Seveso Women's Health Study: a study of the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on reproductive health

Although reproductive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure have been reported in numerous investigations of animals, studies of this association in humans are limited. In 1976, an explosion in Seveso , Italy exposed the surrounding population to among the highest levels of T CDD recorded in humans. The relatively pure exposure to TCDD and the abilit y to quantify individual level TCDD exposure from sera collected in 1976 fo r the Seveso cohort affords a unique opportunity to evaluate the potential dose-response relationship between TCDD exposure and a spectrum of reproduc tive endpoints. The Seveso Women's Health Study (SWHS) is the first compreh ensive study of the reproductive health of a human population exposed to TC DD, The primary objectives of the study are to investigate the relationship of TCDD and the following endpoints: (1) endometriosis; (2) menstrual cycl e characteristics; (3) age at menarche; (4) birth outcomes of pregnancies c onceived after 1976; (5) time to conception and clinical infertility; and ( 6) age at menopause. Included in the SWHS cohort are women who were 0-40 yr old in 1976, who have adequate stored sera collected between 1976 and 1980 , and who resided in Zones A or B at the time of the accident. All women we re interviewed extensively about their reproductive and pregnancy history a nd had a blood draw. For an eligible subset of women, a pelvic exam and tra nsvaginal ultrasound were conducted and a menstrual diary was completed. Mo re than 95% of the women were located 20 yr after the accident and roughly 80% of the cohort agreed to participate. Data collection was completed in J uly 1998, serum TCDD analysis of samples for analysis of endometriosis as a nested case-control study was completed in October 1998, and statistical a nalysis of these data should be completed in early 1999. Serum samples are now being analyzed in order to relate TCDD levels with the remaining reprod uctive outcomes. (C) 2000 Elsevier Science Ltd. All rights reserved.