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Workplace
Original article
Mortality and cancer incidence in ammonium perfluorooctanoate production workers
  1. Katherine K Raleigh1,
  2. Bruce H Alexander1,
  3. Geary W Olsen2,
  4. Gurumurthy Ramachandran1,
  5. Sandy Z Morey3,
  6. Timothy R Church1,
  7. Perry W Logan2,
  8. Laura L F Scott1,
  9. Elizabeth M Allen1
  1. 1Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
  2. 23M Company, Saint Paul, Minnesota, USA
  3. 3More Consulting, Inc., Saint Paul, Minnesota, USA
  1. Correspondence to Dr Bruce H Alexander, Division of Environmental health Sciences, School of Public Health, University of Minnesota, MMC 807 Mayo Building, 420 Delaware Street S.E., Minneapolis, MN 55455, USA; balex{at}umn.edu

Abstract

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.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/oemed-2014-102109

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