Bertazzi et al. Respond to Smith and Lopipero

Bertazzi, Pier Alberto; Consonni, Dario; Bachetti, Silvia; Rubagotti, Maurizia; Baccarelli, Andrea A.; Zocchetti, Carlo; Pesatori, Angela Cecilia

doi:10.1093/aje/153.11.1048

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…The lung is also one of the target organs of the carcinogenic action of TCDD in animals (1, 2). We did not have individual data on smoking habits; however, information from independent surveys of random samples of the population suggests that geographic variation in smoking habits within the region is low (56,57). Other indirect evidence is provided by the finding that other smoking-related cancers were not elevated.…”

Section: Discussionmentioning

confidence: 96%

Mortality in a Population Exposed to Dioxin after the Seveso, Italy, Accident in 1976: 25 Years of Follow-Up

Consonni

Pesatori

Zocchetti³

et al. 2008

American Journal of Epidemiology

197

158

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The Seveso accident in 1976 caused a large, populated area north of Milan, Italy, to be contaminated by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). In this study, the authors followed up the exposed population for chronic effects; this paper reports the results of the mortality follow-up extension for 1997-2001. The study cohort includes 278,108 subjects resident at the time of the accident or immigrating/born in the 10 years thereafter in three contaminated zones with decreasing TCDD soil levels (zone A, very high; zone B, high; zone R, low) and in a reference territory comprising surrounding, noncontaminated municipalities. Vital status and cause-of-death ascertainment were 99% complete. Adjusted rate ratios and 95% confidence intervals were calculated by using Poisson regression. Results confirmed previous findings of excesses of lymphatic and hematopoietic tissue neoplasms in zones A (six deaths; rate ratio = 2.23, 95% confidence interval: 1.00, 4.97) and B (28 deaths; rate ratio = 1.59, 95% confidence interval: 1.09, 2.33). These zones also showed increased mortality from circulatory diseases in the first years after the accident, from chronic obstructive pulmonary disease, and from diabetes mellitus among females. A toxic and carcinogenic risk to humans after high TCDD exposure is supported by the results of this study.

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Section: Discussionmentioning

confidence: 96%

Mortality in a Population Exposed to Dioxin after the Seveso, Italy, Accident in 1976: 25 Years of Follow-Up

Consonni

Pesatori

Zocchetti³

et al. 2008

American Journal of Epidemiology

197

158

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“…The concurrent and most extended mortality follow-up had already shown in this zone a 60-70% increased risk after 15 years of follow-up [11]. Slightly increased mortality from lung cancer has been found in the four most exposed industrial cohorts, particularly in highly exposed subjects, but when dose-response relationships were examined, some uncertainty remained about the nature of the association with TCDD exposure [23-26,35,36]. Confounding by smoking has been evaluated in most of these studies and could not entirely explain the observed excess.…”

Section: Discussionmentioning

confidence: 99%

Cancer incidence in the population exposed to dioxin after the "Seveso accident": twenty years of follow-up

et al. 2009

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BackgroundThe Seveso, Italy accident in 1976 caused the contamination of a large population by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Possible long-term effects have been examined through mortality and cancer incidence studies. We have updated the cancer incidence study which now covers the period 1977-96.MethodsThe study population includes subjects resident at the time of the accident in three contaminated zones with decreasing TCDD soil levels (zone A, very high; zone B, high; zone R, low) and in a surrounding non-contaminated reference territory. Gender-, age-, and period-adjusted rate ratios (RR) and 95% confidence intervals (95% CI) were calculated by using Poisson regression for subjects aged 0-74 years.ResultsAll cancer incidence did not differ from expectations in any of the contaminated zones. An excess of lymphatic and hematopoietic tissue neoplasms was observed in zones A (four cases; RR, 1.39; 95% CI, 0.52-3.71) and B (29 cases; RR, 1.56; 95% CI, 1.07-2.27) consistent with the findings of the concurrent mortality study. An increased risk of breast cancer was detected in zone A females after 15 years since the accident (five cases, RR, 2.57; 95% CI, 1.07-6.20). No cases of soft tissue sarcomas occurred in the most exposed zones (A and B, 1.17 expected). No cancer cases were observed among subjects diagnosed with chloracne early after the accident.ConclusionThe extension of the Seveso cancer incidence study confirmed an excess risk of lymphatic and hematopoietic tissue neoplasms in the most exposed zones. No clear pattern by time since the accident and zones was evident partly because of the low number of cases. The elevated risk of breast cancer in zone A females after 15 years since the accident deserves further and thorough investigation. The follow-up is continuing in order to cover the long time period (even decades) usually elapsing from exposure to carcinogenic chemicals and disease occurrence.

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“…As a point of clarification, people in the Seveso cohort had mean TCDD blood lipid concentration of 136 ng TCDD/kg, which falls between the typical occupational dioxin levels (> 1,000 ng TCDD/kg) and background levels (2–3 ng TCDD/kg) [ 29 ]. Allowing for a latency time window of 15–20 years, results for NHL clearly did stand out, according to Bertazzi et al, with a relative risk of 2.8 (95% CI = 1.1–7.0) [ 30 , 31 ]. These results have recently been confirmed in an extended follow-up study (25 years) [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Risk for non Hodgkin’s lymphoma in the vicinity of French municipal solid waste incinerators

Viel,

Daniau,

Goria

et al. 2008

Environ Health

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Background: Dioxin emissions from municipal solid waste incinerators are one of the major sources of dioxins and therefore are an exposure source of public concern. There is growing epidemiologic evidence of an increased risk for non-Hodgkin's lymphoma (NHL) in the vicinity of some municipal solid waste incinerators with high dioxin emission levels. The purpose of this study was to examine this association on a larger population scale.

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Bertazzi et al. Respond to Smith and Lopipero

Cited by 9 publications

References 12 publications

Mortality in a Population Exposed to Dioxin after the Seveso, Italy, Accident in 1976: 25 Years of Follow-Up

Mortality in a Population Exposed to Dioxin after the Seveso, Italy, Accident in 1976: 25 Years of Follow-Up

Cancer incidence in the population exposed to dioxin after the "Seveso accident": twenty years of follow-up

Risk for non Hodgkin’s lymphoma in the vicinity of French municipal solid waste incinerators

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