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Attachment 2 A & lltrlT lX CANCER PREVALENCE IN SUBJECTS EXPOSED TO ALKYLATED SUBSTANCES (PFAS) James Dahlgrsn M D', Ayman B Ibrahim M D1'2' 3, Ray Warshaw2, Karpreet Takhar MPH3 * i . U C LA School o f Medicine. 2. Comprehensive Health Screening Services. 3. Dahlgren Medical Group Please address correspondence to: Jam es Dahlgren, MD 2811 Wilshire Blvd. Santa Monica, CA 90403 Voice: 310-449-5525 ext. 226 FAX: 310-449-5526 -dahlgren@envirotoxicolog_y_.c_o_m_ K e y words: PFOA, PFOS, PFAS, C8, caacer, prevalence, environmental, exposure, fluorochemicals , Session: Perfluorinated substances LE 1824 8 Perfluoronaied alkane substances (PFAS) are man-made chemicals that include perfluorooctanonic Acid (PFOA) and perfluorooctanoate sulfonate (PFOS). PFOA is also referred 10 as CS. PFOA is a key ingredient agent in the production o f Teflon and other fiuorochemicals and is biopersistent and bioaccumulates. There has been documented chronic exposure to PFOA o f the residents near a plant using CS and other Huorinated contaminants. Our aim was to compare cancer distribution and cancer prevalence rates in a PrOAexposed population (residents) to that o f the industry cancer registry data from an occupational exposed population and finally to the general population (SEER ). \Ye performed a questionnaire on 594 residents living near a PFOA facility. Cancer registry data from the C8 occupational workers was obtained via the freedom o f information act. The SEER data was used for comparison to the general population. The overall cancer prevalence rate is higher in the PFOA-exposed population when compared to the general population. Resident cancer prevalence rates after f ' standardization to the general U.S. population is shown in Table 1. The residents from age 24-65'have a significantly higher rate o f prevalence cancer when compared to the general population (data not shown). Our findings indicate that the exposed population (residents) have similar cancer prevalence findings to the PFOA exposed workers (Table 1). Prostate cancer in the workers was proportionately elevated among young age males. The distribution of cancers in the residents and workers is different than expected. Of qote are the findings o f elevated prevalence rates o f atypical cancers such as Hodgkin's, Leukemia, and Multiple Myeloma. This data suggests that exposure to PFOA and PFOS may alter cancer distribution in exposed populations (worker and residents) and m aybe an important risk factor for an excess o f cancer cases. LE IS } Table 1. Total Prevalence Rates in Dupont Study, Resident Population, and US Population Type of Cancer Dupont Study Cancers Population R ale B la d d e r Bone 10 5523 0 .3 3 % 2 5523 0 .0 4 % Brain 6 5523 0 .1 1 % Breast 5 1034 0.48% C e rv ix Colon & Rectum 32 5 5 2 3 ' 0.58% Esophagus H o d g k in 's Kidney Larynx 3 4 v ' 10 5523 5523 , 5523 5523 0 .0 5 % 0 .0 7 % 0 .3 3 % 0 .1 1 % Oral Cavity Leukem ia 11 5523 0 .2 0 % 11 5523 0 .2 0 % Liver 4 5523 0.07% LljnfJ Melanom a G4 5523 1.16% 17 5523 0 .3 1 % M yelom a 9 5523 0 .1 6 % N on H o d g kin 's 9 5523 0 .1 6 % Pancreas 9 5523 0 .1 6 % P ro s ta le 19 4489 0 .4 2 % Testicular 5 4489 0 .1 1 % thyroid 3 5523 0 .0 5 % litmus 1 1034 0 .1 0 % 1 0 T At. 304 5523 5 .5 0 % R esident D ata Cancers Population Rate 5 576 ' 0.07% 6 293 2.05% 7 293 2.39% 5 500 0.06% 2 579 0 .3 5 % 2 500 0.34% 1 500 0.17% 5 576 0.87% 5 576 0.87% 2 579 0.35% 5 576 0.87% 9 286 3.15% 1 580 0.17% 7 293 2.39% 76 505 15.05% U S. Data C ancers Population 449740 25417 201421906 201421906 03551 2B142190G 1969304 143360343 169992 143360343 940677 281421906 20767 115991 201421906 201421906 106771 92002 202193 201421906 201421906 201421906 166330 2142190G 132G5 201421906 320242 281421906 512355 201421906 46067 201421906 301438 281421906 23135 281421906 1622199 129614 138053563 130053563 245167 281421906 464835 143308343 8722061 201421906 R a te 0 .1 6 % 0 .0 1 % 0.03% 1.37% 0 .1 2 % 0 .3 4 % 0 .0 1 % 0 .0 4 % 0 .0 7 % 0 .0 3 % 0 .0 7 % 0 .0 6 % 0 .0 0 % 0 .1 2 % 0 .1 8 % 0 .0 2 % 0 .1 1 % 0 .0 1 % 1.10% 0 .0 9 % 0 .0 9 % 0 .3 2 % 3 .1 0 % Dupont; US R a tio 2.04 4.01 3.66 0 .3 5 1.72 7.36 1.76 4.91 3 29 2.77 3.37 15.37 9.94 1.69 9.70 1.52 19.02 0 .3 6 1.19 0.62 0 .3 0 1 70 Resident U S R a tio 5 43 I t 4!) 2 0 .1 5 2 .5 6 0 .3 0 5 .2 0 2 .9 2 7.44 4.77 2 0 .7 4 0 .1 0 2.60 1.90 7.37 4.86 LE 1826