Dioxin study in American Journal of Epidemiology

[slester@essential.org]

EXPOSURE TO POLYCHLORINATED DIOXINS AND FURANS (PCDD/F) AND MORTALITY IN 
A COHORT OF WORKERS FROM A HERBICIDE-PRODUCING PLANT IN HAMBURG, FEDERAL 
REPUBLIC OF GERMANY


Dieter Flesch-Janys, Jurgen Berger, Petra Gurn, Alfred Manz, Sibylle 
Nagel, Hiltraud Waltsgott, and James H. Dwyer
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				Abstract

The relation between mortality (all cause:  cancer, cardiovascular 
diseases, ischemic heart diseases, and exposure to polychlorinated 
dibenzo-p-dioxins and -furans (PCDD/F) was investigated in a 
retrospective cohort study.  The cohort consisted of 1189 male workers in 
a chemical plant in Hamburg, Federal Republic of Germany, who had 
produced phenoxy herbicides, chlorophenols, and other herbicides and 
insecticides known to be contaminated with 2,3,7,8 - 
tetrachlorodibenzo-p-dioxin and other, higher chlorinated dioxins and  
and furans.  The authors reported previously on cancer mortality in this 
cohort for the follow-up period 1952-1989.  The current study covers the 
years 1092-1992 and investigated the relation of PCDD/F exposure to 
mortality using a quantitative estimate of PCDD/F exposure for the whole 
cohort derived from blood and adipose tissue in the estimation of 
relative risks (RRs) using year of birth stratified Cox regression.  An 
unexposed cohort of highest relative risk was observed for the highest 
2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) decile (RR=2.43, 95% 
confidence interval (CI) 1.80-3.29).  Cancer mortality and mortality due 
to ischemic heart diseases showed a dose-dependent relation with TCDD and 
all PCDD/F combined.  The highest relative risks for cancer (RR=3.30, 95% 
CI 2.05-5.31) and ischemic heart diseases (RR=2.48, 95% CI 1.32 to 4.66) 
were observed in the highest PCDD/F exposure group.  The pattern of 
effects and tests for trend were similar when the lowest exposure group  
within the chemical worker cohort served as the reference, but the 
relative risks were smaller and the confidence intervals were larger.  
Potential confounding exposures complicate the interpretation of the 
internal comparison.  These findings indicate a strong dose-dependent 
relation between mortality due to cancer or ischemic heart diseases and 
exposure to polychlorinated dioxins and furans.  

American Journal of Epidemiology 1995; 142:1165-75.
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