Serum dioxin concentrations and quality of ovarian function in women of Seveso

Marcella Warner, Brenda Eskenazi, David L. Olive, Stevens Samuels, Sunita Quick-Miles, Paolo Vercellini, Pier Mario Gerthoux, Larry Needham, Donald G. Patterson, Paolo Mocarelli

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Background: Although 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has been associated with alterations in ovarian function and hormones in animals, it has not been studied in humans. On 10 July 1976, an explosion exposed residents of Seveso, Italy, to the highest levels of TCDD in a population. Twenty years later, we initiated the Seveso Women's Health Study to study reproductive health. Objective: We related TCDD levels measured in sera collected near the time of explosion and ovarian function (ovarian cysts, ovarian follicles, ovulation rate, serum hormones) at follow-up. Methods: We included 363 women who were 20-40 years of age and nonusers of oral contraceptives. We examined the relationship of 1976 serum TCDD levels with ultrasound-detected ovarian follicles among 96 women in the menstrual follicular phase and serum hormone levels (estradiol, progesterone) among 129 women in the menstrual luteal phase at follow-up. Ovulation was defined by serum progesterone levels > 3 ng/mL. Results: The median serum TCDD level was 77.3 ppt, lipid-adjusted. Serum TCDD was not associated with number or size of ovarian follicles. Of women in the luteal phase, 87 (67%) ovulated. Serum log10TCDD was not associated with odds of ovulation [adjusted odds ratio = 0.99; 95% confidence interval (CI), 0.5 to 1.9]. Among those who had ovulated, serum log10TCDD was not associated with serum progesterone [adjusted beta (adj-β) = -0.70; 95% CI, -2.4 to 1.0] or estradiol (adj-β = -1.81; 95% CI, -10.4 to 6.8). Conclusions: We found no clear evidence that 1976 TCDD exposure was associated with ovarian function 20 years later in women exposed to relatively high levels in Seveso, Italy.

Original languageEnglish (US)
Pages (from-to)336-340
Number of pages5
JournalEnvironmental health perspectives
Issue number3
StatePublished - Mar 2007

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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