In 1971, sludge wastes contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin were mixed with waste oil and sprayed on a dirt road at the Quail Run Mobile Home Park in Gray Summit, Mo. We performed a comprehensive examination of 154 exposed and 155 unexposed persons in the area. There were no consistent differences between the two groups on medical history, physical examination, serum and urinary chemistry studies, and neurologic tests. Results of liver function tests suggested possible subclinical effects. The exposed group had an increased frequency of anergy (11.8% vs 1.1%) and relative anergy (35.3% vs 11.8%). The exposed group also had non-statistically significant increased frequencies of abnormal T-cell subset test results (10.4% vs 6.8%), a T4/T8 ratio of less than 1.0 (8.1% vs 6.4%), and an abnormality in the functional T-cell test results (12.6% vs 8.5%). These findings suggest that long-term exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin is associated with depressed cell-mediated immunity, although the effects have not resulted in an excess of clinical illness in the exposed group. Further studies are indicated to elucidate the pathophysiology and clinical significance of these immunologic findings.

This study investigated the effects of emissions from the internal combustion engine on pulmonary function and respiratory symptoms in men collecting tolls and directing traffic in areas with high levels of air pollution. Bridge and tunnel officers (BTOs) were administered pulmonary function tests and respiratory questionnaires for up to 11 consecutive years (n = 944). Carboxyhemoglobin levels were also measured. Regression coefficients on year tested were calculated on 466 individuals (49% of all BTOs) tested at least 3 years. The tunnel workers had significantly lower FEV1S (forced expiratory volume at one second) and FVCs (forced vital capacity), respiratory symptoms, and higher carboxyhemoglobin levels than the bridge workers. BTOs working over 20 years had the lowest mean pulmonary function values, the steepest slopes, and the most respiratory symptoms. We believe that the data show an association between working as a bridge and tunnel officer and decreased pulmonary function and increased respiratory symptoms, but it was not readily evident whether the effects were of clinical importance.

The human health effects of long-term exposure to low levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) have not been well established. The results of a prior study showed that persons exposed to TCDD had depressed cell-mediated immunity, and 18 of 51 persons had anergy or relative anergy on skin testing. This paper presents the results of a medical follow-up on participants who were reported to be anergic or relatively anergic in the earlier study. None of the participants in the follow-up study was anergic, and only one exposed and one unexposed participant were relatively anergic. Several technical and biological possibilities for the difference in results of the two studies are presented. The possibility that recovery from the effects of TCDD exposure caused the differing results is the least plausible explanation for the changes in the skin test results.

side stream or exhaled mainstream smoke emitted from a smoker. In 1986, involuntary smoking was the focus of an entire surgeon general's report, The Health Consequences of Involuntary Smoking. The 1986 report concluded that involuntary smoking was dangerous to everyone, not just those with heart and lung disease. The report documented that repeated exposure to smoke from cigarettes caused lung cancer and was associated with adverse respiratory effects, especially in children. The report also explained that simply separating smokers and nonsmokers who shared the same air did not protect them from secondhand smoke exposure (Koop, 1986). The 2006 surgeon general's report confirmed these findings, stating that ventilation systems are not a safe or financially viable option to separate nonsmokers from secondhand smoke (U.S.

Waste oil contaminated with 2,3,7,8-TCDD was sprayed at various sites in the state of Missouri. Eighty-two individuals who reported living or working in TCDD-contaminated areas and 40 individuals with little or no exposure to TCDD were selected for study; 85% elected to participate in the study. Data were obtained from medical histories, general physicals, neurological and dermatological examinations, and laboratory tests. There were no cases of chloracne reported. The only hematologic comparison that was significant was a higher mean platelet count in the exposed group. This study did not produce any firm indication of increased disease prevalence related to environmental TCDD exposures. Since this was a pilot study, it is important that we continue to limit human exposure to dioxin to the lowest levels technologically feasible until definitive answers to the health consequences of exposure are determined.