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March 18, 1988, Vol 259, No. 11 >
ARTICLE | March 18, 1988

Birth Defects in the Seveso Area After TCDD Contamination FREE

Pierpaolo Mastroiacovo, MD; Amedeo Spagnolo, MD; Ernesto Marni, MD; Luigi Meazza, MD; Roberto Bertollini, MD, MPH; Giuseppe Segni, MD
[+] Author Affiliations

Reprint requests to Indagine Policentrica Italiana Malformazioni Congenite, Clinica Pediatrica, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8-00168 Rome, Italy (Dr Mastroiacovo).


JAMA. 1988;259(11):1668-1672. doi:10.1001/jama.1988.03720110030030
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References

A study on the frequency of birth defects was conducted in the area around Seveso, Italy, which was contaminated by 2,3,7,8-tetrachlorodibenzo-p-dioxin in July 1976; this has been the largest population ever exposed to dioxin. From Jan 1, 1977, to Dec 31, 1982, a total of 15291 births (still and live) were examined, and malformations were reported to an ad hoc birth defects registry. In the most highly contaminated area, 26 births were observed. None of these infants had any major structural defect. Two infants had mild defects. The frequencies of major defects detected in the areas of low or very low contamination were 29.9/1000 and 22.1/1000, respectively. A frequency of 27.7/ 1000 was registered in the control area. Relative risks were calculated for specific categories of birth defects and for grouped malformations. Although the data collected failed to demonstrate any increased risk of birth defects associated with 2,3,7,8-tetrachlorodibenzo-p-dioxin, the number of exposed pregnancies was not big enough to show a low and specific teratogenic risk increase.

(JAMA 1988;259:1668-1672)

