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GenX
Trademark name for a synthetic, organofluorine chemical compound

GenX is a Chemours trademark for a synthetic, short-chain organofluorine compound, specifically the ammonium salt of hexafluoropropylene oxide dimer acid (HFPO-DA). Developed commercially by DuPont in 2009 as a replacement for perfluorooctanoic acid (PFOA), GenX was intended to address health effects and ecotoxicity concerns associated with PFOA. However, despite being designed to be less persistent in the environment, GenX's impact may be equally or more harmful. It belongs to a broader class of synthetic organofluorine compounds known as per- and polyfluoroalkyl substances (PFASs).

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Uses

The chemicals are used in products such as food packaging, paints, cleaning products, non-stick coatings, outdoor fabrics and firefighting foam.8 The chemicals are manufactured by Chemours, a corporate spin-off of DuPont, in Fayetteville, North Carolina.9

GenX chemicals are used as replacements for PFOA for manufacturing fluoropolymers such as Teflon,1011 the GenX chemicals serve as surfactants and processing aids in the fluoropolymer production process to lower the surface tension allowing the polymer particles to grow larger. The GenX chemicals are then removed from the final polymer by chemical treatment and heating.12

Chemistry

The manufacturing process combines two molecules of hexafluoropropylene oxide (HFPO) to form HFPO-DA. HFPO-DA is converted into its ammonium salt that is the official GenX compound.1314

The chemical process uses 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)propanoic acid (FRD-903) to generate ammonium 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)propanoate (FRD-902) and heptafluoropropyl 1,2,2,2-tetrafluoroethyl ether (E1).15

When GenX contacts water, it releases the ammonium group to become HFPO-DA. Because HFPO-DA is a strong acid, it deprotonates into its conjugate base, which can then be detected in the water.16

Pollution

In North Carolina, the Chemours Fayetteville plant released GenX compounds into the Cape Fear River, which is a drinking water source for the Wilmington area. A documentary film, The Devil We Know; a fictional dramatization, Dark Waters; and a nonfiction memoir, Exposure: Poisoned Water, Corporate Greed, and One Lawyer's Twenty-Year Battle Against DuPont by Robert Bilott, subsequently publicized the discharges, leading to controversy over possible health effects.17

HFPO-DA was first reported to be in the Cape Fear River in 201218 and an additional eleven polyfluoroalkyl substances (PFAS) were reported 2014.19 These results were published as a formal paper in 2015.20 The following year, North Carolina State University and the EPA jointly published a study demonstrating HFPO-DA and other PFAS were present in the Wilmington-area drinking water sourced from the Cape Fear river.21

In September 2017, the North Carolina Department of Environmental Quality (NCDEQ) ordered Chemours to halt discharges of all fluorinated compounds into the river. Following a chemical spill one month later, NCDEQ cited Chemours for violating provisions in its National Pollutant Discharge Elimination System wastewater discharge permit.22 In November 2017, the Brunswick County Government filed a federal lawsuit alleging that DuPont failed to disclose research regarding potential risks from the chemical.23

In spring 2018, Cape Fear River Watch24 sued Chemours for Clean Water Act violations and sued the NCDEQ for inaction.25 After Cape Fear River Watch's suits were filed, NCDEQ filed a suit against Chemours, the result of all 3 lawsuits culminated in a consent order.26 The order signed by all 3 parties requires Chemours drastically reduce PFAS containing water discharges and air emissions, as well as sampling and filtration for well owners with contaminated wells, among other requirements. All materials relative to status of consent order requirements must be published to a public website. One requirement under the order was for non-targeted analysis which found 257 "unknown" PFAS being released from Fayetteville Works, (aside from the 100 'known' PFAS which can be quantified.27 Cape Fear River Watch published28 that their research of the NC DEQ permit file 29 indicates that the first PFAS byproducts were likely released from Fayetteville Works in 1976 with the production of Nafion which uses HFPO in production (otherwise known as GenX) and creates byproducts termed Nafion Byproducts 1 through 5, some of which have been found in the blood of Cape Fear area residents.30

