ENVIRONMENTAL CHLORACNE: UPDATE AND OVERVIEW

Risk for animal and human health related to the presence of dioxins and dioxin-like PCBs in feed and food

The European Commission asked EFSA for a scientific opinion on the risks for animal and human health related to the presence of dioxins (PCDD/Fs) and DL-PCBs in feed and food. The data from experimental animal and epidemiological studies were reviewed and it was decided to base the human risk assessment on effects observed in humans and to use animal data as supportive evidence. The critical effect was on semen quality, following pre- and postnatal exposure. The critical study showed a NOAEL of 7.0 pg WHO2005-TEQ/g fat in blood sampled at age 9 years based on PCDD/F-TEQs. No association was observed when including DL-PCB-TEQs. Using toxicokinetic modelling and taking into account the exposure from breastfeeding and a twofold higher intake during childhood, it was estimated that daily exposure in adolescents and adults should be below 0.25 pg TEQ/kg bw/day. The CONTAM Panel established a TWI of 2 pg TEQ/kg bw/week. With occurrence and consumption data from European countries, the mean and P95 intake of total TEQ by Adolescents, Adults, Elderly and Very Elderly varied between, respectively, 2.1 to 10.5, and 5.3 to 30.4 pg TEQ/kg bw/week, implying a considerable exceedance of the TWI. Toddlers and Other Children showed a higher exposure than older age groups, but this was accounted for when deriving the TWI. Exposure to PCDD/F-TEQ only was on average 2.4- and 2.7-fold lower for mean and P95 exposure than for total TEQ. PCDD/Fs and DL-PCBs are transferred to milk and eggs, and accumulate in fatty tissues and liver. Transfer rates and bioconcentration factors were identified for various species. The CONTAM Panel was not able to identify reference values in most farm and companion animals with the exception of NOAELs for mink, chicken and some fish species. The estimated exposure from feed for these species does not imply a risk.

The metabolite 3,4,3',4'-tetrachloroazobenzene (TCAB) exerts a higher ecotoxicity than the parent compounds 3,4-dichloroaniline (3,4-DCA) and propanil

3,4,3',4'-tetrachloroazobenzene (TCAB) is not commercially manufactured but formed as an unwanted by-product in the manufacturing of 3,4-dichloroaniline (3,4-DCA) or metabolized from the degradation of chloranilide herbicides, like propanil. While a considerable amount of research has been done concerning the toxicological and ecotoxicological effects of propanil and 3,4-DCA, limited information is available on TCAB. Our study examined the toxicity of TCAB in comparison to its parent compounds propanil and 3,4-DCA, using a battery of bioassays including in vitro with aryl hydrocarbon receptor (AhR) mediated activity by the 7-ethoxyresorufin-O-deethylase (EROD) assay and micro-EROD, endocrine-disrupting activity with chemically activated luciferase gene expression (CALUX) as well as in vivo with fish embryo toxicity (FET) assays with Danio rerio. Moreover, the quantitative structure activity response (QSAR) concepts were applied to simulate the binding affinity of TCAB to certain human receptors. It was shown that TCAB has a strong binding affinity to the AhR in EROD and micro-EROD induction assay, with the toxic equivalency factor (TEF) of 8.7×10(-4) and 1.2×10(-5), respectively. TCAB presented to be a weak endocrine disrupting compound with a value of estradiol equivalence factor (EEF) of 6.4×10(-9) and dihydrotestosterone equivalency factor (DEF) of 1.1×10(-10). No acute lethal effects of TCAB were discovered in FET test after 96h of exposure. Major sub-lethal effects detected were heart oedema, yolk malformation, as well as absence of blood flow and tail deformation. QSAR modelling suggested an elevated risk to environment, particularly with respect to binding to the AhR. An adverse effect potentially triggering ERβ, mineralocorticoid, glucocorticoid and progesterone receptor activities might be expected. Altogether, the results obtained suggest that TCAB exerts a higher toxicity than both propanil and 3,4-DCA. This should be considered when assessing the impact of these compounds for the environment and also for regulatory decisions.

AhR signalling and dioxin toxicity

Dioxins are a family of molecules associated to several industrial accidents such as Ludwigshafen in 1953 or Seveso in 1976, to the Agent Orange used during the war of Vietnam, and more recently to the poisoning of the former president of Ukraine, Victor Yushchenko. These persistent organic pollutants are by-products of industrial activity and bind to an intracellular receptor, AhR, with a high potency. In humans, exposure to dioxins, in particular 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) induces a cutaneous syndrome known as chloracne, consisting in the development of many small skin lesions (hamartoma), lasting for 2-5 years. Although TCDD has been classified by the WHO as a human carcinogen, its carcinogenic potential to humans is not clearly demonstrated. It was first believed that AhR activation accounted for most, if not all, biological properties of dioxins. However, certain AhR agonists found in vegetables do not induce chloracne, and other chemicals, in particular certain therapeutic agents, may induce a chloracne-like syndrome without activating AhR. It is time to rethink the mechanism of dioxin toxicity and analyse in more details the biological events following exposure to these compounds and other AhR agonists, some of which have a very different chemical structure than TCDD. In particular various food-containing AhR agonists are non-toxic and may on the contrary have beneficial properties to human health.

