Cancer, Heart Disease, and Diabetes in Workers Exposed to 2,3,7,8-Tetrachlorodibenzo-p-dioxin

Steenland, Kyle; Piacitelli, Laurie A.; Deddens, James A.; Fingerhut, Marilyn A.; Chang, Lih Ing

doi:10.1093/jnci/91.9.779

Cited by 258 publications

(263 citation statements)

References 15 publications

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“…These findings are consistent with other studies of TCP and PCP workers (Ott et al, 1993;Schecter et al, 1996;Heederik et al, 1998;Coenraads et al, 1999;Ryan and Schecter, 2000). As mentioned earlier, the chlorophenol workers from the Midland plant have been included in the NIOSH Dioxin Registry (Steenland et al, 1999;Piacitelli et al, 2000). Recent analyses of this Registry have omitted workers with PCP and TCP exposure to ''avoid possible confounding of 2,3,7,8-TCDD effects with PCP'' (Steenland et al, 1999).…”

Section: Congeners In Pptsupporting

confidence: 80%

“…As mentioned earlier, the chlorophenol workers from the Midland plant have been included in the NIOSH Dioxin Registry (Steenland et al, 1999;Piacitelli et al, 2000). Recent analyses of this Registry have omitted workers with PCP and TCP exposure to ''avoid possible confounding of 2,3,7,8-TCDD effects with PCP'' (Steenland et al, 1999). Our evaluation of serum dioxin levels in this study indicated that PCP and TCP workers have similar TEQs based on congener potencies to 2,3,7,8-TCDD.…”

Section: Congeners In Pptmentioning

confidence: 99%

“…Examination of these medical records indicated that 15% of these workers (313 of 2072) were diagnosed with definite or probable chloracne. Chloracne was uncommon among these workers before 1964 with 91% of the cases occurring between 1964 and 1979. Most of the workers in this study were also included in both the International Agency for Research on Cancer (IARC) study, (Kogevinas et al, 1997) and the National Institute of Occupational Safety and Health (NIOSH) Dioxin Registry (Steenland et al, 1999). In addition to being the largest single group of workers in these studies, the Dow chlorophenol workers have the longest follow-up, a maximum of 55 years and a minimum of 24 years, of any study group in either of these combined studies.…”

Section: Introductionmentioning

confidence: 99%

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Serum dioxin levels in former chlorophenol workers

Collins

Budinsky

Burns

et al. 2005

J Expo Sci Environ Epidemiol

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Using gas chromatography/mass spectrometry, we measured lipid-adjusted serum levels for all 2,3,7,8-substituted dioxins and furans, and four coplanar polychlorinated biphenyls in 62 workers with chlorophenol exposure and 36 workers without chlorophenol exposures working at the same plant during the same time. We oversampled among workers diagnosed with chloracne. Mean dioxin background levels from 36 nonchlorophenol workers were estimated as 6.0 parts-per-trillion (ppt) for 2,3,7,8 tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) and 67.5 ppt for 1,2,3,4,6,7,8 heptachlorodibenzo-pdioxin (Hepta-CDD). We found different dioxin and furan profiles for trichlorophenol and pentachlorophenol (PCP) workers. Among trichlorophenol workers with chloracne, we found 2,3,7,8-TCDD (mean ¼ 30.5 ppt) above background levels and among PCP workers with chloracne, we found high levels of Hepta-CDD (mean ¼ 312.5 ppt) and other higher chlorinated dioxins and furans. Cumulative exposure estimates for dioxins for both 2,3,7,8-TCDD and the higher chlorinated dioxins created in the early 1980s for our epidemiology studies were highly correlated with serum dioxin levels when age and body mass index were taken into account. While workers previously diagnosed with chloracne had high serum dioxin levels, some workers without diagnosed chloracne also had high levels. Among tradesworkers with plant-wide responsibilities, we observed serum dioxins and PCB levels higher than background indicating workplace exposures. We estimate that the mean level of 2,3,7,8-TCDD present in the serum of workers on the date workplace exposure terminated was 267 ppt (ranging from 8 to 1184 ppt) assuming a 9-year half-life, 582 ppt (ranging from 10 to 2,641 ppt) assuming a 7-year halflife, and 1928 ppt (ranging from 22 to 17,847) when a toxicokinetic model is used. We conclude that our findings are consistent with other studies reporting high serum dioxin levels among chlorophenol workers after occupational exposures.

