Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Via San Barnaba, 8, 20122 Milan, Italy.
Am J Epidemiol. 2013 Aug 1;178(3):350-8. doi: 10.1093/aje/kws588. Epub 2013 Jul 4.
Tetrafluoroethylene (TFE), a compound used for the production of fluorinated polymers including polytetrafluoroethylene, increases the incidence of liver and kidney cancers and leukemia in rats and mice. This is the first time the cancer risk in humans has been explored comprehensively in a cohort mortality study (1950-2008) that included all polytetrafluoroethylene production sites in Europe and North America at the time it was initiated. A job-exposure matrix (1950-2002) was developed for TFE and ammonium perfluoro-octanoate, a chemical used in the polymerization process. National reference rates were used to calculate standardized mortality ratios (SMRs) and 95% confidence intervals. Among 4,773 workers ever exposed to TFE, we found a lower rate of death from most causes, as well as increased risks for cancer of the liver (SMR = 1.27; 95% confidence interval: 0.55, 2.51; 8 deaths) and kidney (SMR = 1.44; 95% confidence interval: 0.69, 2.65; 10 deaths) and for leukemia (SMR = 1.48; 95% confidence interval: 0.77, 2.59; 12 deaths). A nonsignificant upward trend (P = 0.24) by cumulative exposure to TFE was observed for liver cancer. TFE and ammonium perfluoro-octanoate exposures were highly correlated, and therefore their separate effects could not be disentangled. This pattern of findings narrows the range of uncertainty on potential TFE carcinogenicity but cannot conclusively confirm or refute the hypothesis that TFE is carcinogenic to humans.
四氟乙烯（TFE），一种用于生产含氟聚合物的化合物，包括聚四氟乙烯，增加了大鼠和小鼠的肝癌、肾癌和白血病的发病率。这是首次在一项队列死亡率研究（1950-2008 年）中全面探索人类的癌症风险，该研究包括当时欧洲和北美的所有聚四氟乙烯生产地点。开发了用于四氟乙烯和全氟辛烷酸铵的职业暴露矩阵（1950-2002 年），全氟辛烷酸铵是聚合过程中使用的一种化学物质。使用国家参考率计算标准化死亡率比（SMR）和 95%置信区间。在 4773 名曾接触过 TFE 的工人中，我们发现大多数原因导致的死亡率较低，肝癌（SMR=1.27；95%置信区间：0.55，2.51；8 例死亡）、肾癌（SMR=1.44；95%置信区间：0.69，2.65；10 例死亡）和白血病（SMR=1.48；95%置信区间：0.77，2.59；12 例死亡）的风险增加。TFE 累积暴露与肝癌呈非显著上升趋势（P=0.24）。四氟乙烯和全氟辛烷酸铵暴露高度相关，因此无法分辨它们的单独影响。这些发现缩小了 TFE 致癌性的不确定性范围，但不能确定或否定 TFE 对人类具有致癌性的假设。
