Journal of Preventive Medicine and Public Health

  • 제46권5호
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  • Pages.226-236
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  • 2013
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Serum 2,3,7,8-Tetrachlorodibenzo-p-dioxin Levels and Their Association With Age, Body Mass Index, Smoking, Military Record-based Variables, and Estimated Exposure to Agent Orange in Korean Vietnam Veterans

  • Yi, Sang-Wook (Department of Preventive Medicine and Public Health, Kwandong University College of Medicine) ;
  • Ohrr, Heechoul (Department of Preventive Medicine and Public Health, Yonsei University College of Medicine) ;
  • Won, Jong-Uk (Department of Preventive Medicine and Public Health, Yonsei University College of Medicine) ;
  • Song, Jae-Seok (Department of Preventive Medicine and Public Health, Kwandong University College of Medicine) ;
  • Hong, Jae-Seok (Health Insurance Review and Assessment Service)
  • 투고 : 2013.06.10
  • 심사 : 2013.08.05
  • 발행 : 2013.09.30
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초록

Objectives: The aim of this study was to examine the levels of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and evaluate their association with age, body mass index, smoking, military record-based variables, and estimated exposure to Agent Orange in Korean Vietnam veterans. Methods: Serum levels of TCDD were analyzed in 102 Vietnam veterans. Information on age, body mass index, and smoking status were obtained from a self-reported questionnaire. The perceived exposure was assessed by a 6-item questionnaire. Two proximitybased exposures were constructed by division/brigade level and battalion/company level unit information using the Stellman exposure opportunity index model. Results: The mean and median of serum TCDD levels was 1.2 parts per trillion (ppt) and 0.9 ppt, respectively. Only 2 Vietnam veterans had elevated levels of TCDD (>10 ppt). The levels of TCDD did not tend to increase with the likelihood of exposure to Agent Orange, as estimated from either proximity-based exposure or perceived self-reported exposure. The serum TCDD levels were not significantly different according to military unit, year of first deployment, duration of deployment, military rank, age, body mass index, and smoking status. Conclusions: The average serum TCDD levels in the Korean Vietnam veterans were lower than those reported for other occupationally or environmentally exposed groups and US Vietnam veterans, and their use as an objective marker of Agent Orange exposure may have some limitations. The unit of deployment, duration of deployment, year of first deployment, military rank, perceived self-reported exposure, and proximity-based exposure to Agent Orange were not associated with TCDD levels in Korean Vietnam veterans. Age, body mass index and smoking also were not associated with TCDD levels.

