American Journal of Epidemiology Vol. 153, No. 11 : 1031-1044
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Health Effects of Dioxin Exposure: A 20-Year Mortality Study
1 EPOCA, Research Center for Occupational, Clinical and Environmental Epidemiology, Department of Occupational and Environmental Health, University of Milan, Milan, Italy.
2 Unit of Epidemiology, Department of Occupational Health and Safety, Istituti Clinici di Perfezionamento, Milan, Italy.
3 Regional Epidemiological Office, Health Directorate, Regione Lombardia, Milan, Italy.
Follow-up of the population exposed to dioxin after the 1976 accident in Seveso, Italy, was extended to 1996. During the entire observation period, all-cause and all-cancer mortality did not increase. Fifteen years after the accident, mortality among men in high-exposure zones A (804 inhabitants) and B (5,941 inhabitants) increased from all cancers (rate ratio (RR) = 1.3, 95% confidence interval (CI): 1.0, 1.7), rectal cancer (RR = 2.4, 95% CI: 1.2, 4.6), and lung cancer (RR = 1.3, 95% CI: 1.0, 1.7), with no latency-related pattern for rectal or lung cancer. An excess of lymphohemopoietic neoplasms was found in both genders (RR = 1.7, 95% CI: 1.2, 2.5). Hodgkin's disease risk was elevated in the first 10-year observation period (RR = 4.9, 95% CI: 1.5, 16.4), whereas the highest increase for non-Hodgkin's lymphoma (RR = 2.8, 95% CI: 1.1, 7.0) and myeloid leukemia (RR = 3.8, 95% CI: 1.2, 12.5) occurred after 15 years. No soft tissue sarcoma cases were found in these zones (0.8 expected). An overall increase in diabetes was reported, notably among women (RR = 2.4, 95% CI: 1.2, 4.6). Chronic circulatory and respiratory diseases were moderately increased, suggesting a link with accident-related stressors and chemical exposure. Results support evaluation of dioxin as carcinogenic to humans and corroborate the hypotheses of its association with other health outcomes, including cardiovascular- and endocrine-related effects.
accidents, occupational; carcinogens, environmental; chemical industry; dioxins; mortality
Abbreviations: CI, confidence interval; RR, rate ratio; TCDD, 2,3,7,8-tetrachlorodibenzo-p-dioxin.
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in Am. J. Epidemiol.:
- Invited Commentary: How Do the Seveso Findings Affect Conclusions Concerning TCDD as a Human Carcinogen?
- Allan H. Smith and Peggy Lopipero
Am. J. Epidemiol. 2001 153: 1045-1047.[Extract] [FREE Full Text] - Bertazzi et al. Respond to Smith and Lopipero
- Pier Alberto Bertazzi, Dario Consonni, Silvia Bachetti, Maurizia Rubagotti, Andrea Baccarelli, Carlo Zocchetti, and Angela C. Pesatori
Am. J. Epidemiol. 2001 153: 1048-1049.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  K. Yoshizawa, A. E. Brix, D. M. Sells, M. P. Jokinen, M. Wyde, D. P. Orzech, G. E. Kissling, N. J. Walker, and A. Nyska Reproductive Lesions in Female Harlan Sprague-Dawley Rats Following Two-Year Oral Treatment with Dioxin and Dioxin-like Compounds Toxicol Pathol, December 1, 2009; 37(7): 921 - 937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Onozuka, T. Yoshimura, S. Kaneko, and M. Furue Mortality After Exposure to Polychlorinated Biphenyls and Polychlorinated Dibenzofurans: A 40-Year Follow-up Study of Yusho Patients Am. J. Epidemiol., January 1, 2009; 169(1): 86 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Pesatori, A. Baccarelli, D. Consonni, A. Lania, P. Beck-Peccoz, P. A. Bertazzi, and A. Spada Aryl hydrocarbon receptor-interacting protein and pituitary adenomas: a population-based study on subjects exposed to dioxin after the Seveso, Italy, accident Eur. J. Endocrinol., December 1, 2008; 159(6): 699 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. W Turunen, P. K Verkasalo, H. Kiviranta, E. Pukkala, A. Jula, S. Mannisto, R. Rasanen, J. Marniemi, and T. Vartiainen Mortality in a cohort with high fish consumption Int. J. Epidemiol., October 1, 2008; 37(5): 1008 - 1017. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-L. Wang, P.-C. Tsai, C.