1 15 5 https://www.nal.usda.gov/exhibits/speccoll/files/original/f0823836210e4e506c7d5e6b30024225.pdf f27b8237f2250a67fe96458923a3ecfc PDF Text Text Item D Number °2418 Author Bianco, Vanda Corporate Author ROPOrt/ArtlGto Tttta Typescript: Obstetric Monitoring in Brianza de Seveso From 1975to1981 Journal/Book Title Year 000 ° Month/Day Color ° Number of Images 30 Descrtoton Notes Friday, October 05, 2001 Page 2418 of 2422 �CBSTSTSIC MCNITGE32TG 121 3RIANZA DI 3SVZSG ?20H 1975 TO 13S1 Dr Vanda Bianco (researcil worker, University of Milan) Dr L. Meazza Prof. G. Senotti (Coordinator of C.P.2} (tlie Professor of Obstetric and Gynecolccica] holag^', University of Milan) �REPORT GIT OBSTETRIC MONITORING IN 3RIANZA DI SEVSSO Total monitored pregnancies (up to 16/5/83): 21 532 Methods of investigation The aim of this study since the beginning was to gather pregnancy data on a number as close as possible to 100% of the pregnancies of the women residing in the 11 communes. Since we were to study phenomena like the trend of the spontaneous abortion rate in small population samples, such as zones A and 3, the loss of even a few cases could have appreciably affected the rates. Cur study covers all the pregnancies concluded between January 1st 1975 and December 3-lst 1981. ported was checked The completeness of the cases, re- and missing cases recovered by means of: 1) a list of births in the eleven communes (thoroughly checked by Special office personnel as from the third quarter of 1976 but not for the previous quarters); 2) the reports of spontaneous abortion (sent by law to the provincial medical until autority) June 1973 and available from July i976. The search for reports of spontaneous abortion for the period January "975 June 1976 unfortunatelv Droved fruitless. In fact they were no longer to be found in the competent offices because their preservation after the normal statistical work-over and after the entry into fbrce of law 194 was thought to be pointless; 3) the recovery of clinical data from neighboring hospitals (Carate, Cantu, Garbagnate, Clinica Zucchi of Monza, Saronno) net included in the monitoring plan and from the largest hospitals in the city of Milan, attended by a significant percentage of the pregnant women of the 11 communes; 4) the A/D forms of all the hospitals in Lombardy. These forms are available from May-June 1 975: uo to end1976 they appear incomplete whereas from '77 to '81 the standard is de �available only in March. 1983. Case records for cases probably relevant to our study, have been looked for and mainly found, bi± still missing from this report since it is worked on data elaborated by the computer up to May 16th, 1983. The follO7/i;ig data about each pregnancy are always known: mother's registry office data, date of last menstrual period, date of delivery or abortion and weight of the newborn . The date of conception can be established with good approximation by the date of the last menstrual period. The pregnancy data have been stored in the computer of the Special Office at Desio according to a program agreed in advance with the epidemiology group (figure 1). For the study of spontaneous abortions we have chosen the statistical method that relates the number of spontaneous abortions occurring in a given period to the number of conceptions for that period, in order to exclude any factors