In 2020 Michigan adopted drinking water standards for 5 previously unregulated PFAS compounds including HFPO-DA which has a maximum contaminant level (MCL) of 370 parts per trillion (ppt). Two previously regulated PFAS compounds PFOA and PFOS had their acceptable limits lowered to 8 ppt and 16 ppt respectively.3132

In 2022 Virginia's Roanoke River had become contaminated by GenX at levels reported to be 1.3 million parts per trillion.33

Health effects

GenX has been shown to cause a variety of adverse health effects. While it was originally marketed as a safer alternative to legacy PFAS, research suggests that GenX poses significant health risks similar to those associated with its predecessor.3435363738

Liver and kidney toxicity

Studies have demonstrated that the liver is especially vulnerable to GenX exposure.394041 Animal research has shown that even low doses of GenX can cause liver enlargement and damage.4243 Similarly, the kidneys are also sensitive to GenX, with chronic exposure leading to renal toxicity.44 These effects highlight the potential dangers of prolonged exposure to even small amounts of the chemical.4546

Cancer risk

There is increasing concern about the carcinogenic potential of GenX. Research in animal models has linked exposure to various cancers, including liver, pancreatic, and testicular cancers.474849 Although data on humans are limited, the results from these studies have prompted further investigation into the possible cancer risks posed by GenX.5051

Neurotoxicity and developmental effects

Two 2023 studies have identified potential neurotoxic effects of GenX, particularly during critical developmental windows.5253 Pre-differentiation exposure of human dopaminergic-like neurons (SH-SY5Y cells) to low-dose GenX (0.4 and 4 μg/L) resulted in persistent alterations in neuronal characteristics. The study reported significant changes in nuclear morphology, chromatin arrangement, and increased expression of the repressive marker H3K27me3, which is associated with neurodegeneration.54

These changes were accompanied by disruptions in mitochondrial function and an increase in intracellular calcium levels, which are critical markers of neuronal health. Notably, GenX exposure led to altered expression of α-synuclein, a protein closely linked to the development of Parkinson's disease. The findings suggest that developmental exposure to GenX may pose a long-term risk for neurodegenerative disorders, particularly Parkinson's disease, due to its impact on key neuronal processes.55

Recent research has also underscored the potential for GenX to disrupt glucose and lipid metabolism during critical developmental periods. A 2021 study published in Environment International investigated the effects of prenatal exposure to GenX in Sprague-Dawley rats, revealing significant maternal and neonatal adverse outcomes, such as increased maternal liver weight, altered lipid profiles, and reduced glycogen accumulation in neonatal livers, resulting in hypoglycemia. Additionally, neonatal mortality and lower birth weights were observed at higher doses of GenX .56

A 2024 study in Science of the Total Environment expanded upon these findings in mice, demonstrating that gestational exposure to GenX led to increased liver weight, elevated liver enzyme levels (e.g., ALT and AST), and decreased glycogen storage capacity in the liver. Disruptions in gut flora and the intestinal mucosal barrier were also noted, further linking GenX exposure to hepatotoxicity.57

Both studies revealed significant alterations in gene expression, particularly in pathways regulating glucose and lipid metabolism. Genes such as CYP4A14, Sult2a1, and Igfbp1 were upregulated, which may have long-term implications for metabolic health. These findings suggest that gestational GenX exposure could trigger metabolic disorders and liver toxicity, posing potential health risks for populations exposed to GenX through contaminated water sources .5859

Immune system and metabolic effects

Studies have demonstrated that exposure to GenX, a replacement for long-chain PFAS chemicals, can lead to complex health effects. GenX has been linked to alterations in immune responses and metabolic processes, as observed in both human and animal studies. For instance, in a study using Monodelphis domestica, GenX exposure upregulated genes associated with inflammation and fatty acid transport.60 Another study on mice showed that GenX suppressed innate immune responses to inhaled carbon black nanoparticles, while simultaneously promoting lung cell proliferation, including macrophages and epithelial cells.61 These findings suggest that GenX may have immunosuppressive effects, potentially increasing susceptibility to respiratory agents while encouraging cellular growth in the lungs, raising concerns about respiratory health risks.

