Perfluorooctanoic acid (PFOA) exposures and incident cancers among adults living near a chemical plant

Environ Health Perspect. 2013 Nov-Dec;121(11-12):1313-8. doi: 10.1289/ehp.1306615. Epub 2013 Sep 5.


Background: Perfluorooctanoic acid (PFOA) is a synthetic chemical ubiquitous in the serum of U.S. residents. It causes liver, testicular, and pancreatic tumors in rats. Human studies are sparse.

Objective: We examined cancer incidence in Mid-Ohio Valley residents exposed to PFOA in drinking water due to chemical plant emissions.

Methods: The cohort consisted of adult community residents who resided in contaminated water districts or worked at a local chemical plant. Most participated in a 2005-2006 baseline survey in which serum PFOA was measured. We interviewed the cohort in 2008-2011 to obtain further medical history. Retrospective yearly PFOA serum concentrations were estimated for each participant from 1952 through 2011. Self-reported cancers were validated through medical records and cancer registry review. We estimated the association between cancer and cumulative PFOA serum concentration using proportional hazards models.

Results: Participants (n = 32,254) reported 2,507 validated cancers (21 different cancer types). Estimated cumulative serum PFOA concentrations were positively associated with kidney and testicular cancer [hazard ratio (HR) = 1.10; 95% CI: 0.98, 1.24 and HR = 1.34; 95% CI: 1.00, 1.79, respectively, for 1-unit increases in ln-transformed serum PFOA]. Categorical analyses also indicated positive trends with increasing exposures for both cancers: for kidney cancer HRs for increasing exposure quartiles were 1.0, 1.23, 1.48, and 1.58 (linear trend test p = 0.18) and for testicular cancer, HRs were 1.0, 1.04, 1.91, 3.17 (linear trend test p = 0.04).

Conclusions: PFOA exposure was associated with kidney and testicular cancer in this population. Because this is largely a survivor cohort, findings must be interpreted with caution, especially for highly fatal cancers such as pancreatic and lung cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Caprylates / blood
  • Caprylates / toxicity*
  • Chemical Industry / statistics & numerical data*
  • Cohort Studies
  • Environmental Exposure / analysis*
  • Fluorocarbons / blood
  • Fluorocarbons / toxicity*
  • Humans
  • Incidence
  • Neoplasms / chemically induced*
  • Neoplasms / epidemiology*
  • Proportional Hazards Models
  • Water Pollutants, Chemical / blood
  • Water Pollutants, Chemical / toxicity*
  • West Virginia / epidemiology


  • Caprylates
  • Fluorocarbons
  • Water Pollutants, Chemical
  • perfluorooctanoic acid