Morbidity follow up study of BASF employees exposed to 2,3,7, 8-tetrachlorodibenzo-p-dioxin (TCDD) after a 1953 chemical reactor incident.

Abstract

Objective-The aim was to examine the long term morbidity experience of men exposed to 2,3,7, (Occup Environ Med 1994;51:479-486)

Linking dioxins to diabetes: epidemiology and biologic plausibility.

“…Somewhat parallel results were reported by Zober et al (20) in the follow-up of workers exposed to TCDD in a 1953 accident in Germany. Development of chloracne was used as a surrogate for TCDD exposure at the time of the accident.…”

“…Except for the chemical manufacturing workers (20,22), there is a rather consistent finding of a slight increase in diabetes incidence among subjects exhibiting elevated serum lipid TCDD concentrations, as well as abnormal glucose and/or insulin levels among subjects who were exposed to TCDD. No information is available to identify other substances to which the chemical manufacturing workers may have been exposed, although exposure to high levels of trichlorophenol and phenoxy herbicides may be inferred.…”

“…This compresses the range of TCDD levels between slightly and highly exposed subjects, because all concentrations are lower; also, one cannot be confident that the rank ordering of TCDD concentrations at the time of analysis matches the rank ordering at the time of exposure, because whole-body halflives are variable. One cannot improve the statistical power of these studies by recruiting additional subjects, because all those willing to participate are already involved (20).…”

“…As noted above, most of the extant epidemiologic studies involving highly exposed industrially exposed workers do not follow the pattern of a correlation between serum lipid TCDD concentrations and diabetesrelated disorders (20,22). The workers were involved specifically in the production of phenoxy herbicides: 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-T are known peroxisome proliferators that act by binding to PPARs (78,79).…”

“…The following groups of exposed humans have been the subject of dioxinrelated epidemiologic studies: German employees of factories where phenoxy herbicides were manufactured (20); U.S. employees of factories located in Newark, New Jersey, and Verona, Missouri, involved in the manufacture of 2,4,5-trichlorophenol and the associated herbicide 2,4,5-trichlorophenoxyacetic acid (2,4,5-T, no longer used in Europe or North America) (21,22); residents of Seveso, Italy, where a 1976 explosion at a 2,4,5-trichlorophenol factory exposed local residents to TCDD (23); and U.S. Air Force veterans involved in spraying defoliants during the Vietnam War (24)(25)(26)(27).…”