-Y. Yang, and Y. Leon Guo Increased Risk of Diabetes and Polychlorinated Biphenyls and Dioxins: A 24-year follow-up study of the Yucheng cohort Diabetes Care, August 1, 2008; 31(8): 1574 - 1579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Consonni, A. C. Pesatori, C. Zocchetti, R. Sindaco, L. C. D'Oro, M. Rubagotti, and P. A. Bertazzi Mortality in a Population Exposed to Dioxin after the Seveso, Italy, Accident in 1976: 25 Years of Follow-Up Am. J. Epidemiol., April 1, 2008; 167(7): 847 - 858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Yoshizawa, A. Heatherly, D. E. Malarkey, N. J. Walker, and A. Nyska A Critical Comparison of Murine Pathology and Epidemiological Data of TCDD, PCB126, and PeCDF Toxicol Pathol, December 1, 2007; 35(7): 865 - 879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. J. Walker, K. Yoshizawa, R. A. Miller, A. E. Brix, D. M. Sells, M. P. Jokinen, M. E. Wyde, M. Easterling, and A. Nyska Pulmonary Lesions in Female Harlan Sprague-Dawley Rats Following Two-Year Oral Treatment with Dioxin-Like Compounds Toxicol Pathol, December 1, 2007; 35(7): 880 - 889. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. F.A. Vogel, W. Li, E. Sciullo, J. Newman, B. Hammock, J. R. Reader, J. Tuscano, and F. Matsumura Pathogenesis of Aryl Hydrocarbon Receptor-Mediated Development of Lymphoma Is Associated with Increased Cyclooxygenase-2 Expression Am. J. Pathol., November 1, 2007; 171(5): 1538 - 1548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Pelclova, M. Prazny, J. Skrha, Z. Fenclova, M. Kalousova, P. Urban, T. Navratil, Z. Senholdova, and Z. Smerhovsky 2,3,7,8-TCDD exposure, endothelial dysfunction and impaired microvascular reactivity Human and Experimental Toxicology, September 1, 2007; 26(9): 705 - 713. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Baccarelli, C. Hirt, A. C. Pesatori, D. Consonni, D. G. Patterson Jr, P. A. Bertazzi, G. Dolken, and M. T. Landi t(14;18) translocations in lymphocytes of healthy dioxin-exposed individuals from Seveso, Italy Carcinogenesis, October 1, 2006; 27(10): 2001 - 2007. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Boverhof, J. C. Kwekel, D. G. Humes, L. D. Burgoon, and T. R. Zacharewski Dioxin Induces an Estrogen-Like, Estrogen Receptor-Dependent Gene Expression Response in the Murine Uterus Mol. Pharmacol., May 1, 2006; 69(5): 1599 - 1606. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Perucatti, G.P. Di Meo, S. Albarella, F. Ciotola, D. Incarnato, A.C. Jambrenghi, V. Peretti, G. Vonghia, and L. Iannuzzi Increased frequencies of both chromosome abnormalities and SCEs in two sheep flocks exposed to high dioxin levels during pasturage Mutagenesis, January 1, 2006; 21(1): 67 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Chang, L. W. Chang, Y.-H. Cheng, W.-T. Tsai, M.-X. Tsai, and P. Lin Preferential Induction of CYP1A1 and CYP1B1 in CCSP-Positive Cells Toxicol. Sci., January 1, 2006; 89(1): 205 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E G Knox Oil combustion and childhood cancers J Epidemiol Community Health, September 1, 2005; 59(9): 755 - 760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L.-A. Li and P.-W. Wang PCB126 Induces Differential Changes in Androgen, Cortisol, and Aldosterone Biosynthesis in Human Adrenocortical H295R Cells Toxicol. Sci., May 1, 2005; 85(1): 530 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Yoshizawa, T. Marsh, J. F. Foley, B. Cai, S. Peddada, N. J. Walker, and A. Nyska Mechanisms of Exocrine Pancreatic Toxicity Induced by Oral Treatment with 2,3,7,8-Tetrachlorodibenzo-p-Dioxin in Female Harlan Sprague-Dawley Rats Toxicol. Sci., May 1, 2005; 85(1): 594 - 606. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A 't Mannetje, D McLean, S Cheng, P Boffetta, D Colin, and N Pearce Mortality in New Zealand workers exposed to phenoxy herbicides and dioxins Occup. Environ. Med., January 1, 2005; 62(1): 34 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Yoshizawa, N. J. Walker, M. P. Jokinen, A. E. Brix, D. M. Sells, T. Marsh, M. E. Wyde, D. Orzech, J. K. Haseman, and A. Nyska Gingival Carcinogenicity in Female Harlan Sprague-Dawley Rats following Two-Year Oral Treatment with 2,3,7,8-Tetrachlorodibenzo-p-dioxin and Dioxin-Like Compounds Toxicol. Sci., January 1, 2005; 83(1): 64 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H Watanabe, A Suzuki, M Goto, S Ohsako, C Tohyama, H Handa, and T Iguchi Comparative uterine gene expression analysis after dioxin and estradiol administration J. Mol. Endocrinol., December 1, 2004; 33(3): 763 - 771. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Iannuzzi, A. Perucatti, G.P. Di Meo, F. Polimeno, F. Ciotola, D. Incarnato, V. Peretti, A. Caputi-Jambrenghi, A. Pecoraro, F. Manniti, et al. Chromosome fragility in two sheep flocks exposed to dioxins during pasturage Mutagenesis, September 1, 2004; 19(5): 355 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Marlowe, E. S. Knudsen, S. Schwemberger, and A. Puga The Aryl Hydrocarbon Receptor Displaces p300 from E2F-dependent Promoters and Represses S Phase-specific Gene Expression J. Biol. Chem., July 9, 2004; 279(28): 29013 - 29022. