Evaluation of diabetes mellitus, serum glucose, and thyroid function among United States workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

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Abstract
OBJECTIVE: Some studies suggest that exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) may affect glucose metabolism and thyroid function. To further assess the relation between exposure to TCDD and endocrine function, data from the largest morbidity study of industrial workers exposed to TCDD were examined. METHODS: A cross sectional study of workers employed > 15 years earlier in the manufacture of 2,4,5-trichlorophenol or one of its derivatives at two United States chemical plants was conducted. The referent group consisted of people with no occupational exposure to phenoxy herbicides and were recruited from the neighbourhoods where the workers lived. RESULTS: A total of 281 workers and 260 unexposed referents participated. The mean current serum lipid adjusted TCDD concentration among workers was 220 pg/g lipid, and among referents was 7 pg/g lipid (p < 0.05). The half life extrapolated TCDD concentrations (the estimated TCDD concentration when occupational exposure to TCDD stopped) among workers averaged 1900 pg/g lipid (range: not detected--30,000 pg/g lipid). Overall, the prevalence of diabetes mellitus was not significantly different between the workers and referents. Also, there was not a significant positive trend between prevalence of diabetes and increasing serum TCDD concentration. However, diabetes was found in six of 10 (60%) workers with current serum TCDD concentrations > 1500 pg/g lipid. After excluding subjects being treated for diabetes, workers in the group with the highest half life extrapolated TCDD concentrations had a significantly increased adjusted mean serum glucose concentration compared with referents (p = 0.03). Workers were also found to have a significantly higher adjusted mean free thyroxine index compared with referents (p = 0.02), especially among workers in the group with the highest half life extrapolated TCDD concentrations. However, no evidence was found that workers exposed to TCDD were at increased risk of thyroid disease. CONCLUSIONS: These findings provide modest evidence that exposure to TCDD may affect thyroid function and glucose metabolism.

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