Table 2.
Summary of health studies in Seveso residents.
| Outcome | Author, Year | Study Population |
Sample | Exposure Measure |
Key Findings |
|---|---|---|---|---|---|
| CHILD HEALTH | |||||
| Chloracne | Caramaschi, 1981 | Surveillance of children <14 years |
146 cases, zones A, B, R 182 controls, zone nonABR |
Zone | ↑ % chloracne in Zone A |
| Baccarelli, 2005 | Case-control study | 101 cases 211 controls |
Plasma TCDD (1993–98) |
↑ >10 ppt vs ≤ 10 ppt | |
| Liver Function | Mocarelli, 1986 | Surveillance 1976 – 1982 |
1,500 children 6- 10 years, from zones A, B, R |
Zone | ↑ GGT (76–77) in Zone A boys ↑ ALT (76–77) in Zone A boys ↑ AST (8O–82) in Zone A girls |
| Ideo, 1982 | Surveillance 08/76-12/76 |
31 children, from Zone A 6–8 years |
Chloracne status |
↑ d-glucaric acid levels in children with chloracne |
|
| Ideo, 1985 | Surveillance of children 05/1981 |
34 zone A 61 zone B 121 zone R 61 zone nonABR |
Zone | ↔ d-glucaric acid levels | |
| Immune function | Mocarelli, 1991a | Surveillance 1976 – 1982 |
692 zone A 3,703 zone B 6,974 zone R 5,743 nonABR |
Zone | ↑ lymphocytes (76–77) in Zone A children 0 – 14 y ↔ lymphocyte response to PHA in Zone A children 0–14 y |
| Tooth development | Alaluusua, 2004 | Dental exam 2001 |
48 zone A, B, R 65 nonABR |
1976 serum TCDD |
↑ developmental defects of enamel in children <5 years in 1976 |
| REPRODUCTIVE HEALTH | |||||
| Male fertility | Mocarelli, 2008 | Sperm quality study (1997–1998) |
135 men, zone A, B, R and 1–26 y in 1976 184 men nonABR |
1976 serum TCDD |
1–9 y in 1976 ↓ sperm concentration ↓ motile sperm ↓ estradiol ↑ FSH 10–17 y in 1976 ↑ sperm concentration ↑ motile sperm ↓ estradiol ↑ FSH ↔ 17 – 26 years in 1976 |
| Female fertility | Eskenazi, 2010 | SWHS (1996–1998) |
463 women | 1976 serum TCDD, TCDD estimated to pregnancy |
↑ time to pregnancy ↑ infertility |
| Menstrual cycle | Baccarelli, 2005 | Chloracne case-control study |
45 cases 103 controls |
Chloracne | ↔ irregular cycle in cases vs controls |
| Menstrual cycle | Eskenazi, 2002b | SWHS (1996–1998) |
301 women | 1976 serum TCDD |
↑ cycle length only in women who were premenarche in 1976 |
| Ovarian function | Warner, 2007 | SWHS (1996–1998) |
363 women | 1976 serum TCDD |
↔ number or size of follicles ↔ ovulation ↔ progesterone, estradiol |
| Endometriosis | Eskenazi, 2002b | SWHS (1996–1998) |
601 women | 1976 serum TCDD |
↑endometriosis |
| Fibromas | Eskenazi, 2007 | SWHS (1996–1998) |
956 women | 1976 serum TCDD |
↔fibroids |
| Menopause | Eskenazi, 2005 | SWHS (1996–1998) |
616 women | 1976 serum TCDD |
nonmonotonic ↑ early menopause 20.1–100 ppt early menopause >100 ppt |
| CHRONIC HEALTH | |||||
| Cancer | Consonni, 2008 | Cancer Mortality Study (1976–2001) |
804 zone A 5,941 zone B 38,623 zone R 232,740 nonABR Total person- years: 6,192,864 |
Zone | ↔All cancer mortality (76–01) ↑All cancer morality after 20 years in Zone A (96–01) ↑Lymphatic-hematopoietic cancer mortality in Zone A ↑Lymphatic-hematopoietic cancer mortality in Zone B ↔Lymphatic-hematopoietic cancer mortality in Zone R |