An overview of the effects of dioxins and dioxin-like compounds on vertebrates, as documented in human and ecological epidemiology

Dioxins and dioxin-like compounds are primary examples of persistent organic pollutants that induce toxicity in both wildlife and humans. Over the past 200 years these compounds have been almost exclusively generated by human activity and have left a string of disasters in the wake of their accidental release. Most recently, the contamination of the Irish pork supply with dioxins resulted in an international recall of all Irish pork products. Epidemiologic data on human and ecological dioxin exposures have revealed a common pattern of biological response among vertebrate species, which is mediated through activation of the Aryl hydrocarbon Receptor (AhR). These AhR-mediated effects include profound consequences on the vertebrate individual exposed in early life with respect to myriad developmental endpoints including neurologic, immunologic, and reproductive parameters. Humans appear to be susceptible to these effects in a manner similar to that of the laboratory and wildlife species, which have demonstrated such outcomes. Furthermore, epidemiologic data suggest that there is little or no margin of exposure for humans with respect to these developmental effects. Given these concerns, prudent public health policy should include the continued reduction of exposures.

Dioxin-induced chloracne--reconstructing the cellular and molecular mechanisms of a classic environmental disease

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is among the most toxic pollutants known to date that serves as a prototype for a group of halogenated hydrocarbon compounds characterized by extraordinary environmental persistence and unique ability to concentrate in animal and human tissues. TCDD can elicit a complex array of pleiotropic adverse effects in humans, although chloracne, a specific type of acne-like skin disease, is the only consistent manifestation of dioxin intoxication, thus representing a 'hallmark' of TCDD exposure. Chloracne is considered to be one of the most specific and sensitive biomarkers of TCDD intoxication that allows clinical and epidemiological evaluation of exposure level at threshold doses. The specific cellular and molecular mechanisms involved in pathogenesis of chloracne are still unknown. In this review, we summarize the available clinical data on chloracne and recent progress in understanding the role of the dioxin-dependent pathway in the control of gene transcription and discuss molecular and cellular events potentially involved in chloracne pathogenesis. We propose that the dioxin-induced activation of skin stem cells and a shift in differentiation commitment of their progeny may represent a major mechanism of chloracne development.

Photocontact dermatitis and chloracne: two major occupational and environmental skin diseases induced by different actions of halogenated chemicals

Among occupational and environmental disorders, contact or photocontact dermatitis and an acneiform eruption are two major skin disorders. Photocontact dermatitis was historically caused by various halogenated salicylanilides, while the acne is induced by halogenated aromatic hydrocarbons and thus called chloracne. Therefore, it should be noted that halogenated chemical compounds are important causative agents in the occupational and environmental medicine. In photocontact dermatitis, photoconjugation of epidermal cells with a photohaptenic halogenated chemical is the initial step. Langerhans cells serve as antigen-presenting cells and T cells sensitized by photoantigen-bearing Langerhans cells induce this photosensitivity. On the other hand, in chloracne, halogeneted hydrocarbons render keratinocytes of the outer root sheath and sebaceous duct hyperplastic. The dilated infundibulum of most hair follicles is then filled with comedone that consist of many accumulated layers of keratinized cells and sebum. Therefore, halogenated chemicals exhibit different actions, i.e. the induction of an immunologic consequence and the modulation of keratinocyte biology. These two conditions also provide good experimental models for investigating dermatology.

Environmental effects and skin disease

The skin is the largest organ in the body and one of its main functions is to protect the body from noxious substances, whether they are ultraviolet radiation, toxic chemicals or prolonged/repeated exposure to water. It is the level of exposure that determines if damage to the organism will result. The harm that can occur to the skin with sufficient exposure will be considered. Contact dermatitis, halogen acne, chemical depigmentation, connective tissue diseases and skin cancer are the conditions that will be covered in this chapter, as environmental exposure is important in their aetiologies. Systemic absorption will not be dealt with. Most environmental exposure to harmful substances will occur at work, but exposure may occur at home or during normal day-to-day activities.

Chloracne: histopathologic findings in one case

BACKGROUND

Chloracne is an acneiform eruption due to poisoning by halogenated aromatic compounds having a specific molecular shape. This condition is always a symptom of systemic poisoning by chemical chloracnegens and not just a cutaneous disorder.

METHODS

We have studied a patient with severe chloracne who showed cutaneous lesions involving mostly the face and the axillae.

RESULTS

Histopathologic study of the facial lesions demonstrated that almost every vellus hair follicle was involved, showing a dilated infundibulum filled by a keratotic plug. This keratotic material was mostly composed of orthokeratotic basket-weave basophilic corneocytes, namely infundibular keratin, although there were also some dilated infundibula containing eosinophilic laminated or granular sebum at their center. Small infundibular cysts were more numerous than comedones. Mature and well-developed sebaceous glands were seen at the base of many of the dilated infundibula and no squamous metaplasia of the sebaceous glands or ducts could be demonstrated. Hyperpigmentation of the lesions resulted from hyperproduction of melanin by a normal number of melanocytes along the basal layer of the epidermis and infundibular epithelium. Abundant melanin granules also impregnated the corneocytes of the infundibular plugs.

