Mortality in Yusho patients exposed to polychlorinated biphenyls and polychlorinated dibenzofurans: a 50-year retrospect
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RESEARCH
Open Access
Mortality in Yusho patients exposed to polychlorinated biphenyls and polychlorinated dibenzofurans: a 50-year retrospective cohort study Daisuke Onozuka1,2* , Yuko Nakamura3, Gaku Tsuji3,4 and Masutaka Furue3,4
Abstract Background: In 1968, the Yusho incident resulted in accidental exposure to polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs), and related compounds in Japan. This study updated the risk of mortality in Yusho patients. Methods: We obtained updated cohort data for all Yusho patients for the period 1968–2017. We calculated standardized mortality ratios (SMRs) for all-cause and cause-specific mortality over a 50-year follow-up period compared with the general population in Japan. Results: A total of 1664 Yusho patients with 63,566 person-years of follow up were included in the analysis. Among males, excess mortality was observed for all cancers (SMR: 1.22, 95% confidence interval [CI]: 1.02 to 1.45) and lung cancer (SMR: 1.59, 95% CI: 1.12 to 2.19). Among females, increased mortality was observed for liver cancer (SMR: 2.05, 95% CI: 1.02 to 3.67). No significant increase was seen in non-cancer-related mortality compared with the general population. Conclusions: Carcinogenic risk in humans after exposure to PCBs and PCDFs remains higher among Yusho patients. Our findings suggest the importance of care engagement and optimum management to deal with the burden of Yusho disease. Keywords: Polychlorinated biphenyls, Polychlorinated dibenzofurans, Cancer, Cohort study, Yusho
Introduction In 1968, a mass food poisoning incident involving more than 1800 patients occurred in western Japan [1]. The incident was called Yusho (oil disease in Japanese) since it was caused by the ingestion of rice bran oil which had been contaminated with polychlorinated biphenyls * Correspondence: [email protected] 1 Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibeshin-machi, Suita, Osaka 564-8565, Japan 2 Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Full list of author information is available at the end of the article
(PCBs), polychlorinated dibenzofurans (PCDFs), and other dioxin-related compounds [2, 3]. This accidental release of PCBs and PCDFs into rice bran oil led to acute and chronic toxicity, and Yusho patients have suffered a broad range of symptoms such as comedones, acneiform eruption, and pigmentation of the conjunctiva, skin, and gingiva [4, 5]. Following the Yusho incident, a comparable mass food poisoning incident occurred in central Taiwan in 1979, Yucheng (oil disease in Chinese), which was also caused by the ingestion of cooking oil contaminated with PCBs and dioxins [6]. There is a large variation in half-lives between different
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