Determination of polychlorinated dibenzofurans in tissues of patients with 'yusho'

Yusho and its latest findings-A review in studies conducted by the Yusho Group

The Yusho incident is an unprecedented mass food poisoning that occurred in Japan in 1968. It was caused by the ingestion of rice bran oil contaminated with polychlorinated biphenyls (PCBs) and various dioxins and dioxin-like compounds, such as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). The victims of Yusho have suffered from characteristic skin manifestations associated with systemic, ophthalmological, and mucosal symptoms for a long period of time. The Study Group of Yusho (the Yusho Group) has been conducting annual medical check-ups on Yusho victims for more than 45years. Since 2002, when concentrations of dioxins in the blood of Yusho patients started to be measured, the pharmacokinetics of dioxins, relationship between blood levels of dioxins and symptoms/signs in patients directly exposed to dioxins, and the adverse effects on the next generation have become dramatically clear. Herein we review recent findings of studies conducted by the Yusho Group to evaluate chronic dioxin-induced toxicity to the next generation as well as Yusho patients in comparison with a similar food mass poisoning, the Yucheng incident. Additionally, we summarized basic studies carried out by the Yusho Group to re-evaluate the mechanisms of dioxin toxicities in experimental models and various functions of the aryl hydrocarbon receptor (AhR), known as the dioxin receptor, pathway.

[A memoir of my researches on xenobiotic metabolism for 48 years--researches on Kanemi Yusho and endocrine disrupting chemicals]

The author started a research on xenobiotic metabolism at Graduate School of Pharmaceutical Sciences, Kyushu University in 1965. In 1968, an epidemic of a "strange disease", called Yusho, occurred in western Japan. The epidemic was soon identified to be a food poisoning caused by the ingestion of commercial Kanemi rice bran oil which had been accidentally contaminated with large amounts of polychlorinated biphenyls (PCBs) and their related compounds such as polychlorinated dibenzofurans (PCDFs.) At first, in this review, our toxicological studies on Yusho during the early thirty years were briefly described. Next, the studies on aldehyde oxidase, a molybdenum hydroxylase, which is involved in the lactam formation reaction such as 1-phenyl-2-(2-oxopyrrolidine)pentane(oxoprolintane) from 1-phenyl-2-pyrrolidinopentane(prolintane) and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP) lactam from 1-methyl-4-phenyl-2,3-dihydropyridinium ion (MPDP⁺) were also presented. Finally, we investigated how the xenobiotic metabolism of endocrine disrupting chemicals such as bisphenol A (BPA) and some isoflavones affects their estrogenic activities. In this study, we demonstrated that BPA is converted to 4-methyl-2,4-bis(4-hydroxyphenyl)pent-1-ene (MBP), an active metabolite as estrogen, by rat liver S9. In the cases of isoflavones, although genistein was inactivated, biochanin A, 4'-methoxy analogue of genistein, was activated to genistein by O-demethylation with rat liver S9.

Polychlorinated dibenzofurans as a causal agent of fetal Yusho

Polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dioxin-like PCBs) are highly-toxic environmental pollutants that are still ubiquitous. About 40 years ago, a mass food poisoning, termed "Yusho", occurred in western Japan, and the causal agent of Yusho was thought to be PCDFs. The preserved umbilical cords of babies who were born to mothers with Yusho 2-5 years after the outbreak of Yusho and diagnosed with fetal Yusho were recently obtained, and the concentrations of PCDDs, PCDFs, dioxin-like PCBs and polychlorinated biphenyls (PCBs) in these preserved umbilical cords were determined. Among babies with fetal Yusho, the pollutant concentrations in umbilical cords were compared between "black babies", a term that describes the dermatologic abnormality that is classically seen in fetal Yusho, and "non-black babies". There was almost no difference in the concentrations of 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD) toxic equivalents (TEQ) concentrations of PCDDs, PCDFs and dioxin-like PCBs found in these two groups of babies. Therefore, the Yusho infants with the dark brown skin pigmentation seemed to have a hypersensitive genetic predisposition to the production of melanin pigment in the skin after the exposure to these toxic compounds. The concentrations of PCDDs, PCDFs, dioxin-like PCBs and PCBs in the preserved umbilical cords of infants diagnosed with fetal Yusho and of healthy babies were also determined and compared. PCDDs, dioxin-like PCBs and PCBs were detected in both groups. PCDFs, however, were found at high concentration only in the babies with fetal Yusho. In 2,3,7,8-TCDD TEQ concentrations, 90% of the total TEQ concentrations were attributable to PCDFs after taking into account the baseline concentrations found in healthy babies. This evidence shows that fetal Yusho is caused by PCDF intoxication.

