title: Exposure to dioxin and nonneoplastic mortality in the expanded IARC international cohort study of phenoxy herbicide and chlorophenol production workers and sprayers.
abstract: The authors studied noncancer mortality among phenoxyacid herbicide and chlorophenol production workers and sprayers included in an international study comprising 36 cohorts from 12 countries followed from 1939 to 1992. Exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin or higher chlorinated dioxins (TCDD/HCD) was discerned from job records and company questionnaires with validation by biologic and environmental measures. Standard mortality ratio analyses suggested a moderate healthy worker effect for all circulatory diseases, especially ischemic heart disease, among both those exposed and those not exposed to TCDD/HCD. In Poisson regression analyses, exposure to TCDD/HCD was not associated with increased mortality from cerebrovascular disease. However, an increased risk for circulatory disease, especially ischemic heart disease (rate ratio [RR] 1.67, 95% confidence interval [Cl] 1.23-2.26) and possibly diabetes (RR 2.25, 95% Cl 0.53-9.50), was present among TCDD/HCD-exposed workers. Risks tended to be higher 10 to 19 years after first exposure and for those exposed for a duration of 10 to 19 years. Mortality from suicide was comparable to that for the general population for all workers exposed to herbicides or chlorophenols and was associated with short latency and duration of exposure. More refined investigations of the ischemic heart disease and TCDD/HCD exposure association are warranted.
authors.affiliation: Department of Social and Preventive Medicine, State University of New York at Buffalo, USA.
authors.forename: J
authors.initials: J
authors.lastname: Vena
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
authors.forename: H
authors.initials: H
authors.lastname: Becher
authors.forename: T
authors.initials: T
authors.lastname: Benn
authors.forename: H B
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: D
authors.initials: D
authors.lastname: Coggon
authors.forename: D
authors.initials: D
authors.lastname: Colin
authors.forename: D
authors.initials: D
authors.lastname: Flesch-Janys
authors.forename: L
authors.initials: L
authors.lastname: Green
authors.forename: T
authors.initials: T
authors.lastname: Kauppinen
authors.forename: M
authors.initials: M
authors.lastname: Littorin
authors.forename: E
authors.initials: E
authors.lastname: Lynge
authors.forename: J D
authors.initials: JD
authors.lastname: Mathews
authors.forename: M
authors.initials: M
authors.lastname: Neuberger
authors.forename: N
authors.initials: N
authors.lastname: Pearce
authors.forename: A C
authors.initials: AC
authors.lastname: Pesatori
authors.forename: R
authors.initials: R
authors.lastname: Saracci
authors.forename: K
authors.initials: K
authors.lastname: Steenland
authors.forename: M
authors.initials: M
authors.lastname: Kogevinas
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D002617:Chemical Industry; D002733:Chlorophenols / Q000009:adverse effects* / Q000737:chemistry; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology; D004147:Dioxins / Q000009:adverse effects*; D005260:Female; D006540:Herbicides; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure
chemical_list: D002733:Chlorophenols; D004147:Dioxins; D006540:Herbicides