Dioxin exposure and cancer risk in the seveso women's health study

Marcella Warner, Paolo Mocarelli, Steven Samuels, Larry Needham, Paolo Brambilla, Brenda Eskenazi

Research output: Contribution to journalArticle

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Abstract

Background: 2,3,7,8-Tetrachlorodibenzo-para-dioxin (TCDD), a widespread environmental contaminant, disrupts multiple endocrine pathways. The International Agency for Research on Cancer classified TCDD as a known human carcinogen, based on predominantly male occupational studies of increased mortality from all cancers combined. Objectives: After a chemical explosion on 10 July 1976 in Seveso, Italy, residents experienced some of the highest levels of TCDD exposure in a human population. In 1996, we initiated the Seveso Women's Health Study (SWHS), a retrospective cohort study of the reproductive health of the women. We previously reported a significant increased risk for breast cancer and a nonsignificant increased risk for all cancers combined with individual serum TCDD, but the cohort averaged only 40 years of age in 1996. Herein we report results for risk of cancer from a subsequent follow-up of the cohort in 2008. Methods: In 1996, we enrolled 981 women who were 0-40 years of age in 1976, lived in the most contaminated areas, and had archived sera collected near the explosion. Individual TCDD concentration was measured in archived serum by high-resolution mass spectrometry. A total of 833 women participated in the 2008 follow-up study. We examined the relation of serum TCDD with cancer incidence using Cox proportional hazards models. Results: In total, 66 (6.7%) women had been diagnosed with cancer. The adjusted hazard ratio (HR) associated with a 10-fold increase in serum TCDD for all cancers combined was significantly increased [adjusted HR = 1.80; 95% confidence interval (CI): 1.29, 2.52]. For breast cancer, the HR was increased, but not significantly (adjusted HR = 1.44; 95% CI: 0.89, 2.33). Conclusions: Individual serum TCDD is significantly positively related with all cancer incidence in the SWHS cohort, more than 30 years later. This all-female study adds to the epidemiologic evi- dence that TCDD is a multisite carcinogen.

Original languageEnglish
Pages (from-to)1700-1705
Number of pages6
JournalEnvironmental Health Perspectives
Volume119
Issue number12
Publication statusPublished - Dec 2011

Fingerprint

Dioxins
Women's Health
Neoplasms
Serum
Explosions
Carcinogens
Cohort Studies
Confidence Intervals
Breast Neoplasms
International Agencies
Incidence
Reproductive Health
Proportional Hazards Models
Italy
Mass Spectrometry
Retrospective Studies
Mortality

Keywords

  • Cancer
  • Cohort studies
  • Dioxins
  • Environmental carcinogens
  • Female
  • Neoplasms
  • Tetra-chlorodibenzodioxin

ASJC Scopus subject areas

  • Health, Toxicology and Mutagenesis
  • Public Health, Environmental and Occupational Health

Cite this

Warner, M., Mocarelli, P., Samuels, S., Needham, L., Brambilla, P., & Eskenazi, B. (2011). Dioxin exposure and cancer risk in the seveso women's health study. Environmental Health Perspectives, 119(12), 1700-1705.

Dioxin exposure and cancer risk in the seveso women's health study. / Warner, Marcella; Mocarelli, Paolo; Samuels, Steven; Needham, Larry; Brambilla, Paolo; Eskenazi, Brenda.

In: Environmental Health Perspectives, Vol. 119, No. 12, 12.2011, p. 1700-1705.

Research output: Contribution to journalArticle

Warner, M, Mocarelli, P, Samuels, S, Needham, L, Brambilla, P & Eskenazi, B 2011, 'Dioxin exposure and cancer risk in the seveso women's health study', Environmental Health Perspectives, vol. 119, no. 12, pp. 1700-1705.
Warner M, Mocarelli P, Samuels S, Needham L, Brambilla P, Eskenazi B. Dioxin exposure and cancer risk in the seveso women's health study. Environmental Health Perspectives. 2011 Dec;119(12):1700-1705.
Warner, Marcella ; Mocarelli, Paolo ; Samuels, Steven ; Needham, Larry ; Brambilla, Paolo ; Eskenazi, Brenda. / Dioxin exposure and cancer risk in the seveso women's health study. In: Environmental Health Perspectives. 2011 ; Vol. 119, No. 12. pp. 1700-1705.
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abstract = "Background: 2,3,7,8-Tetrachlorodibenzo-para-dioxin (TCDD), a widespread environmental contaminant, disrupts multiple endocrine pathways. The International Agency for Research on Cancer classified TCDD as a known human carcinogen, based on predominantly male occupational studies of increased mortality from all cancers combined. Objectives: After a chemical explosion on 10 July 1976 in Seveso, Italy, residents experienced some of the highest levels of TCDD exposure in a human population. In 1996, we initiated the Seveso Women's Health Study (SWHS), a retrospective cohort study of the reproductive health of the women. We previously reported a significant increased risk for breast cancer and a nonsignificant increased risk for all cancers combined with individual serum TCDD, but the cohort averaged only 40 years of age in 1996. Herein we report results for risk of cancer from a subsequent follow-up of the cohort in 2008. Methods: In 1996, we enrolled 981 women who were 0-40 years of age in 1976, lived in the most contaminated areas, and had archived sera collected near the explosion. Individual TCDD concentration was measured in archived serum by high-resolution mass spectrometry. A total of 833 women participated in the 2008 follow-up study. We examined the relation of serum TCDD with cancer incidence using Cox proportional hazards models. Results: In total, 66 (6.7{\%}) women had been diagnosed with cancer. The adjusted hazard ratio (HR) associated with a 10-fold increase in serum TCDD for all cancers combined was significantly increased [adjusted HR = 1.80; 95{\%} confidence interval (CI): 1.29, 2.52]. For breast cancer, the HR was increased, but not significantly (adjusted HR = 1.44; 95{\%} CI: 0.89, 2.33). Conclusions: Individual serum TCDD is significantly positively related with all cancer incidence in the SWHS cohort, more than 30 years later. This all-female study adds to the epidemiologic evi- dence that TCDD is a multisite carcinogen.",
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