Diabetes, Cardiovascular Disorders and 2,3,7,8-Tetrachlorodibenzo-p-Dioxin Body Burden in Czech Patients 50 Years After the Intoxication

Basic Clin Pharmacol Toxicol. 2018 Sep;123(3):356-359. doi: 10.1111/bcpt.13013. Epub 2018 May 7.

Abstract

The correlation between 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) intoxication and the parameters of metabolic impairment was examined in the last eight male survivors of 80 workers exposed to TCDD during the production of herbicides in a chemical factory in 1965-1967. Their median TCDD blood level was 112 (46-390) pg/g lipids, and the median TCDD body deposit was 3.9 (0.8-11.7) μg. This puts these patients into the most severely intoxicated group of subjects, according to back-calculated levels of TCDD. The median TCDD blood level in eight controls was 12 pg/g (<0.10 to 22.2 pg/g). Markers of metabolic impairment - diabetes, dyslipidaemia, arterial hypertension, carotid artery plaque, skin microvascular reactivity, eye fundus hypertensive angiopathy and history of coronary heart disease - were assessed and compared to a general male population of comparable age. Measured parameters compared with a population of comparable age were as follows: prevalence of diabetes (62.5% versus 17.6%), arterial hypertension (87.5% versus 71.8%), dyslipidaemia (87.5% versus 88.8%), history of coronary heart disease (62.5% versus 26.0%) and eye fundus hypertension angiopathy (50% versus 14%). All eight patients (100% versus 43%) developed plaques in carotid arteries, six had stenosis >50% and two had a carotid intervention (stenting or endarterectomy). Total cholesterol levels decreased compared to the earlier study this patient group in 2008, most likely due to a more intensive use of lipid-lowering drugs. Several metabolic parameters were higher (diabetes as much as 3.5-fold) in the group of severely TCDD-intoxicated subjects than in a general population of comparable age. This suggests that TCDD plays a role in the development of metabolic impairment and vascular changes.

MeSH terms

  • Aged
  • Body Burden
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Czech Republic / epidemiology
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / etiology
  • Environmental Pollutants / blood
  • Environmental Pollutants / toxicity
  • Follow-Up Studies
  • Herbicides / blood
  • Herbicides / toxicity
  • Humans
  • Male
  • Occupational Exposure / adverse effects*
  • Polychlorinated Dibenzodioxins / blood
  • Polychlorinated Dibenzodioxins / toxicity*
  • Prevalence

Substances

  • Environmental Pollutants
  • Herbicides
  • Polychlorinated Dibenzodioxins