The Mortality Experience of Workers Exposed to Tetrachlorodibenzodioxin in a Trichlorophenol Process Accident

Zack, Judith A.; Suskind, Raymond R.

doi:10.1097/00043764-198001000-00005

Cited by 149 publications

(39 citation statements)

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“…The cancer mortality was not increased among 145 Swedish forestry workers exposed to phenoxy herbicides, but an excess risk was observed among 16 foremen (Hogsted & Westerlund, 1980). Three follow-up studies have been undertaken of small groups of workers exposed to 2,3,7,8-TCDD during accidents in the manufacture of 2,4,5-trichlorophenol; at BASF AG, German Federal Republic (Thiess et al, 1982), at Monsanto, Nitro, West Virginia, USA (Zack & Suskind, 1980), and at Dow Chemical, USA (Cook et al, 1980). Taken together, the three studies show a RR of 1.29, C195 0.78-2.01, for overall cancer mortality.…”

Section: Discussionmentioning

confidence: 99%

A follow-up study of cancer incidence among workers in manufacture of phenoxy herbicides in Denmark

Lynge¹

1985

Br J Cancer

128

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Section: Discussionmentioning

confidence: 99%

A follow-up study of cancer incidence among workers in manufacture of phenoxy herbicides in Denmark

Lynge¹

1985

Br J Cancer

128

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“…In 1978, we were able to identify 122 workers who had been exposed to the trichlorophenol runaway reaction which affected the original four. A standard mortality analysis was conducted on 121 workers in this group (30). As of 1979, the standardized mortality ratio for all causes of death was 69 with 32 deaths observed and 46.41 expected.…”

mentioning

confidence: 99%

Chloracne, "the hallmark of dioxin intoxication".

Rr¹

1985

Scand J Work Environ Health

119

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, "the hallmark of dioxinintoxication." Scand J Work Environ Health II (1985) 165-171. Clinical experiences and laboratory studies are described involving a population of workers who were exposed in a plant making 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), including a trichlorophenol runaway reaction. Workers werefollowed for a period of four years, and 30 years later a mortality analysis was done on those exposed to runaway reaction material to determine possible increased risks for causes of death. Subsequently, a morbidity study on 436 employees involving three cohorts was carried out to determine the long-term health effects associatedwith the production of 2,4,5-T including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The mortality and morbidity studies demonstrated that the standardized mortality ratio for all causes of death was 69, and for cancer at all sites and cardiovascular disease it was 100and 68, respectively. The most significant observations emerging from the morbidity study werethat 86 0J0 of the exposedpersons developed chloracne at some time and that 52.7 070 still had chloracne on examination 20 to 30 years after the initial exposure. There appeared to be no evidence, on a long-term basis, of increased risks for cardiovascular disease, hepatic disease, renal disease, central and peripheral nerve problems, reproductive problems, or birth defects among the exposed and those who had chloracneamong the exposed. Studieson the cellkineticsand pathogenesisof chloracne indicate that TCDD induces the modulation of undifferentiated sebaceous gland cells to keratinocytes. This action results in a disappearance of sebaceous glands and substitution of closed comedones and keratin cysts. Production workers have the highest frequency and severity of chloracne and systemic effects. Populations of users of 2,4,5-T rarely, if ever, develop chloracne, and there appear to be no welldocumented systemic effects. Among populations which live in accidentally or otherwise contaminated environments, there are only a limited number of chloracne cases and no well-documented systemic effects. Sufficientexposureto TCDD can inducechloracne,but systemic manifestations such as peripheral neuritis and transient hepatic dysfunctionoccur only in associationwith and subsequentto the appearance of chloracne. Chloracne is the hallmark of TCDD absorption and biological response in humans.

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“…Although Fingerhut's reassessment (49) moderates the degree of association suggested by the four cohort studies (32,122,177,178) and their addendums (31,84,112), the five confirmed cases still represent an excess number. However, three of these five cases did not directly work in manufacturing, and the extent of their exposure to 2,3,7,8-TCDD is in doubt.…”

Section: The Industrial Cohort Studiesmentioning

confidence: 98%

“…Three US studies (32,122,178) of workers exposed to a variety of dioxins and phenoxy herbicides in manufactur ing facilities were published in 1980. Two of the studies (32, 178) examined cohorts of workers involved in acute accidental exposures.…”

Section: The Industrial Cohort Studiesmentioning

confidence: 99%