ObjectiveTo evaluate mortality and cancer incidence in a cohort of ammonium perfluorooctanoate (APFO) exposed workers.MethodsWe linked a combined cohort (n=9027) of employees from APFO and non-APFO production facilities in Minnesota to the National Death Index and to cancer registries of Minnesota and Wisconsin. Industrial hygiene data and expert evaluation were used to create a task-based job exposure matrix to estimate APFO exposure. Standardised mortality ratios were estimated using Minnesota population rates. HRs and 95% CIs for time-dependent cumulative APFO exposure were estimated with an extended Cox model. A priori outcomes of interest included cancers of the liver, pancreas, testes, kidney, prostate and breast, and mortality from cardiovascular, cerebrovascular and chronic renal diseases.ResultsMortality rates in the APFO-exposed cohort were at or below the expected, compared with Minnesota. The HR for dying from the cancer and non-cancer outcomes of interest did not show an association with APFO exposure. Similarly, there was little evidence that the incident cancers were associated with APFO exposure. Compared to the non-exposed population, modestly elevated, but quite imprecise HRs were observed in the higher-exposure quartiles for bladder cancer (HR=1.66, 95% CI 0.86 to 3.18) and pancreatic cancer (HR=1.36, 95% CI 0.59 to 3.11). No association was observed between APFO exposure and kidney, prostate or breast cancers.ConclusionsThis analysis did not support an association between occupational APFO exposure and the evaluated health endpoints, however, the study had limited power to evaluate some conditions of interest.

Background: Community exposure to asbestos from contaminated vermiculite ore from Libby, Montana, occurred in many processing sites in the United States, including a densely populated urban residential neighborhood of Minneapolis, Minnesota.Objective: We examined exposed community residents who never worked at the plant or never lived with a plant worker for radiographic evidence of lung changes consistent with asbestos exposure.Methods: We obtained posteroanterior chest radiographs to identify the prevalence of pleural abnormalities consistent with pneumoconiosis, as determined by consensus of two National Institute for Occupational Safety and Health–certified B-reader radiologists. We estimated cumulative asbestos exposure (fibers per cubic centimeters × months) with air dispersion model data and activity-based modeled exposure estimates for vermiculite processing waste contact. We modeled associations between pleural abnormalities and asbestos exposure using multiple logistic regression to adjust for year of birth, sex, and potential occupational asbestos exposure.Results: Radiographs were obtained for 461 participants. The prevalence of pleural abnormalities by B-reader consensus was 10.8%. A history of direct contact with the waste and ever playing in the waste piles was associated with pleural abnormalities {odds ratio [OR] 2.78 [95% confidence interval (CI): 1.26, 6.10] and 2.17 (95% CI: 0.99, 4.78), respectively, when adjusted for background exposure}. The regression coefficients for log-transformed measures (fibers per cubic centimeters × months) of background exposure and activity-based exposure were 0.322 (95% CI: 0.078, 0.567) and 0.063 (95% CI: –0.013, 0.139), respectively, when adjusted for each other, and 0.283 (95% CI: 0.104, 0.463) for cumulative exposure from all sources.Conclusion: These results support the hypothesis that community exposure to asbestos-contaminated vermiculite originating from Libby, Montana, is associated with measurable effects based on radiographic evidence.

Contaminated vermiculite ore from Libby, Montana was processed in northeast Minneapolis from 1936 to 1989 in a densely populated urban residential neighborhood, resulting in non-occupational exposure scenarios from plant stack and fugitive emissions as well as from activity-based scenarios associated with use of the waste rock in the surrounding community. The objective of this analysis was to estimate potential cumulative asbestos exposure for all non-occupationally exposed members of this community. Questionnaire data from a neighborhood-exposure assessment ascertained frequency of potential contact with vermiculite processing waste. Monte Carlo simulation was used to develop exposure estimates based on activity-based concentration estimates and contact durations for four scenarios: S1, moved asbestos-contaminated waste; S2, used waste at home, on lawn or garden; S3, installed/removed vermiculite insulation; S4, played in or around waste piles at the plant. The simulation outputs were combined with air-dispersion model results to provide total cumulative asbestos exposure estimates for the cohort. Fiber emissions from the plant were the largest source of exposure for the majority of the cohort, with geometric mean cumulative exposures of 0.02 fibers/cc × month. The addition of S1, S2 and S3 did not significantly increase total cumulative exposure above background exposure estimates obtained from dispersion modeling. Activity-based exposures were a substantial contributor to the upper end of the exposure distribution: 90th percentile S4 exposure estimates are ∼10 times higher than exposures from plant emissions. Pile playing is the strongest source of asbestos exposure in this cohort, with other activity scenarios contributing less than from plant emissions.

No abstract