RESUMO
We studied diabetes mellitus and glucose and insulin levels in Air Force veterans exposed to Agent Orange and its contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin), during the Vietnam War. The index subjects of the Air Force's ongoing 20-year prospective epidemiologic study are veterans of Operation Ranch Hand (N = 989), the unit responsible for aerial herbicide spraying in Vietnam from 1962 to 1971. Other Air Force veterans who served in Southeast Asia during the same period but were not involved with spraying herbicides serve as Comparisons (N = 1,276). The median serum dioxin level in the Ranch Hand group was 12.2 parts per trillion (ppt) (range = 0-617.8 ppt), and the median dioxin level in the Comparison group was 4.0 ppt (range = 0-10 ppt). We found that glucose abnormalities [relative risk = 1.4; 95% confidence limits (CL) = 1.1, 1.8], diabetes prevalence (relative risk = 1.5; 95% CL = 1.2, 2.0), and the use of oral medications to control diabetes (relative risk = 2.3; 95% CL = 1.3, 3.9) increased, whereas time-to-diabetes-onset decreased with dioxin exposure. Serum insulin abnormalities (relative risk = 3.4; 95% CL = 1.9, 6.1) increased with dioxin exposure in nondiabetics. These results indicate an adverse relation between dioxin exposure and diabetes mellitus, glucose metabolism, and insulin production.
Assuntos
Desfolhantes Químicos/sangue , Diabetes Mellitus/induzido quimicamente , Dibenzodioxinas Policloradas/sangue , Veteranos , Tecido Adiposo , Fatores Etários , Aviação , Glicemia/análise , Índice de Massa Corporal , Estudos de Coortes , Desfolhantes Químicos/efeitos adversos , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Exposição Ambiental , Humanos , Insulina/sangue , Pessoa de Meia-Idade , Dibenzodioxinas Policloradas/efeitos adversos , Prevalência , Risco , Fatores de Risco , Fumar , Vietnã , GuerraRESUMO
We studied whether exposure to Agent Orange and its contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin), during the Vietnam War is related to current testosterone, follicle-stimulating hormone, luteinizing hormone, or testicular abnormalities, sperm count, sperm abnormalities, or testicular volume. The index subjects were veterans of-Operation Ranch Hand, the unit responsible for aerial herbicide spraying in Vietnam from 1962 to 1971. The referent cohort comprises Air Force veterans who served in Southeast Asia during the same period but were not involved with spraying herbicides. Referents were matched to Ranch Hands on date of birth, race, and military occupation. We found no consistent or meaningful association between serum dioxin levels and any of these outcome variables.