children. Communities near PFAS manufacturing sites show higher anemia prevalence than unexposed reference populations in occupational health studies.
Clinical Implications
Hematologists evaluating unexplained anemia—particularly in patients without nutritional deficiencies or chronic disease—should consider environmental PFAS exposure. Iron supplementation efficacy may be reduced if PFAS-mediated erythropoiesis suppression is not addressed.