Pesatori Angela Cecilia, Consonni Dario, Bachetti Silvia, Zocchetti Carlo, Bonzini Matteo, Baccarelli Andrea, Bertazzi Pier Alberto
Department of Occupational and Environmental Medicine and EPOCA Epidemiology Research Center, Università degli Studi and Istituti Clinici di Perfezionamento, Milan, Italy.
Ind Health. 2003 Jul;41(3):127-38. doi: 10.2486/indhealth.41.127.
The early effects of 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) exposure in the population involved in the Seveso, Italy, incident in 1976, have been examined in numerous studies. Chloracne was the only effect linked with sufficient certainty to dioxin exposure. The possible long-term consequences were investigated with mortality and cancer incidence studies. Mortality and morbidity findings during the 20-year period following the accident showed increased risk from lymphoemopoietic neoplasm, digestive system cancer (rectum in males, and biliary tract among females, in particular) and respiratory system cancer (lung, among males). In the incidence analyses, also thyroid gland and pleura cancer appeared suggestively increased. Soft tissue sarcomas showed an increase in the largest, yet least exposed, exposure sub-cohort. Several hypotheses associating non-cancer effects with dioxin exposure were corroborated by findings in the Seveso population: this was the case with cardiovascular effects (possibly linked to both chemical exposure and stressful disaster experience), endocrine effects (diabetes among females) and reproductive effects: exposure of men to TCDD was linked to a lowered male/female sex ratio in their offspring. The results of many Seveso studies point to possible gender effects, in accordance with animal models. Notwithstanding the acknowledged study limitations (lack of individual exposure markers, short latency, and small population size for certain cancer types), results of previous experimental and epidemiological studies, along with mechanistic knowledge on dioxin toxicity, support the hypotheses that the observed excesses might be associated with dioxin exposure. The mortality and cancer incidence follow-up of the Seveso cohort are continuing.
众多研究已对1976年意大利塞韦索事故中涉事人群接触2,3,7,8-四氯二苯并对二恶英（TCDD）的早期影响进行了调查。氯痤疮是唯一与二恶英接触有足够确定性关联的影响。通过死亡率和癌症发病率研究对可能的长期后果进行了调查。事故发生后的20年期间，死亡率和发病率研究结果显示，淋巴造血系统肿瘤、消化系统癌症（男性为直肠癌，女性尤其为胆管癌）和呼吸系统癌症（男性为肺癌）的风险增加。在发病率分析中，甲状腺癌和胸膜癌也有提示性增加。软组织肉瘤在暴露量最大但接触最少的暴露亚队列中有所增加。塞韦索人群的研究结果证实了一些将非癌症影响与二恶英接触相关联的假设：心血管影响（可能与化学物质接触和压力性灾难经历都有关）、内分泌影响（女性患糖尿病）和生殖影响就是如此：男性接触TCDD与后代中较低的男女性别比有关。许多塞韦索研究的结果表明可能存在性别影响，这与动物模型一致。尽管公认研究存在局限性（缺乏个体暴露标志物、潜伏期短以及某些癌症类型的人群规模小），但先前实验和流行病学研究的结果以及关于二恶英毒性的机制知识支持了以下假设：观察到的超额情况可能与二恶英接触有关。塞韦索队列的死亡率和癌症发病率随访仍在继续。
