{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:58:57Z","timestamp":1776430737103,"version":"3.51.2"},"reference-count":11,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"unspecified","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Solvay Specialty Polymers Italy SpA","award":["PR0577"],"award-info":[{"award-number":["PR0577"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2026,2,11]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Objective<\/jats:title>\n Within a multicentre cohort study, mortality (1960\u20132008) had been evaluated of workers exposed to tetrafluoroethylene (TFE) and perfluorooctanoic acid (PFOA) employed (1960\u20131999) in a plant producing fluoropolymers in Piedmont, North-West Italy. Follow-up of this cohort was updated through 2024.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Workers\u2019 job histories were merged with a semiquantitative job-exposure matrix to calculate cumulative exposure to TFE (still used) and PFOA (phased out in 2013). We calculated standardised mortality ratios (SMRs) and 95% CIs.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 505 male workers, there was high correlation between cumulative exposure to TFE and PFOA (Spearman\u2019s rho 0.57). SMRs (reference: regional rates) were elevated for lung cancer (SMR 1.43, 95% CI 0.95 to 2.16, 23 deaths) and non-Hodgkin\u2019s lymphoma (NHL, SMR 2.73, 95% CI 1.23 to 6.07, 6 deaths). Pleural cancer was also in excess (SMR 3.18 using national rates, 95% CI 1.02 to 9.84, 3 deaths). Mortality from leukaemia (three deaths) was not elevated. Lung cancer was not associated with length of employment or exposure. Three workers who died from liver, kidney and testis cancer had been exposed to TFE and unexposed to PFOA. NHL was positively associated with length of employment, time since first employment and exposure to TFE (all 6 deaths exposed, SMR 3.38, 95% CI 1.52 to 7.51 in unlagged analysis, excess confirmed in lagged analyses), while 3 were unexposed to PFOA. The NHL excess occurred among workers aged 65+ years\u2009last employed before 2000.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study found elevated mortality from NHL. The available evidence suggests an association with TFE rather than PFOA exposure, although exposure misclassification cannot be ruled out.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/oemed-2025-110490","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:20:33Z","timestamp":1772130033000},"page":"50-53","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mortality of workers exposed to tetrafluoroethylene (TFE) and perfluorooctanoic acid (PFOA) in a plant producing fluoropolymers in Italy, 1960\u20132024"],"prefix":"10.1136","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-3843","authenticated-orcid":false,"given":"Dario","family":"Consonni","sequence":"first","affiliation":[{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Fustinoni","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy"},{"name":"Toxicology Lab, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daan Joris","family":"Aarts","sequence":"additional","affiliation":[{"name":"Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"2026041705150869000_83.1.50.1","unstructured":"IARC . IARC monographs on the evaluation of carcinogenic risks to humans. In: Some chemicals used as solvents and in polymer manufacture. 110. Lyon, France: IARC, 2017."},{"key":"2026041705150869000_83.1.50.2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws588"},{"key":"2026041705150869000_83.1.50.3","unstructured":"IARC . IARC monographs on the identification of carcinogenic hazards to humans. In: Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS). 135. Lyon, France: IARC, 2025."},{"key":"2026041705150869000_83.1.50.4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/S1470-2045(23)00622-8","article-title":"Carcinogenicity of perfluorooctanoic acid and perfluorooctanesulfonic acid","volume":"25","author":"Zahm","year":"2024","journal-title":"Lancet Oncol"},{"key":"2026041705150869000_83.1.50.5","doi-asserted-by":"publisher","DOI":"10.1002\/etc.4890"},{"key":"2026041705150869000_83.1.50.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.envint.2020.106125","article-title":"Review: Evolution of evidence on PFOA and health following the assessments of the C8 Science Panel","volume":"145","author":"Steenland","year":"2020","journal-title":"Environ Int"},{"key":"2026041705150869000_83.1.50.7","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12940-024-01074-2","article-title":"All-cause, cardiovascular disease and cancer mortality in the population of a large Italian area contaminated by perfluoroalkyl and polyfluoroalkyl substances (1980-2018)","volume":"23","author":"Biggeri","year":"2024","journal-title":"Environ Health"},{"key":"2026041705150869000_83.1.50.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2023.117743"},{"key":"2026041705150869000_83.1.50.9","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1093\/annweh\/wxac095","article-title":"Historical Trend of Exposure to Perfluoroalkyl Surfactants PFOA, ADV, and cC6O4 and its Management in Two Perfluoroalkyl Polymers Plants, Italy","volume":"67","author":"Fustinoni","year":"2023","journal-title":"Ann Work Expo Health"},{"key":"2026041705150869000_83.1.50.10","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijheh.2024.114440","article-title":"Biochemical and haematological effects of serum PFOA, ADV and cC6O4 in workers of a chemical company producing fluoropolymers, Italy, 2013-2022","volume":"262","author":"Consonni","year":"2024","journal-title":"Int J Hyg Environ Health"},{"key":"2026041705150869000_83.1.50.11","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1002\/ajim.22617","article-title":"Mortality study of employees at a chemical manufacturing plant using administrative databases","volume":"59","author":"Bena","year":"2016","journal-title":"Am J Ind Med"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2025-110490","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:15:21Z","timestamp":1776428121000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2025-110490"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,4,17]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/oemed-2025-110490"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2025-110490","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}