Mortality and cancer incidence in ammonium perfluorooctanoate production workers.
OBJECTIVE
To evaluate mortality and cancer incidence in a cohort of ammonium perfluorooctanoate (APFO) exposed workers.


METHODS
We 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.


RESULTS
Mortality 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.


CONCLUSIONS
This 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.
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Katherine K
KK
Raleigh
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Bruce H
BH
Alexander
3M Company, Saint Paul, Minnesota, USA.
Geary W
GW
Olsen
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Gurumurthy
G
Ramachandran
More Consulting, Inc., Saint Paul, Minnesota, USA.
Sandy Z
SZ
Morey
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Timothy R
TR
Church
3M Company, Saint Paul, Minnesota, USA.
Perry W
PW
Logan
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Laura L F
LL
Scott
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Elizabeth M
EM
Allen
D000328:Adult; D000368:Aged; D064751:Ammonium Compounds / Q000009:adverse effects; D002210:Caprylates / Q000009:adverse effects; D002617:Chemical Industry; D015331:Cohort Studies; D005260:Female; D005466:Fluorocarbons / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D009784:Occupational Diseases / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D009790:Occupations; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D014922:Wisconsin / Q000453:epidemiology
D064751:Ammonium Compounds; D002210:Caprylates; D005466:Fluorocarbons; C023036:perfluorooctanoic acid