This research highlights the potential health implications of GenX exposure, particularly its impact on immune system function and cell proliferation, which may contribute to both immune suppression and adverse health outcomes like inflammation or respiratory diseases. These findings raise concerns about the long-term impact on human health, especially in vulnerable populations.62

U.S. drinking water regulations

In June 2022 the U.S. Environmental Protection Agency (EPA) published drinking water health advisories, which are non-regulatory technical documents, for GenX and PFBS.6364 The lifetime health advisories and health effects support documents assist federal, state, tribal, and local officials and managers of drinking water systems in protecting public health when these chemicals are present in drinking water. EPA also listed recommended steps that consumers may take to reduce possible exposure to GenX and other PFAS chemicals.65

In April 2024 EPA published final drinking water standards for GenX and five other PFAS compounds, pursuant to the Safe Drinking Water Act. The standards, enforced by EPA and state agencies, require all public water systems in the U.S. to monitor for GenX and treat their water, if necessary to meet the 10 ppt standard.66 EPA also announced the availability of grant funds to assist small and disadvantaged communities in testing for and treating PFAS contamination in their water systems.67

See also

References

  1. "C3 Dimer Acid and PFAS". Chemours. Retrieved January 23, 2020. https://www.chemours.com/en/about-chemours/global-reach/fayetteville-works/fayetteville-works-toxicology ↩

  2. Beekman, M.; et al. (December 12, 2016). "Evaluation of substances used in the GenX technology by Chemours, Dordrecht" (PDF). National Institute for Public Health and the Environment (RIVM, The Netherlands). Retrieved July 23, 2017. https://www.rivm.nl/bibliotheek/rapporten/2016-0174.pdf ↩

  3. Hogue, Cheryl (February 12, 2018). "What's GenX still doing in the water downstream of a Chemours plant?". American Chemical Society (ACS). Retrieved August 21, 2019. https://cen.acs.org/articles/96/i7/whats-genx-still-doing-in-the-water-downstream-of-a-chemours-plant.html ↩

  4. Gillam, Carey (June 2, 2023). "Top US chemical firms to pay $1.2bn to settle water contamination lawsuits". The Guardian. Retrieved October 14, 2024. https://www.theguardian.com/environment/2023/jun/02/dupont-pfas-settlement-water-chemical-contamination ↩

  5. Rich, Nathaniel (January 6, 2016). "The Lawyer Who Became DuPont's Worst Nightmare". The New York Times. Archived from the original on January 6, 2016. Retrieved October 14, 2024. https://www.nytimes.com/2016/01/10/magazine/the-lawyer-who-became-duponts-worst-nightmare.html ↩

  6. "US EPA deems two GenX PFAS chemicals more toxic than PFOA". Chemical & Engineering News. Retrieved October 14, 2024. https://cen.acs.org/environment/persistent-pollutants/US-EPA-deems-two-GenX-PFAS-chemicals-more-toxic-than-PFOA/99/i40 ↩

  7. "Fact Sheet: Human Health Toxicity Assessment for GenX Chemicals" (PDF). United States Environmental Protection Agency. March 2023. Retrieved October 14, 2024. https://www.epa.gov/system/files/documents/2023-03/GenX-Toxicity-Assessment-factsheet-March-2023-update.pdf ↩

  8. "Basic Information on PFAS". PFOA, PFOS and Other PFASs. Washington, D.C.: U.S. Environmental Protection Agency (EPA). February 18, 2018. https://www.epa.gov/pfas/basic-information-pfas ↩

  9. "GenX Frequently Asked Questions" (PDF). GenX Investigation. Raleigh, NC: North Carolina Department of Environmental Quality (NCDEQ). February 15, 2018. https://files.nc.gov/ncdeq/GenX/SAB/FAQ_updated_021518.pdf ↩