that might affect the number of conceptions. In fact the number of conceptions in the populations under study might have been affected in varying degree, contraception having been heavily promulgated at the beginning due to fear of damaging effects of TCDD on the concept embryo . Table 1 gives the total number of pregnancies monitored and the disaggregation by year of conception and by zone of residence of the cravida a**" the ^"me of cc'cclus1' 0*1 of ^~he ^rec^aif '""'•* ^S*T-- •* ~ oregnancies failed to 36 sssicr.ed to rhs zor.es due '"c iv"~c~'2l=~-— •--» ^ c ^ r> £ T- yi -a -^ at— • c •!— ^- r <~* - £ -• .-- s r P ••- 2 �The 1974 conception data are incomplete in that the numbers in the table refer only to the conceptions resulting in delivery or abortion on or after January 1st 1975. Similarly the 1981 data are incomplete because they include only the conceptions resulting in delivery or abortion by 31 December 1981 . 21 532 pregnancies were monitored (all pregnancies ending in voluntary abortion have been deliberately excluded) . This table shows that the total number of conceptions was steadily declining from 1975 to 1980 in line v/ith the national trend. 1975 only was cut of line as throughout the territory and in each individual zone the figures were lower than in 1977, probably due to the heavy contraception program in the area immediately after the accident, through 1977. in scnes A and B, after a low in 1976 the figure rose again in 1977 and 1973, probably by way of compensation. In 1979 and 1980 zones A and B came back into line v/ith the rest of the territory with a progressive fall in the conception rate similar to that for the whole of the Lcnbardy Region. This declining trend justifies the criterion chosen for the determination of the abortion rate. Table 2 gives the number of abortions and of conceptions by area according to tha decree of pollution and by quarter of ccncsptisr from the foxirth quarter cf 1974 to the first quarter of 1981 . Table 3 gives the related percentages. The tone A values are not studied individuallv because the small number of pregnancies to allow a. significant evaluation. From these tablas and from graph 1 there emerges a relativel" �stable trend ir. the nor. ABR zone (index of the reliability of the data), which fluctuates between 1G% and 13% with only two values definitely below the lower limit (9.37% in the 2nd quarter of 1976 and 9.37% in the 2nd quarter cf 1980) and two values above the upper limit (14.47% in the 4th quarter of 1976, the highest value found in the non A3P. zone, and 14.24% in the 4th quarter of 1977) . If we consider the rates for A + B , R and A+3+R exceeding the upper limit found in non A3R (14.47%), -~e note a concentration between the 3rd quarter of 1976 and the 4th quarter of 1978 (table 3A) . The peak - 33.33% - was reached in A-t-3 in the first quarter of 1977. This behavior is indicative of an acute .phenomenon adversely affecting the conceptions in A+3 and R(and A-fB+R) from the 3rd ouarter of 1976 and lasting throughout 1973. • Throughout the period preceding the accident and since the 1st quarter cf 1979 in zone R and in the whole of A+3-i-R there is no single rate exceeding the threshold of 14.47% (maximum value in the control zone). The situation in A+3 is different. Zven thcugh here too the peak concentration of values exceeding 14.47% is