title: Mortality in a population exposed to dioxin after the Seveso, Italy, accident in 1976: 25 years of follow-up.
abstract: The Seveso accident in 1976 caused a large, populated area north of Milan, Italy, to be contaminated by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). In this study, the authors followed up the exposed population for chronic effects; this paper reports the results of the mortality follow-up extension for 1997-2001. The study cohort includes 278,108 subjects resident at the time of the accident or immigrating/born in the 10 years thereafter in three contaminated zones with decreasing TCDD soil levels (zone A, very high; zone B, high; zone R, low) and in a reference territory comprising surrounding, noncontaminated municipalities. Vital status and cause-of-death ascertainment were 99% complete. Adjusted rate ratios and 95% confidence intervals were calculated by using Poisson regression. Results confirmed previous findings of excesses of lymphatic and hematopoietic tissue neoplasms in zones A (six deaths; rate ratio = 2.23, 95% confidence interval: 1.00, 4.97) and B (28 deaths; rate ratio = 1.59, 95% confidence interval: 1.09, 2.33). These zones also showed increased mortality from circulatory diseases in the first years after the accident, from chronic obstructive pulmonary disease, and from diabetes mellitus among females. A toxic and carcinogenic risk to humans after high TCDD exposure is supported by the results of this study.
authors.affiliation: Unit of Epidemiology, Department of Preventive Medicine, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.forename: Angela C
authors.initials: AC
authors.lastname: Pesatori
authors.forename: Carlo
authors.initials: C
authors.lastname: Zocchetti
authors.forename: Raffaella
authors.initials: R
authors.lastname: Sindaco
authors.forename: Luca Cavalieri
authors.initials: LC
authors.lastname: D'Oro
authors.forename: Maurizia
authors.initials: M
authors.lastname: Rubagotti
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Bertazzi
mesh_terms: D000062:Accidents, Occupational; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002617:Chemical Industry; D003920:Diabetes Mellitus / Q000401:mortality; D004147:Dioxins / Q000506:poisoning*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000401:mortality; D008297:Male; D009369:Neoplasms / Q000401:mortality; D016012:Poisson Distribution; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality
chemical_list: D004147:Dioxins