BackgroundThe C8 Health Project was created, authorized, and funded as part of the settlement agreement reached in the case of Jack W. Leach, et al. v. E.I. du Pont de Nemours & Company (no. 01-C-608 W.Va., Wood County Circuit Court, filed 10 April 2002). The settlement stemmed from the perfluorooctanoic acid (PFOA, or C8) contamination of drinking water in six water districts in two states near the DuPont Washington Works facility near Parkersburg, West Virginia.ObjectivesThis study reports on the methods and results from the C8 Health Project, a population study created to gather data that would allow class members to know their own PFOA levels and permit subsequent epidemiologic investigations.MethodsFinal study participation was 69,030, enrolled over a 13-month period in 2005–2006. Extensive data were collected, including demographic data, medical diagnoses (both self-report and medical records review), clinical laboratory testing, and determination of serum concentrations of 10 perfluorocarbons (PFCs). Here we describe the processes used to collect, validate, and store these health data. We also describe survey participants and their serum PFC levels.ResultsThe population geometric mean for serum PFOA was 32.91 ng/mL, 500% higher than previously reported for a representative American population. Serum concentrations for perfluorohexane sulfonate and perfluorononanoic acid were elevated 39% and 73% respectively, whereas perfluorooctanesulfonate was present at levels similar to those in the U.S. population.ConclusionsThis largest known population study of community PFC exposure permits new evaluations of associations between PFOA, in particular, and a range of health parameters. These will contribute to understanding of the biology of PFC exposure. The C8 Health Project also represents an unprecedented effort to gather basic data on an exposed population; its achievements and limitations can inform future legal settlements for populations exposed to environmental contaminants.

• Smoke-free environments are a key element in a comprehensive approach to tobacco control, contributing to reductions in smoking prevalence and protecting the health of non-smokers and ex-smokers alike • Smoke-free environments have been one of the great success stories in tobacco control in Australia, however implementation of smoke-free environments across the country has lacked consistency • E-cigarettes are challenging the ways we think about 'smoke-free', and have the capacity to undermine smoke-free successes if regulation does not prevent their use in smoke-free environments

Aim:.This study aims to describe the perceived ease of accessing tobacco retail outlets in New South Wales (NSW), Australia, and the sociodemographic factors associated with reported higher density of tobacco retail outlets. Methods: A cross-sectional online survey was conducted with a sample of NSW adults in February 2019. The accessibility of cigarettes was assessed and a binary logistic regression model was used to examine characteristics associated with having four or more retailers within a 5-minute drive of their home. Results: A total of 3213 NSW adults completed the survey. The vast majority of participants, 89.9% (n = 2888), described cigarettes as being easily accessed from where they live. Half of the participants (50.7%) reported having four or more tobacco retail outlets within a 5-minute drive of their home. Never-smokers were significantly less likely than daily smokers to report four or more tobacco retailers within a 5-minute drive of their home, although non-smokers may be less likely to identify tobacco retailers. Females, those living in regional areas of NSW and those with a university qualification were also less likely to report having four or more tobacco retailers within a 5-minute drive of their home. Conclusion: The ease of access to tobacco retailers in NSW is incongruent with the significant health risks associated with tobacco use and highlights the need for measures to reduce the supply of tobacco, such as a fee-based tobacco licensing system.