Dioxins and polychlorinated biphenyls (PCBs) are persistent organic pollutants widely distributed in the food chain, which is the main source of human exposure. Their effects on human health at background exposure levels are still poorly understood. Recent epidemiological evidence suggests a possible association between these pollutants and diabetes. We report here the results of a population-based study in Belgium on 257 (142 women and 115 men) environmentally exposed subjects, including 10 cases of endometriosis and nine cases of diabetes. Seventeen 2,3,7,8-polychlorinated dibenzodioxins/dibenzofurans (PCDD/Fs or dioxins), four coplanar PCBs (International Union of Pure and Applied Chemistry [IUPAC] nos 77, 81, 126 and 169) and 12 PCB markers (IUPAC nos 3, 8, 28, 52, 101, 118, 138, 153, 180, 194, 206 and 209) were quantified in serum fat from fasting blood samples in order to estimate the body burden of these pollutants. Whilst no difference was found between women with endometriosis and their controls, diabetic patients had significantly increased serum levels of dioxins, coplanar PCBs and the 12 PCB markers. After adjustment for age and other covariates, serum total toxic equivalent activity (sum of PCDD/Fs and coplanar PCBs) and 12 PCB marker concentrations in diabetics were 62% (p = 0.0005) and 39% (p = 0.0067) higher, respectively, than in controls. The risk of diabetes was significantly increased in subjects in the top decile for adjusted concentrations of dioxins (odds ratio 5.1, 95% confidence interval [CI] 1.18-21.7), coplanar PCBs (odds ratio 13.3, 95% CI 3.31-53.2) or 12 PCB markers (odds ratio 7.6, 95% CI 1.58-36.3). These findings warrant further studies to assess the significance of the associations between diabetes and environmental exposure to polychlorinated pollutants.

This paper presents the main findings of a study on health effects of environmental cadmium pollution in China, performed in 1998, i.e. approximately 25 years after the first warnings of such effects were published in Ambio. Forearm bone mineral density (BMD) and renal dysfunction were assessed in population groups exposed to cadmium via rice. Decreased BMD was found in postmenopausal women with elevated urinary cadmium (CdU) or cadmium in blood (CdB) and among men with elevated CdB. Also, clear and statistically significant dose-effect and dose-response relationships were found between CdB or CdU and renal dysfunction (increased excretion of retinol-binding protein). This is the first report of bone effects among Cd-exposed population groups in Asia outside Japan. The report is also of interest since it demonstrates that bone effects, a comparatively severe adverse health effect of Cd, in combination with renal dysfunction, still occurs in environmentally exposed population groups in Asia. Recent reports on bone effects in Cd-exposed population groups in Europe are discussed.

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The impact of a recently closed old municipal solid waste incinerator (MSWI) on polychlorodibenzo-p-dioxin (PCDD), polychlorodibenzofuran (PCDF), and polychlorinated biphenyl (PCB) levels in the surrounding environment and resident serum has been studied in a small rural area of France. Studied soils and eggs from chickens foraging on these soils were sampled in the vicinity of the MSWI underthe prevailing wind stream, while comparison samples were collected outside the assumed impact zone. PCB levels observed in soils and eggs did not differ statistically from comparison sites. This confirmed the low impact of MSWI PCB emission on environmental media, compared to other well-known sources. PCDD/PCDF levels in soils and eggs were significantly higher than in comparison samples, pointing out the impact of MSWI emission on the surrounding environment. The high dioxin concentrations in eggs set aside for private consumption would increase the dioxin intake for the studied population. Blood specimens of 10 nonoccupationally exposed volunteers who had lived within a 2 km radius of the incinerator for at least 25 years have been analyzed. When adjusted for age, PCB and PCDD/F blood levels were higher than general European populations and comparable to a similarly exposed Belgian population.

We evaluated the impact of two iron and steel plants and two municipal solid waste incinerators (MSWI) in Wallonia (Belgium) on the exposure of residents to dioxins, polychlorinated biphenyls (PCBs), and heavy metals. In total, 142 volunteers living around these facilities were recruited and compared with 63 referents from a rural area with no industrial source of pollution. Information about smoking habits, dietary habits, anthropometric characteristics, residential history, and health status was obtained from a self-administered questionnaire. The volunteers provided blood under fasting conditions in order to evaluate the body burden of dioxins (17 polychlorinated dibenzo-p-dioxins/dibenzofurans [PCDD/Fs] congeners) and PCBs. Samples of blood and urine were also taken for the determination of cadmium, mercury, and lead. After adjustment for covariates, concentrations of cadmium, mercury, and lead in urine or blood were not increased in subjects living in the vicinity of MSWIs or sinter plants by comparison with referents. Residents around the sinter plants and the MSWI located in the industrial area had concentrations of dioxins and PCBs in serum similar to that of referents. By contrast, subjects living in the vicinity of the MSWI in the rural area showed significantly higher serum levels of dioxins (geometric mean, 38 vs. 24 pg TEQ/g fat) and coplanar PCBs (geometric mean, 10.8 vs. 7.0 pg TEQ/g fat). Although age-adjusted dioxin levels in referents did not vary with local animal fat consumption, concentrations of dioxins in subjects living around the incinerators correlated positively with their intake of local animal fat, with almost a doubling in subjects with the highest fat intake. These results indicate that dioxins and coplanar PCBs emitted by MSWIs can indeed accumulate in the body of residents who regularly consume animal products of local origin.

No evidence for excessive thyroid cancer incidence around the Belgian nuclear power plants was found. On the other hand, an increased incidence of thyroid cancer was observed around the sites with other nuclear activities. Further research is recommended to verify whether the observed increases could be related to the site-specific nuclear activities.

The Belgian PCB/dioxin incident is a food contamination that occurred in Belgium in January 1999 when a tank of recycled fats used to produce animal feeds was accidentally contaminated by approximately 100 L of polychlorinated biphenyl (PCB) oil containing 50 kg PCBs expressed as the sum of the seven markers, 1 g (TEQ) dioxins (PCDD/Fs) and 2 g toxic equivalent (TEQ) dioxin-like PCBs. The incident was discovered when a poultry poisoning resembling the classic chick edema disease broke out in several farms that had received contaminated feeds. The delay in making public this incident resulted in a major political and food crisis and caused much concern in the population. We review here the health risk evaluations that were made after this incident and we assess the likelihood of the different scenarios by taking into account recent data on the real scale of the contamination and on the dioxin body burden of the general population in Belgium. These new data confirm that the incident was too limited in time and in scale to have increased the PCB/dioxin body burden of the general population at large, a conclusion supported by a survey of dioxin levels in blood conducted at the end of 1999. Only farmers in poultry farms affected by the incident (about 30 farms) and having regularly consumed their own products could have increased their PCB/dioxin body burden. It is unlikely, however, that these farmers could have increased their PCB/dioxin body burden above levels prevailing in the 1980s or now found in communities regularly consuming seafood.