REFERENCES

1 +
Pocchiari F, Silano V, Zampieri A:  Human health effects from accidental release of tetrachlorodibenzo-p-dioxin (TCDD) at Seveso, Italy. Ann NY Acad Sci 1979;;320:311-320.
2 +
Pocchiari F, Di Domenico A, Silano V, et al:  Environmental impact of the accidental release of TCDD at Seveso, Italy , in Pocchiari F, Coulstone F (eds): Accidental Exposure to Dioxins: Human Health Aspects . Orlando, Fla, Academic Press Inc, 1983;, pp 5-35.
3 +
Pocchiari F, Del Corno G, Favaretti C, et al:  The chemical risk management process in Italy: A case study: The Seveso accident. Sci Total Environ 1986;;51:227-235.
4 +
Caramaschi F, Del Corno G, Favaretti C, et al:  Chloracne following environmental contamination by TCDD in Seveso, Italy. Int J Epidemiol 1981;;10:135-143.
5 +
Fanelli R, Chiabrando C, Bonaccorsi A: TCDD contamination in the Seveso incident. Drug Metab Rev 1982;;13:407-422.
6 +
D'Ambrosio A:  Violenza, coscienza, aborto. Sapere 1976;;796:85-90.
7 +
Reheder H, Sanchioni L, Cefis F, et al:  Pathologischembryologische Untersuchungen an Abortusfällen im Zusammenhang mit dem Seveso-Unglück. Schweiz Med Wochenschr 1978;;108:1617-1625.
8 +
Tenchini ML, Grimaudo C, Simoni G, et al:  Approaches to the evaluation of genetic damage after a major hazard in chemical industry: Preliminary cytogenetic findings in TCDD-exposed subjects after the Seveso accident , in Berg K (ed): Genetic Damage in Man Caused by Environmental Agents . Orlando, Fla, Academic Press Inc, 1979;, pp 301-316.
9 +
Bisanti L, Bonetti F, Caramaschi F, et al:  Experiences from the accident of Seveso. Acta Morphol Hung 1980;;28:139-157.
10 +
Fara GM, Del Corno G:  Pregnancy outcome in the Seveso area after TCDD contamination. Prog Clin Biol Res 1985;;163B:279-285.
11 +
Leck I:  Teratogenic risk of disease and therapy. Contrib Epidemiol Biostat 1979;;1:23-43.
12 +
Mastroiacovo P:  The Italian Birth Defects Monitoring System: Baseline rates based on 283 453 births and comparison with other registries. Prog Clin Biol Res 1985;;163B:17-21.
13 +
Källén B, Bertollini R, Castilla E, et al:  A joint international study on the epidemiology of hypospadias. Acta Paediatr Scand , 1986;, (suppl 324) , pp 1-52.
14 +
Indagine Policentrica Italiana sulle Malformazioni Congenite: Teratos-Notizie e Informazioni dall'IPIMC , (Sept 29) , 1986;.
15 +
Myrianthopoulos NC, Chung CS:  Congenital malformations in Singleton A: Epidemiologic survey. Birth Defects 1974;;10:1-20.
16 +
Bruzzi P, Strigini P, Raschetti R, et al:  Unanswered issues in low-level chemical pollution: The case of dioxins and related compounds , in Castellani A (ed): Epidemiology and Quantitation of Environmental Risk in Humans From Radiation and Other Agents . New York, Plenum Publishing Corp, 1985;, pp 537-550.
17 +
Registro delle Malformazioni dell'Ufficio Speciale di Seveso: Rapporto conclusivo sui difetti congeniti ed altri esiti sfavorevoli della gravidanza rilevati nella popolazione dell'area di Seveso interessata all'inquinamento da TCDD il 10/7/1976. Documento dell'Ufficio Speciale di Seveso, 1983.
18 +
Santi L, Boeri R, Remotti G, et al:  Five years after Seveso. Lancet 1983;;1:343-344.
19 +
Bianco W, Meazza L, Remotti G: Monitoraggio ostetrico nella Brianza di Seveso dal 1975 al 1981. Documento dell'Ufficio Speciale di Seveso, 1986.
20 +
Friedman JM:  Does Agent Orange cause birth defects? Teratology 1984;;29:193-221.
21 +
Giavini E, Prati M, Vismara C:  Rabbit teratology study with 2,3,7,8-tetrachlorodibenzo-p-dioxin. Environ Res 1982;;2:74-78.
22 +
Sare WM, Forbes PI:  Possible dysmorphogenic effects of an agricultural chemical 2,4,5-T. NZ Med J 1972;;85:37-38.
23 +
May G:  Tetrachlorodibenzodioxin: A survey of subjects ten years after exposure. Br J Ind Med 1982;;39:128-135.
24 +
Bogen G:  Symptoms in Vietnam veterans exposed to Agent Orange. JAMA 1979;;242:2391.
25 +
Norman C:  Vietnam's herbicide legacy. Science 1983;;219:1196-1197.
26 +
Tung TT, Anh TK, Tyen BC, et al:  Clinical effects of massive and continuous utilization of defoliants on civilians: Preliminary survey. Vietnam Stud 1971;;29:53-81.
27 +
Thomas HF:  2,4,5-T use and congenital malformations rates in Hungary. Lancet 1980;;2: 214-215.
28 +
Nelson CJ, Holson JF, Green MG, et al:  Retrospective study of the relationship between agricultural use of 2,4,5-T and cleft palate occurrence in Arkansas. Teratology 1979;;19:377-384.
29 +
Hanify JA, Metcalf P, Nobbs CL, et al:  Aerial spraying of 2,4,5-T and human birth malformations: An epidemiological investigation. Science 1981;;212:349-351.
30 +
Kunstadter P: A Study of Herbicides and Birth Defects in the Republic of Vietnam: An Analysis of Hospital Records . Washington, DC, National Academy Press, 1982;.
31 +
Erickson DJ, Mulinare J, McClain MS, et al:  Vietnam veterans' risks for fathering babies with birth defects. JAMA 1984;;252:903-912.
32 +
Donovan JW: Case-Control Study of Congenital Anomalies and Vietnam Service . Sydney, Australia, Commonwealth Institute of Health, University of Sydney, 1983;.
33 +
Townsed JC, Bodner KM, Van Peenen PFD, et al:  Survey of reproductive events of wives of employees exposed to chlorinated dioxins. Am J Epidemiol 1982;;115:695-713.
34 +
Smith AM, Fisher DO, Pearce N, et al:  Congenital defects and miscarriages among New Zealand 2,4,5-T sprayers. Arch Environ Health 1982;;37:197-200.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Pocchiari F, Silano V, Zampieri A:  Human health effects from accidental release of tetrachlorodibenzo-p-dioxin (TCDD) at Seveso, Italy. Ann NY Acad Sci 1979;;320:311-320.
