Persistence of Dioxin TCDD in Southern Vietnam Soil and Water Environments and Maternal Exposure Pathways with Potential Consequences on Congenital Heart Disease Prevalence in Vietnam
Waterlogged soils and submerged sediments in wetlands and agricultural lands used for rice paddies and aquaculture have anaerobic conditions that slow and prevent the photo and microbial degradation of dioxin TCDD (2,3,7,8-tetracholorodibenzo-p-dioxin), enabling it to persist in environments for long periods. Over 1.6 million ha of land in southern Vietnam were sprayed with 2,4,5-T herbicides (e.g. Agent Orange) contaminated with dioxin TCDD during the Vietnam War (1961-1971); 45% of these ha received four or more spray flight missions. Dioxins are endocrine disrupters and may induce cardiovascular disease, growth, and developmental defects, diabetes, hormonal dysfunctions and disruptions, certain cancers, and chloracne. Outpatient screening clinic 2020 data on Vietnamese children suspected of congenital heart disease (CHD) showed the childhood CHD prevalence rate in Vietnam of 13.356/1000, significantly elevated compared to the Asian CHD prevalence rate of 3.531/1000. CHD prevalence rate differences between North Vietnam (2.541/1000) and south of the 17th parallel (10.809/1000) were significant. Vietnamese farmers, especially pregnant women whose occupations involve daily contact with soil and sediments where dioxin TCDD persists in the environment may be at risk of dioxin accumulation from dermal exposure and bioaccumulation via diet. There is an urgent need for funded longitudinal genetic and clinical studies to assess CHD and other organ system childhood malformations due to in utero TCDD exposure. We recommend an integrated research design involving 1) site-specific locations that received high volumes and multiple spray loads of herbicides during the Vietnam War; 2) soil sampling of submerged and waterlogged soils and sediments where TCDD may not have degraded; 3) production areas of agriculture, fisheries, and other aquatic products; 4) risk assessment dioxin levels in foods where TCDD is likely to bioaccumulate; 5) child-bearing age and pregnant women with potentially high sensitivity to long-term low dose exposure, and 6) men and women in occupations that are in daily contact with contaminated soil and sediments as part of their job routines.