Research Article Advance Publication
Environ Health Perspect; DOI:10.1289/ehp.1510391
Modeled Perfluorooctanoic Acid (PFOA) Exposure and Liver Function in a Mid-Ohio Valley Community
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Background: Perfluorooctanoic acid (PFOA or C8) has hepatotoxic effects in animals. Cross-sectional epidemiologic studies suggest PFOA is associated with liver injury biomarkers.
Objectives: We estimated associations between modeled historical PFOA exposures and liver injury biomarkers and medically-validated liver disease.
Methods: Participants completed surveys during 2008-2011 reporting demographic, medical, and residential history information. Self-reported liver disease, including hepatitis, fatty liver, enlarged liver and cirrhosis, was validated with healthcare providers. Alanine aminotransferase (ALT), γ-glutamyltransferase (GGT) and direct bilirubin, markers of liver toxicity, were obtained from blood samples collected in the C8 Health Project (2005-2006). Historically modeled PFOA exposure, estimated using environmental fate and transport models and participant residential histories, was analyzed in relation to liver biomarkers (n=30,723, including 1892 workers) and liver disease (n=32,254, including 3713 workers).
Results: Modeled cumulative serum PFOA was positively associated with ALT levels (p for trend <0.0001), indicating possible liver toxicity. An increase from the first to the fifth quintile of cumulative PFOA exposure was associated with a 6% increase in ALT levels (95%CI: 4-8%) and a 16% increased odds of having above-normal ALT (95%CI odds ratio: 1.02-1.33%). There was no indication of association with either elevated direct bilirubin or GGT; however, PFOA was associated with decreased direct bilirubin. We observed no evidence of an effect of cumulative exposure (with or without a 10-year lag) on all liver disease (n=647 cases), nor on enlarged liver, fatty liver and cirrhosis only (n=427 cases).
Conclusion: Results are consistent with previous cross-sectional studies showing association between PFOA and ALT, a marker of hepatocellular damage. We did not observe evidence that PFOA increases the risk of clinically-diagnosed liver disease.
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Citation: Darrow LA, Groth AC, Winquist A, Shin HM, Bartell SM, Steenland K. Modeled Perfluorooctanoic Acid (PFOA) Exposure and Liver Function in a Mid-Ohio Valley Community. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1510391
Received: 26 June 2015
Accepted: 22 February 2016
Advance Publication: 15 March 2016
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