Benzene exposure and risk of benzene poisoning in Chinese workers. Issue 9 (10th March 2022)

• Record Type: Journal Article
• Authors: Vermeulen, Roel; Portengen, Lützen; Li, Guilan; Gilbert, Ethel S; Dores, Graça M; Ji, Bu-Tian; Hayes, Richard; Yin, Sognian; Rothman, Nathaniel; Linet, Martha S; Lan, Qing
• Other Names: author non-byline.; Ding Cheng-yu author non-byline.; Dores Graça M author non-byline.; Gao Yuan author non-byline.; Gilbert Ethel S author non-byline.; Hayes Richard B author non-byline.; Ji Bu-tian author non-byline.; Lan Qing author non-byline.; Li Gui-lan author non-byline.; Li Gui-zhen author non-byline.; Linet Martha S author non-byline.; Liu Lian-Cui author non-byline.; Ni Yu-ne author non-byline.; Niu Xin-hua author non-byline.; Portengen Lutzen author non-byline.; Rothman Nathaniel author non-byline.; Sun Gui-fen author non-byline.; Tang Qiang author non-byline.; Tian Hao-yuan author non-byline.; Vermeulen Roel author non-byline.; Xiao Lu-wu author non-byline.; Yin Song-nian author non-byline.; Zhao Hong-bin author non-byline.; Zhou Guang-fa author non-byline.; Zhou Jie-sen author non-byline.
• Is Part Of: Occupational and environmental medicine. Volume 79:Issue 9(2022)
• Page Start: 610
• Page End: 617
• Publication Date: 2022-03-10
• Subjects: benzene -- hematology -- leukemia -- risk assessment -- epidemiology; Medicine, Industrial -- Periodicals; Environmental health -- Periodicals; 616.980305
• DOI: 10.1136/oemed-2021-108155
• Languages: English
• ISSNs: 1351-0711

Abstract

Abstract : Objectives: Benzene is a known haematoxin and leukemogen that can cause benzene poisoning (BP), that is, a persistent reduction in white cell counts that is strongly associated with increased risk of lymphohaematopoietic malignancies. Data are needed on the exposure–response, particularly at low doses and susceptible populations for clinical and regulatory purposes. Methods: In a case-cohort study among 110 631 Chinese workers first employed 1949–1987 and followed up during 1972–1999, we evaluated BP risk according to benzene exposure level and investigated risk modification by subject (sex, attained age) and exposure-related factors (latency, exposure windows, age at first benzene exposure, coexposure to toluene) using excess relative risk and excess absolute risk models. Results: There were 538 BP cases and 909 benzene-exposed referents. The exposure metric with best model fit was cumulative benzene exposure during a 5-year risk window, followed by a 9-month lag period before BP diagnosis. Estimated excess absolute risk of BP at age 60 increased from 0.5% for subjects in the lowest benzene exposure category (>0 to 10 ppm-years) to 5.0% for those in the highest category (>100 ppm-years) compared with unexposed subjects. Increased risks were apparent at low cumulative exposure levels and for workers who were first exposed at <30 years of age. Conclusions: Our data show a clear association between benzene exposure and BP, beginning at low cumulative benzene exposure levels with no threshold, and with higher risks for workers exposed at younger ages. These findings are important because BP has been linked to a strongly increased development of lymphohaematopoietic malignancies.