  10. Beekman, M.; et al. (December 12, 2016). "Evaluation of substances used in the GenX technology by Chemours, Dordrecht" (PDF). National Institute for Public Health and the Environment (RIVM, The Netherlands). Retrieved July 23, 2017. https://www.rivm.nl/bibliotheek/rapporten/2016-0174.pdf ↩

  11. "What is the difference between PFOA, PFOS and GenX and other replacement PFAS?". PFOA, PFOS and Other PFASs. EPA. February 18, 2018. https://www.epa.gov/pfas/basic-information-pfas#difference ↩

  12. "What is GenX? | Get the Facts". https://www.chemours.com/en/about-chemours/genx ↩

  13. Hogue, Cheryl (February 12, 2018). "What's GenX still doing in the water downstream of a Chemours plant?". American Chemical Society (ACS). Retrieved August 21, 2019. https://cen.acs.org/articles/96/i7/whats-genx-still-doing-in-the-water-downstream-of-a-chemours-plant.html ↩

  14. Beekman, M.; et al. (December 12, 2016). "Evaluation of substances used in the GenX technology by Chemours, Dordrecht" (PDF). National Institute for Public Health and the Environment (RIVM, The Netherlands). Retrieved July 23, 2017. https://www.rivm.nl/bibliotheek/rapporten/2016-0174.pdf ↩

  15. "DuPont GenX Processing Aid for Making Fluoropolymer Resins" (PDF). February 9, 2016. Archived from the original (PDF) on February 8, 2018. Retrieved August 21, 2019. https://web.archive.org/web/20180208165313/https://www.ozhz.nl/fileadmin/user_upload/2016-02-09_Brief_gedeputeerde_Janssen_en_beantwoording_vragen_BenW_Sliedrecht_over_historische_PFOA-emissies_Chemours_voorheen_Dupont_de_Nemours_bijlagen__nazending_2_.pdf ↩

  16. Hogue, Cheryl (February 12, 2018). "What's GenX still doing in the water downstream of a Chemours plant?". American Chemical Society (ACS). Retrieved August 21, 2019. https://cen.acs.org/articles/96/i7/whats-genx-still-doing-in-the-water-downstream-of-a-chemours-plant.html ↩

  17. "N.C. drinking water tainted with chemical byproduct for decades?". CBS News. June 26, 2017. https://www.cbsnews.com/news/wilmington-nc-cape-fear-river-water-tainted-genx-dupont-chemours/ ↩

  18. Strynar, Mark J.; Dagnino, Sonia; Lindstrom, Andrew; Andersen, Eric; Mcmillan, Larry; Thurman, Michael; Ferrer, Imma; Ball, Carol (2012). Identification of novel polyfluorinated compounds in natural waters using accurate mass TOFMS. SETAC. Long Beach, CA – via ResearchGate. https://www.researchgate.net/publication/358128921 ↩

  19. Strynar, Mark J.; McMahen, Rebecca; Liang, Shuang; Dagnino, Sonia; Lindstrom, Andrew; Andersen, Erik; McMillan, Larry; Thurman, Michael; Ferrer, Imma; Ball, Carol (November 9–13, 2014). Determination of perfluoroalkyl ether carboxylic acids (PFECAs) and sulfonic acids (PFESAs) in North Carolina surface water using high resolution mass spectrometry. SETAC. Vancouver, BC – via ResearchGate. https://www.researchgate.net/publication/358128738 ↩

  20. McCord, James; Strynar, Mark (May 7, 2019). "Identification of Per- and Polyfluoroalkyl Substances in the Cape Fear River by High Resolution Mass Spectrometry and Nontargeted Screening". Environmental Science & Technology. 53 (9): 4717–4727. Bibcode:2019EnST...53.4717M. doi:10.1021/acs.est.8b06017. ISSN 0013-936X. PMC 7478245. PMID 30993978. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478245 ↩