CONCLUSIONS

Our findings support the notion that tiny infundibular cysts rather than comedones represent the basic lesions of chloracne.

Human health effects after exposure to 2,3,7,8-TCDD

In 1949, the first descriptions of human exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD)-contaminated chemicals were reported after a trichlorophenol reactor explosion in Nitro, West Virginia, USA. Reported non-cancer health effects included a range of conditions affecting most systems. Additional reports of the health consequences of exposure continued through the remainder of the century. The majority of effects have been reported among highly exposed groups including occupational populations, such as chemical production workers, pesticide applicators, and individuals who handled or were exposed to materials treated with 2,3,7,8-TCDD-contaminated pesticides, and among residents of communities contaminated with tainted waste oil (Missouri, USA) and industrial effluent (Seveso, Italy). For only six exposed populations were biological measurements of 2,3,7,8-TCDD-contaminated collected and used to examine the relationship between non-cancer health effects and exposure. Of the many non-cancer health effects thought to be associated with 2,3,7,8-TCDD exposure, only chloracne, elevations in GGT and triglyceride levels, and alterations in FSH and LH were related to serum 2,3,7,8-TCDD levels. Mortality from cardiovascular diseases also appeared to be elevated among cohorts of exposed chemical workers and Seveso residents. Continued surveillance of the health of exposed populations will be useful in identifying the long-term effects of both high and low 2,3,7,8-TCDD exposure.

Toxicological consequences of Aroclor 1254 ingestion by female rhesus (Macaca mulatta) monkeys and their nursing infants. Part 3: post-reproduction and pathological findings

A group of 80 menstruating rhesus (Macaca mulatta) monkeys were randomly allocated to four similar rooms (20 monkeys/room) and then to one of five dose groups (four females/dose group/room). Each day the monkeys self-ingested capsules containing doses of 0, 5, 20, 40 or 80 microg Aroclor 1254/kg body weight. After 25 months of continuous dosing, approximately 90% of the treated females had attained a qualitative pharmacokinetic steady state with respect to the concentration of polychlorinated biphenyl (PCB) in their nuchal fat pad. Concurrently, sebaceous glands were being examined for changes analogous to chloracne. Subsequently, the females were paired with untreated males. The infants' blood PCB levels at birth were not correlated with its dam's dose or blood PCB level. However, there was an association between an infants preweaning blood PCB levels and its dam's dose and PCB milk levels. After weaning, the infants were not dosed with PCB. The half-life for the PCB in the infants' blood was determined and found to be slightly more than 15 wk. After 6 yr on test, three monkeys from the 0, 5, 20 and 40 microg dose groups were randomly allocated to a depletion study to ascertain the half-lives of specific PCB congeners (Mes et al., Chemosphere 1995, 30, 789-800). Concurrently, necropsies began of the remaining females, and of seven infants from the treated dams and four infants from the control dams, which had attained an age of 2 yr. Approximately 3 yr later, the depletion monkeys were necropsied. The only statistically significant treatment-related pathological changes found during the study were in the adult females, in which an involution of the sebaceous glands and a dose related increase in liver weight due to hyperplasia were evident.

Leukocyte activation induces aryl hydrocarbon receptor up-regulation, DNA binding, and increased Cyp1a1 expression in the absence of exogenous ligand

The aryl hydrocarbon receptor (AhR) functions as a transcription factor after ligand binding by halogenated aromatic hydrocarbons. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic halogenated aromatic hydrocarbon, is dependent on binding to the AhR to mediate a broad range of toxic effects. Immune suppression is one of the most sensitive sequela associated with TCDD exposure, yet, paradoxically, resting leukocytes express a relatively low amount of AhR. Here we report that activation of leukocytes produced a 6-fold increase in AhR steady state mRNA levels and a concordant increase in AhR protein expression. Furthermore, leukocyte activation induced AhR translocation, DNA binding to a dioxin response element, and CYP1A1 transcription in the absence of TCDD. Activated leukocytes exhibited an even greater enhancement of dioxin response element binding by the AhR in the presence of TCDD than in the absence of TCDD. These studies suggest that the mechanism responsible for the sensitivity of immunocompetent cells to TCDD may be directly associated with a marked increase in AhR expression, which accompanies leukocyte activation.

Modulation of gene expression and endocrine response pathways by 2,3,7,8-tetrachlorodibenzo-p-dioxin and related compounds

The aryl hydrocarbon (Ah) receptor binds several different structural classes of chemicals, including halogenated aromatics, typified by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), polynuclear aromatic and heteropolynuclear aromatic hydrocarbons. TCDD induces expression of several genes including CYP1A1, and molecular biology studies show that the Ah receptor acts as a nuclear ligand-induced transcription factor that interacts with xenobiotic or dioxin responsive elements located in 5'-flanking regions of responsive genes. TCDD also elicits diverse toxic effects, modulates endocrine pathways and inhibits a broad spectrum of estrogen (17 beta-estradiol)-induced responses in rodents and human breast cancer cell lines. Molecular biology studies show that TCDD inhibited 17 beta-estradiol-induced cathepsin D gene expression by targeted interaction of the nuclear Ah receptor with imperfect dioxin responsive elements strategically located within the estrogen receptor-Sp1 enhancer sequence of this gene.

