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Yushchenko's dioxin level 6,000 times higher than normal

Thursday, December 16, 2004

LONDON -- New tests reveal Ukrainian presidential candidate Viktor Yushchenko's blood contains the second-highest level of dioxin poisoning ever recorded in a human -- more than 6,000 times the normal concentration, according to the expert analyzing the samples.

Abraham Brouwer, professor of environmental toxicology at the Free University in Amsterdam, where the blood samples were sent for analysis, said they contained about 100,000 units of dioxin per gram of blood fat.

However, the concentration could prove to be even higher, or lower, once results are in later this week from a more definitive test, said Arnold Schechter, a specialist in dioxin analysis from the University of Texas Southwestern Medical Center in Dallas.

The test also will show how long Yushchenko may show symptoms from the poison.

Schecter said it also could determine that Yushchenko was poisoned with dioxin-like PCBs, rather than dioxins. PCBs were used in electrical transformers and as hydraulic fluid until they were banned in much of the world in the 1970s because they are so toxic and persist so long in the environment.

Brouwer's team has narrowed the search from more than 400 types of dioxin to about 29 and is confident they will identify the poison by week's end. That, in turn, could provide clues to its source.

"From a [chemical] fingerprint, at least you can deduce what kind of sources might have been involved," Brouwer said. "The labs will ... try to find out whether it matches any of the batches of dioxins that are around, so that maybe you can trace it back to where it came from."

Experts say Yushchenko, whose face has been pockmarked and disfigured, has probably experienced the worst effects already and should gradually recover, with no impairment to his working ability.

The 50-year-old reformist candidate, who faces Kremlin-backed Viktor Yanukovych in a repeat runoff on Dec. 26, fell ill after having dinner with Ukrainian Security Service chief Ihor Smeshko and his deputy Volodymyr Satsyuk on Sept. 5. Yushchenko reported having a headache about three hours after the dinner, and by the next day had developed an acute stomach ache.

He later reported pancreatitis and gastrointestinal pain, as well as a severe backache.

About three weeks after his first symptoms, Yushchenko developed the rough, acne-like rash on his face which is the hallmark of dioxin poisoning.

"It was very late before the rash started to develop, so if he had died it would have been a mystery illness of his pancreas, his liver or his gut and they would have said maybe it's some rare bug thing," said John Henry, a toxicologist at London's Imperial College. "He would have died within a few days and nobody would ever, ever have thought of dioxins."

Brouwer said the highest dose recorded so far was in a woman in Vienna, who was intentionally poisoned with dioxin in the mid-1990s. Tests showed her blood had 144,000 units per gram of fat, and she survived.

"We don't actually know what the lethal dose is. The only thing we do know is there's a woman who had an even higher dose, who didn't die, so it must be higher than that," Brouwer said.

The woman, who was among five people deliberately poisoned at a textile institute in 1997, was sick for two years and was in and out of the hospital with various symptoms, said Schecter, who was involved in tracking the case. A second woman fell ill from the poisoning, but the other three people had no symptoms at all.

It would not be difficult to deliver the dose Yushchenko received, experts say. If the dioxin he ingested is the most hazardous type, tetrachlorodibenzoparadioxin, or TCDD, it would take only a drop or two, or a tiny amount of powder mixed in food, to poison him.

Most of what is known about the health effects of acute dioxin poisoning comes from experiments on animals. Most animals would die from the levels in Yushchenko's blood.

Dioxin is a term referring to a group of substances created mostly by factories that use chlorine, such as paper, pesticide or plastics plants. It comes from burning fuels like wood, coal or oil. Natural sources include forest fires, but most often it comes from manufacturing or waste burning, whether municipal or backyard.

Dioxins are widespread in the environment and rise through the food chain from the soil and river beds to animals. They are particularly concentrated in meat, fish and dairy products because the chemicals dissolve well in fat.

Nearly everybody has some level of dioxin in their body. The normal level found in the blood ranges from 10 to 20 units per gram of blood fat.

Evidence of the hazards comes from studies of exposed workers or from people involved in industrial accidents. The research suggests Yushchenko faces an increased risk of heart attack, cancer, diabetes, muscle aches, irritability, fatigue, immune deficiency and other less severe symptoms, but it is unclear how high that risk has risen from a single poisoning.

The disfiguring acne, while not harmful to his health, may persist for decades, experts say.

"It'll be a couple of years, and he will always be a bit pockmarked. After damage as heavy as that, I think he will not return to his film star looks," said Henry.

Dioxin, which settles in the body fat, can stay in the body for 35 years. Eliminating it quickly would likely reduce Yushchenko's chances of long-term ill health.

One uproven possibility is a couple of courses of liposuction, a procedure that sucks the fat out of the body.

Another option being discussed by scientists is the use of olestra, a fake fat substance used in diet food that could act as a magnet to draw the poison out of the body fat into the gut for elimination. The technique has been proposed before for the elimination of other fat-soluble pollutants, said Diane Henshel, an environmental toxicologist at Indiana University.

Studies have indicated the body keeps the levels of dioxin in the blood and in the body fat equal, she said. When there's an imbalance, it redistributes to return to equilibrium. The idea is that olestra could be used to create a "sink" in the gut that would draw the dioxin out of the blood, forcing the body fat to release more of it into the blood, Henshel said.

"There are some studies, but the results are not very impressive. You get rid of some of the dioxins, but it's a slow process. Liposuction would probably be a better idea," Brouwer said.


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