Accidental release of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) at Sèveso, Italy. IV. Vertical distribution of TCDD in soil

Developmental dental toxicity of dioxin and related compounds--a review

Non-halogenated polycyclic aromatic hydrocarbons (PAHs) and halogenated aromatic hydrocarbons such as polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs, or dioxins), and polychlorinated biphenyls (PCBs) are wide-spread environmental pollutants that have unequivocal adverse effects on different species, including humans. Accidental exposure of children to high amounts of PCDD/Fs has been found to be associated with developmental enamel defects and missing permanent teeth. An association between dioxin exposure via mother's milk and developmental mineralisation defects in permanent first molars was also found in otherwise healthy Finnish children born in the late 1980s but not in those born in the late 1990s. Results of experimental animal studies in vivo and in vitro are compatible with findings in human teeth. In addition to the dose, dental effects of the most toxic dioxin congener, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), essentially depend on the stage of tooth development at the time of exposure. Accordingly, TCDD arrests early rat and mouse molar tooth development and in more advanced teeth it interferes with mineralisation of enamel and dentine and arrests root development. Expression of the specific dioxin receptor (AhR) in dental cells at TCDD-sensitive stages of tooth development suggests that the dental, like other developmental effects of TCDD, are mediated by the AhR. Early effects also depend on the epidermal growth factor receptor and involve enhanced apoptosis. The lowest TCDD dose (30ng/kg) causing adverse dental effects in rats has been estimated to result in maternal tissue levels approaching the high end of human background range and human milk PCDD/F levels that were associated with enamel defects in children. However, because of the uniform and clear decline in background dioxin and PCB levels in mother's milk during the last twenty years, dioxins are currently likely to be of small or no account as regards developmental dental defects in children. Even so, this is not the case after heavy exposure and little is known about the possible synergistic effects of these toxicants with other chemicals interfering with tooth development.

Developmental dental aberrations after the dioxin accident in Seveso

Children's developing teeth may be sensitive to environmental dioxins, and in animal studies developing teeth are one of the most sensitive targets of toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Twenty-five years after the dioxin accident in Seveso, Italy, 48 subjects from the contaminated areas (zones A and B) and in patches lightly contaminated (zone R) were recruited for the examination of dental and oral aberrations. Subjects were randomly invited from those exposed in their childhood and for whom frozen serum samples were available. The subjects were frequency matched with 65 subjects from the surrounding non-ABR zone for age, sex, and education. Concentrations of TCDD in previously analyzed plasma samples (zone ABR subjects only) ranged from 23 to 26,000 ng/kg in serum lipid. Ninety-three percent (25 of 27) of the subjects who had developmental enamel defects had been < 5 years of age at the time of the accident. The prevalence of defects in this age group was 42% (15 of 36) in zone ABR subjects and 26% (10 of 39) in zone non-ABR subjects, correlating with serum TCDD levels (p = 0.016). Hypodontia was seen in 12.5% (6 of 48) and 4.6% (3 of 65) of the zone ABR and non-ABR subjects, respectively, also correlating with serum TCDD level (p = 0.05). In conclusion, developmental dental aberrations were associated with childhood exposure to TCDD. In contrast, dental caries and periodontal disease, both infectious in nature, and oral pigmentation and salivary flow rate were not related to the exposure. The results support our hypothesis that dioxins can interfere with human organogenesis.

Relationship of serum TCDD concentrations and age at exposure of female residents of Seveso, Italy

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.

Human exposures from dioxin in soil--a meeting report

A 1984 risk assessment identified 1 part per billion (ppb) of dioxin in soil as a "level of concern" at Times Beach, Mo. The authors of the assessment had to rely on many assumptions in their analysis, but since that time, a number of investigators have obtained data that bear directly on estimating exposures from substances in soil. Partly because of the assumptions and partly because of the site-specific nature of their analysis, the authors of the Times Beach risk assessment cautioned against the adoption of 1 ppb as a delineator between acceptable and nonacceptable levels of contamination. Those cautions have been more frequently ignored than honored, and 1 ppb has become a de facto standard. In November 1989, the Center for Risk Management at Resources for the Future hosted 50 experts at a workshop that heard and discussed published and new research about exposure estimates and measures. The 1984 assessment identified soil ingestion by toddlers as the single most important source of exposure to dioxin in soil; it assumed that toddlers ingested 10 g soil daily. Research discussed at the workshop shows that the average child ingests about 0.04 g soil daily, but that 1 of 320 studied children ingested 5 g. These findings leave open the risk management decision about whether acceptable exposure levels should be established to protect the average child or the extreme child. Furthermore, the absence of children from commercial and industrial sites led to suggestions that higher concentrations of dioxin are acceptable in soil at such sites. Some workshop participants objected to those suggestions because of the difficulty of assuring that such sites would not revert to residential use in the future. Whether deed restrictions are sufficient to prevent such reversions was seen as an important research topic. Workshop participants repeatedly discussed the importance of site-specific data in estimating exposures: Measured half-lives of dioxin in different soils range from 18 mo to greater than 100 yr; bioavailability from various soils differs by at least 20-fold; and the amounts of soil ingested by grazing cattle can differ 20-fold depending on conditions. Workshop participants agreed upon some suggestions for research and generally favored the development of guidelines for exposure assessment that would allow consideration of site-specific information. Furthermore, they generally agreed that no single concentration should be taken as a level of concern. Instead, levels should be established that consider the planned uses of the sites.

Guidelines for the definition of environmental action alert thresholds for polychlorodibenzodioxins and polychlorodibenzofurans

In July 1986, a 314-ha area surrounding the municipal solid waste incinerator of San Donnino (Florence, Italy) was subjected to hygienic and sanitary measures as polychlorodibenzodioxins (PCDDs) and polychlorodibenzofurans (PCDFs) had been detected in soil at levels higher than the "reference technical limits" adopted by the National Toxicology Commission in 1985. In this report the case of San Donnino is the starting point used to define "maximum tolerable environmental limits" for complex mixtures of PCDDs and PCDFs. Limits are expressed in "2,3,7,8-tetrachlorodibenzo-p-dioxin toxicity equivalence" units according to a relative toxicity ranking where the toxic potency of the aforementioned chemical is considered the highest and set equal to unit. Man's exposure to PCDDs and PCDFs is estimated on the basis of experimental findings and with reference to such limits.