Mortality and cancer incidence in perfluorooctanesulfonyl fluoride production workers.

BACKGROUND: Exposure to per- and polyfluoroalkyl substances (PFAS) has been associated with several health outcomes, though few occupationally-exposed populations have been studied. We evaluated mortality and cancer incidence in a cohort of perfluorooctanesulfonyl fluoride-based specialty chemical manufacturing workers. METHODS: The cohort included any employee who ever worked at the facility from 1961 to 2010 (N = 4045), with a primary interest in those who had 365 cumulative days of employment (N = 2659). Vital status and mortality records were obtained through 2014 and the cohort was linked to state cancer registries to obtain incident cancer cases from 1995 to 2014. Cumulative exposure was derived from a comprehensive exposure reconstruction that estimated job-specific perfluorooctanesulfonate (PFOS)-equivalents (mg/m3 ) exposure. Overall and exposure-specific standardized mortality ratios (SMR) were estimated in reference to the US population. Hazard ratios (HRs) and 95% confidence interval (CI) for cumulative PFOS-equivalent exposure (log2 transformed) were estimated within the cohort for specific causes of death and incident cancers using a time-dependent Cox model. RESULTS: Death rates were lower than expected except for cerebrovascular disease (SMR = 2.42, 95% CI = 1.25-4.22) and bladder cancer (SMR = 3.91, 95% CI = 1.07-10.02) in the highest exposure quartile. Within the cohort, the incidence of bladder, colorectal, and pancreatic cancer were positively associated with exposure, however except for lung cancer (HR = 1.05, 95% CI = 1.00-1.11) the CIs did not exclude an HR of 1. CONCLUSIONS: This study provides some evidence that occupational exposure to PFOS is associated with bladder and lung cancers and with cerebrovascular disease.

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.

Comparative emissions of random orbital sanding between conventional and self-generated vacuum systems.

Conventional abrasive sanding generates high concentrations of particles. Depending on the substrate being abraded and exposure duration, overexposure to the particles can cause negative health effects ranging from respiratory irritation to cancer. The goal of this study was to understand the differences in particle emissions between a conventional random orbital sanding system and a self-generated vacuum random orbital sanding system with attached particle filtration bag. Particle concentrations were sampled for each system in a controlled test chamber for oak wood, chromate painted (hexavalent chromium) steel panels, and gel-coated (titanium dioxide) fiberglass panels using a Gesamtstaub-Probenahmesystem (GSP) sampler at three different locations adjacent to the sanding. Elevated concentrations were reported for all particles in the samples collected during conventional sanding. The geometric mean concentration ratios for the three substrates ranged from 320 to 4640 times greater for the conventional sanding system than the self-generated vacuum sanding system. The differences in the particle concentration generated by the two sanding systems were statistically significant with the two sample t-test (P < 0.0001) for all three substances. The data suggest that workers using conventional sanding systems could utilize the self-generated vacuum sanding system technology to potentially reduce exposure to particles and mitigate negative health effects.

Cohort mortality study of roofing granule mine and mill workers. Part II. Epidemiologic analysis, 1945-2004.

The mortality of 2650 employees (93.4% males) in the mine and mill production of roofing granules at four plants was examined between 1945 and 2004. Hypotheses focused on diseases associated with exposure to silica: nonmalignant respiratory disease, lung cancer, and nonmalignant renal disease. Study eligibility required ≥ 1 year of employment by 2000. Work history and vital status were followed through 2004 with < 1% lost to follow-up. Industrial hygiene sampling data (1871 sampling measurements over a 32-year period) and professional judgment were used to construct 15 respirable crystalline silica exposure categories. A category was assigned to all plant-, department-, and time-dependent standard job titles. Cumulative respirable crystalline silica exposure (mg/m(3)-years) was calculated as the sum of the product of time spent and the average exposure for each plant-, department-, job-, and calendar-year combination. The cohort geometric mean was 0.17 mg/m(3)-years (geometric standard deviation 4.01) and differed by plant. Expected deaths were calculated using U.S. (entire cohort) and regional (each plant) mortality rates. Poisson regression was used for internal comparisons. For the entire cohort, 772 deaths (97.4% males) were identified (standardized mortality ratio 0.95, 95% CI 0.88-1.02). There were 50 deaths from nonmalignant respiratory diseases (1.14, 95% CI 0.85-1.51). Lagging exposure 15 years among the male cohort, the relative risks for nonmalignant respiratory disease were 1.00 (reference), 0.80, 1.94, and 2.03 (p value trend = 0.03) when cumulative exposure was categorized < 0.1, 0.1- < 0.5, 0.5- < 1.0, and ≥ 1.0 mg/m(3)-years, respectively. There was a total of 77 lung cancer deaths (1.11, 95% CI 0.88-1.39). Lagging exposure 15 years, the relative risks for males were 1.00 (reference), 1.83, 1.83, and 1.05 (p value trend = 0.9). There were 16 deaths from nonmalignant renal disease (1.76, 95% CI 1.01-2.86). This exposure-response trend was suggestive but imprecise. The study results are consistent with other cohorts with similar levels of exposure to respirable crystalline silica.

