title: Cancer incidence in the population exposed to dioxin after the "Seveso accident": twenty years of follow-up.
abstract: BACKGROUND
  The Seveso, Italy accident in 1976 caused the contamination of a large population by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Possible long-term effects have been examined through mortality and cancer incidence studies. We have updated the cancer incidence study which now covers the period 1977-96.
  
  
  METHODS
  The study population includes subjects resident at the time of the accident in three contaminated zones with decreasing TCDD soil levels (zone A, very high; zone B, high; zone R, low) and in a surrounding non-contaminated reference territory. Gender-, age-, and period-adjusted rate ratios (RR) and 95% confidence intervals (95% CI) were calculated by using Poisson regression for subjects aged 0-74 years.
  
  
  RESULTS
  All cancer incidence did not differ from expectations in any of the contaminated zones. An excess of lymphatic and hematopoietic tissue neoplasms was observed in zones A (four cases; RR, 1.39; 95% CI, 0.52-3.71) and B (29 cases; RR, 1.56; 95% CI, 1.07-2.27) consistent with the findings of the concurrent mortality study. An increased risk of breast cancer was detected in zone A females after 15 years since the accident (five cases, RR, 2.57; 95% CI, 1.07-6.20). No cases of soft tissue sarcomas occurred in the most exposed zones (A and B, 1.17 expected). No cancer cases were observed among subjects diagnosed with chloracne early after the accident.
  
  
  CONCLUSIONS
  The extension of the Seveso cancer incidence study confirmed an excess risk of lymphatic and hematopoietic tissue neoplasms in the most exposed zones. No clear pattern by time since the accident and zones was evident partly because of the low number of cases. The elevated risk of breast cancer in zone A females after 15 years since the accident deserves further and thorough investigation. The follow-up is continuing in order to cover the long time period (even decades) usually elapsing from exposure to carcinogenic chemicals and disease occurrence.
authors.affiliation: Unit of Epidemiology, Department of Preventive Medicine, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via San Barnaba 8, 20122 Milano, Italy. angela.pesatori@unimi.it
authors.forename: Angela Cecilia
authors.initials: AC
authors.lastname: Pesatori
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.forename: Maurizia
authors.initials: M
authors.lastname: Rubagotti
authors.forename: Paolo
authors.initials: P
authors.lastname: Grillo
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Bertazzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002617:Chemical Industry; D002648:Child; D002675:Child, Preschool; D004147:Dioxins / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D055906:Seveso Accidental Release / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D004147:Dioxins; D004785:Environmental Pollutants