Concentrations of polychlorinated biphenyls in blood of Yusho patients over 35 years after the incident

We conducted a congener-specific analysis of polychlorinated biphenyls (PCBs) in blood collected from 242 Yusho patients (mean: 65.5 years, median: 67.0 years) and 74 Yusho-suspected persons (mean: 54.7 years, median: 55.0 years) in 2004, and compared each congener concentrations of PCBs among the groups of Yusho patients, Yusho-suspected persons, and normal controls (mean: 68.1 years, median: 67.0 years) with the concentrations previously reported. Among the 209 PCB congeners, 8 congeners of mono-ortho PCBs and 56 congeners of non-dioxin-like PCBs were identified in the blood of Yusho patients and Yusho-suspected persons. Among the PCB congeners measured in the present study, hexaCB-153, hexaCB-138, heptaCB-180, and heptaCB-182/heptaCB-187 showed high ratios to total concentrations of 64 PCB congeners detected in the blood of Yusho patients and Yusho-suspected persons, and the congener profiles were the same as those obtained in normal controls. The sums of the concentrations of 64 PCB congeners in the blood of Yusho patients and Yusho-suspected persons were 40-3032 (mean: 645, median: 536) and 20-1418 (mean: 355, median: 317) ng g(-1) lipid, respectively, and the concentrations were 50% higher and 20% lower than those of normal controls, respectively. The relative contribution ratios of the concentrations of the triCBs, tetraCBs, and pentaCBs to the total concentrations of 64 PCB congeners in the blood of Yusho patients were slightly lower than those of Yusho-suspected persons and normal controls, and the ratios of nonaCBs and decaCB-209 concentrations were nearly the same among the Yusho patients, Yusho-suspected persons, and normal controls. However, the ratios of the concentrations of hexaCBs, heptaCBs, and octaCBs to the total concentrations of 64 PCB congeners in the blood of Yusho patients tended to be slightly higher compared to those of the Yusho-suspected persons and normal controls. From the results comparing the concentrations of 64 PCB congeners in the blood between Yusho patients and normal controls, the concentrations of hexaCB-156, hexaCB-157, heptaCB-181, and heptaCB-189 of the Yusho patients were 3.4, 3.8, 3.9, and 3.8 times higher than those of the normal controls, respectively, indicating that even now, 35 years after exposure, Yusho patients still have a higher concentration of hexaCB-156, hexaCB-157, heptaCB-181, and heptaCB-189 in their blood than do unaffected people. These four congeners may be considered the most important congeners for evaluating the PCBs toxicity of Yusho patients.

History of Public Health Crises in Japan

In Japan, a number of serious public health crises involving environmental pollution, food-borne diseases, and health hazards due to pharmaceuticals (i.e., "Yakugai") have occurred in the past 50 years. Based on the literature, we summarize the initial investigations and the subsequent measures. Some common points emerge: (1) prolonged cause identification, (2) lack of countermeasures after the cause was identified, and (3) discrimination against victims and they contributed to spreading the damage. We identify lack of corporate ethics and ill-timed disclosure of information as the principal problems in Japan's crisis-management systems. Defects in information gathering were common to all of the cases, thus we suggest necessary corrective measures, such as the establishment of a new reporting system for health hazard-related information.