2 +
Pocchiari F, Di Domenico A, Silano V, et al:  Environmental impact of the accidental release of TCDD at Seveso, Italy , in Pocchiari F, Coulstone F (eds): Accidental Exposure to Dioxins: Human Health Aspects . Orlando, Fla, Academic Press Inc, 1983;, pp 5-35.
3 +
Pocchiari F, Del Corno G, Favaretti C, et al:  The chemical risk management process in Italy: A case study: The Seveso accident. Sci Total Environ 1986;;51:227-235.
4 +
Caramaschi F, Del Corno G, Favaretti C, et al:  Chloracne following environmental contamination by TCDD in Seveso, Italy. Int J Epidemiol 1981;;10:135-143.
5 +
Fanelli R, Chiabrando C, Bonaccorsi A: TCDD contamination in the Seveso incident. Drug Metab Rev 1982;;13:407-422.
6 +
D'Ambrosio A:  Violenza, coscienza, aborto. Sapere 1976;;796:85-90.
7 +
Reheder H, Sanchioni L, Cefis F, et al:  Pathologischembryologische Untersuchungen an Abortusfällen im Zusammenhang mit dem Seveso-Unglück. Schweiz Med Wochenschr 1978;;108:1617-1625.
8 +
Tenchini ML, Grimaudo C, Simoni G, et al:  Approaches to the evaluation of genetic damage after a major hazard in chemical industry: Preliminary cytogenetic findings in TCDD-exposed subjects after the Seveso accident , in Berg K (ed): Genetic Damage in Man Caused by Environmental Agents . Orlando, Fla, Academic Press Inc, 1979;, pp 301-316.
9 +
Bisanti L, Bonetti F, Caramaschi F, et al:  Experiences from the accident of Seveso. Acta Morphol Hung 1980;;28:139-157.
10 +
Fara GM, Del Corno G:  Pregnancy outcome in the Seveso area after TCDD contamination. Prog Clin Biol Res 1985;;163B:279-285.
11 +
Leck I:  Teratogenic risk of disease and therapy. Contrib Epidemiol Biostat 1979;;1:23-43.
12 +
Mastroiacovo P:  The Italian Birth Defects Monitoring System: Baseline rates based on 283 453 births and comparison with other registries. Prog Clin Biol Res 1985;;163B:17-21.
13 +
Källén B, Bertollini R, Castilla E, et al:  A joint international study on the epidemiology of hypospadias. Acta Paediatr Scand , 1986;, (suppl 324) , pp 1-52.
14 +
Indagine Policentrica Italiana sulle Malformazioni Congenite: Teratos-Notizie e Informazioni dall'IPIMC , (Sept 29) , 1986;.
15 +
Myrianthopoulos NC, Chung CS:  Congenital malformations in Singleton A: Epidemiologic survey. Birth Defects 1974;;10:1-20.
16 +
Bruzzi P, Strigini P, Raschetti R, et al:  Unanswered issues in low-level chemical pollution: The case of dioxins and related compounds , in Castellani A (ed): Epidemiology and Quantitation of Environmental Risk in Humans From Radiation and Other Agents . New York, Plenum Publishing Corp, 1985;, pp 537-550.
17 +
Registro delle Malformazioni dell'Ufficio Speciale di Seveso: Rapporto conclusivo sui difetti congeniti ed altri esiti sfavorevoli della gravidanza rilevati nella popolazione dell'area di Seveso interessata all'inquinamento da TCDD il 10/7/1976. Documento dell'Ufficio Speciale di Seveso, 1983.
18 +
Santi L, Boeri R, Remotti G, et al:  Five years after Seveso. Lancet 1983;;1:343-344.
19 +
Bianco W, Meazza L, Remotti G: Monitoraggio ostetrico nella Brianza di Seveso dal 1975 al 1981. Documento dell'Ufficio Speciale di Seveso, 1986.
20 +
Friedman JM:  Does Agent Orange cause birth defects? Teratology 1984;;29:193-221.
21 +
Giavini E, Prati M, Vismara C:  Rabbit teratology study with 2,3,7,8-tetrachlorodibenzo-p-dioxin. Environ Res 1982;;2:74-78.
22 +
Sare WM, Forbes PI:  Possible dysmorphogenic effects of an agricultural chemical 2,4,5-T. NZ Med J 1972;;85:37-38.
23 +
May G:  Tetrachlorodibenzodioxin: A survey of subjects ten years after exposure. Br J Ind Med 1982;;39:128-135.
24 +
Bogen G:  Symptoms in Vietnam veterans exposed to Agent Orange. JAMA 1979;;242:2391.
25 +
Norman C:  Vietnam's herbicide legacy. Science 1983;;219:1196-1197.
26 +
Tung TT, Anh TK, Tyen BC, et al:  Clinical effects of massive and continuous utilization of defoliants on civilians: Preliminary survey. Vietnam Stud 1971;;29:53-81.
27 +
Thomas HF:  2,4,5-T use and congenital malformations rates in Hungary. Lancet 1980;;2: 214-215.
28 +
Nelson CJ, Holson JF, Green MG, et al:  Retrospective study of the relationship between agricultural use of 2,4,5-T and cleft palate occurrence in Arkansas. Teratology 1979;;19:377-384.
29 +
Hanify JA, Metcalf P, Nobbs CL, et al:  Aerial spraying of 2,4,5-T and human birth malformations: An epidemiological investigation. Science 1981;;212:349-351.
30 +
Kunstadter P: A Study of Herbicides and Birth Defects in the Republic of Vietnam: An Analysis of Hospital Records . Washington, DC, National Academy Press, 1982;.
31 +
Erickson DJ, Mulinare J, McClain MS, et al:  Vietnam veterans' risks for fathering babies with birth defects. JAMA 1984;;252:903-912.
32 +
Donovan JW: Case-Control Study of Congenital Anomalies and Vietnam Service . Sydney, Australia, Commonwealth Institute of Health, University of Sydney, 1983;.
33 +
Townsed JC, Bodner KM, Van Peenen PFD, et al:  Survey of reproductive events of wives of employees exposed to chlorinated dioxins. Am J Epidemiol 1982;;115:695-713.
34 +
Smith AM, Fisher DO, Pearce N, et al:  Congenital defects and miscarriages among New Zealand 2,4,5-T sprayers. Arch Environ Health 1982;;37:197-200.

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