  21. Sun, Mei; Arevalo, Elisa; Strynar, Mark; Lindstrom, Andrew; Richardson, Michael; Kearns, Ben; Pickett, Adam; Smith, Chris; Knappe, Detlef R. U. (December 13, 2016). "Legacy and Emerging Perfluoroalkyl Substances Are Important Drinking Water Contaminants in the Cape Fear River Watershed of North Carolina". Environmental Science & Technology Letters. 3 (12): 415–419. Bibcode:2016EnSTL...3..415S. doi:10.1021/acs.estlett.6b00398. /wiki/Bibcode_(identifier) ↩

  22. "GenX Timeline". NCDEQ. Archived from the original on December 24, 2018. Retrieved April 22, 2018. https://web.archive.org/web/20181224080952/https://deq.nc.gov/news/hot-topics/genx-investigation/genx-timeline ↩

  23. Clabby, Catherine (November 2, 2017). "Newest GenX Lawsuit Attacks DuPont Science". Chapel Hill, NC: North Carolina Health News. https://www.northcarolinahealthnews.org/2017/11/02/newest-genx-lawsuit-attacks-dupont-science/ ↩

  24. "PFAS - Cape Fear River Watch". September 20, 2019. https://capefearriverwatch.org/genx/ ↩

  25. Alder, Cole (May 16, 2018). "Cape Fear River Watch to file suit against Chemours". Per- and Polyfluoroalkyl Substances; News. Boston, MA: Northeastern University, Social Science Environmental Health Research Institute. https://pfasproject.com/2018/05/16/cape-fear-river-watch-to-file-suit-against-chemours/ ↩

  26. "PFAS - Cape Fear River Watch". September 20, 2019. https://capefearriverwatch.org/genx/ ↩

  27. "Consent Order Compliance". https://www.chemours.com/en/about-chemours/global-reach/fayetteville-works/compliance-testing ↩

  28. "PFAS - Cape Fear River Watch". September 20, 2019. https://capefearriverwatch.org/genx/ ↩

  29. "Str_Error_Page_Title". https://edocs.deq.nc.gov/WaterResources/DocView.aspx?id=611983&dbid=0&repo=WaterResources&searchid=627d7915-27f4-4e8b-beb3-ec53cd75941b ↩

  30. "Welcome to the GenX Exposure Study". GenX Exposure Study. North Carolina State University. Retrieved June 23, 2025. https://genxstudy.ncsu.edu/ ↩

  31. Matheny, Keith (August 3, 2020). "Michigan's drinking water standards for these chemicals now among toughest in nation". Detroit Free Press. Archived from the original on January 31, 2022. Retrieved March 31, 2022. https://www.freep.com/story/news/local/michigan/2020/08/03/tougher-pfas-standards-drinking-water-michigan/5574268002/ ↩

  32. "New state drinking water standards pave way for expansion of Michigan's PFAS clean-up efforts". Michigan.gov. August 3, 2020. Archived from the original on January 3, 2022. Retrieved April 5, 2022. https://www.michigan.gov/egle/0,9429,7-135--535602--,00.html ↩

  33. "Source of 'forever chemical' in the Roanoke River traced to Elliston plant". November 10, 2022. https://roanoke.com/news/local/source-of-forever-chemical-in-the-roanoke-river-traced-to-elliston-plant/article_e7953262-613e-11ed-baad-bb83787f5da8.html ↩

  34. Ahearn, Ashley (March 24, 2019). "A Regrettable Substitute: The Story of GenX". Podcasts: The Researcher's Perspective. 2019 (1). doi:10.1289/EHP5134. ISSN 2169-2181. https://doi.org/10.1289%2FEHP5134 ↩

  35. "US EPA deems two GenX PFAS chemicals more toxic than PFOA". Chemical & Engineering News. Retrieved October 14, 2024. https://cen.acs.org/environment/persistent-pollutants/US-EPA-deems-two-GenX-PFAS-chemicals-more-toxic-than-PFOA/99/i40 ↩

