title: Health effects of dioxin exposure: a 20-year mortality study.
abstract: 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.
authors.affiliation: EPOCA, Research Center for Occupational, Clinical and Environmental Epidemiology, Department of Occupational and Environmental Health, University of Milan, Milan, Italy. pieralberto.bertazzi@unimi.it
authors.forename: P A
authors.initials: PA
authors.lastname: Bertazzi
authors.forename: D
authors.initials: D
authors.lastname: Consonni
authors.forename: S
authors.initials: S
authors.lastname: Bachetti
authors.forename: M
authors.initials: M
authors.lastname: Rubagotti
authors.forename: A
authors.initials: A
authors.lastname: Baccarelli
authors.forename: C
authors.initials: C
authors.lastname: Zocchetti
authors.forename: A C
authors.initials: AC
authors.lastname: Pesatori
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality*; D000072317:Polychlorinated Dibenzodioxins / Q000506:poisoning*; D011159:Population Surveillance; D013723:Teratogens; D013997:Time Factors
chemical_list: D000072317:Polychlorinated Dibenzodioxins; D013723:Teratogens