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Original Article
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
Sang-Wook Yi, Heechoul Ohrr, Jong-Uk Won, Jae-Seok Song, Jae-Seok Hong
J Prev Med Public Health. 2013;46(5):226-236.   Published online September 30, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.5.226
  • 11,650 View
  • 87 Download
  • 12 Crossref
AbstractAbstract PDF
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 proximity-based 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.

Summary

Citations

Citations to this article as recorded by  
  • Determinants of exposure to polychlorinated biphenyls in the Italian population in the last decades
    Anna Maria Ingelido, Vittorio Abate, Annalisa Abballe, Stefania Paola De Filippis, Elena Dellatte, Silvia De Luca, Fabiola Ferri, Anna Rita Fulgenzi, Nicola Iacovella, Anna Laura Iamiceli, Valentina Marra, Roberto Miniero, Silvia Valentini, Elena De Felip
    Environmental Science and Pollution Research.2023; 30(16): 47012.     CrossRef
  • Serum dioxin concentrations in military workers at three dioxin-contaminated airbases in Vietnam
    Phan Van Manh, Pham The Tai, Nguyen Minh Phuong, Muneko Nishijo, Do Minh Trung, Pham Ngoc Thao, Ho Anh Son, Tran Van Tuan, Nguyen Van Chuyen, Nguyen Van Long, Nguyen Van Khoi, Nguyen Tung Linh, Hoang Van Luong, Do Ba Quyet
    Chemosphere.2021; 266: 129024.     CrossRef
  • Risk for animal and human health related to the presence of dioxins and dioxin‐like PCBs in feed and food
    Helle Katrine Knutsen, Jan Alexander, Lars Barregård, Margherita Bignami, Beat Brüschweiler, Sandra Ceccatelli, Bruce Cottrill, Michael Dinovi, Lutz Edler, Bettina Grasl‐Kraupp, Christer Hogstrand, Carlo Stefano Nebbia, Isabelle P Oswald, Annette Petersen
    EFSA Journal.2018;[Epub]     CrossRef
  • Concentrations of polychlorinated dibenzodioxins, polychlorodibenzofurans, and polychlorobiphenyls in women of reproductive age in Italy: A human biomonitoring study
    Anna Maria Ingelido, Vittorio Abate, Annalisa Abballe, Fulvia Lucia Albano, Tatiana Battista, Valter Carraro, Michele Conversano, Rosa Corvetti, Silvia De Luca, Silva Franchini, Anna Rita Fulgenzi, Laura Giambanco, Nicola Iacovella, Anna Laura Iamiceli, A
    International Journal of Hygiene and Environmental Health.2017; 220(2): 378.     CrossRef
  • High Prevalence of Agent Orange Exposure Among Thyroid Cancer Patients in the National Va Healthcare System
    Karen T. Le, Mark P. Sawicki, Marilene B. Wang, Jerome M. Hershman, Angela M. Leung
    Endocrine Practice.2016; 22(6): 699.     CrossRef
  • Herbicide Exposure, Vietnam Service, and Hypertension Risk in Army Chemical Corps Veterans
    Yasmin S. Cypel, Amii M. Kress, Stephanie M. Eber, Aaron I. Schneiderman, Victoria J. Davey
    Journal of Occupational & Environmental Medicine.2016; 58(11): 1127.     CrossRef
  • Authors' response to: ME Ginevan et al. Exposure estimates in epidemiological studies of Korean veterans of the Vietnam War
    S.-W. Yi, S.-Y. Ryu
    International Journal of Epidemiology.2015; 44(1): 359.     CrossRef
  • A critical review of the epidemiology of Agent Orange or 2,3,7,8-tetrachlorodibenzo-p-dioxin and lymphoid malignancies
    Ellen T. Chang, Paolo Boffetta, Hans-Olov Adami, Jack S. Mandel
    Annals of Epidemiology.2015; 25(4): 275.     CrossRef
  • A critical review of the epidemiology of Agent Orange/TCDD and prostate cancer
    Ellen T. Chang, Paolo Boffetta, Hans-Olov Adami, Philip Cole, Jack S. Mandel
    European Journal of Epidemiology.2014; 29(10): 667.     CrossRef
  • Challenges in investigating the association between Agent Orange and cancer: Site‐specific cancer risk and accuracy of exposure assessment
    Thomas H. Sinks
    Cancer.2014; 120(23): 3595.     CrossRef
  • Agent Orange exposure and cancer incidence in Korean Vietnam veterans: A prospective cohort study
    Sang‐Wook Yi, Heechoul Ohrr
    Cancer.2014; 120(23): 3699.     CrossRef
  • Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean Veterans Health Study
