Mortality and cancer incidence in ammonium perfluorooctanoate production workers

Abstract

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.

Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health

“…We identified 14 studies investigating PFAS exposure and kidney function, of which three (21%) used indirect exposure assessments and 11 (79%) used directly measured PFAS serum concentrations, with two additionally using indirect model-based estimates. None of the studies using indirect exposure estimates demonstrated associations with CKD prevalence or kidney function, including a 30-year prospective study of only 53 adults finding no association with serum creatinine (7,11,(25)(26)(27). We identified no studies investigating proteinuria outcomes.…”

Per- and polyfluorinated substances (PFASs): Environmental challenges

“…serum PFOA concentration 350 ng/mL; general population ~4 ng/nL) reported an increase of malignant and non-malignant renal diseases, but on limited numbers, and no exposure/response trend for diabetes or ischemic heart disease [278]. The most recent evaluation of mortality and cancer incidence in APFO production workers found no association between APFO exposure and risk of prostate and kidney cancer, diabetes and stroke [279]. The study was not powerful enough to evaluate the risk of testicular, thyroid, bladder, liver and pancreas cancers.…”

Reliability of perfluoroalkyl substances in plasma of 100 women in two consecutive pregnancies

“…The potential for health effects from exposure to PFAS is under active investigation in various settings including occupational exposure, communities with above-average exposure, and background-exposed populations (Barry et al, 2013; Geiger et al, 2014; Raleigh et al,2014; Steenland et al, 2013; Uhl et al, 2013; Winquist and Steenland 2014). Many of the epidemiological findings on PFAS exposure and disease are affected by the long-term reliability of a single measurement of plasma or serum PFASs concentration.…”