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참고문헌

  1. Institute of Medicine. Veterans and Agent Orange: update 2010. Washington, DC: National Academy Press; 2011, p. 54-71, 89-92.
  2. Ohrr H, Yi SW, Hong JS, Yi JJ, Kang HJ, Won JU, et al. The 3rd epidemiologic study on the adverse health effects of Agent Orange among Vietnam veterans. Seoul: Yonsei University Health System; 2006, p. 27-44, 51-54 (Korean).
  3. Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin levels in US Army Vietnam-era veterans. The Centers for Disease Control Veterans Health Studies. JAMA 1988;260(9):1249-1254. https://doi.org/10.1001/jama.1988.03410090081035
  4. Kahn PC, Gochfeld M, Nygren M, Hansson M, Rappe C, Velez H, et al. Dioxins and dibenzofurans in blood and adipose tissue of Agent Orange-exposed Vietnam veterans and matched controls. JAMA 1988;259(11):1661-1667. https://doi.org/10.1001/jama.1988.03720110023029
  5. Kim JS, Kang HK, Lim HS, Cheong HK, Lim MK. A Study on the correlation between categorization of the individual exposure levels to Agent Orange and serum dioxin levels among the Korean Vietnam veterans. Korean J Prev Med 2001;34(1):80- 88 (Korean).
  6. Fingerhut MA, Halperin WE, Marlow DA, Piacitelli LA, Honchar PA, Sweeney MH, et al. Cancer mortality in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. N Engl J Med 1991; 324(4):212-218. https://doi.org/10.1056/NEJM199101243240402
  7. Michalek JE, Tripathi RC. Pharmacokinetics of TCDD in veterans of Operation Ranch Hand: 15-year follow-up. J Toxicol Environ Health A 1999;57(6):369-378. https://doi.org/10.1080/009841099157584
  8. Wolfe WH, Michalek JE, Miner JC, Rahe A, Silva J, Thomas WF, et al. Health status of Air Force veterans occupationally exposed to herbicides in Vietnam. I. Physical health. JAMA 1990; 264(14):1824-1831. https://doi.org/10.1001/jama.1990.03450140046032
  9. Pinsky PF, Lorber MN. A model to evaluate past exposure to 2,3,7,8-TCDD. J Expo Anal Environ Epidemiol 1998;8(2):187-206.
  10. Collins JJ, Bodner K, Burns CJ, Budinsky RA, Lamparski LL, Wilken M, et al. Body mass index and serum chlorinated dibenzo-p-dioxin and dibenzofuran levels. Chemosphere 2007;66(6):1079-1085. https://doi.org/10.1016/j.chemosphere.2006.06.063
  11. Garabrant DH, Franzblau A, Lepkowski J, Gillespie BW, Adriaens P, Demond A, et al. The University of Michigan Dioxin Exposure Study: predictors of human serum dioxin concentrations in Midland and Saginaw, Michigan. Environ Health Perspect 2009;117(5):818-824. https://doi.org/10.1289/ehp.11779
  12. Patterson DG Jr, Turner WE, Caudill SP, Needham LL. Total TEQ reference range (PCDDs, PCDFs, cPCBs, mono-PCBs) for the US population 2001-2002. Chemosphere 2008;73(1 Suppl): S261-S277. https://doi.org/10.1016/j.chemosphere.2007.08.074
  13. Chen Q, Garabrant DH, Hedgeman E, Little RJ, Elliott MR, Gillespie B, et al. Estimation of background serum 2,3,7,8-TCDD concentrations by using quantile regression in the UMDES and NHANES populations. Epidemiology 2010;21 Suppl 4:S51-S57. https://doi.org/10.1097/EDE.0b013e3181ce9550
  14. Fierens S, Eppe G, De Pauw E, Bernard A. Gender dependent accumulation of dioxins in smokers. Occup Environ Med 2005; 62(1):61-62. https://doi.org/10.1136/oem.2004.013730
  15. Muto H, Takizawa Y. Dioxins in cigarette smoke. Arch Environ Health 1989;44(3):171-174. https://doi.org/10.1080/00039896.1989.9935882
  16. Kim BH, Ikonomou MG, Lee SJ, Kim HS, Chang YS. Concentrations of polybrominated diphenyl ethers, polychlorinated dibenzo-p-dioxins and dibenzofurans, and polychlorinated biphenyls in human blood samples from Korea. Sci Total Environ 2005;336(1-3):45-56. https://doi.org/10.1016/j.scitotenv.2004.05.030
  17. Ohrr H, Yi SW, Won JU, Park WS, Hong JS, Sull JW, et al. The 2nd epidemiologic study on the adverse health effects of Agent Orange among Vietnam veterans. Seoul: Yonsei University Health System; 2001, p. 13-21 (Korean).
  18. Moon CS, Chang YS, Kim BH, Shin D, Ikeda M. Evaluation of serum dioxin congeners among residents near continuously burning municipal solid waste incinerators in Korea. Int Arch Occup Environ Health 2005;78(3):205-210. https://doi.org/10.1007/s00420-005-0603-0
  19. Decouflé P, Holmgreen P, Boyle CA, Stroup NE. Self-reported health status of Vietnam veterans in relation to perceived exposure to herbicides and combat. Am J Epidemiol 1992;135(3): 312-323. https://doi.org/10.1093/oxfordjournals.aje.a116285
  20. Stellman JM, Stellman SD, Weber T, Tomasallo C, Stellman AB, Christian R Jr. A geographic information system for characterizing exposure to Agent Orange and other herbicides in Vietnam. Environ Health Perspect 2003;111(3):321-328.
