Relative rates of cancers and deaths in Australian communities with PFAS environmental contamination associated with firefighting foams: A cohort study using linked data

ElsevierVolume 82, February 2023, 102296Cancer EpidemiologyAuthor links open overlay panelHighlights•

We studied 23 incident cancers and four causes of death in three PFAS exposure areas.

The study included everyone who had ever lived in an exposure area since 1984.

We sampled comparison groups from areas without known PFAS contamination.

Study participants were linked to national cancer and death registries.

There was limited evidence for increased risk of any cancer or cause-specific death.

AbstractBackground

Per- and polyfluoroalkyl substances (PFAS) are environmental contaminants that are potentially harmful to health. We examined if rates of selected cancers and causes of deaths were elevated in three Australian communities with local environmental contamination caused by firefighting foams containing PFAS. The affected Australian communities were Katherine in Northern Territory, Oakey in Queensland and Williamtown in New South Wales.

Methods

All residents identified in the Medicare Enrolment File (1983–2019)—a consumer directory for Australia’s universal healthcare—who ever lived in an exposure area (Katherine, Oakey and Williamtown), and a sample of those who ever lived in selected comparison areas, were linked to the Australian Cancer Database (1982–2017) and National Death Index (1980–2019). We estimated standardised incidence ratios (SIRs) for 23 cancer outcomes, four causes of death and three control outcomes, adjusting for sex, age and calendar time of diagnosis.

Findings

We observed higher rates of prostate cancer (SIR=1·76, 95 % confidence interval (CI) 1·36–2·24) in Katherine; laryngeal cancer (SIR=2·71, 95 % CI 1·30–4·98), kidney cancer (SIR=1·82, 95 % CI 1·04–2·96) and coronary heart disease (CHD) mortality (SIR=1·81, 95 % CI 1·46–2·33) in Oakey; and lung cancer (SIR=1·83, 95 % CI 1·39–2·38) and CHD mortality (SIR=1·22, 95 % CI 1·01–1·47) in Williamtown. We also saw elevated SIRs for control outcomes. SIRs for all other outcomes and overall cancer were similar across exposure and comparison areas.

Interpretation

There was limited evidence to support an association between living in a PFAS exposure area and risks of cancers or cause-specific deaths.

Keywords

PFAS

Cancer

Mortality

Firefighting foams

© 2022 The Author(s). Published by Elsevier Ltd.

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