title: The C8 health project: design, methods, and participants.
abstract: BACKGROUND
  The 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.
  
  
  OBJECTIVE
  This 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.
  
  
  METHODS
  Final 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Department of Community Medicine, West Virginia University School of Medicine, Morgantown, West Virginia 26506-9105, USA. sfrisbee@hsc.wvu.edu
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Frisbee
authors.forename: A Paul
authors.initials: AP
authors.lastname: Brooks
authors.forename: Arthur
authors.initials: A
authors.lastname: Maher
authors.forename: Patsy
authors.initials: P
authors.lastname: Flensborg
authors.forename: Susan
authors.initials: S
authors.lastname: Arnold
authors.forename: Tony
authors.initials: T
authors.lastname: Fletcher
authors.forename: Kyle
authors.initials: K
authors.lastname: Steenland
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Knox
authors.forename: Cecil
authors.initials: C
authors.lastname: Pollard
authors.forename: Joel A
authors.initials: JA
authors.lastname: Halverson
authors.forename: Verónica M
authors.initials: VM
authors.lastname: Vieira
authors.forename: Chuanfang
authors.initials: C
authors.lastname: Jin
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Leyden
authors.forename: Alan M
authors.initials: AM
authors.lastname: Ducatman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002210:Caprylates / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004784:Environmental Monitoring; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012107:Research Design; D012727:Sex Characteristics; D014874:Water Pollutants, Chemical / Q000097:blood*; D014881:Water Supply / Q000032:analysis*
chemical_list: D002210:Caprylates; D005466:Fluorocarbons; D014874:Water Pollutants, Chemical; C023036:perfluorooctanoic acid