found in the period immediately after the accident, "re nonetheless find similar peaks in the preceding period (2nd quarter o£ •j. : IS.42%; 1st quarter of 1976: 22.22%) and after 1973 (1st quarter of 1379: 14.31%; 4th quarter 197?: 19.23%; 1st quarter l?3l: 15.33%) As the population sample is small, these may be thought to be fortuitous events. However, the next table (table 33) may suggest other hypotheses. This table highlights those quarterly rates for zones A+B, �exceeding the peak value of non A3R, exceed the rate for the non A32 zone for the same qtiarter. The follc^/ing points are of great interest: 1) higher rates in R and A+3---R than in non ABU are a practically constant finding right up to end-1373, after v/hich they occur only in the 4th quarter of 1979 and in the 3rd quarter of 1930; 2} in A-i-3 the rates -ere higher than in non A3R in 13 of the 26 quarters studied, 7/1 th a practically uniform distribution. It could be argued that A-r3 has a genetically more abortion-prone "lO^Q population or one chronically exposed to abortigenic factors that are expressed throughout the period under reviet/: in the period July 1976-March 1978 this population experienced an additional factor that.accentuated this predisposition to spontaneous abortion. Cr it may be argued that the factor responsible for the increase in spontaneous abortions in,- 2 (and in A-T-3+?.) in the period from the 3rd quarter of 1976 to the 4th quarter of 1973 w'as' operative in A-r3 previously as veil and that its action in that zone continued into 1979 and 193C. Another line of argument is that II and A-r-3-rZl "5/ere previously exposed to factors capable of increasing the rate of spontaneous abortions and that the sane factors ?/ere at tvcrlc on a greater scale, or nev; factors -rere s-.iperadded '?-ith a S3~ergic action, causing an even more striking increase in the period July 197-5December 1972 . Interestingly, as from January 1979 the rates for ~. (and A+3+lO "•/ere actually lor/er than in non A32. This datum rules o".t the possibility of a greater gei'.etic predisposition to spontaneous abortion for the inhabitants cf zone li. A rr.cre lilcelv h r '~oth- �:he preventive meas^•lres (removal, killing of animals, prohibition on cultivation, health and hygiene regulations, etc) and reclamation took effect by eliminating the environmental factors (TCDD ? Others ?) that were previously responsable for higher spontaneous abortion rates in this zone than in the control (non ABR) zone. Ail analysis of the population by maternal ace, parity, number of previous abortions elicited no significant differences in the various zones compared, as is appears from table 4. We have calculated the statistical significance of the differences found between the rates in the zones compared. To increase the statistical power of the analysis, we considered zones A, B and R globally and compared periods of four consecutive quarters, taking July "376 as the reference date. This enables us to look at the zones we are comparing for a year before the accident and for four years after (tables 5 and 6). The rates for the first period are identical in the zones compared. In the periods July 1376-June i377 and July 1977-June 1973 the rates for A+3-r3 were higher than in non A3?.. For the statistical comparison we used the Z test according to the formula: ?