| Relationship of Serum TCDD Concentrations and Age at Exposure of Female Residents of Seveso, Italy Brenda Eskenazi,1 Paolo Mocarelli,2 Marcella Warner,1 Larry Needham,3 Donald G. Patterson, Jr.,3 Steven Samuels,1,4 Wayman Turner,3 Pier Mario Gerthoux,2 and Paolo Brambilla2 1School of Public Health, University of California at Berkeley, Berkeley, California, USA; 2Department of Laboratory Medicine, University of Milano-Bicocca, School of Medicine, Hospital of Desio, Desio-Milano, Italy; 3Division of Environmental Health Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; 4Division of Occupational/Environmental Medicine and Epidemiology, University of California, Davis, California, USA Abstract
In 1976, a chemical plant explosion near Seveso, Italy, resulted in the highest known exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in residential populations. In 1996, we initiated the Seveso Women's Health Study (SWHS) , a historical cohort study of females who were  40 years old at the time of explosion and residents of the most heavily contaminated areas, zones A and B. Serum samples collected near the time of the explosion were analyzed for TCDD. We also analyzed pooled serum samples collected in 1976 from females who resided in zone non-ABR, the "unexposed" zone, to assess concurrent background exposures to other dioxins, furans, and coplanar polychlorinated biphenyls (PCBs) . The median lipid-adjusted TCDD level for residents of zones A and B combined was 56 ppt (range = 2.5-56,000 ppt) . Zone A residents had 5-fold higher TCDD levels (n = 67, median = 272 ppt) than did zone B residents (n = 814, median = 47 ppt) . The youngest children had the highest TCDD levels, which decreased with age at explosion until approximately 13 years of age and were constant thereafter. Therefore, children living in zones A and B received a disproportionately higher exposure to TCDD as a result of the explosion. Zone of residence and age were the strongest predictors of TCDD level. Chloracne, nearby animal mortality, location (outdoors vs. indoors) at the time of explosion, and consumption of homegrown food were also related to serum TCDD levels. The serum pools from zone non-ABR residents had an average TCDD concentration of 20.2 ppt, and average total toxic equivalent (TEQ) concentration of 100.4 ppt. Therefore, background exposure to dioxins, furans, and PCBs unrelated to the explosion may have been substantial. As a consequence, previous SWHS studies that considered only TCDD exposure may have underestimated health effects due to total TEQ concentrations. Key words: biomarkers, children, dioxin, exposure, TCDD, tetrachlorodibenzo-p-dioxin. Environ Health Perspect 112:22-27 (2004) . doi:10.1289/ehp.6573 available via http://dx.doi.org/ doi:10.1289/ehp.6573 available via http://dx.doi.org/ [Online 20 October 2003]
Address reprint requests to B. Eskenazi, School of Public Health, University of California, 2150 Shattuck Avenue, Suite 600, Berkeley, CA 94720-7380 USA. Telephone: (510) 642-3496. Fax: (510) 642-9083. E-mail: eskenazi@uclink.berkeley.edu We thank S. Casalini for coordinating data collection at the Hospital of Desio. We especially thank the women of Seveso, Italy, who participated in this study. This work was supported by U.S. Environmental Protection Agency grant R82471, National Institutes of Health grant R01 ES07171, Endometriosis Association grant EA-M1977, National Institute of Environmental Health Sciences grant 2P30-ESO01896-17, and grants from Regione Lombardia and Fondazione Lombardia Ambiente, Milan, Italy. The authors declare they have no competing financial interests. Received 9 July 2003 ; accepted 20 October 2003.
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