Division of Environmental Health Sciences, University of Minnesota, School of Public Health, Minneapolis, MN 55455, USA.
Epidemiology. 2009 Nov;20(6):921-8. doi: 10.1097/EDE.0b013e3181b5f395.
Perfluorooctanoate (PFOA) is a synthetic chemical widely detectable in blood of nonoccupationally exposed persons. Its human health effects are not well-characterized.
We conducted a mortality study in a cohort of 3993 employees of an ammonium perfluorooctanoate (APFO) manufacturing facility. APFO rapidly dissociates to PFOA in blood. We estimated standardized mortality ratios (SMRs) compared with the general population, and fit time-dependent Cox regression models to estimate the risks using an internal-cohort referent population. A priori diseases of interest were liver, pancreatic, prostate, and testicular cancer; cirrhosis of the liver; and cerebrovascular disease.
APFO exposure was not associated with liver, pancreatic or testicular cancer or with cirrhosis of the liver. SMRs (95% CI) for prostate cancer with no, probable and definite exposure strata were 0.4 (0.1-0.9), 0.9 (0.4-1.8), and 2.1 (0.4-6.1), respectively, and for cerebrovascular disease 0.5 (0.3-0.8), 0.7 (0.4-1.1), and 1.6 (0.5-3.7), respectively. The diabetes SMR for probable exposure was 2.0 (1.0-3.2). Compared with an internal referent population of nonexposed workers, moderate or high exposures to ammonium perfluorooctanoate were positively associated with prostate cancer (HR = 3.0 [0.9-9.7] and 6.6 [1.1-37.7], respectively) and with cerebrovascular disease (1.8 [0.9-3.1] and 4.6 [1.3-17.0], respectively). Diabetes was associated with moderate exposure 3.7 (1.4-10.1); no deaths from diabetes occurred in workers with high exposure.
We did not observe ammonium perfluorooctanoate exposure to be associated with liver, pancreatic, and testicular cancer or cirrhosis of the liver. Exposure was associated (albeit inconsistently) with prostate cancer, cerebrovascular disease, and diabetes.
全氟辛烷酸（PFOA）是一种广泛存在于非职业暴露人群血液中的合成化学物质。其对人类健康的影响尚未得到充分阐明。
我们对一家全氟辛烷酸（APFO）制造工厂的 3993 名员工进行了一项死亡率研究。APFO 在血液中迅速分解为 PFOA。我们使用标准化死亡率比（SMR）与一般人群进行比较，并使用内部队列参考人群拟合时间依赖性 Cox 回归模型来估计风险。预先确定的感兴趣疾病包括肝癌、胰腺癌、前列腺癌和睾丸癌、肝硬化和脑血管疾病。
APFO 暴露与肝癌、胰腺癌或睾丸癌或肝硬化无关。无、可能和明确暴露人群的前列腺癌 SMR（95%CI）分别为 0.4（0.1-0.9）、0.9（0.4-1.8）和 2.1（0.4-6.1），脑血管疾病分别为 0.5（0.3-0.8）、0.7（0.4-1.1）和 1.6（0.5-3.7）。可能暴露的糖尿病 SMR 为 2.0（1.0-3.2）。与非暴露工人的内部参考人群相比，中等或高度暴露于全氟辛烷酸铵与前列腺癌（HR=3.0[0.9-9.7]和 6.6[1.1-37.7]）和脑血管疾病（1.8[0.9-3.1]和 4.6[1.3-17.0]）呈正相关。糖尿病与中度暴露相关 3.7（1.4-10.1）；高暴露工人中无糖尿病死亡。
我们没有观察到全氟辛烷酸铵暴露与肝癌、胰腺癌和睾丸癌或肝硬化有关。暴露与前列腺癌、脑血管疾病和糖尿病（尽管不一致）相关。