Concentrations of polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, and non-ortho and mono-ortho polychlorinated biphenyls in blood of Yusho patients

We measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), non-ortho polychlorinated biphenyls (non-ortho PCBs) and mono-ortho polychlorinated biphenyls (mono-ortho PCBs) in blood collected from 279 Yusho patients living in Japan, 92 Yusho-suspected persons living in Japan and 127 normal controls living in Fukuoka Prefecture, and compared among the groups in terms the concentrations of these compounds. The total toxic equivalents (TEQ) concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in the bloods of Yusho patients and Yusho-suspected persons were 161.4 and 51.2 pg TEQ/g lipid, respectively and were about 3.5 and 1.1 times higher than those of normal controls, respectively. Although the TEQ concentrations of PCDDs, non-ortho PCBs, and mono-ortho PCBs among Yusho patients, Yusho-suspected persons and normal controls were nearly the same, the PCDFs levels of Yusho patients were significantly higher than those of Yusho-suspected persons and about 10.3 times higher than those of normal controls. In Yusho patients, PCDFs contributed about 65% to the total TEQ concentration. Among the PCDFs congeners for Yusho patients, the concentration of 2,3,4,7,8-pentachlorodibenzofuran (PeCDF) was about 11.3 times higher than that of normal controls. These findings indicated that Yusho patients even now, more than 34 years after the outbreak of Yusho, have much higher blood levels of 2,3,4,7,8-PeCDF in general than do unaffected persons.

Comparison between "Yusho" patients and healthy Japanese in contamination level of dioxins and related chemicals and frequency of sister chromatid exchanges

Highly toxic organochlorine chemicals such as polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and coplanar polychlorinated biphenyls (CoPCBs) were determined in the peripheral blood and sebum from the face of 16 "Yusho" patients of about 27 yr after the outbreak of Yusho accident, and 39 healthy Japanese people. The mean total toxic equivalent (TEQ) levels of PCDDs, PCDFs and CoPCBs in the blood were still about seven times higher in Yusho patients than in healthy Japanese at the age of 45 yr and more. The sebum excretion of these chemicals seemed proportional to their blood levels in Yusho patients. These toxic chemicals, however, did not enhance frequencies of sister chromatid exchanges (SCEs) in the control and 7,8-benzoflavone (ANF) treated cultures in Yusho patients. Hence, no significant difference was observed in the mean SCE rates between the Yusho patients and general Japanese people of more than 45 yr of age. In this study, the number of Yusho patients examined is limited, so further large-scale investigations are needed to get more conclusive results concerning the genotoxic potency such as SCE induction.

The toxicokinetics and metabolism of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) and their relevance for toxicity

This article reviews the present state of the art regarding the toxicokinetics and metabolism of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs). The absorption, body distribution, and metabolism can vary greatly between species and also may depend on the congener and dose. In biota, the 2,3,7,8-substituted PCDDs and PCDFs are almost exclusively retained in all tissue types, preferably liver and fat. This selective tissue retention and bioaccumulation are caused by a reduced rate of biotransformation and subsequent elimination of congeners with chlorine substitution at the 2,3,7, and 8 positions. 2,3,7,8-Substituted PCDDs and PCDFs also have the greatest toxic and biological activity and affinity for the cytosolic arylhydrocarbon (Ah)-receptor protein. The parent compound is the causal agent for Ah-receptor-mediated toxic and biological effects, with metabolism and subsequent elimination of 2,3,7,8- substituted congeners representing a detoxification process. Congener-specific affinity of PCDDs and PCDFs for the Ah-receptor, the genetic events following receptor binding, and toxicokinetics are factors that contribute to the relative in vivo potency of an individual PCDD or PCDF in a given species. Limited human data indicate that marked species differences exist in the toxicokinetics of these compounds. Thus, human risk assessment for PCDDs and PCDFs needs to consider species-, congener-, and dose-specific toxicokinetic data. In addition, exposure to complex mixtures, including PCBs, has the potential to alter the toxicokinetics of individual compounds. These alterations in toxicokinetics may be involved in some of the nonadditive toxic or biological effects that are observed after exposure to mixtures of PCDDs or PCDFs with PCBs.

