Hepatic and gastrointestinal effects in an occupational cohort exposed to 2,3,7,8-tetrachlorodibenzo-para-dioxin.
OBJECTIVE
To examine the effect of occupational exposure to substances contaminated with 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) on the liver and gastrointestinal system.


METHODS
A medical survey.


METHODS
The exposed participants were employed at two chemical plants more than 15 years earlier in the manufacture of sodium trichlorophenol and its derivatives. The reference group consisted of individuals with no occupational exposure to phenoxy herbicides and who lived within the communities of the workers. A total of 281 workers and 260 unexposed referents participated in the medical study.


RESULTS
The workers had substantial exposure to substances contaminated with TCDD, as evidenced by a mean serum TCDD level, lipid adjusted, of 220 pg per gram of lipid compared with a mean of 7 pg per gram of lipid in the referents. Compared with the unexposed reference group, workers had a statistically significantly elevated risk for an out-of-range gamma-glutamyltransferase (GGT) level (odds ratio, 2.27; 95% confidence interval, 1.17 to 4.39 [unadjusted for confounders]). In multivariate analyses run with logistic regression, a statistically significant interaction was found between TCDD exposure and lifetime alcohol consumption, indicating that the elevated risk for an out-of-range GGT was confined to those workers with a history of alcohol consumption and that the risk among the alcohol-consuming workers for an out-of-range GGT increased with increasing TCDD level. No difference was found between workers and referents for any of the other liver and gastrointestinal outcomes of interest.


CONCLUSIONS
This study found no evidence of an elevated risk for clinical hepatic or gastrointestinal disease in a group of workers with high exposure to TCDD. However, TCDD-exposed workers with a history of sufficient alcohol consumption were found to have a statistically significantly elevated risk for an out-of-range GGT compared with referents.
Calvert
G M
GM
Division of Surveillance, Hazard Evaluations, and Field Studies, NIOSH, Cincinnati, OH 45226.
Hornung
R W
RW
Sweeney
M H
MH
Fingerhut
M A
MA
Halperin
W E
WE
D003430:Cross-Sectional Studies; D005767:Gastrointestinal Diseases / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000453:epidemiology*; D008923:Missouri / Q000453:epidemiology; D009515:New Jersey / Q000453:epidemiology; D009784:Occupational Diseases / Q000097:blood / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects*; D012044:Regression Analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
D000072317:Polychlorinated Dibenzodioxins; D005723:gamma-Glutamyltransferase