Angiosarcoma, porphyria cutanea tarda, and probable chloracne in a worker exposed to waste oil contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin

A worker developed angiosarcoma, porphyria cutanea tarda, and skin lesions characteristic of mild chloracne. About 10 years earlier he had been employed at a truck terminal in Saint Louis, Missouri, at a time when it was sprayed with waste oil contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The occurrence of these three rare conditions in a single exposed worker supports the aetiological relation between environmental exposure to TCDD and the subsequent development of soft tissue sarcoma and porphyria cutanea tarda.

Targets for dioxin: genes for plasminogen activator inhibitor-2 and interleukin-1 beta

Dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin, TCDD), a widespread environmental contaminant, may elicit its effects by altering gene expression in susceptible cells. Five TCDD-responsive complementary DNA clones were isolated from a human keratinocyte cell line. One of these clones encodes plasminogen activator inhibitor-2, a factor that influences growth and differentiation by regulating proteolysis of the extracellular matrix. Another encodes the cytokine interleukin-1 beta. Thus, TCDD alters the expression of growth regulatory genes and has effects similar to those of other tumor-promoting agents that affect both inflammation and differentiation.

Dermatological findings in children exposed transplacentally to heat-degraded polychlorinated biphenyls in Taiwan

We studied 128 children who were transplacentally exposed to polychlorinated biphenyls and dibenzofurans in Taiwan, their parents and siblings who were directly exposed, and 115 control children. Direct exposure of the mothers stopped in 1979 and the children were born as late as 1985. At birth, exposed children had increased rates of hyperpigmentation, eyelid swelling and discharge, deformed nails, acne, natal teeth and swollen gums compared to controls. On examination, they had a much higher rate of dystrophic finger-nails and pigmented or dystrophic toe-nails than controls. They also had an increased rate of hyperpigmentation and acne. In addition they had more generalized itching, localized skin infections and hair loss. The findings seen in transplacentally exposed children differ from those seen in people directly exposed, particularly in the latter group in higher prevalence of acne.

Disposition of 1,2,3,7,8-pentachlorodibenzofuran in the rat

1,2,3,7,8-Pentachlorodibenzofuran (1PeCDF) is one of several toxic polychlorinated dibenzofurans (PCDFs) which are ubiquitous environmental contaminants. Related in structure and toxicity to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), PCDFs have been detected in municipal and industrial effluents, PCB mixtures, and in a variety of antiseptics and preservative solutions. The objective of this study was to evaluate the distribution and elimination of 1PeCDF in the rat and to compare these parameters with that of 2,3,4,7,8-pentachlorodibenzofuran (4PeCDF) and 2,3,7,8-tetrachlorodibenzofuran (TCDF). After iv administration of 0.1 mumol [3H]1PeCDF/kg, 1PeCDF was rapidly cleared from the blood and distributed to the liver, muscle, skin, and adipose tissue in a manner similar to that for other dibenzofurans. The initial pool sizes of 1PeCDF-derived radioactivity in the liver, muscle, skin, and adipose tissue were 43,35,10, and 7% of the administered dose, respectively. In all cases, loss of radioactivity from these tissues could be described by exponential decay and the initial half-lives for these tissues were 1.36, 0.03, 13, and 1 day, respectively. After redistribution from the muscle, skin, and adipose tissues to the liver, 1PeCDF was metabolized to a polar metabolite(s) and excreted from the body via the bile into the feces. No parent compound was detected in the bile and fecal excretion was the major route of elimination. Most of the radioactivity in the urine was excreted within the first day, after which less than 0.5% of the dose/day was detected. More than half of the administered dose was excreted in the urine and feces within 2 days. The whole-body half-life of related compounds is 4PeCDF much greater than 1PeCDF greater than or equal to TCDF. Therefore, persistence appears to be inversely related to the metabolism of these compounds and metabolism is inhibited by chlorine-substituted carbon atoms adjacent to the oxygen atom in the dibenzofuran ring.

Chronic toxicity of 3,4,3',4'-tetrachlorobiphenyl in the marmoset monkey (Callithrix jacchus)

Cotton top marmoset monkeys (Callithrix jacchus) were orally dosed with 3, 1, 0.1 or 0 mg 3,4,3',4'-tetrachlorobiphenyl (TCB)/kg body weight twice per week for 18-23 weeks. Severe toxicity occurred in the highest dose group. Clinical signs of toxicity were a rapid decrease in body weight, alopecia, abnormal nail growth, nodular enlargement of the nipple area and scaly skin. Haematological analysis of peripheral blood revealed mild leukocytosis and anemia. Biochemical alterations observed were elevated triglyceride levels and cholesterol levels. Histopathology revealed dose dependent changes in a variety of tissues. Squamous metaplasia was found in skin and adnexa as well as in salivary glands. In the stomach, parietal cells were decreased and mucus producing cells were increased. The duodenal mucosa was hyperplastic. Ovaries showed an absence of corpora lutea. In the thyroid follicular cell hyperplasia and hypertrophy were noted. Toxicity was less severe in marmoset monkeys dosed with 1 mg TCB/kg, while minor toxic effects were observed in the animals dosed with 0.1 mg TCB/kg. The marmoset monkey appears to be less sensitive to the toxic action of TCB than the rhesus monkey. The pattern of histological and biochemical changes induced by TCB in marmoset monkeys is comparable to that described in humans and in other primate species exposed to PCBs. The marmoset monkey model may be valuable for investigations on human-related toxicity of PCBs.