Association between blood polychlorinated biphenyl concentration and serum triglyceride level in chronic "Yusho" (polychlorinated biphenyl poisoning) patients

The association between blood polychlorinated biphenyl (PCB) concentration and serum triglyceride level was investigated in 259 "Yusho" patients (PCB poisoning) who underwent health examinations for Yusho in 1988. Geometric means of PCB and triglyceride were 3.84 ppb (95% confidence interval: 3.54-4.17) and 114.3 mg/dl (106.6-122.6), respectively. Both correlation and multiple regression analyses showed a weak but statistically significant correlation between these two variables. The mean triglyceride level adjusted for age and sex was then calculated for comparison among four PCB levels, using analysis of covariance. This indicated a progressive increase with increasing PCB: 98.36, 117.78, 117.84, and 127.65 mg/dl at < 2.7, 2.7+, 4.1+, and 6.1+ ppb, respectively (F = 2.01, P = 0.113). Comparing PCB levels, the difference in adjusted mean triglyceride levels was marginally significant between the first and second (P = 0.088), and the first and third quartiles (P = 0.066), and reached significance between the first and fourth quartiles (P = 0.021). Thus, a weak but significant association between blood PCB and serum triglyceride was observed in the patients 20 years after exposure, although their blood PCB and serum triglyceride were relatively close to the normal levels.

Mutagenicity of 3-nitrodibenzofuran and 3-aminodibenzofuran

Mutagenicities of 3-nitrodibenzofuran and 3-aminodibenzofuran were examined using Salmonella typhimurium TA98 and TA100. Strong mutagenicity was found in both compounds. The mutagenic potency of 3-nitrodibenzofuran was approximately 3.5-fold stronger in TA98 and twice stronger in TA100 than that of benzo[a]pyrene. Mutagenicity of 3-aminodibenzofuran was observed under metabolic activation and was 10 times stronger in TA98 and about 5 times stronger in TA100 than that of benzo[a]pyrene.

Mutagenicity of monochlorodibenzofurans detected in the environment

Recently, monochlorodibenzofuran, which is formed by the reaction of dibenzofuran with residual chlorine, has been detected in tap water in one region of Japan. The mutagenicities of 1-, 2-, 3-, and 4-chlorodibenzofuran were tested using Salmonella typhimurium TA98 and TA100. 1-Chlorodibenzofuran and 4-chlorodibenzofuran proved to be practically non-mutagenic, while 2-chlorodibenzofuran was weakly mutagenic. Unlike these three isomers, 3-chlorodibenzofuran was markedly mutagenic, and the intensity of its mutagenicity in TA98 was about one-fifth and in TA100 about one-twentieth of that of benzo[a]pyrene.

Genetically mediated induction of aryl hydrocarbon hydroxylase activity in mice by polychlorinated dibenzofuran isomers and 2,3,7,8-tetrachlorodibenzo-p-dioxin

Hepatic aryl hydrocarbon hydroxylase (AHH)-inducing potency of toxic polychlorinated aromatic hydrocarbons such as polychlorinated dibenzofurans (PCDFs), 3,4,5,3',4',5'-hexachlorobiphenyl (HCB) and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was studied in four inbred strains of mice with different phenotypes of Ah locus, i.e., AHH-responsive strains: C57BL/6N and AKR/Ms Qdj, and AHH-nonresponsive strains: DBA/2Cr Slc and Qdj; DDD. Eight individual PCDF isomers or TCDD were administered IP in doses of 30 micrograms/kg; HCB was given in a dose of 120 micrograms/kg. In AHH-nonresponsive strains of mice, only TCDD significantly induced hepatic AHH activity, while in AHH-responsive strains, 2,3,7,8-tetrachlorodibenzofuran(2,3,7,8-TCDF), 1,2,3,7,8-pentachlorodibenzofuran(1,2,3,7,8-PCDF), 2,3,4,7,8-pentachlorodibenzofuran(2,3,4,7,8-PCDF), and TCDD significantly enhanced the enzyme activity, and the induced AHH activities with the three PCDF isomers were about 30-65% of those of TCDD. These results indicate that AHH responsiveness in mice segregates with the induction of AHH activity by PCDF isomers and may also segregate with the toxic potency of the isomers; i.e., toxic potencies of 2,3,7,8-TCDF, 1,2,3,7,8-PCDF, and 2,3,4,7,8-PCDF in AHH-responsive strains of mice may be much greater than those in AHH-nonresponsive strains of mice. Taking into account both the potent AHH inducibility and the high bioaccumulation of 2,3,7,8-TCDF, 1,2,3,7,8-PCDF, and 2,3,4,7,8-PCDF, these three PCDF isomers should be given greater attention with regard to environmental contamination.

