Serum dioxin concentrations and bone density and structure in the Seveso Women's Health Study.
BACKGROUND
2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), a widespread environmental contaminant, is a known endocrine disruptor. In animal studies, TCDD exposure impairs bone metabolism and increases fragility. To our knowledge, no epidemiologic studies have examined this association.


OBJECTIVE
On 10 July 1976, a chemical explosion in Seveso, Italy, resulted in the highest known residential exposure to TCDD. In 1996, we initiated the Seveso Women's Health Study, a retrospective cohort study of the health of the women. In 2008, we followed up the cohort. Here, we evaluated the association between TCDD exposure and bone structure and geometry in adulthood, and considered whether timing of TCDD exposure before achievement of peak bone mass (assumed to occur 2 years after onset of menarche) modified the association.


METHODS
Individual TCDD concentration was measured in archived serum collected soon after the explosion. In 2008, 350 women who were <20 years old in 1976 underwent a dual-energy X-ray absorptiometry (DXA) bone scan. Bone mineral density was measured at the lumbar spine and hip, and hip geometry was extracted from hip DXA scans using the hip structural analysis method.


RESULTS
Among premenopausal women, TCDD serum levels were associated with some indexes indicating better bone structure in women exposed before peak bone mass (n=219), with stronger associations in those exposed before 5 years of age (n=46). In contrast, among postmenopausal women, TCDD levels were associated with evidence of better bone structure in women exposed after peak bone mass (n=48) than in other women (n=18).


CONCLUSIONS
Our current results do not support the hypothesis that postnatal TCDD exposure adversely affects adult bone health. Continued follow-up of women who were youngest at exposure is warranted. Future studies should also focus on those exposed in utero.
Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, California, USA.
Brenda
B
Eskenazi
Marcella
M
Warner
Marcella
M
Sirtori
Thomas
T
Fuerst
Stephen A
SA
Rauch
Paolo
P
Brambilla
Paolo
P
Mocarelli
Alessandro
A
Rubinacci
D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D000072317:Polychlorinated Dibenzodioxins / Q000097:blood*; D012189:Retrospective Studies; D016387:Women's Health; D055815:Young Adult
D000072317:Polychlorinated Dibenzodioxins