Health effects of dioxin exposure: A 20-year mortality study
Health effects of dioxin exposure: A 20-year mortality study
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DOI：
10.1093/aje/153.11.1031
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发表时间：
2001-06-01
影响因子：
5
通讯作者：
Pesatori, AC
中科院分区：
文献类型：
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作者：
Bertazzi, PA;Consonni, D;Pesatori, AC
对1976年意大利塞维索事故后接触二恶英的人群的跟踪调查延长至1996年。在整个观察期内，所有原因和所有癌症的死亡率没有增加。事故发生15年后，高暴露区域A区(804名居民)和B区(5941名居民)的死亡率从所有癌症(比率比(RR)=1.3，95%可信区间(CI)：1.0，1.7)、直肠癌(RR=2.4，95%可信区间：1.2，4.6)和肺癌(RR=1.3，95%CI：1.0，1.7)上升，直肠癌或肺癌没有潜伏期相关模式。淋巴造血性肿瘤在男女患者中均有明显增加(RR=1.7，95%CI：1.2，2.5)。非霍奇金淋巴瘤(RR=2.8，95%CI：1.1，7.0)和髓系白血病(RR=3.8，95%CI：1.2，12.5)的发病风险最高。未发现软组织肉瘤病例(预计0.8例)。据报道，糖尿病的总体发病率有所增加，尤其是在女性中(RR=2.4，95%CI：1.2，4.6)，慢性循环系统和呼吸系统疾病适度增加，这表明与事故相关的压力源和化学物质暴露有关。结果支持二恶英对人类致癌的评估，并证实了二恶英与其他健康后果相关的假设，包括与心血管和内分泌相关的影响。
Follow-up of the population exposed to dioxin after the 1976 accident in Seveso, Italy, was extended to 1996. During the entire observation period, all-cause and all-cancer mortality did not increase. Fifteen years after the accident, mortality among men in high-exposure zones A (804 inhabitants) and B (5,941 inhabitants) increased from all cancers (rate ratio (RR) = 1.3, 95% confidence interval (CI): 1.0, 1.7), rectal cancer (RR = 2.4, 95% CI: 1.2, 4.6), and lung cancer (RR = 1.3, 95% CI: 1.0, 1.7), with no latency-related pattern for rectal or lung cancer. An excess of lymphohemopoietic neoplasms was found in both genders (RR = 1.7, 95% CI: 1.2, 2.5). Hodgkin's disease risk was elevated in the first 10-year observation period (RR = 4.9, 95% CI, 1.5, 16.4), whereas the highest increase for non-Hodgkin's lymphoma (RR = 2.8, 95% CI: 1.1, 7.0) and myeloid leukemia (RR = 3.8, 95% CI: 1.2, 12.5) occurred after 15 years. No soft tissue sarcoma cases were found in these zones (0.8 expected). An overall increase in diabetes was reported, notably among women (RR = 2.4, 95% CI: 1.2, 4.6), Chronic circulatory and respiratory diseases were moderately increased, suggesting a link with accident-related stressors and chemical exposure. Results support evaluation of dioxin as carcinogenic to humans and corroborate the hypotheses of its association with other health outcomes, including cardiovascular- and endocrine-related effects.