目标:Seveso事故(1976年)在米兰以北地区造成了2,3,7,8-四氯二苯并对二恶英(TCDD)的污染,意大利。我们报告了截至2013年暴露人群死亡率和癌症发病率的最新结果。
方法:研究队列包括生活在三个TCDD土壤浓度降低的污染区(A区,B和R)以及周围未受污染的区域(参考)。泊松模型分层/调整性别,对年龄和时期进行拟合以计算比率(RR)和95%CIs。
结果:在男性的A区中,我们发现,在事故发生后的头十年中,循环系统疾病的死亡率上升(17人死亡,RR2.00,95%CI1.24至3.23)。在女性中,糖尿病死亡率增加,各地区都有积极的趋势。在最初的十年中,男性在R区的软组织肉瘤的发病率增加(6例,RR2.62,95%CI1.01至6.83)。在B区的女性中,30年后有过多的非霍奇金淋巴瘤(6例,RR2.87,95%CI1.14至7.23)。B区女性多发性骨髓瘤在第二个十年增加(4例,RR5.09,95%CI1.82至14.2),男性在R区(11例,RR2.15,95%CI1.08至4.26)。在R区的男性中,30年后出现白血病过度(23例,RR2.02,95%CI1.04至3.93)。
结论:尽管不同性别的模式不同,地区和时间,我们证实了先前心血管疾病增加的结果,糖尿病,软组织肉瘤,以及淋巴癌和造血肿瘤。
OBJECTIVE: The Seveso accident (1976) caused the contamination with 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) in an area north of Milan, Italy. We report the results of the update of mortality and cancer incidence in the exposed population through 2013.
METHODS: The study cohort includes subjects living in three contaminated zones with decreasing TCDD soil concentrations (zone A, B and R) and in a surrounding uncontaminated territory (reference). Poisson models stratified/adjusted for gender, age and period were fitted to calculate rate ratios (RRs) and 95% CIs.
RESULTS: In zone A in males, we found elevated mortality from circulatory diseases in the first decade after the accident (17 deaths, RR 2.00, 95% CI 1.24 to 3.23). In females, mortality from diabetes mellitus was increased, with a positive trend across zones. Incidence of soft tissue sarcoma was increased in males in zone R in the first decade (6 cases, RR 2.62, 95% CI 1.01 to 6.83). In females in zone B, there was an excess of non-Hodgkin\'s lymphoma after 30 years (6 cases, RR 2.87, 95% CI 1.14 to 7.23). Multiple myeloma was increased in the second decade in females in zone B (4 cases, RR 5.09, 95% CI 1.82 to 14.2) and in males in zone R (11 cases, RR 2.15, 95% CI 1.08 to 4.26). In males in zone R, there was a leukaemia excess after 30 years (23 cases, RR 2.02, 95% CI 1.04 to 3.93).
CONCLUSIONS: Although with different patterns across gender, zone and time, we confirmed previous results of increased cardiovascular diseases, diabetes, soft tissue sarcoma, and lymphatic and haematopoietic cancers.