EPA/600/BP-92/001b

EPIDEMIOLOGY/HUMAN DATA

DRAFT-DO NOT QUOTE OR CITE
Health Assessment Document for 2,3,7,8-Tetrachlorodibenzo-p-dioxin(TCDD) and Related Compounds
go to Contents - Overview EPA/600/BP-92/001a,b,c
CONTENTS - VOLUME II
SELECT Tables
SELECT Figures
SELECT Abbreviations and Acronyms
SELECT Preface
SELECT Authors, Contributors, and Reviewers
go to 7.0. PART A: CANCER EFFECTS

7.1. INTRODUCTION

7.2. SCOPE

7.3. PREVIOUS EPA REVIEWS

7.4. REVIEW METHODS

7.5. FOLLOW-UP STUDIES OF CHEMICAL MANUFACTURING AND PROCESSING WORKERS

7.5.1. United States

7.5.2. Germany

7.5.3. Ten-Country Study by International Agency for Research on Cancer

7.5.4. Other Studies

7.5.5. Summary

7.6. CASE-CONTROL STUDIES IN GENERAL POPULATIONS

7.6.1. Sweden

7.6.2. United States

7.6.3. New Zealand

7.6.4. Italy

7.6.5. Summary

7.7. STUDIES OF PULP AND PAPER MILL WORKERS

7.8. OTHER STUDIES

7.8.1. Vietnam Veterans

7.8.2. Residents of Seveso, Italy

7.8.3. Rice Oil Poisonings in Taiwan and Japan Involving Compounds Structurally Related to Dioxin

7.9. CONCLUSIONS

REFERENCES FOR CHAPTER 7, PART A

go to 7.0. PART B: EFFECTS OTHER THAN CANCER  

7.10. INTRODUCTION

7.11. CROSS-SECTIONAL STUDIES: USES AND LIMITATIONS

7.12. DESCRIPTION OF PRINCIPAL STUDIES

7.12.1. Occupational Studies

7.12.1.1. U.S. Chemical Workers: West Virginia

7.12.1.2. U.S. Chemical Workers: The NIOSH Study

7.12.1.3. BASF Accident Cohort

7.12.2. Studies of Community Residents

7.12.2.1. The Missouri Experience

7.12.2.2. Seveso, Italy

7.12.3. Studies of Vietnam Veterans

7.12.3.1. The Vietnam Experience Study

7.12.3.2. U.S. Air Force Ranch Hand Study

7.13. REVIEW OF EFFECTS ASSOCIATED WITH EXPOSURE TO 2,3,7,8-TCDD

7.13.1. Dermal Effects

7.13.1.1. Chloracne

7.13.1.2. Dermatologic Disorders Other Than Chloracne

7.13.1.3. Comments

7.13.2. Gastrointestinal Effects

7.13.2.1. Hepatic Effects

7.13.2.2. Liver Size

7.13.2.3. Enzyme Levels

7.13.2.4. GOT

7.13.2.5. AST and ALT

7.13.2.6. D-Glucaric Acid

7.13.2.7. Comment

7.13.2.8. Porphyrin Metabolism

7.13.2.9. Comment

7.13.2.10. Lipid Levels

7.13.2.11. Total Cholesterol

7.13.2.12. Triglycerides

7.13.2.13. Comment

7.13.3. Other Gastrointestinal Disorders

7.13.4. Thyroid Function

7.13.4.1. Comment

7.13.5. Diabetes

7.13.5.1. Comment

7.13.6. Immunologic Effects

7.13.6.1. Comment

7.13.7. Neurologic Effects

7.13.7.1. Neurobehavioral Assessments

7.13.7.2. Neurologic Status

7.13.7.3. Comment

7.13.8. Circulatory System

7.13.8.1. Comment

7.13.9. Pulmonary Effects

7.13.9.1. Comment

7.13.10. Renal Effects

7.13.11. Reproductive Effects

7.13.12. Review of the Literature Prior to 1984

7.13.12.1. Occupational Studies

7.13.12.2. Environmental Studies

7.13.12.3. The Seveso, Italy, Dioxin Accident of 1976

7.13.12.4. Studies of Exposure to Agent Orange by Military Veterans and Vietnamese Civilians

7.13.13. Review of the Literature From 1984 to 1992

7.13.14. Environmental Studies

7.13.14.1. The Times Beach, Missouri, 2,3,7,8-TCDD Episode

7.13.14.2. Studies of Vietnam Experience in Ground Troops and Ranch Hands Published 1984-1992

7.13.15. Study Results

