Medical monitoring of dioxin clean-up workers.

The effectiveness of the safety measures established to protect clean-up workers from 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) exposure during clean-up operations of the most highly TCDD-contaminated area following the Seveso accident was evaluated. Clean-up workers (N = 36) and referent subjects (N = 36) underwent a 2-yr prospective controlled study aimed at detecting whether specific clinical and biochemical outcomes differed between the two groups. No cases of overt TCDD-related clinical disease occurred (i.e., chloracne, liver disease, peripheral neuropathy, porphyria cutanea tarda), and no clear-cut differences in biochemical outcomes between clean-up and reference workers were detected. The safety measures that were taken together with worker's compliance during clean-up operations were effective in preventing acute health effects. The safety, industrial hygiene, and health monitoring programs which were established following the Seveso accident should be applied as a minimum in similar situations.