ORIGINAL ARTICLE

Mortality of employees of a perfluorooctanesulphonyl fluoride manufacturing facility

B H Alexander¹, G W Olsen², J M Burris², J H Mandel², J S Mandel³

¹ University of Minnesota, School of Public Health, Division of Environmental and Occupational Health, MMC 807 Mayo Building, 420 Delaware St, SE Minneapolis, MN 55409, USA
² 3M Company, Medical Department, Saint Paul, MN, USA
³ Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, USA

Correspondence to:
Correspondence to:
Dr B H Alexander
University of Minnesota, School of Public Health, Division of Environmental and Occupational Health, MMC 807 Mayo Building, 420 Delaware St, SE Minneapolis, MN 55409, USA; balex{at}umn.edu

Aim: To evaluate the mortality experience of a cohort of employees of a perfluorooctanesulphonyl fluoride (POSF) based fluorochemical production facility.

Methods: A retrospective cohort mortality study followed all workers with at least one year of cumulative employment at the facility. The jobs held by cohort members were assigned to one of three exposure subgroups; high exposed, low exposed, and non-exposed, based on biological monitoring data for perfluorooctane sulphonate (PFOS).

Results: A total of 145 deaths were identified in the 2083 cohort members. Sixty five deaths occurred among workers ever employed in high exposed jobs. The overall mortality rates for the cohort and the exposure subcohorts were lower than expected in the general population. Two deaths from liver cancer were observed in the workers with at least one year of high or low exposure (standardised mortality ratio (SMR) 3.08, 95% CI 0.37 to 11.10). The risk of death from bladder cancer was increased for the entire cohort (three observed, SMR 4.81, 95% CI 0.99 to 14.06). All three bladder cancers occurred among workers who held a high exposure job (SMR 12.77, 95% CI 2.63 to 37.35). The bladder cancer cases primarily worked in non-production jobs, including maintenance and incinerator and wastewater treatment plant operations.

Conclusion: Workers employed in high exposure jobs had an increased number of deaths from bladder cancer; however it is not clear whether these three cases can be attributed to fluorochemical exposure, an unknown bladder carcinogen encountered during the course of maintenance work, and/or non-occupational exposures. With only three observed cases the possibility of a chance finding cannot be ruled out.

Keywords: fluorochemicals; perfluroroctane sulphonate; bladder cancer; mortality

Abbreviations: CI, confidence interval; ICD, International Classification of Disease; NDI, National Death Index; N-EtFOSE, N-ethylperfluorooctane sulphonamide alcohol; PFOA, perfluorooctanoic acid; PFOS, perfluorooctane sulphonate; POSF, perfluorooctanesulphonyl fluoride; SMR, standardised mortality ratio

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