Genetically mediated induction of aryl hydrocarbon hydroxylase activity in human lymphoblastoid cells by polychlorinated dibenzofuran isomers and 2,3,7,8-tetrachlorodibenzo-p-dioxin

Aryl hydrocarbon hydroxylase(AHH)-inducing potency of toxic polychlorinated aromatic hydrocarbons such as polychlorinated dibenzofuran (PCDF) isomers, 3,4,5,3',4',5'-hexachlorobiphenyl (HCB) and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was investigated in human lymphoblastoid cell lines with different AHH inducibility for 3-methylcholanthrene (3-MC) obtained from healthy subjects. Each of the cell lines was treated with eight individual PCDF isomers, TCDD, and HCB at doses of 1.9-15 ng/ml of culture medium, 1.9-7.5 ng/ml and 95 ng/ml, respectively. Lymphoblastoid cell lines were arbitrarily classified into three groups based on their AHH inducibilities with 3-MC (2.5 microM); low (3-MC/control = I less than 3), middle (3 less than or equal to I less than 6) and high (I greater than or equal to 6). Degrees of the enzyme inducibilities of the organochlorine compounds proportionally increased with those for 3-MC. AHH inducibilities with 2,3,4,7,8-pentachlorodibenzofuran(2,3,4,7,8-PCDF), 1,2,3,4,6,7-hexachlorodibenzofuran(1,2,3,4,6,7-HCDF) and 1,2,3,4,7,8-hexachlorodibenzofuran(1,2,3,4,7,8-HCDF) were comparable to those of TCDD at doses of 7.5 ng/ml, and about twice as high as those of 2,3,7,8-tetrachlorodibenzofuran (TCDF), at the same dose, HCB, at a dose of 95 ng/ml, did not induce enzyme activity. The experimental evidence indicated that AHH inducibility by the organochlorine compounds reflected the genetic susceptibility of the cells to the phenomenon of induction, and PCDF isomers found at relatively high concentrations in tissues of mammals exerted the highest values of AHH induction.

Teratogenicity of 2,3,7,8-tetrachlorodibenzofuran in the mouse

2,3,7,8-Tetrachlorodibenzofuran (TCDBF) was administered in single doses (0.1-0.8 mg/kg body weight) intraperitoneally to pregnant C57BL mice on d 10, 11, 12, or 13 of gestation. A dose-dependent increase was observed in the frequency of fetal resorptions and fetal death, especially in the earlier stages (d 10-11). Cleft palate and hydronephrosis as well appeared in a dose-dependent manner, with a peak in sensitivity after administration on d 11-12. TCDBF given at a dose level of 0.1 mg/kg body weight on d 12 of gestation (only dose- and stage-tested) produced a marked thymic hypoplasia as well. A few cases of general hydrops occurred. The pattern of malformations and time of sensitivity corresponded well to that observed earlier after administration of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD; ED50 approximately equal to 25 micrograms/kg) and 3,3',4,4'-tetrachloroazoxybenzene (TCAOB; ED50 approximately equal to 6 mg/kg), two congeners of TCDBF, indicating common mechanisms of action of this family of compounds. Ornithine decarboxylase (ODC) is an important enzyme in cell proliferation and growth with a high activity in embryonic tissues. Liver ODC activity has previously been found to be stimulated by TCDD in weaning mice. However, this enzyme was not found to be stimulated in fetal and placental tissues, but slightly in maternal kidney after treatment with TCDBF in teratogenic doses. It is possible that the ODC activity increases under certain conditions only, on administration of TCDD and its congeners.

