title: Case report: the University of Michigan dioxin exposure study: a follow-up investigation of a case with high serum concentration of 2,3,4,7,8-pentachlorodibenzofuran.
abstract: BACKGROUND
  Polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, and dioxin-like polychlorinated biphenyls that have toxic equivalency factors (TEFs) were measured in serum of 946 subjects in five Michigan counties. The study was motivated by concerns about human exposure to dioxin-contaminated sediments in the Tittabawassee River (TR). Most of the toxic equivalency in TR sediments is from two furan congeners, 2,3,7,8-tetrachlorodibenzofuran and 2,3,4,7,8-pentachlorodibenzofuran (2,3,4,7,8-pentaCDF).
  
  
  METHODS
  The individual with the highest adjusted (for age, age squared, and body mass index) serum level of 2,3,4,7,8-pentaCDF in the study (42.5 ppt) reported a unique history of raising cattle and vegetables in the floodplain of the TR. Interviews and serum samples were obtained from the index case and 15 other people who ate beef and vegetables raised by the index case. 2,3,4,7,8-pentaCDF in beef lipid was estimated to have been more than three orders of magnitude greater than background (1,780 vs. 1.1 ppt). The mean, median, and 95th percentile for serum 2,3,4,7,8-pentaCDF in the study control population were 6.0, 5.4, and 13.0 ppt, respectively, and were 9.9, 8.4, and 20.5 ppt among beef and vegetable consumers, respectively. Back extrapolation for the index case suggests that his increase in serum concentration of 2,3,4,7,8-pentaCDF above background may have been as high as 146 ppt.
  
  
  CONCLUSIONS
  Consumption of beef and/or vegetables raised on dioxin-contaminated soil may be an important completed pathway of exposure. RELEVANCE TO PUBLIC HEALTH PRACTICE: Animals and crops should not be raised for human consumption in areas contaminated with dioxins.
authors.affiliation: Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA. afranz@umich.edu
authors.forename: Alfred
authors.initials: A
authors.lastname: Franzblau
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hedgeman
authors.forename: Olivier
authors.initials: O
authors.lastname: Jolliet
authors.forename: Kristine
authors.initials: K
authors.lastname: Knutson
authors.forename: Tim
authors.initials: T
authors.lastname: Towey
authors.forename: Qixuan
authors.initials: Q
authors.lastname: Chen
authors.forename: Biling
authors.initials: B
authors.lastname: Hong
authors.forename: Peter
authors.initials: P
authors.lastname: Adriaens
authors.forename: Avery
authors.initials: A
authors.lastname: Demond
authors.forename: David H
authors.initials: DH
authors.lastname: Garabrant
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Gillespie
authors.forename: James
authors.initials: J
authors.lastname: Lepkowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001572:Benzofurans / Q000097:blood* / Q000633:toxicity; D002417:Cattle; D006801:Humans; D008824:Michigan; D008875:Middle Aged; D012989:Soil Pollutants / Q000032:analysis; D055815:Young Adult
chemical_list: D001572:Benzofurans; D012989:Soil Pollutants; C038890:2,3,4,7,8-pentachlorodibenzofuran; C014211:2,3,7,8-tetrachlorodibenzofuran
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