| Pesatori, 2009 | Cancer Incidence Study (1976–1996) |
723 zone A 4,821 zone B 31,643 zone R 181,574 nonABR |
Zone | ↔All cancer incidence (76–96) ↑Breast cancer in Zone A (ns) ↑Lymphatic-hematopoietic cancer in Zone A (ns) ↑Lymphatic-hematopoietic cancer in Zone B |
|
| Warner, 2002 | SWHS (1976–1996) |
981 women | 1976 serum TCDD |
↑Breast cancer incidence | |
| Warner, 2011 | SWHS (1976–2008) |
833 women | 1976 serum TCDD |
↑All cancer incidence | |
| Cardiovascular disease | Consonni, 2008 | Mortality Study (1976–2001) |
804 zone A 5,941 zone B 38,623 zone R 232,740 nonABR |
Zone | ↔All cause mortality ↑IHD mortality in Zone A males ↑Hypertension mortality in Zone A females |
| Warner, 2014 | SWHS (1976–2008) |
965 women | 1976 serum TCDD |
↑All CVD incidence (ns) ↑IHD incidence (ns) |
|
| Diabetes | Consonni, 2008 | Mortality Study (1976–2001) |
804 zone A 5,941 zone B 38,623 zone R 232,740 nonABR |
Zone | ↑Diabetes mortality in females in Zones A, B, R |
| Warner, 2013 | SWHS (1976–2008) |
981 women | 1976 serum TCDD |
↔Diabetes ↔BMI, Obesity ↑Metabolic syndrome in <12y in 1976 |
|
| Bone health | Eskenazi, 2014 | SWHS (2008–2009) |
340 women <20y in 1976 |
1976 serum TCDD |
↔BMD (spine, total hip, femoral neck) ↑Bone structure in women exposed before peak bone mass |
| Thyroid health | Chevrier, 2014 | SWHS (2008–2009) |
909 women | 1976 serum TCDD 1996 serum TCDD |
↓TT4 in 1996 ↔ TSH, FT3, FT4 in 1996 ↓TT4 in 2008 ↔ TSH, FT3, FT4 in 2008 |
| Immune function | Baccarelli, 2002 | Immunology study (1992–1994) |
62 zone A, B 58 zone nonABR |
1992 plasma TCDD |
→IgG w TCDD ↔IgM, IgA, C3, C4 w TCDD |
| Neurologic function | Pocchiari, 1979 | Surveillance 1977–1978 |
446 zone A, 255 zone B, R |
Zone | ↑ idiopathic clinical neurologic damage in Zone A |
| Assenato, 1989 | Surveillance 1985 |
193 chloracne cases |
↔Abnormal electrophysiologic or nerve conduction velocity measures |
||
| Ames, 2017a | SWHS (1996–1998) (2008–2009) |
154 women 459 women |
1976 serum TCDD |
↔Physical function↔Working memory | |
| SECOND GENERATION HEALTH | |||||
| Sex ratio | Mocarelli, 1996 | Municipality birth registry |
74 births (04/77 – 12/84) |
Zone A | ↓ Sex ratio (1977–84) ↔Sex ratio (1985–94) |
| Mocarelli, 2000 | Municipality birth registry |
674 births (04/77 – 12/96) |
1976 serum TCDD |
↓Sex ratio in fathers < 19 years in 1976 and TCDD >15 ppt ↔Sex ratio in fathers > 19 years in 1976 and TCDD >15 ppt |
|
| Neonatal thyroid | Baccarelli, 2008 | Neonatal Screening Registry (1994–2005) |
56 zone A 425 zone B 533 nonABR |
Zone | ↑b-TSH in Zone A ↑b-TSH in Zone B ↑b-TSH>5μU/mL in Zone A |
| Chloracne Study |
51 mother-child pairs |
TCDD extrapolated to pregnancy |
↑b-TSH w TCDD and TEQ extrapolated to pregnancy |
||
| Male fertility | Mocarelli, 2011 | Sperm quality study (2002–2003) |
39 Seveso sons born 1977–1984 58 unexposed male blood donors |
lactational exposure |
↓sperm concentration ↓progressive motility ↓FSH |