Serum dioxin concentrations and quality of ovarian function in women of Seveso.
BACKGROUND
Although 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has been associated with alterations in ovarian function and hormones in animals, it has not been studied in humans. On 10 July 1976, an explosion exposed residents of Seveso, Italy, to the highest levels of TCDD in a population. Twenty years later, we initiated the Seveso Women's Health Study to study reproductive health.


OBJECTIVE
We related TCDD levels measured in sera collected near the time of explosion and ovarian function (ovarian cysts, ovarian follicles, ovulation rate, serum hormones) at follow-up.


METHODS
We included 363 women who were 20-40 years of age and nonusers of oral contraceptives. We examined the relationship of 1976 serum TCDD levels with ultrasound-detected ovarian follicles among 96 women in the menstrual follicular phase and serum hormone levels (estradiol, progesterone) among 129 women in the menstrual luteal phase at follow-up. Ovulation was defined by serum progesterone levels > 3 ng/mL.


RESULTS
The median serum TCDD level was 77.3 ppt, lipid-adjusted. Serum TCDD was not associated with number or size of ovarian follicles. Of women in the luteal phase, 87 (67%) ovulated. Serum log(10)TCDD was not associated with odds of ovulation [adjusted odds ratio = 0.99; 95% confidence interval (CI), 0.5 to 1.9]. Among those who had ovulated, serum log(10)TCDD was not associated with serum progesterone [adjusted beta (adj-beta ) = -0.70; 95% CI, -2.4 to 1.0] or estradiol (adj-beta = -1.81; 95% CI, -10.4 to 6.8).


CONCLUSIONS
We found no clear evidence that 1976 TCDD exposure was associated with ovarian function 20 years later in women exposed to relatively high levels in Seveso, Italy.
Warner
Marcella
M
School of Public Health, University of California at Berkeley, Berkeley, California 94720-7360, USA. mwarner@berkeley.edu
Eskenazi
Brenda
B
Olive
David L
DL
Samuels
Steven
S
Quick-Miles
Sunita
S
Vercellini
Paolo
P
Gerthoux
Pier Mario
PM
Needham
Larry
L
Patterson
Donald G
DG
Mocarelli
Paolo
P
D000328:Adult; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood* / Q000633:toxicity; D004958:Estradiol / Q000097:blood; D005107:Explosions; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000453:epidemiology; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects; D010053:Ovary / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D010060:Ovulation / Q000187:drug effects; D000072317:Polychlorinated Dibenzodioxins / Q000097:blood* / Q000633:toxicity; D011374:Progesterone / Q000097:blood; D014463:Ultrasonography
D004785:Environmental Pollutants; D000072317:Polychlorinated Dibenzodioxins; D011374:Progesterone; D004958:Estradiol