Perfluorooctanoic Acid Exposure and Cancer Outcomes in a Contaminated Community: A Geographic Analysis

Verónica M. Vieira,^1,2 Kate Hoffman,^1,3 Hyeong-Moo Shin,^4,5 Janice M. Weinberg,⁶ Thomas F. Webster,¹ and Tony Fletcher⁷

¹Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA; ²Program in Public Health, Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, California, USA; ³Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; ⁴School of Social Ecology, University of California, Irvine, Irvine, California, USA; ⁵Department of Public Health Sciences, University of California, Davis, Davis, California, USA; ⁶Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA; ⁷Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom

Abstract

Background: Perfluorooctanoic acid (PFOA) has been linked to cancer in occupational mortality studies and animal toxicologic research.

Objective: We investigated the relationship between PFOA exposure and cancer among residents living near the DuPont Teflon-manufacturing plant in Parkersburg, West Virginia (WV).

Methods: Our analyses included incident cases of 18 cancers diagnosed from 1996 through 2005 in five Ohio (OH) counties and eight WV counties. For analyses of each cancer outcome, controls comprised all other cancers in the study data set except kidney, pancreatic, testicular, and liver cancers, which have been associated with PFOA in animal or human studies. We applied logistic regression models to individual-level data to calculate adjusted odds ratios (AORs) and confidence intervals (CIs). For the combined analysis of OH and WV data, the exposure of interest was resident water district. Within OH, geocoded addresses were integrated with a PFOA exposure model to examine the relationship between cancer odds and categories of estimated PFOA serum.

Results: Our final data set included 7,869 OH cases and 17,238 WV cases. There was a positive association between kidney cancer and the very high and high serum exposure categories [AOR = 2.0 (95% CI: 1.0, 3.9) n = 9 and 2.0 (95% CI: 1.3, 3.2) n = 22, respectively] and a null association with the other exposure categories compared with the unexposed. The largest AOR was for testicular cancer with the very high exposure category [2.8 (95% CI: 0.8, 9.2) n = 6], but there was an inverse association with the lower exposure groups, and all estimates were imprecise because of small case numbers.

Conclusions: Our results suggest that higher PFOA serum levels may be associated with testicular, kidney, prostate, and ovarian cancers and non-Hodgkin lymphoma. Strengths of this study include near-complete case ascertainment for state residents and well-characterized contrasts in predicted PFOA serum levels from six contaminated water supplies.

Key words: C8, GIS, kidney cancer, PFOA, testicular cancer.

Environ Health Perspect 121:318–323 (2013). http://dx.doi.org/10.1289/ehp.1205829 [Online 8 January 2013]

Address correspondence to V.M. Vieira, Program in Public Health, AIRB 2042, University of California, Irvine, Irvine, CA 92697 USA. Telephone: (949) 824-7017. E-mail: vvieira@uci.edu

Supplemental Material is available online (http://dx.doi.org/10.1289/ehp.1205829).

We gratefully acknowledge the staff at the West Virginia Cancer Registry (Office of Epidemiology and Prevention Services, Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV) and the Ohio Cancer Incidence Surveillance System (OCISS), Ohio Department of Health (ODH), for their assistance with the cancer data.

The project was supported by the C8 Class Action Settlement Agreement (Circuit Court of Wood County, WV) between DuPont and plaintiffs, which resulted from releases into drinking water of the chemical perfluorooctanoic acid (PFOA, or C8). Funds were administered by the Garden City Group (Melville, NY), which reports to the court.

OCISS is a registry participating in the National Program of Cancer Registries of the Centers for Disease Control and Prevention (CDC). Use of these data does not imply ODH or CDC either agrees or disagrees with any presentations, analyses, interpretations, or conclusions. Our work and conclusions are independent of either party to the C8 Class Action lawsuit.

The authors declare they have no actual or potential competing financial interests.

Received 28 July 2012; Accepted 7 January 2013; Online 8 January 2013.