ABSTRACr Ten years after an incident in which workers were exposed to tetrachlorodibenzodioxin (TCDD) a controlled biochemical study showed statistically significant increases in the serum cholesterol and triglyceride concentrations of workers both with and without chloracne. Urinary excretion of D-glucaric acid was significantly higher for all workers.Tetrachlorodibenzodioxin (TCDD) is a potent multisystem toxin with high acute toxicity, the LD 50 for several species being of the order of 0 1 mg/kg bodyweight.' Other toxic effects include chloracne, impaired liver function, carcinogenesis, lipid abnormalities, porphyria, peripheral neuropathy, and psychiatric disturbances.' 2 It has been suggested that some of the toxic effects of TCDD may be linked to its enzyme inducing action.35 In epidemiological research on subjects exposed to TCDD life style factors such as social class, alcohol intake, dietary and smoking habits, and drug therapy could have a confounding effect6 because of differences between subjects and controls in the extent of enzyme induction due to agents other than TCDD. In this study, therefore, the subject and control populations were matched for age, social class, alcohol intake, smoking habits, height/weight ratios, and drug therapy.Subjects with and without chloracne who had been exposed to TCDD were tested as, although the presence of chloracne is a good indicator of exposure to TCDD, evidence from a study of workers exposed to a different chloracnegen' shows that it does not necessarily follow that its absence in an individual exposed to TCDD precludes the possibility of other toxic manifestations.
SubjectsThree groups of subjects were recruited. Group A-One hundred and twenty control subjects from an engineering works where there was no exposure to organic chemicals. Most were operatives on shift work but some were management staff.Group B-Fifty four subjects, mainly shift workers but including some laboratory and management staff, with varying levels of exposure to TCDD, but who had never had chloracne.Group C-Forty one subjects, mainly shift workers but including some laboratory and management staff, who had been diagnosed as having chloracne.
MethodsSubjects were asked to fast for 10 hours (overnight) and a venepuncture sample of blood was obtained at 9 30 am for the following biochemical tests: alkaline phosphatase, alanine and aspartate aminotransferase, bilirubin, protein corrected calcium, total and HDL cholesterol, triglyceride and gammaglutamyl transferase (GGT). D-glucaric acid/creatinine ratios (DGA) were measured on a sample of urine taken at the same time. All estimates were carried out using standard methodology in two NHS laboratories with some of the analyses being carried out in both laboratories.
ResultsThe table shows the means and range of values, plus the laboratory's normal range for those of the tests where there were differences between the subjects and controls. Mean cholesterol and triglyceride are significantly higher in groups B and C than in the controls. The pa...