title: Mortality risk among workers with exposure to dioxins.
abstract: BACKGROUND
  In several studies, dioxin exposure has been associated with increased risk from several causes of death.
  
  
  OBJECTIVE
  To compare the mortality experience of workers exposed to dioxins during trichlorophenol (TCP) and pentachlorophenol (PCP) production to that of the general population and to examine mortality risk by estimated exposure levels.
  
  
  METHODS
  A retrospective cohort study which followed up workers' vital status from 1940 to 2011, with serum surveys to support estimation of historical dioxin exposure levels.
  
  
  RESULTS
  Among the 2192 study subjects, there were nine deaths in TCP workers from acute non-lymphatic leukaemia [standardized mortality ratio (SMR) = 2.88, 95% confidence interval (CI) 1.32-5.47], four mesothelioma deaths (SMR = 5.12, 95% CI 1.39-13.10) and four soft tissue sarcoma (STS) deaths (SMR = 3.08, 95% CI 0.84-7.87). In PCP workers, there were eight deaths from non-Hodgkin's lymphoma (SMR = 1.92, 95% CI 0.83-3.79), 150 from ischaemic heart disease (SMR = 1.20, 95% CI 1.01-7.89) and five from stomach ulcers (SMR = 3.38, 95% CI 1.10-7.89). There were no trends of increased mortality with increased dioxin exposure except for STS and 2,3,7,8-tetrachlorodibenzo-p-dioxin levels. This finding for STS should be interpreted with caution due to the small number of deaths and the uncertainty in diagnosis and nosology.
  
  
  CONCLUSIONS
  While some causes of death were greater than expected, this study provides little evidence of increased risk when dioxin exposures are considered.
authors.affiliation: Saginaw Valley State University, University Center, MI 48710, USA, jjcollin@svsu.edu.
authors.forename: J J
authors.initials: JJ
authors.lastname: Collins
authors.affiliation: Health Services, The Dow Chemical Company, Midland, MI 48674, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Bodner
authors.affiliation: Summit Toxicology, Falls Church, VA 22041, USA.
authors.forename: L L
authors.initials: LL
authors.lastname: Aylward
authors.affiliation: Health Services, The Dow Chemical Company, Midland, MI 48674, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Bender
authors.affiliation: Health Services, The Dow Chemical Company, Midland, MI 48674, USA.
authors.forename: S
authors.initials: S
authors.lastname: Anteau
authors.affiliation: Health Services, The Dow Chemical Company, Midland, MI 48674, USA.
authors.forename: M
authors.initials: M
authors.lastname: Wilken
authors.affiliation: Health Services, The Dow Chemical Company, Midland, MI 48674, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Bodnar
mesh_terms: D002617:Chemical Industry / Q000592:standards / Q000706:statistics & numerical data; D015331:Cohort Studies; D004147:Dioxins / Q000633:toxicity*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects / Q000633:toxicity; D012189:Retrospective Studies; D012509:Sarcoma / Q000453:epidemiology / Q000209:etiology; D013276:Stomach Ulcer / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D000078329:Workforce
chemical_list: D004147:Dioxins; D000072317:Polychlorinated Dibenzodioxins
keywords: Bio-monitoring; cancer; dioxin; exposure estimation.