  21. Institute of Medicine. The utility of proximity-based herbicide exposure assessment in epidemiologic studies of Vietnam veterans. Washington, DC: National Academy Press; 2008, p. 35-61.
  22. Kang HK, Dalager NA, Needham LL, Patterson DG Jr, Lees PS, Yates K, et al. Health status of Army Chemical Corps Vietnam veterans who sprayed defoliant in Vietnam. Am J Ind Med 2006;49(11):875-884. https://doi.org/10.1002/ajim.20385
  23. Aylward LL, Hays SM. Temporal trends in human TCDD body burden: decreases over three decades and implications for exposure levels. J Expo Anal Environ Epidemiol 2002;12(5): 319-328. https://doi.org/10.1038/sj.jea.7500233
  24. Schecter A, Päpke O, Tung KC, Joseph J, Harris TR, Dahlgren J. Polybrominated diphenyl ether flame retardants in the U.S. population: current levels, temporal trends, and comparison with dioxins, dibenzofurans, and polychlorinated biphenyls. J Occup Environ Med 2005;47(3):199-211. https://doi.org/10.1097/01.jom.0000158704.27536.d2
  25. Buckner JE. Final report: vegetation control plan CY68. San Francisco: United States Army Advisory Group; 1969, p. E-1.
  26. Yi SW, Ohrr H, Lim HS. Agent Orange-related chemical exposure: health effects and compensation policy in Korea. J Environ Health Sci 2013;39(3):197-210 (Korean).
  27. Leem JH, Hong YC, Lee KH, Kwon HJ, Jang JY. Exposure assessment of PCDD/Fs and monitoring of health effects on workers and residents near the waste incinerators in Korea. Korean J Prev Med 2003;36(4):314-322 (Korean).
  28. Yang JY, Lim YG, Chang YS, Kim CS, Shin DC. Serum PCDDs/ PCDFs levels for the residents living in the vicinity and workers of the municipal waste incinerators in Seoul, Korea. J Environ Toxicol 2006;21(4): 337-347 (Korean).
  29. Yang YH, Kim BH, Chang YS. Analysis of PCDD/Fs and PCBs in human blood and characteristics of contamination sources. Anal Sci Technol 2001;14(2):147-158 (Korean).
  30. Sorg O, Zennegg M, Schmid P, Fedosyuk R, Valikhnovskyi R, Gaide O, et al. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) poisoning in Victor Yushchenko: identification and measurement of TCDD metabolites. Lancet 2009;374(9696):1179-1185. https://doi.org/10.1016/S0140-6736(09)60912-0
  31. Kerger BD, Leung HW, Scott P, Paustenbach DJ, Needham LL, Patterson DG Jr, et al. Age- and concentration-dependent elimination half-life of 2,3,7,8-tetrachlorodibenzo-p-dioxin in Seveso children. Environ Health Perspect 2006;114(10):1596-1602. https://doi.org/10.1289/ehp.8884
  32. Milbrath MO, Wenger Y, Chang CW, Emond C, Garabrant D, Gillespie BW, et al. Apparent half-lives of dioxins, furans, and polychlorinated biphenyls as a function of age, body fat, smoking status, and breast-feeding. Environ Health Perspect 2009;117(3):417-425. https://doi.org/10.1289/ehp.11781
  33. Needham LL, Gerthoux PM, Patterson DG Jr, Brambilla P, Turner WE, Beretta C, et al. Serum dioxin levels in Seveso, Italy, population in 1976. Teratog Carcinog Mutagen 1997-1998; 17(4-5):225-240.
  34. Hsu JF, Chang YC, Liao PC. Age-dependent congener profiles of polychlorinated dibenzo-p-dioxins and dibenzofurans in the general population of Taiwan. Chemosphere 2010;81(4): 469-477. https://doi.org/10.1016/j.chemosphere.2010.07.044
  35. Eskenazi B, Mocarelli P, Warner M, Needham L, Patterson DG Jr, Samuels S, et al. Relationship of serum TCDD concentrations and age at exposure of female residents of Seveso, Italy. Environ Health Perspect 2004;112(1):22-27.
  36. Kim YS. A study on the association between life factor and dioxin in blood [dissertation]. Seoul: Yonsei University; 2004 (Korean).
  37. Ferriby LL, Knutsen JS, Harris M, Unice KM, Scott P, Nony P, et al. Evaluation of PCDD/F and dioxin-like PCB serum concentration data from the 2001-2002 National Health and Nutrition Examination Survey of the United States population. J Expo Sci Environ Epidemiol 2007;17(4):358-371. https://doi.org/10.1038/sj.jes.7500498
  38. Goldman LR, Harnly M, Flattery J, Patterson DG Jr, Needham LL. Serum polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans among people eating contaminated home-produced eggs and beef. Environ Health Perspect 2000; 108(1):13-19. https://doi.org/10.1289/ehp.00108s113

피인용 문헌

  1. Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean Veterans Health Study vol.43, pp.6, 2013, https://doi.org/10.1093/ije/dyu183
  2. Herbicide Exposure, Vietnam Service, and Hypertension Risk in Army Chemical Corps Veterans vol.58, pp.11, 2016, https://doi.org/10.1097/jom.0000000000000876
  3. Concentrations of polychlorinated dibenzodioxins, polychlorodibenzofurans, and polychlorobiphenyls in women of reproductive age in Italy: A human biomonitoring study vol.220, pp.2, 2013, https://doi.org/10.1016/j.ijheh.2016.11.009