Industrial disasters and epidemiology. A review of recent experiences.

Bertazzi, Pier Alberto

doi:10.5271/sjweh.1867

Cited by 75 publications

(27 citation statements)

References 37 publications

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“…The former could have precipitated early deaths among persons with preexisting ill health conditions (44). This hypothesis is supported by the early postaccident occurrence of the deaths, the advanced age of some of the affected people, and the prevailing chronic type of cardiovascular disorders (40).…”

Section: Discussionmentioning

confidence: 97%

“…This hypothesis is supported by the early postaccident occurrence of the deaths, the advanced age of some of the affected people, and the prevailing chronic type of cardiovascular disorders (40). TCDD alters lipid metabolism, cardiac function, and morphology in experimental studies with animals (45)(46)(47)(48)(49)(50)(51)(52), although data for humans are still inconclusive (53 (44). In addition, the immunotoxic action of dioxin may have impaired defense mechanisms that usually protect against respiratory infection episodes, which play major roles in the natural history of COPD (54).…”

Section: Discussionmentioning

confidence: 99%

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The Seveso studies on early and long-term effects of dioxin exposure: a review.

Bertazzi

Bernucci

Brambilla

et al. 1998

Environ Health Perspect

196

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The industrial accident that occurred in the town of Seveso, Italy, in 1976 exposed a large population to substantial amounts of relatively pure 2,3,7,8-tetrachlorodibenzo-p-dioxin. Extensive monitoring of soil levels and measurements of a limited number of human blood samples allowed classification of the exposed population into three categories, A (highest exposure), B (median exposure), and R (lowest exposure). Early health investigations including liver function, immune function, neurologic impairment, and reproductive effects yielded inconclusive results. Chloracne (nearly 200 cases with a definite exposure dependence) was the only effect established with certainty. Long-term studies were conducted using the large population living in the surrounding noncontaminated territory as reference. An excess mortality from cardiovascular and respiratory diseases was uncovered, possibly related to the psychosocial consequences of the accident in addition to the chemical contamination. An excess of diabetes cases was also found. Results of cancer incidence and mortality follow-up showed an increased occurrence of cancer of the gastrointestinal sites and of the lymphatic and hematopoietic tissue. Experimental and epidemiologic data as well as mechanistic knowledge support the hypothesis that the observed cancer excesses are associated with dioxin exposure. Results cannot be viewed as conclusive. The study is continuing in an attempt to overcome the existing limitations (few individual exposure data, short latency period, and small population size for certain cancer types) and to explore new research paths (e.g., differences in individual susceptibility). -Environ Health Perspect 106(Suppl 2):625-633 (1998). http://ehpnetl.niehs.nih.gov/docs/1998/Suppl-2/625-633bertazzi/abstract.html

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

The Seveso studies on early and long-term effects of dioxin exposure: a review.

Bertazzi

Bernucci

Brambilla

et al. 1998

Environ Health Perspect

196

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“…Earlier disaster studies, e.g., on the aftermath of the incident with a nuclear reactor at Three Mile Island, Pennsylvania (1979), have demonstrated that signs and symptoms of psychological distress may be measured as long as 6 years after an event (5). Increased mortality from cardiovascular disease attributed to the effects of stress has been reported after the 1976 disaster with highly toxic dioxin at Seveso, Italy (6). In the case of the Chernobyl disaster the occurrence of psychological distress in the exposed population has been documented, but the clinical significance of this is as yet unknown (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Health Effects of the Chernobyl Disaster: Illness or Illness Behavior? A Comparative General Health Survey in Two Former Soviet Regions

Havenaar¹,

Rumyantzeva²,

Kasyanenko³

et al. 1997

Environmental Health Perspectives

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Results are described of a general health survey (n= 3044) that was conducted 6.5 years after the Chernobyl accident in 1986 in a seriously contaminated region in Belarus and a socioeconomically comparable, but unaffected, region in the Russian Federation. The purpose of the study was to investigate whether there are differences in the general health status of the inhabitants of the two regions that may be attributed to the Chernobyl disaster. A broad-based population sample from each of these regions was studied using a variety of self-report questionnaires. A subsample (n=449) was further examined with a standardized physical and psychiatric examination. The results show significantly higher scores on the self-report questionnaires and higher medical service utilization in the exposed region. No significant differences were observed in global clinical indices of health. Although there were trends for some disorders to be more prevalent in the exposed region, none of these could be directly attributed to exposure to ionizing radiation. The results of this study suggest that the Chernobyl disaster had a significant long-term impact on psychological well-being, health-related quality of life, and illness behavior in the exposed population. Environ Health Perspect 105(Suppl 6): 1533-1537 (1997)

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“…Koplan et al [66] suggested that epidemiologic studies following disasters should accurately establish dose-response relationship which would be useful in identifying exposed and ill persons and determining longterm effects. Selection of cohort was recommended by Betrazii [67] for epidemiological studies rather than use of a population registry to avoid two major biases: (1) dilution of exposure prevalence and (2) selective migration of people from the disaster area. Some of the Bhopal population might have left Bhopal forever immediately after the disaster, thus resulting in dilution of exposure prevalence in the selected cohort.…”

Section: Deficiencies In Earlier Reports and Future Directionmentioning

confidence: 99%