Desktop study of occupational exposure judgments: do education and experience influence accuracy?

This study examines the impact of several experience and education determinants on exposure judgment accuracy. The study used desktop assessments performed on several different tasks with different exposure profiles to identify correlations between determinants and judgment accuracy using logistic regression models. The exposure judgments were elicited from industrial hygienists with varying levels of experience, education, and training. Videos and written and oral information about the exposure tasks were presented to all participants as they documented a series of qualitative and quantitative exposure judgment probabilities in four exposure categories. Participants (n = 77) first documented their qualitative and then their quantitative exposure assessments after receiving the series of sampling data points. Data interpretation tests and training in simple rules-of-thumb for data interpretation were also given to each participant to investigate the impact of data interpretation skills on exposure judgment accuracy. Logistic regression analysis indicated "years of exposure assessment experience" (p < 0.05), "highest EHS degree" (p < 0.05), and a participant's "data interpretation test score" (p < 0.05) directly impacted qualitative exposure judgment accuracy. Logistic regression models of quantitative judgment accuracy showed positive correlation with "greater than 10 years of exposure assessment experience" (p < 0.05), "highest EHS degree" (p < 0.05), a participant's "data interpretation test score" (p < 0.001), rules-of-thumb data interpretation training (p < 0.001), and the number of sample data points available for a judgment (p < 0.005). Analyzing judgments in subsets for participants with less or more than 10 years' experience indicated additional correlations with Certified Industrial Hygienist and Certified Safety Professional certifications, total number of task exposure assessments, and career number of air surveys. The correlation of qualitative and quantitative exposure judgment accuracy with "greater than 10 years experience" supports similar research findings from other fields. The results of this study indicate that several determinants of experience, education, and training, in addition to the availability of sampling data, significantly impact the accuracy of exposure assessments. The findings also suggest methods for enhancing exposure judgment accuracy through statistical tools, mathematical exposure modeling, and specific training.

An occupational exposure assessment of a perfluorooctanesulfonyl fluoride production site: biomonitoring.

This investigation randomly sampled a fluorochemical manufacturing employee population to determine the distribution of serum fluorochemical levels according to employees' jobs and work areas. Previous analyses of medical surveillance data have not shown significant associations between fluorochemical production employees' clinical chemistry and hematology tests and their serum PFOS and perfluorooctanoate (PFOA, C(7)F(15)COO(-)) concentrations, but may have been subject to nonparticipation bias. A random sample of the on-site film plant employee population, where fluorochemicals are not produced, determined their serum concentrations also. Of the 232 employees randomly selected for serum sampling, 186 (80%) employees participated (n=126 chemical plant; n=60 film plant). Sera samples were extracted using an ion-pairing extraction procedure and were quantitatively analyzed for seven fluorochemicals using high-pressure liquid chromatography electrospray tandem mass spectrometry methods. Geometric means (in parts per million) and 95% confidence intervals (in parentheses) of the random sample of 126 chemical plant employees were: PFOS 0.941 (0.787-1.126); PFOA 0.899 (0.722-1.120); perfluorohexanesulfonate 0.180 (0.145-0.223); N-ethyl perfluorooctanesulfonamidoacetate 0.008 (0.006-0.011); N-methyl perfluorooctanesulfonamidoacetate 0.081 (0.067-0.098); perfluorooctanesulfonamide 0.013 (0.009-0.018); and perfluorooctanesulfonamidoacetate 0.022 (0.018-0.029). These geometric means were approximately one order of magnitude higher than those observed for the film plant employees.