= ± 2 V od-o) n The differences for ?ercer.tage rate n = number of conceptions the periods July 1976-June 1977 and July 1 377-June 1S73 are statistically significant. The difference for the period July 1 37S-June 1380, in which A+2-i-R presents lower rates than ncn A33, (see diagram), is significant. At the request of the ISC (International Steering Committee^ we conducted a survey of gestaticnal are and birthweights (as possible indicators of to::icity) in the monitored tsrritory. Graph �2 shows exactly superposable gestational age curves for A+3+R and nor. A3H. Graphs 3 and 4 (gestational age by maternal age ar.d gestational age by parity) represent the trend of this phenomenon in the -/hole sample. Since there were no significant differences in respect of these factors in the cones compared, we saw no point in reproducing these graphs with a disaggregation by zone. The birthweicht study was conducted on a percentile basis. Graphs 5-11 give the curves for the 5th, 10th, 25th, 5Cth, 73th, 30th and 95th percentiles, comparing the global sample with A+3+R before and after 10 July 1976 and with non A3R before and after the same date. These graphs do not seem to reveal any important differences between the zones compared. The differences in the first and last weeks probably depend on the smallness of the sample for these weelcs. As these data are very recent, any opinion we can express now is very superficial. CCNCLuSlblTS In the eleven communes there is one area, namsly A+B-Kx, in which the abortion rate is higher than in the rest of the territory, the difference being statisticallv significant for the two years following the ICI-IZoA accident (July 1975-June 1975). In 1979 and 1 9SC the rates in A-r3-rIl "'•ere lower than in non A3?., significantly so in I960. In the period July 1975-June 1976 the rates in the two zones compared were identical. v."e have no direct toxicolocical or biological evidence on which to base an assertion that TCDD was responsible for the difference but the time co~'nci— de'^ce "rovld s~roncplT;t sv.ccest that i.t "*/as. Zone A-r3 considered separately >resen~3 almost consistently higher �spontaneous abortion rates tiian dees non A3?., v/ith a peak cf 33.22% in the 1st quarter of 1977. However, the phenomer.cn may be more apparent than real (apart from the period 1376/72) and related to the small number of cases, 'which results in a distribution of abortion cases in which higher percentage levels (talc en one by one) are likely to be more frequent. The scale of the phenomenon is cf sufficient interest to warrant further investigation, ^/hich is ncv under -;/ay. There are no sizable differences between the populations compared in regard to gestational age, birthweicht or the various pathological conditions of pregnancy other than spontaneous abortion. �Figure 1 PREGNANCY DATA I:T?UT CODE no. : individual number (registry office) maiden name, forename, husband's name place and date of birth. domicile, residence PREGNANCY STARTING DATE ORIGINAL FORM (last menstrual p e r i o d ) CASE SHEET RECOVERED FCRI-i -RE-PREGNANCY HISTORY: 1 ) malformations 2} hereditary diseases - thalassemia 3) hereditary diseases - other 4) hypertension o) nephropathy 6 ) other PREGNANCY CCU2SE : 1 ) E?H toxemia 2} hypertension ( 140-160) 3) hypertension (over 160) 4) nephropathy: cystopyelitis 5) nephropathy: other 6) other 7) RK isoimmunisation . 