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. MacDonald, H. P. Ciolino, and G. C. Yeh The Drug Salicylamide Is an Antagonist of the Aryl Hydrocarbon Receptor That Inhibits Signal Transduction Induced by 2,3,7,8-Tetrachlorodibenzo-p-dioxin Cancer Res., January 1, 2004; 64(1): 429 - 434. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Thackaberry, E. J. Bedrick, M. B. Goens, L. Danielson, A. K. Lund, D. Gabaldon, S. M. Smith, and M. K. Walker Insulin Regulation in AhR-null Mice: Embryonic Cardiac Enlargement, Neonatal Macrosomia, and Altered Insulin Regulation and Response in Pregnant and Aging AhR-null Females Toxicol. Sci., December 1, 2003; 76(2): 407 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Conney Enzyme Induction and Dietary Chemicals as Approaches to Cancer Chemoprevention: The Seventh DeWitt S. Goodman Lecture Cancer Res., November 1, 2003; 63(21): 7005 - 7031. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K M Bodner, J J Collins, L J Bloemen, and M L Carson Cancer risk for chemical workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin Occup. Environ. Med., September 1, 2003; 60(9): 672 - 675. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P Comba, V Ascoli, S Belli, M Benedetti, L Gatti, P Ricci, and A Tieghi Risk of soft tissue sarcomas and residence in the neighbourhood of an incinerator of industrial wastes Occup. Environ. Med., September 1, 2003; 60(9): 680 - 683. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Frumkin Agent Orange and Cancer: An Overview for Clinicians CA Cancer J Clin, July 1, 2003; 53(4): 245 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Tsuda, A. Naito, C. K. Kim, K. Fukamachi, H. Nomoto, and M. A. Moore Carcinogenesis and Its Modification by Environmental Endocrine Disruptors: In Vivo Experimental and Epidemiological Findings Jpn. J. Clin. Oncol., June 1, 2003; 33(6): 259 - 270. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. Landi, P. A. Bertazzi, A. Baccarelli, D. Consonni, S. Masten, G. Lucier, P. Mocarelli, L. Needham, N. Caporaso, and J. Grassman TCDD-mediated alterations in the AhR-dependent pathway in Seveso, Italy, 20 years after the accident Carcinogenesis, April 1, 2003; 24(4): 673 - 680. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. T. Bowen, M. E. Frew, S. Rollinson, P. L. Roddam, A. Dring, M. T. Smith, S. E. Langabeer, and G. J. Morgan CYP1A1*2B (Val) allele is overrepresented in a subgroup of acute myeloid leukemia patients with poor-risk karyotype associated with NRAS mutation, but not associated with FLT3 internal tandem duplication Blood, April 1, 2003; 101(7): 2770 - 2774. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. M. Moran, C. A. VandeVoort, J. W. Overstreet, B. L. Lasley, and A. J. Conley Molecular Target of Endocrine Disruption in Human Luteinizing Granulosa Cells by 2,3,7,8-Tetrachlorodibenzo-p-Dioxin: Inhibition of Estradiol Secretion Due to Decreased 17{alpha}-Hydroxylase/17,20-Lyase Cytochrome P450 Expression Endocrinology, February 1, 2003; 144(2): 467 - 473. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E Fattore, R Fanelli, and C La Vecchia Persistent organic pollutants in food: public health implications J Epidemiol Community Health, November 1, 2002; 56(11): 831 - 832. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Martinez, C. A. Afshari, P. R. Bushel, A. Masuda, T. Takahashi, and N. J. Walker Differential Toxicogenomic Responses to 2,3,7,8-Tetrachlorodibenzo-p-dioxin in Malignant and Nonmalignant Human Airway Epithelial Cells Toxicol. Sci., October 1, 2002; 69(2): 409 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Zhao, E. A. Pritts, V. A. Chao, J.-F. Savouret, and R. N. Taylor Dioxin stimulates RANTES expression in an in-vitro model of endometriosis Mol. Hum. Reprod., September 1, 2002; 8(9): 849 - 854. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. B. Starr Significant Shortcomings of the U.S. Environmental Protection Agency's Latest Draft Risk Characterization for Dioxin-Like Compounds Toxicol. Sci., November 1, 2001; 64(1): 7 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Smith and P. Lopipero Invited Commentary: How Do the Seveso Findings Affect Conclusions Concerning TCDD as a Human Carcinogen? Am. J. Epidemiol., June 1, 2001; 153(11): 1045 - 1047. [Full Text] [PDF]
|
|
|
|
|
|
P. A. Bertazzi, D. Consonni, S. Bachetti, M. Rubagotti, A. Baccarelli, C. Zocchetti, and A. C. Pesatori Bertazzi et al. Respond to Smith and Lopipero Am. J. Epidemiol., June 1, 2001; 153(11): 1048 - 1049. [Full Text] [PDF]
|
|