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.

Perfluorooctanoic acid (PFOA) has been detected in environmental samples in Ohio and West Virginia near the Washington Works Plant in Parkersburg, West Virginia. This paper describes retrospective fate and transport modeling of PFOA concentrations in local air, surface water, groundwater, and six municipal water systems based on estimates of historic emission rates from the facility, physicochemical properties of PFOA, and local geologic and meteorological data beginning in 1951. We linked several environmental fate and transport modeling systems to model PFOA air dispersion, transit through the vadose zone, surface water transport, and groundwater flow and transport. These include AERMOD, PRZM-3, BreZo, MODFLOW, and MT3DMS. Several thousand PFOA measurements in municipal well water have been collected in this region since 1998. Our linked modeling system performs better than expected, predicting water concentrations within a factor of 2.1 of the average observed water concentration for each of the six municipal water districts after adjusting the organic carbon partition coefficient to fit the observed data. After model calibration, the Spearman's rank correlation coefficient for predicted versus observed water concentrations is 0.87. These models may be useful for estimating past and future public well water PFOA concentrations in this region.

Background We assessed the association between perfluorooctanoic acid (PFOA) and pregnancy outcome in an area with elevated exposure to PFOA from drinking water contaminated by chemical plant releases. Methods Serum PFOA was measured and reproductive and residential histories were obtained in 2005 – 2006. We estimated serum PFOA levels at the time of pregnancy for 11,737 pregnancies occurring between 1990 and 2006 based on historical information on PFOA releases, environmental distribution, pharmacokinetic modeling, and residential histories. We assessed the association between PFOA and the odds of miscarriage, stillbirth, preeclampsia, preterm birth, term low birthweight, and birth defects controlling for calendar time, age, parity, education, and smoking. PFOA exposure was evaluated as a continuous measure (with and without log-transformation) and in quintiles, combining the lowest two quintiles (<6.8 ng/mL) as the referent. Results Measures of association between PFOA and miscarriage, preterm birth, term low birthweight, and birth defects were close to the null. Odds of stillbirth were elevated in the 4th quintile only. For preeclampsia, the odds ratio was 1.13 (95% confidence interval = 1.00 – 1.28) for an interquartile shift in log-transformed PFOA, and the odds ratios were 1.1 – 1.2 across the upper three quintiles of exposure. Conclusions In this large, population-based study in a region with markedly elevated PFOA exposure, we found no associations between estimated serum PFOA levels and adverse pregnancy outcomes other than possibly preeclampsia. Conclusions are tempered by inherent limitations in exposure reconstruction and self-reported pregnancy outcome information.

Background: People living or working in eastern Ohio and western West Virginia have been exposed to perfluorooctanoic acid (PFOA) released by DuPont Washington Works facilities.Objectives: Our objective was to estimate historical PFOA exposures and serum concentrations experienced by 45,276 non-occupationally exposed participants in the C8 Health Project who consented to share their residential histories and a 2005–2006 serum PFOA measurement.Methods: We estimated annual PFOA exposure rates for each individual based on predicted calibrated water concentrations and predicted air concentrations using an environmental fate and transport model, individual residential histories, and maps of public water supply networks. We coupled individual exposure estimates with a one-compartment absorption, distribution, metabolism, and excretion (ADME) model to estimate time-dependent serum concentrations.Results: For all participants (n = 45,276), predicted and observed median serum concentrations in 2005–2006 are 14.2 and 24.3 ppb, respectively [Spearman’s rank correlation coefficient (rs) = 0.67]. For participants who provided daily public well water consumption rate and who had the same residence and workplace in one of six municipal water districts for 5 years before the serum sample (n = 1,074), predicted and observed median serum concentrations in 2005–2006 are 32.2 and 40.0 ppb, respectively (rs = 0.82).Conclusions: Serum PFOA concentrations predicted by linked exposure and ADME models correlated well with observed 2005–2006 human serum concentrations for C8 Health Project participants. These individualized retrospective exposure and serum estimates are being used in a variety of epidemiologic studies being conducted in this region.