8) threatened abortion within week 23 9) threatened abortion after week 2Z 10) radiation up to end week 24 11) radiation after week 24 12) exanthematous infections before end week 15 13) exanthematous infections after week 15 • 14) other viral infectious diseases 15.) other infectious diseases 16) other diseases 17) drugs taken: steroid hormones 18) drugs taken: yasosuprina 19) drugs taken: other (excl. Ca and vitamins) * 20) Debendox taken * 21 ) Debendox not taken PREVIOUS PREGNANCIES duration in weeks �CUTCCM3 OF PREGNANCY commune of delivery or abortion date of delivery or abortion spontaneous abortion induced abortion normal delivery non surgical vaginal surgical abdominal b ir t;T!/e i gh t (s) * Datum stored only for gravidas residing in Seregno at the specific request of the USSL 62 operators. For the other gravidas the use of Debendox is included under item 13. �Table 1 Zone A 3 ?. N'or.A3?. Unas sign. 13" A 5 55 39 £l 2 . 149 197 5 11 97 503 2 .83 9 197 5 5 74 45 7 2 .578 2 3 .134 100 = 25 2 . 539 2 24 3.2 Year " 5T - 5 2 .520 3.5 53 ^ 197 3 ----- 11 105 454 2 . 33 1 2 . 308 1979 4 85 453 2 .19 T 4 2 . 73 4 1980 4 77 41Q 2 .14 9 * 2 .553 198 1 0 17 2- 50 - 3 42 521 3.450 17.439 24 21.532 Total Number - 48 of pregnancies observed by zone of residence and by year of conception and totals by zone and by year. �Table 2 3 c IV. 74 A ~ .i - C A C ? quarter 1 -7 14 143 52 73S 1 7 19 15 139 36 577 I 0 1 II C 4 34 19 152 59 709 "7 1 13 130 Ci 736 C i 2 ^ 2 1 22 91 717 I C 1 •7 14 i^ 152 A 124 52 399 II 0 3 3 22 15 131 75 672 III 0 0 C 19 103 35 516 1 i 10 23 4 17 117 100 691 589 T IV . 7 5 IV. 76 T 1 3 7 21 15 126 77 TT 0 1 6 29 20 133 33 645 I I I 22 17 141 79 695 650 1 3 IV. 77 0 0 3 2 28 17 126 94 I r; 1 1- 3 26 20 109 64 396 0 5 2 26 19 109 61 555 III 0 3 4 26 14 124 57 611 1 2 3 27 17 112 72 576 0 3 4 24 12 103 66 490 TT 0 0 3 21 9 107 61 304 III 0 1 4. 14 4 121 77 505 593 IV. 73 I 0 0 3 25 16 122 •j- A 0 0 2 14 7 53 550 II 1 3 2 19 5 105 37 47 475 III 0 0 0 22 15 1 15 62 549 10 1 69 554 IV. 79 IV . 30 0 1 3 22 1 1" Number of conceptions ending on spontaneous abortion (A) and total number of conceptions (C) by quarter and by zone of residence. �Table 3 QUARTER ZONE A— 3 ZONE •3 ZONE ZONE A— 3— x nor. .-. 3 ~. 5. 5 4/7-a 5 . 33 9 79 1/75 2/73 3/73 £/73 5 _ 00 13. 42 3. 59 7- 41 10. 79 1 1 . 73 12. CO 9. 21 10. 06 1 3 • 00 1 1 . 56 3. 94 1 2. 70 a . 73 1 1 . 01 1 2. 59 1/75 2/75 3/76 4/75 22 . 22 1 2 . 00 1 2. 1 G 1 2 . 21 1 3. ^5 i 3 . •; S 1 2. 1 3 1 0 . -1 1 31 1 9- 23 1 4. 53 15. 31 1 5 - 33 1 3- 30 1 4 .£L .1/77 2/77 3/77 i/77 33- 33 20. 00 1 5 .00 7. 14 1 1 . 90 1 5- 04. 12. 06 1 3. 49 i 5 . 33 15. 95 12. 65 12. 3 — 1 3- 07 12. 37 1/73 2/73 3/73 4/73 14. 31 5. 45 13. 79 1 3. 79 13. 35 1 7 . 43 1 1 . 29 1 5 . 13 17. 65 1 5 - 00 1 1 . 76 1-a. 39 10. 7- ' 10. 99 10. 97 1/79 2/79 3/79 i/79 * 4 dt 1 i. 29 5 . £T " 3 • 23 11.! t 3 . /*,- 11. 9. 37 3 • 63 : ~• i ^ 1 3 • il"T '. 2. - .-*T '2. T 1 2 . 35 "/ 0 t ii _ ^ • •* i 1 3. i ! 9. w J 1 1. * — 37 24 1 2. 32 1 i 2; 53 " 2 . ^3 £ " - ' ^ ." 3 5. 0 /' 5 . 90 -/ 0 '• - • 04 a _ ~- v • - .' - T= ~ . •" 5 o •? : . 36 3 . 25 7 _ 2^ ' 2 - 5- ?'- 3 J - -" �TABLE QUARTER 3a ZONE ZONE ZONE •--- 3—?. •3 .- — 3 ... ••---•,-:•:-•: 5 .33 1/75 2/75 3/75 4/75 5 .00 in -53 3 1 1 73 1 2 . 00 m 7 . 41 ~22l 12 .00 — o / -• <- 2/ / O 3/75 4/76 1/77 2/77 3/77 A/ 77 1/73 2/73 3/73 . 