Studies of transformer repair workers exposed to PCBs: I. Study design, PCB concentrations, questionnaire, and clinical examination results

A cross-sectional study compared 55 transformer repairmen, 38 currently, and 17 previously exposed to polychlorinated biphenyls (PCBs) with 56 non-exposed subjects. PCBs exposures occurred from air and contaminated surfaces, predominantly from Aroclor 1260 with some exposure to Aroclor 1242. Each worker underwent: a questionnaire; standardized medical examination; delayed hypersensitivity testing; and determination of serum and adipose tissue lipid total PCB concentrations. Adipose and serum [PCBs] were significantly higher in the currently exposed, but previously exposed workers did not differ significantly from comparison subjects. No subjects had a classical syndrome of PCB poisoning. A number of neurobehavioral and irritant symptoms were significantly more prevalent in the exposed group, but were probably not related to PCBs. Comedones were more frequent in the exposed group, but no evidence of classical chloracne was noted. Cutaneous delayed hypersensitivity responses to mumps and to trichophyton antigens did not differ between the groups. The association of PCBs with job functions were explored.

Composition of diet modifies toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in cold-adapted rats

The effect of a high carbohydrate, high fat or high protein diet was studied on the acute toxicity of TCDD (125 micrograms/kg) in cold-adapted (4 +/- 1 degrees C) rats. Within 10 days after dosing, TCDD-treated rats fed a high carbohydrate or a high protein diet reduced their caloric intake by 25% whereas those fed a high fat diet consumed only 15% fewer kcal/MBS (metabolic body size). TCDD-treated rats fed a high protein diet lost body weight at the same rate as their pair-fed controls, whereas body weight loss in high fat-fed rats was significantly higher than in their pair-fed controls. In contrast, TCDD-treated rats fed a high carbohydrate diet effectively maintained their body weight in the 4 days immediately after TCDD dosage, whereas their pair-fed controls lost weight. Mortality in TCDD-treated animals was 100% irrespective of the diet; all pair-fed control rats (except one fed a high protein diet) were terminated on days corresponding to the spontaneous death of their TCDD-treated pairs. Mean time to 50% mortality and mean time to death were significantly longer in TCDD-treated rats fed a high carbohydrate diet in comparison with the other two TCDD-treated groups (p less than 0.05), although caloric intake was comparable. Serum triiodothyronine (T3) was reduced in TCDD-treated animals fed a high fat or a high carbohydrate diet but not in those fed a high protein diet; serum thyroxine (T4) was reduced in all the treated groups, irrespective of diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Health-risk estimates for 2,3,7,8-tetrachloro-dibenzodioxin: an overview

As has been abundantly noted by many investigators, the paucity of definitive knowledge of metabolism, pharmacokinetics and pathogenesis of the chlorinated dioxins, principally 2,3,7,8-TCDD, in human populations continues to severely limit our ability to evaluate the scope of the chronic and delayed effects of exposure to these agents. The marked qualitative and quantitative differences in the response of animals to TCDD plus the inability to validate a number of the critical assumptions and mathematical models relative to risk assessment make the extrapolation of data from intact animals to man particularly uncertain. Hence, it is vital to vigorously pursue the elaboration of the mechanism of action of TCDD at the molecular level. This should greatly contribute to our fundamental understanding of this agent and the potential danger that it may pose for man.

Assessing the health effects of potential exposure to PCBs, dioxins, and furans from electrical transformer fires: the Binghamton State Office Building medical surveillance program

A medical surveillance program has been established for 482 persons who were potentially exposed to polychlorinated biphenyls (PCBs), dibenzo-p-dioxins, and dibenzofurans from an electrical transformer fire in a Binghamton, NY office building in 1981. Blood samples were analyzed for serum concentrations of PCBs and for biochemical and hematologic parameters at the time of the fire and 9 to 12 mo later. Firefighters and individuals who were in the building for 25 hr or more were also asked about post-fire symptomatology and examined after 1 yr for disorders of the skin, eyes, liver, and neurologic system. The results indicated that reported exposure was positively related to mean serum PCB levels (p = .004). The means and individual values, however, were within the range reported by other studies of persons with no unusual exposures. Significant correlations were observed between serum PCB concentrations and levels of liver enzymes and lipids, but mean levels of these biochemical parameters were not associated with reported exposure after adjustment for relevant covariables. Approximately one-half of those examined had skin lesions, but no cases of chloracne were detected, and there was no clinical evidence of any other exposure-related systemic disorder. The data suggest that exposure to contaminants from the building did not result in substantial absorption or cause any major short-term health effects.

