Serum dioxin concentrations and risk of uterine leiomyoma in the Seveso Women's Health Study.
Uterine leiomyomata (fibroids), benign neoplasms of the smooth muscle, are a major cause of hysterectomy. Exposure to hormonally active chemicals may play an etiologic role. The authors investigated the risk of uterine leiomyoma associated with exposure to 2,3,7,8,-tetrachlorodibenzo-p-dioxin (TCDD) for women who resided near Seveso, Italy, in 1976 at the time of a chemical explosion. Twenty years later, women enrolled in the Seveso Women's Health Study were asked about history of fibroids, medical records were obtained, and vaginal ultrasonography was performed for a subset. Serum collected soon after the explosion was analyzed for TCDD. A likelihood-based method that combines both historical and current status (ultrasound) data was adapted to estimate the hazard ratio. Of 956 eligible women, 251 (26.3%) had fibroids. Compared with that for women with TCDD levels of < or = 20 parts per trillion, the age-adjusted hazard ratios were 0.58 (95% confidence interval: 0.41, 0.81) for women with levels of 20.1-75.0 parts per trillion and 0.62 (95% confidence interval: 0.44, 0.89) for women with levels of >75.0 parts per trillion. This finding suggests that TCDD may have antiestrogenic effects in the uterine myometrium, in contrast to apparently estrogenic effects previously found in the breast of Seveso Women's Health Study women.
Eskenazi
Brenda
B
Department of Epidemiology, School of Public Health, University of California, Berkeley, CA 94720-7380, USA. eskenazi@berkeley.edu
Warner
Marcella
M
Samuels
Steven
S
Young
Jessica
J
Gerthoux
Pier Mario
PM
Needham
Larry
L
Patterson
Donald
D
Olive
David
D
Gavoni
Nicoletta
N
Vercellini
Paolo
P
Mocarelli
Paolo
P
D000328:Adult; D016001:Confidence Intervals; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy; D007889:Leiomyoma / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008499:Medical Records; D008875:Middle Aged; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects* / Q000097:blood; D013997:Time Factors; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging; D016387:Women's Health
D004785:Environmental Pollutants; D000072317:Polychlorinated Dibenzodioxins