4/73 in "23] ' 1 *2 T • -J v B35SS ft? FTo" . QCj 7 .14 |TZ•~aTj 6 .45 13 .73 13 .79 5 .5 1 0 .06 1 3 .00 i : . 56 g . 34 10. 73 TT1] 1/75 • 3 .3 - 2 .70 3 . 73 4/7* 3. /^ •« 1 2. 10 1 2 .33 12. 21 1 FnrT=] "5^1 [T4T 11. 30 ZONE *— . — ^ r^o r. .-\ w .< - 2 .13 FT? . ?'| irf . ** '^ \ 9 .73 .1 1 .01 12 • 53 10 • 35 11 • w ' 1 3 . 30 nil !l£ FT" r\ /t] fTf 7T31 FT?~Q=1 12. 06 13. 49 12 .65 1 2 .34 EH53 EZ, g =j 10 i 6Ell FT . 53 10 .97 12 • 52 i i . 11 11 .35 ^ >* 3 • 37 . 55 ^ " 4, i ^ " i .10 1 2 • 73 n 7 ..4"3l 1 1 . 29 fTT _ r,rj 1 1 .75 13 .07 12 .37 1 1 .37 1 4. 24 ^4 i n .39 \ •™. 1/73 2/79 3/79 4/7? mi OZ 1 4 .29 6 . 57 p 9 7T!1 . 3. 41 •5 31 • * . 1- : - ~ ~J • . 25 . 53 9 . 53 •z . 3~ •' ,^- ' 4 .29 ~ . 57 7 13 £ . 90 3,' 30 4/ 3 0 - C - - ; J . 04 ; J . Ci 3 . 93 "] > . » w •» Q :/30 2/30 .64 • 47 ^ . ^w �TABLE 3b UARTER ZONE ZONE A- 3 ZONE ZONE A-3-?, 9.3 6.39 5 .5 - * 1/75 2/73 3/73 A/75 1/75 2/75 3/76 4/76 ^ _ CO 1 3. 42 10. 79 3. 69 7 • —1 22 . 1 1 1 2. 00 9. 21 10.06 1 3.00 11.56 3 . 94 12 .70 c .73 1 1 .01 1 2 .69 1 2.10 * 1 "* 2 •4 4 I i . T3 1 2 . QQ - 1 2 ^ 21 12.18 1 3 . 43 1.9..._ 2 1 1 4. "6.31 li ii 10 . 3 3 i i ^1 * 13 .30 14 .47 1/77 2/77 3/77 4/77 33.-- -3 3 20. 00 1 6 . 00 7. 14 1 1 . 90 15.33 13.95 12.65 12.34 1 3 .07 12 .37 1 1 • 37 14 .24 1/73 2/73 3/73 4/73 1 a. i l 6. 45 12 17.65 10 .74 10 • 99 10 • 97 12 .'52 1/ 7 9 2/79 2/79 4/79 * / 30 2/30 3/ 3-0 4 •' 3 0 • W ^ ^ B * 1 ^3 5 • 04 12. .PJL 1 3 • 49 13. 17. £1 1 1 ."29 15. i 5 3" n. 1 * 22 3 . -11 .•M^— • i j. C . * -i 1 5.00 11 .76 1 4.. 3? 11 .35 9-37 3-53 67 23 3 . T *r i 3 •^.» '-•"'? 29 5 . 57 7.36 ~ "" 6. 90 1 3 • 91 • " "^ij. 3 . ••3 1 13 .47 12 . 1 0 ; ^ • 73 • "i 2 . 3 3 ; -, 3 .i . '1.6 - ,5 tt _ 55 Q ~" * . i '^ . " ? . — v' " �TABLE 4a PERCENTAGE DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE A) BY MATERNAL AGE GROUP 20- 21-25 25-30 31-35 36-40 A-3-R 14,27 r.cn A3?. 10,50 Unassign. 46 , 15 35,74 35,71 23.07 29,93 31,53 30,75 12,90 14,50 0.00 5,94 5,13 0,00 TOTAL 35,"0 31,21 14,25 5.12 3) 11,23 46-50 50- 1,15 1,35 0,00 0,04 0,09 0, OO 0,00 0,00 0,00 1.31 0,03 0,GO BY NUMBER OF PREVIOUS PREGNANCIES 0 A*a-R . i Unassign . 50 ,31 54 , 55 75 ,92 24 ,8722 ,53 23 ,07 TOTAL 53 ,31 22 ,99 no n A3?. C) 41-45 2 9 ,00 3 3* 0 ,00 3 ,31 2 ,53 0,00 1,99 1 , 56 0,00 a ,53 2 ,32 1,72 a ,56 'BY NUMBER OF PREVIOUS ABORTIONS A-3-R non A3?. Unassign. TOTAL ' ' 92,50 92, 71. 92.30 5,39 5,59 7,59 1,23 1.15 O.CO 0,31 0,42 0,00 92,57 5,73 1,13 0,40 �TABLE 4b DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE AND BY AGE GROUP 20- 26-30 31-35 A-8-R 322 305 non ABR 35? 323T Unassign. 5 3 573 2302 4 291 1344 0 134 553 0 25 123 0 1 3 0 0 0 0 2253 3203 1 3 TOTAL 3331 1533 703 151 10 0 11471 1235 21-25 4036 36-40 41-45 46-50 50- TOTAL DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE AND BY NUMBER OF PREVIOUS PREGNANCIES 0 1 2 3 A^B-R 1360 non A3R 5350 Unassign. 10 351 2074 3 203 733 0 35 233 0 45 153 0 TOTAL 2533 931 324 193 732O 3^ TOTAL 2255 9203 13 • 11471 DISTRIBUTION OF PREGNANCIES BY RESIDENCE ZONE AND BY NUMBER OF PREVIOUS ABORTIONS 0 A-3-R non ABR Unassign. TOTAL 1 2 2025 3333 12 133 324 1 23 107 0 10531 553 2-7 33 0 2255 3203 13 �TABLE 5 half year -5 —- — -. - - 41 49 I. 77 II. 77 40 I. 73 43 1 1 7^ 10 . 23 1 53 • -2 293 236 313 35 33 II. 75 395 352 42 I -: 12 . 13 3 1 5.02 15 . os IS 5 15 0 12 . 