Chloracne from pentachlorophenol-preserved wood

A patient is presented who developed chloracne after exposure to lumber which was pressure-treated with pentachlorophenol (PCP). It was presumed that his disease arose via percutaneous absorption of polychlorinated aromatic compounds (dioxins and furans) which are known to contaminate technical grade PCP. The patient's condition improved after treatment with oral isotretinoin.

Chloracne and chloracnegens

Chloracne, an acneform eruption resulting from poisoning by halogenated aromatic compounds, has been a considerable problem over the last 40 years. The condition is always a symptom of systemic poisoning and should be familiar to all practitioners, particularly dermatologists. It is difficult to treat and can last for long periods without known additional exposure to chloracnegens. Some chloracnegens are capable of causing a variety of systemic signs and symptoms and may be oncogenic. Although there are probably fewer than 4,000 persons with chloracne worldwide, those found with the disorder should be evaluated medically on a regular basis and followed, if possible, throughout their lives.

Delayed wasting syndrome and alterations of liver gluconeogenic enzymes in rats exposed to the TCDD congener 3,3', 4,4'-tetrachloroazoxybenzene

A delayed wasting syndrome similar to that induced by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was observed in male Sprague-Dawley rats exposed to 3,3', 4,4'-tetrachloroazoxybenzene (TCAOB) and 3,3',4,4'-tetrachloroazobenzene (TCAB). After a slow growth period, all treatment animals (25 mg/kg, i.p., 2 doses per week) exhibited a starvation-like syndrome characterized by reduced food intake, dramatic loss of body weight and subsequent death. Although the growth of all major organs in the treatment animals was affected, the thymus appeared severely atrophied. The growth kinetics during the earlier phase were further analyzed using serially-killed rats receiving TCAOB. In addition, TCAOB was found to markedly depress the specific activity (mumol/min/g wet liver) of glucose-6-phosphatase, fructose-1,6-bisphosphatase, phosphoenolpyruvate carboxykinase, and pyruvate kinase in the liver. Significant changes in the levels of cytochrome P-450, glutamic-pyruvic transaminase and malic enzyme in the liver were also observed.

2,3,7,8-Tetrachlorodibenzo-p-dioxin induces hyperplasia in confluent cultures of human keratinocytes

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is the prototype for a group of halogenated aromatic hydrocarbons which can be potent modulators of growth and differentiation of epithelial tissues. TCDD causes chloracne and can act as a skin tumor promoter, but these actions have been demonstrated only in animals in which TCDD causes epidermal hyperplasia. Study of the hyperplastic response to TCDD has been hampered by lack of an in vitro model; all previous investigations indicated that TCDD had no in vitro effect on cell growth. We show here that nanomolar concentrations of TCDD cause hyperplasia in confluent cultures of human keratinocytes and suggest that this model system will be useful for analyzing mechanisms of TCDD-induced epithelial hyperplasia and genetic differences in responsiveness to TCDD.

The skin and occupational diseases

The skin is a major potential route for the absorption of hazardous materials encountered in the workplace. Percutaneous absorption is influenced by a large number of factors. In some situations, it may be the major route of absorption. Methods are available to determine this in industrial situations. Occupational dermatoses are the most frequent of all occupational diseases. Sources of information about these diseases are reviewed and limitations discussed. There is a particular need for analytic epidemiologic studies. In the case of occupational skin disease, such studies particularly need a sound design, appropriate comparison groups, the systematic collection of cutaneous observations, and attention to potential confounding factors.

Cutaneous signs of systemic toxicity due to dioxins and related chemicals

The controversy about dioxin effects on human health received a great deal of attention recently when the State of Missouri was declared to have a dioxin crisis. However, dioxin and several related chemicals are widespread throughout the world. Cutaneous signs play an important part in evaluating toxicity of dioxin and similar chemicals. Chloracne is the most sensitive indicator of significant dioxin exposure. Porphyria cutanea tarda and hyperpigmentation are other known cutaneous effects, and malignant fibrous histiocytomas of the skin may possibly be associated, although data are inconclusive on this point. The AMC Council on Scientific Affairs recommended that all physicians become familiar with chloracne and other toxic effects of dioxin. Dermatologists, especially, should be aware of the problem and may discover early cases of previously unsuspected exposure to this group of chemicals.

Polychlorinated biphenyls (PCBs) and polybrominated biphenyls (PBBs): biochemistry, toxicology, and mechanism of action

Polychlorinated and polybrominated biphenyls are industrial chemical mixtures which have been implicated in numerous human poisonings in Taiwan and Japan (PCBs) and Michigan (PBBs). Moreover, these polyhalogenated biphenyls have been widely detected in the environment including the air, water, fish, wildlife, human adipose tissue, and blood and breast milk. A major problem associated with the analysis and toxicology of this group of chemicals is their chemical complexity (e.g., there are 209 possible PCB isomers and congeners) and the remarkable effects of structure on activity. This article will discuss the effects of structure on the biologic and toxic effects of individual PCB and PBB congeners as well as reconstituted mixtures. The results clearly show that like "dioxin" (or 2,3,7,8-TCDD), the PCBs and PBBs elicit their effects through a cytosolic receptor protein which preferentially binds with the toxins which are approximate isostereomers of 2,3,7,8-TCDD. The evidence for this mechanism of action will be discussed in detail.