A comparative study of polychlorinated dibenzofurans, polychlorinated biphenyls and 2,3,7,8-tetrachlorodibenzo-p-dioxin on aryl hydrocarbon hydroxylase inducing potency in rats

The aryl hydrocarbon hydroxylase (AHH) inducing potency of toxic chlorinated aromatic hydrocarbons such as polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs) and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was studied in the young male Wistar rats. Alternatively, a technical PCDF mixture, 15 individual PCDF isomers or TCDD were administered i.p. in doses of 5 micrograms/kg; a PCB mixture was given in a dose of 50 mg/kg. The order of AHH inducing ability was TCDD greater than PCDFs much greater than PCBs in kidney, lung, and liver. In the prostate, thymus, and spleen, only TCDD enhanced the AHH activity. The AHH inducibility in the lung and liver, induced by 15 pure PCDF isomers with varying chlorine substitutions was also examined. Only 2,3,7,8-tetrachlorodibenzofuran (2,3,7,8-tetra-CDF) and 2,3,4,7,8-pentachlorodibenzofurans (2,3,4,7,8-penta-CDF) significantly induced the hepatic AHH activity (4- and 2-fold, respectively), while eight PCDF isomers, including these two, significantly enhanced the pulmonary AHH activity (6- to 30-fold). Taking into account both the potent AHH inducibility and the high bioaccumulation of these compounds, 2,3,7,8-tetra- and 2,3,4,7,8-penta-CDF should be given due attention with regard to environmental-related factors and the possibility of involvement in the etiology of "yusho" disease.

Effect of polychlorinated biphenyls and polychlorinated quaterphenyls in Cynomolgus monkey (Macaca fascicularis)

Female Cynomolgus monkeys (Macaca fascicularis) with P-KC-400, Y-PCB, PY-PCB or polychlorinated quaterphenyls (PCQ) received a daily dose of 5 mg for 20 weeks, and some monkeys received a daily dose of 10 mg of Y-PCB or 0.5 mg of PCQ. The chemical compositions of the polychlorobiphenyls (PCB) used for the oral administration were as follows: P-KC-400, PCB from which polychlorodibenzofurans (PCDF) have been removed from Kanecklor 400, largely contains tri- and tetrachlorobiphenyls and no PCDF. Whereas, Y-PCB and PY-PCB, PCB with constituents similar to PCB ingested by yusho patients, largely contain penta- and hexachlorobiphenyls, in addition, PCDF of 400 ppm was present only in Y-PCB, but not in PY-PCB. There were immunosuppression, enlargement and histopathological changes of the liver (such as interstitial inflammation, and proliferation of epithelial cells of biliary duct, etc.) in the groups fed P-KC-400 and PY-PCB (free of PCDF). In the group fed Y-PCB (with PCDF), there were more apparent decreases in body weight, immunosuppression, fatty liver and histopathological changes than in the groups P-KC-400 and PY-PCB. In addition, there were hair loss, acneform eruptions, edema of the eyelid, congestion and abscess of the Meibomian gland, and cornifications of the skin, characteristic dermatological findings of yusho disease.

Role of polychlorinated dibenzofuran in yusho (PCB poisoning)

In the blood of 15 patients with yusho or "polychlorinated biphenyl poisoning" that occurred in 1979 in Taiwan, was found polychlorinated dibenzofurans (14 of 15) and polychlorinated quaterphenyls (15 of 15), as well as polychlorinated biphenyls (15 of 15). The mean concentration ratio of these substances was approximately 1 : 160 : 500. Based on the following evidence, we propose that polychlorinated quaterphenyls were major pathogenic substances in the development of yusho: (1) Clinical manifestations and course of yusho patients are disproportionately severe and persistent for the observed blood levels of polychlorinated biphenyls, while patients who were occupationally exposed to pure polychlorinated biphenyls take characteristically mild and benign clinical course despite polychlorinated biphenyl levels often much higher than those noted in yusho patients; (2) Polychlorinated debenzofurans show a marked tendency to accumulate in the liver, which might explain frequent presence of jaundice and other abdominal symptoms in yusho, which are, again, not observed in those with occupational polychlorinated biphenyl poisoning; (3) Toxicity of polychlorinated dibenzofurans is a hundred to ten thousand times greater than that of polychlorinated biphenyls and polychlorinated quaterphenyls in animal experiments.