Environment and Breast Cancer: Science Review

Evidence From Humans
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Mortality and cancer incidence in ammonium perfluorooctanoate production workers
Raleigh, K. K., Alexander, B. H., Olsen, G. W., Ramachandran, G., Morey, S. Z., Church, T. R., Logan, P. W., Scott, L. L., Allen, E. M. Occup Environ Med. 2014. 71:7, 500-6.
Topic area
Environmental pollutant - PFCs PFAS
Study design
Retrospective cohort
Funding agency
3M Company Midwest Center for Occupational Health
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
No analysis based on menopausal status
Number in Cohort
Cohort: 1,478 womem
Cohort participation rate
Not applicable. This study was records-based.
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Participants were employees from two 3M facilities in the Minneapolis/St. Paul areas who had worked at a facility for at least one year. The Cottage Grove facility had a Chemical Division that developed APFO and a Non-Chemical Division that did not produce APFO; participants included employees who had worked at the Cottage Grove facility between 1983 and 2002. The St. Paul facility was considered the referent cohort and were not occupationally exposed to APFO; participants had worked there before 1999 for at least one year. Breast cancer incidence was followed from 1988-2008, and breast cancer mortality from 1960-2008.
Comment about participation selection
200 workers with employment records were included in the APFO analysis, reported below.
Exposure Investigated
Exposures investigated
AFPO exposure in air (mg/m3) from a task-based exposure model based on work history records, industrial hygiene monitoring data, average annual APFO production. The referent group at the St. Paul facility were assigned a background level to reflect exposu
Exposure assessment comment
Workers in the Minneapolis facility in the non-chemical division had a higher geometric mean of PFOA in blood than blood donors in the same area, 282 ng/ml compared to 4.5 ng/ml in blood.
Breast cancer outcome investigated
Primary incident breast cancer
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Birth year, age
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Strength of associations reported
Breast cancer incidence, Cottage Grove facility compared to referent St. Paul facility:
Quartile 1 (<2.9E-5 ug/m3) (8 cases): HR 0.36 (95% CI 0.16-0.79)
Quartile 2 (2.9E-5> and <1.5E-4 ug/m3) (8 cases): HR 0.65 (95% CI 0.29-1.42)
Quartile 3 (1.5E-4> and <7.9E-4 ug/m3): HR 1.47 (95% CI 0.77-2.80)
Quartile 4 (>7.9E-4 ug/m3) (4 cases): HR 0.85 (95% CI 0.29-2.46)
Results Comments
It was not specified in the paper whether the analyses reported were for female breast cancer only or for male and female combined.
Author address
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA. 3M Company, Saint Paul, Minnesota, USA. More Consulting, Inc., Saint Paul, Minnesota, USA.
Reviewers Comments
HRs for breast cancer mortality were below 1 and were not statically significant. Compared to the state of MN, the St. Paul reference group had non-significantly elevated breast cancer mortality, SMR 1.39 (0.78 to 2.29) which may indicate that this was not an appropriate reference group for the analysis.