Résumé :
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[BDSP. Notice produite par INIST kR7rR0x3. Diffusion soumise à autorisation]. Follow-up of the population exposed to dioxin after the 1976 accident in Seveso, Italy, was extended to 1996. During the entire observation period, all-cause and all-cancer mortality did not increase. Fifteen years after the accident, mortality among men in high-exposure zones A (804 inhabitants) and B (5,941 inhabitants) increased from all cancers (rate ratio (RR)=1.3,95% confidence interval (Cl) : 1.0,1.7), rectal cancer (RR=2.4,95% Cl : 1.2,4.6), and lung cancer (RR=1.3,95% Cl : 1.0,1.7), with no latency-related pattern for rectal or lung cancer. An excess of lymphohemopoietic neoplasms was found in both genders (RR=1.7,95% Cl : 1.2,2.5). Hodgkin's disease risk was elevated in the first 10-year observation period (RR=4.9,95% CI : 1.5,16.4), whereas the highest increase for non-Hodgkin's lymphoma (RR=2.8,95% Cl : 1.1,7.0) and myeloid leukemia (RR=3.8,95% Cl : 1.2,12.5) occurred after 15 years. No soft tissue sarcoma cases were found in these zones (0.8 expected). An overall increase in diabetes was reported, notably among women (RR=2.4,95% Cl : 1.2,4.6). Chronic circulatory and respiratory diseases were moderately increased, suggesting a link with accident-related stressors and chemical exposure. Results support evaluation of dioxin as carcinogenic to humans and corroborate the hypotheses of its association with other health outcomes, including cardiovascular-and endocrine-related effects.
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