Excretion and distribution of two occupational toxicants, tetrachloroazobenzene and tetrachloroazoxybenzene in the rat

The clearance profile and tissue distribution of 2 occupational toxicants, 3,3',4,4'-tetrachloroazobenzene (TCAB) and 3,3',4,4'-tetrachloroazoxybenzene (TCAOB), were examined in male Sprague-Dawley rats. TCAB was found to be cleared from the body more rapidly than TCAOB when a single dose of 14C-labeled TCAB or TCAOB was administered orally. While 66% of the administered TCAB dose was excreted via the urine and feces within the first 24 h, TCAOB-treated animals were only able to clear 37% of the administered dose by the same elimination route. The half-lives for elimination of TCAB and TCAOB were estimated to be 18 h and 34 h, respectively. Examination of the tissue distribution of the remaining radioactivity indicated that, for both compounds, the adipose tissue contained the highest level of radioactivity. The rapid elimination of TCAB and TCAOB by rats may explain in part the reduced toxicity of these 2 compounds to whole animals in comparison to the isosteric 2,3,7,8-tetrachlorodibenzo-p-dioxin.

Investigation of hyperkeratotic activity of polybrominated biphenyls in Firemaster FF-1

A polybrominated biphenyl (PBB) mixture was fractionated by normal-phase preparative high-performance liquid chromatography. The hexane fractions were concentrated and applied to rabbit ears. Only the most polar fraction produced hyperkeratosis on the rabbit ears. This active fraction was subfractionated by using the same procedure. Again, the extent of hyperkeratotic activity increased with increasing polarity. The PBBs of the largest concentration levels in the active fraction were purified by preparative gas chromatography and tested on rabbit ears. The major compounds did not demonstrate hyperkeratotic activity.

Are datascreen terminals a source of increased PCB-concentrations in the working atmosphere?

The use of polychlorinated biphenyls (PCBs) restricted to closed systems. They are thus still used as dielectric fluids in capacitors and transformers. The hypothesis that skin rashes and excema reported among datascreen operators might be caused by leakage of PCB from components in the screen terminals was investigated. No information about the chemical content of the electric components in the actual datascreen terminals were available. The PCB-concentration in the atmosphere in a workplace where such skin reactions had previously occurred was therefore determined. Air was sampled through 2 or 3 days, during work hours only. A glass fiber backed by an amberlite XAD-2 column was used to trap the sample. The total level of PCBs in this sample was analysed by glass-capillary gas chromatography with electron capture detection. Commercial PCB mixtures were used as standards. PCB-concentrations in the working atmosphere (56-81 ng/M3) were about 50-80 times the level of PCB in samples collected outside the building. Indoor and outdoor samples differed also qualitatively. The indoor samples contained only Aroclor 1242, while the outdoor samples contained a mixture of Aroclor 1242 and 1254. The amounts of PCBs measured were below the safety level for working atmosphere, as recommended by NIOSH in 1977. However, knowing that the samples were collected in an office where there was no known use of PCBs, the levels found were unexpectedly high. Further investigations should therefore be undertaken to clarify whether datascreen terminals might be sources of PCB-contamination.

Embryotoxicity of 3,3',4,4'-tetrachloroazobenzene and 3,3',4,4'-tetrachloroazoxybenzene in the chick embryo

The toxicity of 3,3',4,4'-tetrachloroazobenzene (TCAB) and 3,3',4,4'-tetrachloroazoxybenzene (TCAOB) to chick embryos was examined. TCAB or TCAOB was dissolved in corn oil and injected into the air cell of fertile chicken eggs. The time of injection had a major effect on embryo mortality as eggs injected with TCAB or TCAOB on the fourth day of incubation had a higher incidence of embryo mortality than eggs injected on days 11-13. Both TCAB and TCAOB were more toxic than all other chemicals that have been tested in the chick embryo with the exception of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Comparing the potency of the two compounds, TCAOB was more potent than TCAB in the chick embryo with an estimated LD50 of 12 ng and 44 ng respectively. Rump edema was the major abnormality observed in embryos treated with either TCAB or TCAOB. Other malformations included altered feather pattern and lack of down, hemorrhage, external viscera, reduced body size, failure to withdraw the yolk sac, beak malformation, dilation of blood vessels, and monomicropthalmia. The results of this investigation suggest that both TCAB and TCAOB are teratogenic in the chick embryo.

Thymic atrophy induced by acute exposure of 3,3',4,4'-tetrachloroazobenzene and 3,3',4,4'-tetrachloroazoxybenzene in rats

The effects of 3,3',4,4'-tetrachloroazobenzene (TCAB) and 3,3',4,4'-tetrachloroazoxybenzene (TCAOB) on lymphoid organs in male Sprague-Dawley rats were investigated in various acute exposure studies. Significant thymic atrophy was observed in rats 10 days after the i.p. administration of either compound (on days 1 and 5) at a dose of 25 mg/kg. When 8-week-old animals were studied, the relative thymus weight was reduced to 69% and 49% of the control value by the respective treatment of TCAB and TCAOB. In 2 groups of weanling rats the same dosage of TCAOB was able to reduce the relative thymus weight to 31% and 38% of the comparable control animals. In addition, TCAOB causes a decrease in the body weight gain and a decrease in the weights of major organs in the weanling animals. This toxic response cannot be explained solely on the basis of decreased food intake since qualitatively the same results were observed in a pair-feeding experiment. The involvement of glucocorticoid hormones was rejected as the underlying mechanism since adrenalectomy was found to provide no protection towards the degenerative effect seen upon the lymphoid tissues. This investigation constitutes the first study concerning the effects of these 2 environmental and occupational toxicants on lymphoid organs.

