Contents:

1. Message from the C8 Science Panel
2. Final Science Panel Announcements

1. Message from the C8 Science Panel

Dear Subscriber,

Welcome to the tenth and final newsletter. We have been circulating to about 500 subscribers each quarter. We, the members of the C8 Science Panel, have now completed our primary task, which is to provide to the Wood County Court a series of evaluations on whether or not there is a “Probable Link” between exposure to PFOA/C8 and a range of diseases among people living in the Mid-Ohio Valley. In October of this year we delivered the last five reports (these are summarized below). In all, we have reported on the following categories of disease:

• Cardiovascular Disease
  High blood pressure, high cholesterol, coronary artery disease, stroke
• Cancer
  21 different cancers: bladder, brain, breast, cervical, colorectal, esophageal, kidney, leukemia, liver, lung, lymphoma, melanoma, oral, ovarian, pancreatic, prostate, soft tissue, stomach, testicular, thyroid, uterine
• Pregnancy/Pregnancy Outcome
  Pregnancy-induced hypertension and preeclampsia, miscarriages, stillbirths, preterm birth, low birth weight, birth defects
• Neurological disease
  Neurobehavioral development in children, Parkinson’s disease
• Respiratory Disease
  Asthma, chronic obstructive pulmonary disease
• Infectious Disease
  Respiratory, gastrointestinal, other
• Autoimmune Disease
  Colitis, Crohn’s disease, rheumatoid arthritis, lupus, Type 1 diabetes, multiple sclerosis
• Diabetes, Type 2
• Thyroid Disease
• Kidney Disease
• Liver Disease
• Osteoarthritis

To reach these conclusions we have relied mainly on data collected by the C8 Science Panel and the C8 Health Project, as well as other published scientific studies. We would like to emphasize our gratitude for the cooperation of all the many thousands of community and worker participants in our studies, officials from the water districts, local county administrations, state health departments and cancer registries, and state environmental protection departments who assisted us in our research and patiently responded to questions and emails. We also appreciate the confidence and support of the Settling Parties and Judge Beane in allowing us to take the time that was needed to fulfil our charge carefully.

For most of the long list of conditions we considered, we concluded there was not evidence sufficient to make a probable link with C8. However, for six, we have determined that there is a Probable Link with exposure to C8:

• High Cholesterol
• Kidney Cancer
• Testicular Cancer
• Thyroid Disease
• Pregnancy-Induced Hypertension/Preeclampsia
• Ulcerative Colitis

Reports summarizing our conclusions for each of the diseases considered have been filed with the Wood County Court and are freely available on our website.

We are also preparing detailed scientific articles for all the key results, so that our results can be considered by the scientific community as research on the health effects of PFOA continues outside the activities of the C8 Science Panel. Some of these have been published and the others are being prepared or are currently in review and will be published over the coming months.

While we have completed our work for the Court and the Science Panel’s work is completed, our work as independent scientists continues and may involve one or more of us further examining health in relation to exposures to PFOA/C8 in the Mid-Ohio valley. Our paths may therefore cross in the future and if so we look forward to continued contact with the community.

Meanwhile, the three of us can still be reached via our email panel.c8study@gmail.com. Thank you again and farewell,

Tony Fletcher, David Savitz, Kyle Steenland

2. Final Science Panel Announcements

On October 29, 2012 the Science Panel submitted five Probable Link Reports to the Wood County Court. The Science Panel has concluded that there is a Probable Link between C8 (PFOA) and diagnosed high cholesterol; and that there is not a Probable Link between C8 and diagnosed hypertension, coronary artery disease, chronic kidney disease, liver disease, osteoarthritis or Parkinson’s disease. This is the fourth and final series of Probable Link reports. These conclusions are summarized below and are available in full on the Science Panel website. For each decision, in reaching an evaluation of a Probable Link between C8 and disease, the Science Panel considered evidence from toxicological data in animals, outside epidemiologic studies, and four epidemiologic studies conducted by the Science Panel.

Probable Link Evaluation of Heart Disease

Heart diseases considered in this Probable Link Evaluation are diagnosed high blood pressure (hypertension), diagnosed high cholesterol (hypercholesterolemia), and coronary artery disease.

Hypertension is defined as systolic blood pressure >140 mmHg and/or diastolic blood pressure >90 mmHg. Hypercholesterolemia is defined as cholesterol level higher than 240 mg/dL. Specific lipids measurements assessed were total cholesterol, LDL and HDL cholesterols and triglycerides. Included with coronary artery disease were its manifestations as myocardial infarction, angina, and other indications of coronary artery disease like coronary bypass surgery.

On the basis of epidemiological and other data available to the C8 Science Panel, we conclude that there is a probable link between exposure to C8 (also known as PFOA) and diagnosed hypercholesterolemia, but there is not a probable link between exposure to C8 and diagnosed hypertension or coronary artery disease.

Probable Link Evaluation of Kidney Disease

Chronic kidney disease is diagnosed when the kidneys lose their ability to effectively remove waste and excess fluids from the body. In the early stages, there may be no symptoms. The loss of function usually takes months or years to occur. The final stage of chronic kidney disease is called end-stage renal disease. At this stage, the kidneys are no longer able to function and the patient needs dialysis or a kidney transplant.

Chronic kidney disease and end-stage renal disease are rare conditions. They affect about 1 out of every 500 people in the United States. Diabetes and high blood pressure are the two most influential risk factors. In one study based on blood tests, chronic kidney disease was defined as an estimated glomerular filtration rate of <60 mL/minute/1.73m². In another study kidney disease was studied based on reporting chronic kidney disease, renal failure, or renal insufficiency. Kidney cancer was not considered here as the C8 Science Panel previously considered kidney cancer along with other cancers.

On the basis of epidemiological and other data available to the C8 Science Panel, we conclude that there is not a probable link between exposure to C8 (also known as PFOA) and chronic kidney disease.

Probable Link Evaluation of Liver Disease

Two classifications of liver disease are presented in this evaluation: all liver diseases (including hepatitis) and a narrower group comprising enlarged liver, fatty liver disease (both alcoholic and non-alcoholic) and cirrhosis. Liver cancer is not included as the C8 Science Panel previously considered liver cancer along with other cancers.

On the basis of epidemiological and other data available to the C8 Science Panel, we conclude that there is not a probable link between exposure to C8 (also known as PFOA) and liver disease.

Probable Link Evaluation of Osteoarthritis

Osteoarthritis is a progressive disorder of the joints caused by gradual loss of cartilage, resulting in joint pain and stiffness. It is quite common as people age and affects a sizable proportion of the population to varying degrees. Rheumatoid arthritis was not considered in this evaluation as it was previously considered by the Science Panel in the Probable Link report regarding autoimmune disease.

On the basis of epidemiological and other data available to the C8 Science Panel, we conclude that there is not a probable link between exposure to C8 (also known as PFOA) and osteoarthritis.

Probable Link Evaluation of Parkinson’s Disease

Parkinson’s disease is a neurological disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination. Although it is rare, it is the one of the most common of the neurodegenerative disorders. Other major neurodegenerative diseases not evaluated are amyotrophic lateral sclerosis (AML, also known as Lou Gehrig’s disease) and Alzheimer’s disease, both of which could not be assessed effectively using any of the study designs that were available.

On the basis of epidemiological and other data available to the C8 Science Panel, we conclude that there is not a probable link between exposure to C8 (also known as PFOA) and Parkinson’s disease.