50 17 •: II. 73 ;_ 79 39 220 255 294 23 263 10. 55 II.7S 25 234 I.30 13 29 223 9. 15 7. 39 272 1C. 66 II.30 1". 53 1 ~! 13. 25 •_ 1 7 13 ,1 5 c 13 35 1-= 53 1 7 -• 13 1 . 3** *i 12 .36 13 07 14 . 15 1 2 .97 1234 13 55 12 .77 1 15 1 10 .36 1 1 37 11 594 « ji. Q 11 .1 3 -i .73 13 12 03 1036 11 13 12 .30 1C .62 11 . 77 Number of conceptions ending in abortion (A), total number of conceptions (C) and rate (£) by half year of conception and by residence zone. TABLE 6 nor. A3S period July 75-June 76 July; 76-June 77 July 77-June 78 "4 : 650 1 ii 9C 369 1 3- July 78-June 79 57 537 July 79-June 80 1A 312 .33 310 2724 11. 33 5 .32 1 c 40 34; 2S41 293 75 C6 13. 53 1 1 CO 2 03 266 2131 12. 20 3 . 39 264 2239 11. 79 1 Number of conceptions ending in spontaneous abortion (A), total number of conceptions (C) and rates ($) by one-year period before and after the ICMESA accident in zone A+B+R and in zone non ABR. �CALCULATION OF STATISTICAL SIGNIFICANCE - MODEL Comparison of spontaneous abortion rates in zone A+B+R and in zone non ABR in one-year periods before and after the ICMESA accident according to the Z test. period July 1975-June 1976: A+B+R rate non ABR rate= 11.38 period July 1976-June 1977 13.53 I 2 2541 confidence limits: 12.13 rate for A+B+R = 15.82 15.33 SIGNIFICANT period July 1977-June 1978 :i.S9 I 2 / 16.49 (100- 15.49) confidence limits: 10.41 _ rate for A+B+R = 16.49 13.37 SIGNIFICANT period July 19,78-June 1979 12.20 ± 2 . T12.G3 (130 - 12.03! 2131 confidence limits: rate for A+B+R 10.31 = 12.03 NON SIGNIFICANT period July 1979-June 1980 confidence limits: rate for A+B+R = 8.59 SIGNIFICANT �Graph 1 ABORTION RATES BY QUARTER IN ZONES non A+B+R, A + B + R , A+B, R ,\ • \ A nit-n 111 it \ I'-HJl) c i u; 1 1 ' I i • i • v 11)111 �Graph 2 DISTRIBUTION OF DELIVERIES BY GESTATIONAL AGE AND RESIDENCE ZONE SO 40 RESIDENCE ZONE i >> i i- 0( 0 0 _'ti 1'f) :i(V :)l 32"~3l""34 35 36 ""37 ~'3fl 30 40 42 43 44 45 46 gestational age �Graph 3 DISTRIBUTION OF DELIVERIES BY GESTIONAL AGE AND PARITY -10 PARITY 'J 0 20 Ml :> i on 01 ) 'JO :i ~32~"'Ji3~"~3~"35~ 36 37 38' 39 40 41 42 43 44 45 46 .^esrational age �Graph 4 nrSTHIMUTlON OF DELIVERIES BY GESTIONAL AGE AND MATERNAL AGE GROUP 1U M A T E R N A L AGE GROUP - 20 2 1 L'ii 2fi 30 — — . - 3 1 3t> 3 0 '10 (II g e s t a t i o n a l age ��Graph 7 :JJ.th 4-100 25th PERCENTILE '1000 '.11)00 IHOO ;MOO tola I 2200 — • — • - n o i i A i II[fl 2000 l i J t i II 11)00 lt>00 1200 . born up to 1/7/76 1001 .. born after 1/7/76 nooj4~3 44 45 46 " gestational age ��light Graph 9 1-100 75th PERCENTTLE •1200 'IOOO .mot A :i io :ioo 2-IO A,in - - no,, .<! . born up to 1/7/76 .. born a f t e r 1/7/76 ft 36 37 3fl 30 40 41 '\2 13 14 45 46 yestational age � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 095 Folder The folder containing the original item. 2418 Series The series number of the original item. Series IV Subseries IV Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Bianco, Vanda L. Meazza G. Remotti Title A name given to the resource Typescript: Obstetric Monitoring in Brianza de Seveso From 1975 to 1981 Subject The topic of the resource congenital birth defects Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 030 Folder The folder containing the original item. 0530 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Cattaneo, M. G. Remotti D. Coviello A. Carini F. Cefis Source A related