Evidence of degradation of polybrominated biphenyls in soil samples from Michigan

Soil samples obtained from the former polybrominated biphenyls (PBB) manufacturing site in Michigan were analyzed by gas chromatography and gas chromatography with mass spectrometric detection. The results indicate significant degradation of the PBB residue in the soil sample. The soil sample with the highest concentration of PBB had the greatest degree of degradation. Principal degradation products include 2,3', 4,4', 5-pentabromobiphenyl, 2,2', 4,4', 5-pentabromobiphenyl and two unidentified tetrabromobiphenyls. The degradation pattern observed supports a photochemical decomposition mechanism. These degraded residues may be more toxic than the original Firemaster residues. The implications of the results are discussed.

Acnegenic activity of 3-methylcholanthrene and benzo[a]pyrene, and a comparative study with 2,3,7,8-tetrachlorodibenzo-p-dioxin in the rabbit and hairless mouse

The non-halogenated hydrocarbons 3-methylcholanthrene (MC) and benzo[a]pyrene (BP) were tested for acnegenic activity using the rabbit ear test. Both compounds induced characteristics follicular hyperkeratosis, although their acnegenic potency was approximately 4 orders of magnitude lower when compared to the potent acnegen 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). These results are discussed in view of the hypothesis that the acnegenic activity of TCDD and its congeners is mediated through stereospecific binding to a cytosolic receptor protein. In an experiment with hairless (hrhr) mice, which mutant has been described as an animal model for testing acnegenic potency, reduction in sebaceous gland tissue but no follicular hyperkeratosis was observed after application of a total dose of 0.4 microgram TCDD on the back skin. At a 10 times lower dose, no effects were seen. The hairless mouse strain used was responsive to TCDD as judged from the dose-related increase in the activity of aryl hydrocarbon hydroxylase (AHH) in liver microsomes, the increased liver weight and the histopathological changes in the liver. In comparison, a total dose of 0.12 microgram TCDD produced a strong follicular hyperkeratosis in the rabbit ear. From these results and from literature data, the adequacy of the hairless mouse for the testing of compounds for acnegenic potency is questioned.

Hyperkeratosis induced by sunlight degradation products of the major polybrominated biphenyl in Firemaster

Sunlight photodegradation of 2,2', 4,4', 5,5' -hexabromobiphenyl, the major component of Firemaster, gave a mixture that produces severe hyperkeratosis of the rabbit ear. This component in its pure state does not cause hyperkeratosis. One or more of the four major photolysis products must be responsible for this activity. A similar photodegradation pattern was observed for 2,2', 3,4,4', 5,5' -heptabromobiphenyl, the second largest component of Firemaster.

Metabolism studies of 3,3',4,4'-tetrachloroazobenzene. I. In vitro metabolic pathways with rat liver microsomes

The metabolism of 3,3',4,4'-tetrachloroazobenzene (TCAB), an important environmental and occupational toxicant, by rat liver microsomes has been examined in a NADPH-generating system. The metabolic pathways were delineated by the combined use of high pressure liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS). The rate of [14C]TCAB metabolism using induced microsomes was found to be 381 +/- 59 pmol/min/mg microsomal protein. Approximately 13% of the radioactivity from the [14C]TCAB substrate was covalently bound to the macromolecular pellet at the end of a 2-h incubation period. In addition, three distinct TCAB metabolites were isolated from the organic extracts and subsequently identified. Experiments with carbon monoxide, 2-diethylaminoethyl 2,2-diphenylvalerate hydrochloride (SKF 525-A), and control (uninduced) microsomes indicated the participation of the cytochrome P-450-dependent monooxygenases. The biological significance of both oxidative and reductive metabolic pathways were discussed. It was suggested that the generation of a reactive arene oxide intermediate mediated by oxidative enzymes may be crucial for some of the TCAB toxic effects observed in rodent tissues.

Tetrachloroazobenzene in 3,4-dichloroaniline and its herbicidal derivatives: propanil, diuron, linuron, and neburon

The presence of 3,3', 4,4'-tetrachloroazobenzene (TCAB) was determined by high performance liquid chromatography in 3, 4-dichloroaniline and herbicides made therefrom. The concentrations of TCAB in 3, 4-dichloroanilines and in different herbicides from a variety of manufacturers ranged from 9 to 1400 micrograms/g (ppm). The chloracnegenic potential of these products, as determined by rabbit ear test, suggests that it is in the same range of 2, 3, 7, 8-tetrachlorodibenzodioxin, a known potent chloracnegenic agent.