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Association Between Dioxins/Furans Exposures and Incinerator Workers’ Hepatic Function and Blood Lipids

Hu, Suh-Woan PhD; Cheng, Tsun-Jen MD, ScD; ChangChien, Guo-Ping PhD; Chan, Chang-Chuan ScD

Journal of Occupational and Environmental Medicine: June 2003 - Volume 45 - Issue 6 - p 601-608
doi: 10.1097/01.jom.0000069243.06498.cf
ORIGINAL ARTICLES: CME Article #3
Learning Objectives 
  • Recall the clinical abnormalities reported in epidemiological studies to be more frequent in workers at waste incinerating plants.
  • Identify any associations between high or low blood levels of dioxins/furans and altered blood lipid levels.
  • Describe the changes in liver enzymes, if any, associated with high exposure of waste-burning workers, and note any interactive effect of dioxins/furans and hepatitis B infection on enzyme levels.

Recall the clinical abnormalities reported in epidemiological studies to be more frequent in workers at waste incinerating plants.Identify any associations between high or low blood levels of dioxins/furans and altered blood lipid levels.Describe the changes in liver enzymes, if any, associated with high exposure of waste-burning workers, and note any interactive effect of dioxins/furans and hepatitis B infection on enzyme levels. This study examined the effects of dioxins/furans on blood lipids and hepatic function and assessed potential interaction between hepatitis B virus (HBV) infection and dioxins on hepatic function for 133 male workers of municipal waste incinerators. We found that total cholesterol levels in workers with blood dioxins/furans levels of 15.4–59.0 pg TEQ/g lipid (high-exposure workers) averaged 13.5 mg/dL higher than workers with 5.5–15.3 pg TEQ/g lipid (low-exposure workers). The adjusted odds ratio for total cholesterol abnormality (>220 mg/dL) was 2.8 (95% confidence interval = 1.0–7.9) between high and low-exposure workers. High-exposure workers showed consistently, although not statistically significantly, higher abnormality in γ-glutamyltransferase (>52 U/L), alanine aminotransferase (>41 U/L), and aspartate aminotransferase (>37 U/L) than did low-exposure workers. However, there was no statistically significant interaction between dioxins/furans and HBV on these hepatic enzymes among incinerator workers.

From the Institute of Stomatology, Chung Shan Medical University, Taichung, Taiwan (Dr Hu); Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan (Dr Cheng, Dr Chan); and Super Micro Mass Research and Technology Center, Cheng-Shiou Institute of Technology, Kaoshiung, Taiwan (Dr ChangChien).

Address correspondence to: Chang-Chuan Chan, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; e-mail: ccchan@ha.mc.ntu.edu.tw.

Chang-Chuan Chan has no commercial interest related to this article.

©2003The American College of Occupational and Environmental Medicine