7.13.15.1. Atlanta Congenital Defects Program Study

7.13.15.2. CDC Vietnam Experience Study

7.13.15.3. American Legion Study

7.13.15.4. Boston Hospital Study

7.13.15.5. The Ranch Hand Study

7.13.15.6. Reproductive Hormones

7.13.15.7. Comment

7.14. NONCANCER EFFECTS OF INGESTION OF RICE OIL CONTAMINATED WITH POLYCHLORINATED DIBENZOFURANS, QUATERPHENYLS, AND BIPHENYLS IN JAPAN (YUSHO) AND TAIWAN (YU-CHENG) .

7.14.1. Acute Effects in Adults and Children Directly Exposed to Contaminated Rice Oil

7.14.1.1. Yusho

7.14.1.2. Yu-Cheng

7.14.1.3. Effects Observed in Offspring of Yu-Cheng Cases

7.14.1.4. Comment

7.15. SUMMARY

7.15.1. Effects Having a Positive Relationship With Exposure to 2,3,7,8-TCDD

7.15.1.1. Chloracne

7.15.1.2. Gamma Glutamyl Transferase (GOT) Levels

7.15.1.3. Diabetes and Fasting Serum Glucose Levels

7.15.1.4. Reproductive Hormones

7.15.2. Possible Acute Effects of Exposure to 2,3,7,8-TCDD

7.15.2.1. Dermatologic Conditions Other Than Chloracne

7.15.2.2. Liver Enzymes Other Than GGT and Hepatomegaly

7.15.2.3. Pulmonary Disorders

7.15.2.4. Neurologic Disorders

7.15.2.5. Porphyrias

7.15.3. Effects For Which Further Research Is Needed

7.15.3.1. Diseases of the Circulatory System

7.15.3.2. Reproductive Effects

7.15.3.3. Specific Reproductive End Points

7.15.3.4. Immunologic Effects

7.15.3.5. Lipids

7.15.3.6. Thyroid Function

REFERENCES FOR CHAPTER 7, PART B

go to 8.0. DOSE-RESPONSE MODELING  

8.1. INTRODUCTION

8.1.1. Introduction to Modeling for TCDD

8.1.2. Dose Delivery, Tissue Modeling, and Biochemical Modeling

8.2. TOXIC EFFECTS

8.2.1. Modeling Liver Tumor Response for TCDD

8.2.2. Tumor Incidence

8.2.2.1. A Potential Alternative Model for Promotion of Carcinogenesis by Dioxin

8.2.3. Other Effects: Mammary/Uterine/Anticancer End Points

8.2.4. Noncancer End Points

8.2.5. Neurological and Behavioral Toxicity

8.2.6. Teratological and Developmental

8.2.6.1. Cleft Palate

8.2.6.2. Hydronephrosis

8.2.6.3. Thymic Atrophy

8.2.7. Immunotoxicity

8.2.8. Reproductive Toxicity

8.2.8.1. Female Reproductive Toxicity

8.2.8.2. Male Reproductive Toxicity

8.3. COMPARATIVE END POINTS/QUALITATIVE COMPARISONS

8.4. RELEVANCE OF ANIMAL DATA FOR ESTIMATING HUMAN RISKS

8.5. HUMAN MODELS

8.5.1. Introduction

8.5.2. Modeling Toxic Effects in the Liver

8.5.3. Lung Cancer and All Cancers Combined

8.5.3.1. Dose-Response Models

8.5.3.2. Exposure and Dose Estimates

8.5.3.3. Calculation of Risk Estimates

8.5.3.4. Low-Dose Deviation From Linearity

8.5.3.5. Uncertainties in Estimates From Human Epidemiology

8.5.3.6. Conclusions

8.6. KNOWLEDGE GAPS

REFERENCES FOR CHAPTER 8 AND APPENDICES C AND D

go to APPENDIX A: Mechanistic Model of Effects of Dioxin on Gene Expression in the Rat Liver
go to APPENDIX B: Modeling Receptor-Mediated Processes with Dioxin: Implications for Pharmacokinetics and Risk Assessment
go to APPENDIX C: Parameters for Analyzing Preneoplastic Lesions and Tumor Incidence in Rat Hepatocytes
go to APPENDIX D: Considerations for Using Dose Surrogates in Estimating Tumor Incidence
go to APPENDIX E: Tetrachlorodibenzo-p-Dioxin Empirical Relationships for Non-Cancer End Points