Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Dioxins and Health: Human Exposure Level and Epidemiologic Evidences of Health Effects

다이옥신과 건강: 인체 노출 수준 및 건강영향에 대한 역학적 연구

  • Jang, Jae-Yeon (Department of Preventive Medicine and Public Health, Ajou University) ;
  • Kwon, Ho-Jang (Department of Preventive Medicine, Dankook University College of Medicine)
  • 장재연 (아주대학교 의과대학 예방의학교실) ;
  • 권호장 (단국대학교 의과대학 예방의학교실)
  • Published : 2003.12.01
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Abstract

General information is summarized, that is necessary to introduce a scientific assessment of the human health and exposure issue concerning dioxin and dioxin-like compound. Scientific literatures were reviewed to assess the background exposures to the dioxin-like compounds for normal residents. Epidemiologic studies were also reviewed to assess malignant and nonmalignant sweets of dioxins. In 1997, the International Agency for Research on Cancer classified 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as a human carcinogen, primarily based on occupational cohort studies. The US Environmental Protection Agency made the same decision in it's Draft Dioxin Reassessment. Epidemiologic evidences point to a generalized excess of all cancers, without any pronounced excess at specific sites. Reported non-cancer effects included a range of conditions affecting most systems. Among them, chloracne, elevation in gamma glutamyl transferase(GGT), and alterations in reproductive hormones are related to TCDO, Other adverse outcomes, such as lipid concentrations, diabetes, circulatory and heart diseases, immunologic disorders, neurobehavioral effects, and developmental outcomes require further study before their respective relationships to TCDD can be more definitively assessed.

다이옥신은 단일 화학물질이 아니라 비슷한 화학적 구조와 독성작용을 갖는 화학물질들의 그룹이다. 다이옥신 중에 가장 많은 연구가 이루어졌고 독성도 강한 물질이 2,3,7,8-tetrachlorodibenzo-p-dioxin(TCDD)인데, 다이옥신 혼합체의 독성을 평가할 때는 각 물질 별로 TCDD에 대한 상대독성을 고려하여 독성등가계수(TEQ)라는 지표를 만들어 사용한다. 일반인들의 평균적인 혈중 다이옥신에 대한 기준값은 명확하게 제시되지는 않고 있으나 관련 연구들을 종합할 때 대략 10-20 ppt $I-TEQ_{DF}$ 범위를 일반인의 평균적인 수준으로 볼 수 있다. 오염 가능지역의 주민들의 혈중 다이옥신 값은 지역에 따라 차이가 있으나 대부분 20ppt $I-TEQ_{DF}$ 이상의 값을 나타내고 있으며 특히 오염이 심한 지역의 주민들의 경우에는 직업적인 노출이 없는 일반 주민들임에도 불구하고 혈중 다이옥신 농도가 약 50 ppt $I-TEQ_{DF}$까지 상승할 수 있다. 다이옥신의 건강영향에 관해서는 수많은 역학적 연구들이 수행되었지만 혈액내에서 TCDD를 직접 측정하여 인체 노출을 비교적 정확하게 평가한 사업장 코호트나 세베소 지역 주민 코호트에서 나온 결과들이 보다 많은 신뢰를 받고 있다. 다이옥신 노출에 따른 건강영향은 크게 암발생과 암을 제외한 건강영향으로 구분할 수 있다. 국제암연구기구(IARC)나 미국 환경보호청(EPA) 모두 TCDD를 인체 발암물질로 분류하고 있으나 역학적 증거들이 충분한 상태는 아니다. TCDD를 제외한 나머지 다이옥신에 대해서는 IARC에서 발암성의 증거가 불충분한 물질(Group 3)로 분류하고 있다. 대부분의 장기에서 다이옥신의 건강영향에 대한 조사가 이루어져 왔다. 현재까지 비교적 다이옥신 노출과 관련성이 높은 것으로 평가되고 있는 것은 염소성여드름, 간 효소의 하나인 GGT의 상승, 그리고 생식호르몬의 변화 등이다. 그밖에 지질농도, 당뇨, 면역학적 영향, 심혈관계에 대한 영향, 갑상선기능, 신경계에 대한 영향, 소아 발달에 대한 영향 등에 대해서는 역학 연구들이 일관된 결과를 보여주지 못하고 있기 때문에 계속적인 연구를 필요로 하고 있다. 다이옥신의 독성은 수많은 동물실험을 통해 증명이 되었으나 인간을 대상으로 한 역학적 연구는 아직 기대만큼 명료한 결과들을 제시해주지 못하고 있다. 그러나 IARC나 EPA모두 인체발암물질로 분류하였고 다양한 건강영향에 대한 증거들이 있는 것은 분명한 만큼 다이옥신 노출을 최소화하려는 노력을 게을리 해서는 안 될 것이다.

Keywords

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