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Section: Congeners In Pptsupporting

confidence: 80%

Section: Congeners In Pptmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum dioxin levels in former chlorophenol workers

Collins

Budinsky

Burns

et al. 2005

J Expo Sci Environ Epidemiol

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“…Several reports based on mortality rates analysis [6,7] or on self-reported diabetes also show associations between environmental pollution levels and prediabetes and/or diabetes [8][9][10]. However, in only few studies was diabetes diagnosed with the aid of fasting plasma glucose (FPG) (≥126 mg/dl [7.0 mmol/l]), HbA 1c (>6.1%) [9] or random glucose level (≥200 mg/dl=11.1 mmol/l) [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail

et al. 2010

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Aims/hypothesis A heavily polluted area of Eastern Slovakia was targeted by the PCBRISK cross-sectional survey to search for possible links between environmental pollution and both prediabetes and diabetes. Methods Associations of serum levels of five persistent organic pollutants (POPs), namely polychlorinated biphenyls (PCBs), 2,2′-bis(4-chlorophenyl)-1,1-dichloroethylene (p,p′-DDE), 2,2′-bis(4-chlorophenyl)-1,1,1-trichloro-ethane (p,p′-DDT), hexachlorobenzene (HCB) and β-hexachlorocyclohexane (β-HCH), with prediabetes and diabetes were investigated in 2,047 adults. Diabetes and prediabetes were diagnosed by fasting plasma glucose in all participants and by OGTT in 1,220 compliant participants. Results Our population was stratified in terms of individual POPs quintiles and associations between environmental pollution, prediabetes and diabetes were investigated. Prevalence of prediabetes and diabetes increased in a dose-dependent manner, with individuals in upper quintiles of individual POPs showing striking increases in prevalence of prediabetes as shown by OR and 95% CI for PCBs (2.74; 1.92-3.90), DDE (1.86; 1.17-2.95), DDT (2.48; 1.77-3.48), HCB (1.86; 1.7-2.95) and β-HCH (1.97; 1.28-3.04). Interestingly, unlike PCBs, DDT and DDE, increased levels of HCB and β-HCH seemed not to be associated with increased prevalence of diabetes. Nevertheless, individuals in the 5th quintile of the variable expressing the cumulative effect of all five POPs (sum of orders) had a more than tripled prevalence of prediabetes and more than six times higher prevalence of diabetes when compared with the 1st referent quintile. Conclusions/interpretation Increasing serum concentrations of individual POPs considerably increased prevalence of prediabetes and diabetes in a dose-dependent manner. Interaction of industrial and agricultural pollutants in increasing prevalence of prediabetes or diabetes is likely.

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“…Exposure to dioxins has recently been associated with an increased risk of diabetes [1]. Prospective cohort studies of individuals exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most potent dioxin congener of persistent organic pollutants (POPs) in occupational or accidental settings, have reported increased risk of diabetes, modified glucose metabolism or insulin resistance [2][3][4][5][6]. Type 2 diabetes was associated with the exposure to dioxin-containing Agent Orange in Vietnam [7].…”

mentioning

confidence: 99%

A cross-sectional study of the association between persistent organic pollutants and glucose intolerance among Greenland Inuit

Jørgensen

Borch‐Johnsen

Bjerregaard³

2008

Diabetologia

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Aims/hypothesis Some evidence supports the hypothesis that persistent organic pollutants (POPs) may increase the risk of type 2 diabetes. The Inuit population in Greenland, which is highly exposed to POPs due to a high intake of marine mammals, has experienced a rapid increase in diabetes prevalence over the last 30 years. Thus the aim was to study the association between POPs and glucose intolerance and markers of insulin resistance and insulin secretion using a population-based design. Methods From 1999 to 2002 the Greenland population study was carried out among adult Inuit living in Greenland. The examination included a 75 g OGTT, anthropometric measurements, a structured interview, and blood tests. Plasma glucose and serum insulin were analysed, and three defined subclasses of POPs were analysed in a subgroup. Associations were adjusted for age, sex, waist circumference, Inuit heritage, cigarette smoking, alcohol consumption and educational level. Results Data on POPs were available on 692 individuals, 305 men (mean age 50 years) and 387 women (mean age 49 years). The prevalence of diabetes was 10.3%, and 10.5% had impaired glucose tolerance. The concentrations of several POPs were exceptionally high. While no associations were found between POPs and stages of glucose intolerance or markers of insulin resistance, POPs were significantly inversely associated with stimulated insulin concentrations and homeostasis model assessment of beta cell function. Conclusions/interpretation The study indicates that POPs may affect insulin secretion rather than being involved in the pathogenesis of insulin resistance. No association was seen between POPs and glucose intolerance or markers of insulin resistance.

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Cancer, Heart Disease, and Diabetes in Workers Exposed to 2,3,7,8-Tetrachlorodibenzo-p-dioxin

Cited by 258 publications

References 15 publications

Serum dioxin levels in former chlorophenol workers

Serum dioxin levels in former chlorophenol workers

High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail

A cross-sectional study of the association between persistent organic pollutants and glucose intolerance among Greenland Inuit

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