resource from which the described resource is derived Annali di Ostetricia, Ginecologia, Medicina Perinatale Date A point or period of time associated with an event in the lifecycle of the resource 1981 Title A name given to the resource Placental Histology of the TCDD Exposed Pregnant Women Subject The topic of the resource human exposure health effects ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 029 Folder The folder containing the original item. 0490 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Bianco, Vanda L. Meazza G. Remotti Description An account of the resource Corporate Author: University of Milan Date A point or period of time associated with an event in the lifecycle of the resource May 16 1983 Title A name given to the resource Obstetric Monitoring in Brianza Di Seveso from 1975 to 1981 Subject The topic of the resource Italy human exposure dioxin industrial spills ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 029 Folder The folder containing the original item. 0492 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource Bisanti, L. F. Bonetti F. Caramaschi G. Del Corno C. Favaretti S.E. Giambelluca E. Marni E. Montesarchio V. Puccinelli G. Remotti C. Volpato E. Zambrelli E.M. Fara Source A related resource from which the described resource is derived Acta morphologica Academiae Scientiarum Hungaricae Date A point or period of time associated with an event in the lifecycle of the resource 1980 Title A name given to the resource Experiences from the Accident of Seveso Subject The topic of the resource Italy industrial spills dioxin human exposure ao_seriesIII Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alvin L. Young Collection on Agent Orange Description An account of the resource The Alvin L. Young Collection on Agent Orange comprises 120 linear feet and spans the late 1800s to 2005; however, the bulk of the coverage is from the 1960s to the 1980s and there are many undated items. The collection was donated to Special Collections of the National Agricultural Library in 1985 by Dr. Alvin L. Young (1942- ). Dr. Young developed the collection as he conducted extensive research on the military defoliant Agent Orange. The collection is in good condition and includes letters, memoranda, books, reports, press releases, journal and newspaper clippings, field logs and notebooks, newsletters, maps, booklets and pamphlets, photographs, memorabilia, and audiotapes of an interview with Dr. Young. For more about this collection, <a href="/exhibits/speccoll/exhibits/show/alvin-l--young-collection-on-a">view the Agent Orange Exhibit.</a> Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Box The box containing the original item. 029 Folder The folder containing the original item. 0493 Series The series number of the original item. Series III Subseries I Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Creator An entity primarily responsible for making the resource L. Bisanti F. Bonetti F. Caramaschi G. Del Corno C. Favaretti S.E. Giambelluca E. Marni E. Montesarchio V. Puccinelli G. Remotti C. Volpato E. Zambrelli Date A point or period of time associated with an event in the lifecycle of the resource 1979 Title A name given to the resource Chapter 11: Experience of the Accident at Seveso, Italy Subject The topic of the resource industrial spills dioxin human exposure ao_seriesIII