    Sang-Wook Yi, So-Yeon Ryu, Heechoul Ohrr, Jae-Seok Hong
    International Journal of Epidemiology.2014; 43(6): 1825.     CrossRef
Review
Dioxins and Health: Human Exposure Level and Epidemiologic Evidences of Health Effects.
Jae Yeon Jang, Ho Jang Kwon
Korean J Prev Med. 2003;36(4):303-313.
  • 2,057 View
  • 37 Download
AbstractAbstract PDF
General information is summarized, that is necessary to introduce a scientific assessment of the human health and exposure issue concerning dioxin and dioxin-like compound. Scientific literatures were reviewed to assess the background exposures to the dioxin-like compounds for normal residents. Epidemiologic studies were also reviewed to assess malignant and nonmalignant effects of dioxins. In 1997, the International Agency for Research on Cancer classified 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD) as a human carcinogen, primarily based on occupational cohort studies. The US Environmental Protection Agency made the same decision in it's Draft Dioxin Reassessment. Epidemiologic evidences point to a generalized excess of all cancers, without any pronounced excess at specific sites. Reported non-cancer effects included a range of conditions affecting most systems. Among them, chloracne, elevation in gamma glutamyl transferase (GGT), and alterations in reproductive hormones are related to TCDD. Other adverse outcomes, such as lipid concentrations, diabetes, circulatory and heart diseases, immunologic disorders, neurobehavioral effects, and developmental outcomes require further study before their respective relationships to TCDD can be more definitively assessed.
Summary
Original Article
A Study on the Correlation between Categorization of the Individual Exposure Levels to Agent Orange and Serum Dioxin Levels Among the Korean Vietnam Veterans.
Joung Soon Kim, Han K Kang, Hyun Sul Lim, Hae Kwan Cheong, Min Kyung Lim
Korean J Prev Med. 2001;34(1):80-88.
  • 2,313 View
  • 31 Download
AbstractAbstract PDF
OBJECTIVES
In an epidemiologic study on the health impact of Agent Orange exposure, the valid estimation of exposure level is the most important step. Based on recent studies, we examined the correlation between exposure levels categorized by personal exposure estimates and serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD, Dioxin), exploring the possibility of utilizing the exposure level as a surrogate for the estimate of exposure to agent orange. METHODS: During the study period (Jan 1996-Feb 1996), blood specimens of 745 subjects taken randomly among 1,329 persons and kept frozen, were analyzed for 2,3,7,8-TCDD and six other dioxin congeners. The serum dioxin and congeners were measured in 1998 by CDC ,adjusted for serum lipids. We categorized the total exposure scores into five groups based on Agent Orange exposure data collected by interview and military records. Pearson and Spearman's correlation coefficients & multiple regression analysis were used to identify the relationship of the exposure level categorized with serum concentration of 2,3,7,8-TCDD, and six other dioxin congeners. RESULTS: Dioxin and the other congeners, except 1,2,4,6,7,8-HpCDD, showed significant correlations to exposure categories (p<0.005); 2,3,7,8-TCDD and OCDD showed positive correlations, whereas the other congeners did negative. The values of 2,3,7,8-TCDD differed according to exposure category and proportionally increased from the low exposure group to the high, a dose-response relationship, even after other possible confounding variables were adjusted for. In multiple regression analysis, age(beta=0.033), dioxin(beta=0.433), 1,2,3,7,8-PeCDD(beta=0.998), 1,2,3,4,7,8-HxCDD(beta=0.773), 1,2,3,6,7,8-HxCDD(beta=0.255), 1,2,3,7,8,9-HxCDD(beta=3.468), 1,2,3,4,6,7,8-HpCDD(beta=0.109) were found to be significantly related to the total exposure score(p<0.005). CONCLUSION: This study demonstrated that the use of such categorizations as a surrogate measure of agent orange exposure in identifying exposure degrees in a health impact study is valid.
Summary

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