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Dioxins and cardiovascular disease mortality.

Authors
Humblet-O; Birnbaum-L; Rimm-E; Mittleman-MA; Hauser-R
Source
Environ Health Perspect 2008 Nov; 116(11):1443-1448
NIOSHTIC No.
20034962
Abstract
OBJECTIVE: in this systematic review we evaluated the evidence on the association between dioxin exposure and cardiovascular disease (CVD) mortality in humans. DATA SOURCES AND EXTRACTION: we conducted a PubMed search in December 2007 and considered all English-language epidemiologic studies and their citations regarding dioxin exposure and CVD mortality. To focus on dioxins, we excluded cohorts that were either primarily exposed to polychlorinated biphenyls or from the leather and perfume industries, which include other cardiotoxic coexposures. DATA SYNTHESIS: We included results from 12 cohorts in the review. Ten cohorts were occupationally exposed. We divided analyses according to two well-recognized criteria of epidemiologic study quality: the accuracy of the exposure assessment, and whether the exposed population was compared with an internal or an external (e.g., general population) reference group. Analyses using internal comparisons with accurate exposure assessments are the highest quality because they minimize both exposure misclassification and confounding due to workers being healthier than the general population ("healthy worker effect"). The studies in the highest-quality group found consistent and significant dose-related increases in ischemic heart disease (IHD) mortality and more modest associations with all-CVD mortality. Their primary limitation was a lack of adjustment for potential confounding by the major risk factors for CVD. CONCLUSIONS: The results of this systematic review suggest that dioxin exposure is associated with mortality from both IHD and all CVD, although more strongly with the former. However, it is not possible to determine the potential bias, if any, from confounding by other risk factors for CVD.
Keywords
Cardiac-function; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-system-disease; Chemical-hypersensitivity; Chemical-processing; Exposure-levels; Mortality-data; Mortality-rates; Mortality-surveys; Occupational-exposure; Occupational-hazards; Epidemiology; Statistical-analysis; Author Keywords: Cardiovascular disease; Dioxin; Epidemiology; Healthy worker effect; Herbicides; Ischemic heart disease; Mortality; Occupational exposure; PCB; TCDD
Contact
R. Hauser, Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Ave., Building I, Room 1405, Boston, MA 02115
CODEN
EVHPAZ
CAS No.
11097-69-1
Publication Date
20081101
Document Type
Journal Article
Email Address
rhauser@hohp.harvard.edu
Funding Type
Grant
Fiscal Year
2009
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008416
Issue of Publication
11
ISSN
0091-6765
Source Name
Environmental Health Perspectives
State
MA; NC
Performing Organization
Harvard School of Public Health
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