  36. "Fact Sheet: Human Health Toxicity Assessment for GenX Chemicals" (PDF). United States Environmental Protection Agency. March 2023. Retrieved October 14, 2024. https://www.epa.gov/system/files/documents/2023-03/GenX-Toxicity-Assessment-factsheet-March-2023-update.pdf ↩

  37. "Basic Information on PFAS". PFOA, PFOS and Other PFASs. Washington, D.C.: U.S. Environmental Protection Agency (EPA). February 18, 2018. https://www.epa.gov/pfas/basic-information-pfas ↩

  38. Caverly Rae, JM; Craig, Lisa; Stone, Theodore W.; Frame, Steven R.; Buxton, L. William; Kennedy, Gerald L. (2015). "Evaluation of chronic toxicity and carcinogenicity of ammonium 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)-propanoate in Sprague–Dawley rats". Toxicology Reports. 2: 939–949. Bibcode:2015ToxR....2..939C. doi:10.1016/j.toxrep.2015.06.001. PMC 5598527. PMID 28962433. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598527 ↩

  39. Caverly Rae, JM; Craig, Lisa; Stone, Theodore W.; Frame, Steven R.; Buxton, L. William; Kennedy, Gerald L. (2015). "Evaluation of chronic toxicity and carcinogenicity of ammonium 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)-propanoate in Sprague–Dawley rats". Toxicology Reports. 2: 939–949. Bibcode:2015ToxR....2..939C. doi:10.1016/j.toxrep.2015.06.001. PMC 5598527. PMID 28962433. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598527 ↩

  40. Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225 ↩

  41. Zhang, Qin-Yao; Xu, Ling-Ling; Zhong, Mei-Ting; Chen, Yu-Kui; Lai, Ming-Quan; Wang, Qi; Xie, Xiao-Li (2024). "Gestational GenX and PFOA exposures induce hepatotoxicity, metabolic pathway, and microbiome shifts in weanling mice". Science of the Total Environment. 907. Elsevier BV: 168059. Bibcode:2024ScTEn.90768059Z. doi:10.1016/j.scitotenv.2023.168059. ISSN 0048-9697. PMID 37884144. /wiki/Bibcode_(identifier) ↩

  42. Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225 ↩

  43. Xu, Ling-Ling; Chen, Yu-Kui; Zhang, Qin-Yao; Chen, Li-Jian; Zhang, Kai-Kai; Li, Jia-Hao; Liu, Jia-Li; Wang, Qi; Xie, Xiao-Li (2022). "Gestational exposure to GenX induces hepatic alterations by the gut-liver axis in maternal mice: A similar mechanism as PFOA". Science of the Total Environment. 820. Elsevier BV: 153281. Bibcode:2022ScTEn.82053281X. doi:10.1016/j.scitotenv.2022.153281. ISSN 0048-9697. PMID 35066053. /wiki/Bibcode_(identifier) ↩

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  45. "FACT SHEET: GenX Chemicals Toxicity Assessment - March 2023 Update" (PDF). US EPA. Retrieved October 15, 2024. https://www.epa.gov/system/files/documents/2023-03/GenX-Toxicity-Assessment-factsheet-March-2023-update.pdf ↩

  46. Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225 ↩

  47. Caverly Rae, JM; Craig, Lisa; Stone, Theodore W.; Frame, Steven R.; Buxton, L. William; Kennedy, Gerald L. (2015). "Evaluation of chronic toxicity and carcinogenicity of ammonium 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy)-propanoate in Sprague–Dawley rats". Toxicology Reports. 2: 939–949. Bibcode:2015ToxR....2..939C. doi:10.1016/j.toxrep.2015.06.001. PMC 5598527. PMID 28962433. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598527 ↩

  48. Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225 ↩

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  50. Chappell, Grace A.; Thompson, Chad M.; Wolf, Jeffrey C.; Cullen, John M.; Klaunig, James E.; Haws, Laurie C. (March 6, 2020). "Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks". Toxicologic Pathology. 48 (3). SAGE Publications: 494–508. doi:10.1177/0192623320905803. ISSN 0192-6233. PMC 7153225. PMID 32138627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153225 ↩

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