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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 & Environmental Medicine: June 2003 - Volume 45 - Issue 6 - pp 601-608

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.

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:

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

©2003The American College of Occupational and Environmental Medicine