Long-Term Effects of Polychlorinated Biphenyls and Dioxins on Pregnancy Outcomes in Women Affected by the Yusho Incident

By Tsukimori, Kiyomi; Tokunaga, Shoji et al. | Environmental Health Perspectives, May 2008 | Go to article overview

Long-Term Effects of Polychlorinated Biphenyls and Dioxins on Pregnancy Outcomes in Women Affected by the Yusho Incident


Tsukimori, Kiyomi, Tokunaga, Shoji, Shibata, Satoko, Uchi, Hiroshi, Nakayama, Daisuke, Ishimaru, Tadayuki, Nakano, Hitoo, Wake, Norio, Yoshimura, Takesumi, Furue, Masutaka, Environmental Health Perspectives


Polychlorinated biphenyls (PCBs), a group of persistent organochlorine compounds, are man-made chemicals first introduced in the late 1920s. In the late 1960s to the 1970s, many countries realized the potential dangers of PCBs and either banned them or restricted their use. However, PCBs are still present in the environment and in food chains because of their high resistance to abiotic and biotic degradation (Gladen et al. 1999; Wicklund-Glynn et al. 2000).

Maternal exposure to PCBs may affect pregnancy outcomes. Dietary PCB exposure increases the rate of spontaneous abortion and stillbirth in animals (Arnold et al. 1990; Barsotti et al. 1976; McNulty 1985). Only a few epidemiologic studies have examined the association between maternal exposure to PCBs and dioxins, and pregnancy outcomes in humans. A case-control study of Taiwanese women who consumed rice oil contaminated with PCBs and dioxins in the Yu-cheng incident showed an increase in stillbirth but not in spontaneous abortion (Yu et al. 2000). Higher proportions of spontaneous abortion and preterm delivery occurred in women who lived in a town contaminated with dioxin from a chemical plant in Chapayevsk, Russia (Revich et al. 2001). Increased maternal consumption of fish contaminated with dioxins and furans in Sweden was associated with lower infant birth weights (Rylander et al. 2000). However, recent cohort studies failed to support an association between maternal serum levels of chemicals and adverse pregnancy outcomes in women exposed to PCBs and dioxins (Axmon et al. 2004; Eskenazi et al. 2003; Sugiura-Ogasawara et al. 2003). Thus, it is controversial whether maternal exposure to PCBs and dioxins is associated with adverse pregnancy outcomes in humans. Although there are only a few studies evaluating groups with high levels of exposure, these studies are particularly informative with regard to the association between PCB and dioxin consumption and pregnancy outcomes.

In Western Japan in 1968, accidental human exposure to rice oil contaminated with PCBs and other dioxin-related compounds led to the development of what was later referred to as Yusho oil disease (Kunita et al. 1985). PCB contamination occurred in the production of cooking oil, during which commercial PCB preparations were used for heat exchange. Pyrolysis of PCBs and chlorinated benzenes at high temperatures produced polychlorinated dibenzofurans (PCDFs) and polychlorinated dibenzo-p-dioxins (PCDDs). Consequently, Yusho oil disease is now recognized as mixed toxicity from PCBs and dioxin-related compounds (Furue et al. 2005). Over 1,900 people presented with clinical symptoms, including acneform eruptions; pigmentation of the skin, nails, and conjunctivae; increased discharge from the eyes; and paresthesias of the extremities (Ikeda 1996; Urabe and Asahi 1985). More than 500 victims died thereafter. From an epidemiologic survey of 141 Yusho patients, Hayabuchi et al. (1979) estimated that the total amounts of PCBs, PCDFs, and polychlorinated quarterphenyls (PCQs) ingested by each patient were 633, 3.4, and 0.62 mg on average, respectively. From the follow-up data of 5 Yusho patients, fat-based concentrations of the toxic equivalent quantity (TEQ) and PCBs were estimated to have decreased from 40 ppb and 75 ppm, respectively, in 1969, to 0.6 ppb and 2.3 ppm, respectively, in 1999 (Masuda 2001, 2005). However, a recent study showed that from 2001 to 2003, mean blood levels of total dioxins (pg-TEQ/g lipid) and 2,3,4,7,8-penta-chlorodibenzofuran (PeCDF; picograms per gram lipid) in Yusho patients were 3.4-4.8 and 11.6-16.8 times higher, respectively, than the mean levels in normal controls (Furue et al. 2005). Thus, dioxins and PCBs persisted for a long time in Yusho patients.

The aim of this study was to investigate the relationship between maternal PCB or dioxin exposure and adverse pregnancy outcomes in Yusho women. We interviewed the living Yusho women about their pregnancy outcomes over the past 36 years. …

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